Pulmonary rehab update

Mes amis!

With the exception of a bitterly cold day with a high of 19 degrees, and Thanksgiving Day, I have faithfully attended pulmonary rehabilitation every Tuesday and Thursday for a dozen weeks now. I still guard my energy stores avidly, but on my good days, I can squeeze in a bit more excitement. For example, last week I drove myself to and from pulmonary rehab, put in my full hour plus of exercise, hosted three midwives and a husband for our weekly get together, and still won at Scrabble after they'd gone home! On the other hand, I definitely overdid it. Showering was my most strenuous activity the following day. Yet despite my fatigue, I couldn’t suppress my satisfaction that I’m at least a little stronger than before I began this program.  

My rehab sessions have begun to follow a predictable pattern with some hard-won modifications. I always begin and end each session with five minutes of stretching to warm up and cool down. I do a circuit of "Arm-R-Cise," ten upper body exercises in a row, beginning with boxing jabs and ending with reverse speed bag (the air version of the small punching bag). Thirty seconds of each exercise adds up to five minutes of burning arms and then huge relief upon sitting down again. The eventual goal is to reach the maximum ninety seconds per exercise. "Leg-R-Cise" is based on a similar premise and ranges from hamstring curls to chair stands, repeatedly alternating sitting and standing with arms crossed x-style on the chest. I also use free weights for additional arm strengthening. During my initial sessions, I progressed from six to eight to ten to twelve minutes on the treadmill. After pleading for a bit more of a challenge, I finally received permission to advance my pace from 1.5 to a blazing 1.6 miles an hour. Unfortunately, I've maxed out my upright exercise strenuousness. Pulmonary hypertension sometimes causes a paradoxical drop in blood pressure during exercise, putting patients at risk of sudden fainting with excessive exertion. Clearly, this is suboptimal on a moving treadmill, however slowly I'm walking. Due to this limitation, my most strenuous exercise is on the Nu-Step, a recumbent elliptical machine. This decreases the concern for complications following a drop in blood pressure, since the machine is human-powered and stops when I stop. If I feel lightheaded, I'm already seated and don't risk a fall. The Nu-Step lets me feel as if I'm getting a "real" workout, even if I'm only up to level four out of ten after twenty-four rehab sessions. Since I started at level two, this feels like an accomplishment.

Repeating the same set of exercises twice weekly, however varied their order, can grow monotonous very quickly. However, Deb and Shawn, our faithful team of respiratory therapist and exercise physiologist, constantly think of new ways to make the sessions more enjoyable. Distraction is a recurrent element of their schemes. From the weekly trivia question, I’ve learned both that Jonathan Priestly discovered oxygen in 1774, and that the heaviest recorded pumpkin weighed 2,323 pounds this October. Also, you disperse 39,000 organisms when you sneeze! Their patter of light conversation keeps us energized as they come to check oxygenation levels at the halfway point of each exercise. The team’s joking banter has built camaraderie within my cohort of rehab participants, bridging the gap between me at 36 and the oldest participants in their 70s. We now inquire solicitously after each other’s pets and grandchildren and spouses like old friends, and worry about each other if someone is absent for a session. There’s nothing like a stressful experience to unify a group quickly. The double stresses of enforced exercise and transplant preparation have served quite adequately. Even if I'm not feeling my best, I always leave an exercise session feeling supported by my rehab buddies and gratified that I'm strong enough to bear the stress of transplant surgery. Officially, a course of pulmonary rehab ends after thirty-six sessions. In my case, I'll continue to attend until my transplant surgery in order to sustain the benefits of increased activity tolerance. Maybe by my next update, I'll be up to level five on the Nu-Step...

This is a special nasal cannula called an oxymizer; it conserves oxygen in the moustache to give a slightly larger dose.
My fingers are too cold to give accurate oxygen readings, so the headband keeps my forehead probe in place. Except that I have way too much hair for a measly headband. It's a good look, right?