by Jean Rommes
I have emphysema, as well as chronic bronchitis and an asthma component. I smoked for 30 years and quit in 1992, mostly because I realized that I was organizing my entire day at work around when I could smoke. I decided that was pretty stupid, so I got the patches and quit. I had never tried to quit before; I had cut back occasionally, but I never really tried to quit until I actually did it.
When I quit, I was already having difficulty with my breathing. Going up stairs was very difficult and going up a lot of stairs (like at a concert or football game) was awful. When I quit smoking, I started exercising, mostly to see whether I had any lungs left and also to try to avoid the weight gain so many people often experience. I exercised religiously for about two and a half years, but then started getting respiratory infections that made it really difficult to exercise.
I went to my family doctor in 2000 because I was having trouble breathing. Walking any distance was hard, and going up stairs was something I avoided like the plague. I think I saw my basement maybe once a week if I was lucky. My doctor diagnosed me with asthma and prescribed a couple of inhalers. One of them made me cough so hard that I went back for something different. He then prescribed a bronchodilator, an inhaled steroid and albuterol for rescue. At that point, I knew it was probably COPD (chronic obstructive pulmonary disease). I knew I had chronic bronchitis; every time I caught anything it went right to my chest.
Unfortunately, not exercising and feeling sorry for myself resulted in a significant weight gain over the next several years. In September 2002, my husband and I made a trip to Yellowstone and Glacier National Parks. The altitude nearly did me in. Walking any distance was very difficult, showering was really hard and actually doing anything was really out of the question. I did manage to go on a float trip, but the effort required was incredible, and my inability to do much of anything was becoming very embarrassing for me.
When we got home, I promptly caught something and ended up in my doc’s office for my usual antibiotic, and he put me on oxygen, 24/7. I had an oxygen concentrator at home, a concentrator in my office and portable tanks for everything else.
Things continued to deteriorate. By February 2003, I was having trouble showering completely because breathing was so difficult, making the bed was a 20-minute activity requiring lots of resting, and I hadn’t been downstairs to the basement in weeks. One Sunday morning, I had to get out of the shower before I could rinse the shampoo out of my hair. The next morning, I knew I couldn’t shower at all.
I finally got dressed and on my way to work realized that I was in real trouble. I called my PCP and asked if he wanted me to go to his office or the ER. His staff told me to come to the office. We’d had a really wet snow the night before and then it froze solid; typical Iowa weather. When I got to the clinic, I did something I had never done before; I parked in a handicapped parking place.
Between my oxygen tank, my purse and the struggle to get out of the car, I had to wait to catch my breath for a good three or four minutes before I dared to try to walk across the rutted driveway to the front door. When I finally got inside, I sort of collapsed on the sofa and just gasped catching my breath. The two ladies at the desk asked if I was all right, and, being really proud (and stupid), I gasped that I was fine.
My doctor’s nurse took one look at me and told me I was going to the hospital. I felt so rotten at that point I didn’t even argue.
I was on intravenous steroids and antibiotics and on 6L of oxygen at rest in bed. I’m an administrator and a manager, and my first question to my doc was, “How do I fix this?” He told me if I lost weight that would help both the COPD and my type 2 diabetes. He also made it pretty clear (I thought—he says he didn’t intend to give me this impression) that he didn't think I would or could. He also made it clear that if I didn't do something, life was going to continue to be a pretty scary experience.
He sent me home with oxygen 24/7, a CPAP (continuous positive air pressure) machine for sleep apnea, inhalers, a nebulizer, all my meds for diabetes, and Lasix, because I was retaining lots of fluid in my legs especially. I was a mess.
Between being scared and being mad (powerful motivators, both!), I lost 100 pounds by February 2005. I talked with my doc about pulmonary rehab, but he didn’t think that what they offered at the local hospital would really help me.
He did give me permission and encouragement to begin exercising in April 2003. I started using the exercise bike I already had. When I first got on it, I could barely manage five minutes without being exhausted. I slowed down and went for time first. When I could manage 20 minutes at a time, I increased my speed, and within about six months was able to do five miles in 20 minutes. I added a treadmill in June. The first time I got on it, I managed about five minutes at a really slow speed. So I went for time and, when I got to 45 minutes, added speed and incline.
Between exercise and diet, I made a lot of progress. I gradually reduced my need for supplemental oxygen, going from needing it 24/7 to needing it only for sleep and exercise, then sleep only and, by January 2005, not needing it at all. I also stopped taking fluid-retention medication, reduced my diabetes medications and need only minimal medications for my COPD. A bonus for me: I ended up with a whole new wardrobe and a much healthier, more energetic life.
Jean Rommes lives in West Des Moines, Iowa. Though semiretired, she still works as a consultant and as a part-time employee for a national accrediting company. She also is a COPD advocate for numerous organizations including EFFORTS, the COPD Foundation and the American Lung Association. She was recently appointed to the Medical and Scientific Advisory Board for the COPD Foundation.