Welcome to Duke Lung Transplant Friends
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Diane Detmer
Website designed, published and maintained by Diane Detmer
Contact Webmaster: dinki@charter.net
Diane Detmer
Website designed, published and maintained by Diane Detmer
Contact Webmaster: dinki@charter.net
If check-in is done quickly, we still have to wait to get started our exercise. The graduate class is out on the floor and we have to wait until they are finished. Once we all see their group stand and start gathering up their belongings, it looks like a homestead stampede is occurring. Movement escalates as the seated group begins to rise and shuffle their way towards the center gym floor. My group is so intent in seeing if they can get a piece of prime real estate on the floor and is the cause for the jam. What inevitably happens is that one group is trying to get in between the lines of machines while the other group becomes trapped and blocked as they try to exit and wiggle past.
The first group doesn't have to clean and put away their equipment when they are pooped from the workout...I guess that is a privilege of being a graduate. But after a couple of classes of wiping down other people’s equipment, spreading towels out on the mat and afterwards juggling to put it all away…I just went to Wal-mart and bought my own weights and mat. Voila! I no longer have to worry about spreading my germs and can save my energy to use somewhere else. I don’t have to wait in line to put my stuff away. I can go sit and start my snack while others tend to their clean up. Selfish perhaps, but I just see it as being wise. I plan on exercise being a major component in my future, so buying the equipment is an investment towards my future health…in more ways than one!
And now the REAL work begins.
On day number one, we have to just sit in a chair and observe everyone else. That way we will have a better time of understanding instructions the following day while lying on the mat. On my first day. I chose to raise my arms and legs along with the group while sitting in the chair. It was hard just sitting. I was really antsy to get down on the floor too. I have been doing exercise at home on my treadmill and bike, workouts with Christian Fitness TV and tapes, and rehab one day a week at my local hospital for two years…so I was really raring to start.
We all strap on leg weights…I am pretty strong so I started with 2 lb leg weights instead of one pound and I just got moved up to 3 pound this week. They are NOT designed for walking…they (and therapy bands) are designed to provide resistance during leg lifts and ankle rotations. We also use the dumb bells to increase our arm strength. We have trainers who guide us through a solid non-stop one hour workout. Every day a different staff member leads us thru the workout from their mat in the middle of the gym, which is surrounded by a circle of dozens of mats spread more than arm distance apart. The patients tend to set up where they find space and after a couple of days they inevitably lay unspoken claim to their turf. I flipped and flopped the first week or so while I tried to “find” my space. Some locations I laid my mat under were in direct line of the air vents. Anyone who really knows me KNOWS I can’t stand being cold. I survived the exercises by placing my towel over me like a blanket. I used more calories and did more wiggling trying to adjust the towel with each exercise than the weights probably used up. LOL Other times, I found myself directly under a light. Again, anyone who knows me KNOWS bright lights hurt my eyes. - To get enough light needed to brighten up the gym requires way more “Brightness” lumens than I am comfortable with. Even with eyes closed it seems to penetrate the fine skin of my eye lid. I didn’t want a headache, so I used my stretchy thera-band as a pseudo blindfold by draping it over my eyes. If it was thera-band time…I used the towel that was supposed to support my head as a face covering instead. I think the staff finally figured it out because they use mood lighting most of the time now. (Thank you staff, especially David!)
Back to the trainers. Duke Center for Living staff are the most awesome people I have ever met. They are helpful, knowledgeable, and determined to help you have a successful operation and recovery. They KNOW their stuff. I like the fact that each day a different person leads the floor exercise instruction because each has their own specific style and area of the body they like to work out on. The routines are all fairly similar, but the trainers add their own twists. We have days that seem tougher than others….because some trainers are “grueling and unmerciful” (again, thanks David) while others use a slower pace with more breathing opportunities built in. But you know the saying, no pain…no gain. That goes for sweat too! I finally found out what that is! I have noticed how attentive the staff is to our needs: always checking the level of oxygen in our tanks, asking how we are doing, providing smiles of encouragement, assisting with equipment. They just represent customer service at its highest levels. I have NEVER seen anyone grumpy or upset. They all seem to really enjoy their work and it shows.
I have to laugh sometimes because you can really tell that, although they are all respiratory /physical therapists, none have them have apparently ever been short of breath before. They are “normal” breathers and sometimes their instructions reflect this “handicap” of theirs. I mentioned to a fellow patient one day that I love the work-outs but the breathing rate is a joke. Who amongst us can honestly breath like them at our stage? They like to give us step-by-step instructions via microphone so we all can lay and do it without having to look to see what they are doing. The instructions are, for the most part, well-choreographed. It is very important that proper breathing be utilized instead us all developing habits of holding our breath during difficult times, so they provide breathing guidance.
I don’t know if the reader has ever dealt with breathlessness, but in order to balance our oxygen and carbon dioxide exchange, particularly for COPD patients, it is important to use diaphragmatic breathing. We breath in through our nose for 2 counts (because we don’t have enough lung volume space left for taking any long deep breaths) and we exhale for 4 counts through pursed lips, which provides a positive pressure. This breathing technique linked together with tightening of the abdomen during the inhale helps strengthen the diaphragm.
Test your own breathing. Place one hand just below the rib cage and at the belly button. Only the belly should be rising and lowering - not the upper chest moving. Make your hand rise when you inhale deep through your nose and then drop when you exhale through pursed lips. That is the proper way to breathe. Breathing in the upper chest are requires using auxiliary muscles in your neck and shoulder and invites rapid shallow breathing, which can lead to shortness of breath.
The trainers will tell us to take a deep breath the whole time we slowly lift our leg (4 sec) and breathe out while we slowly lower our leg, or arm. The problem is they want us to take in a long 4 count breath…and a long 4 count exhale. Meanwhile, we are gasping for breath and literally taking two breath cycles to their one…. It’s actually kinda comical as I observe new arrivals struggling to breath at the instructed rate before realizing they have to breath with their own pursed lip breathing pattern in order to prevent panic shortness of breath.
So, long story short…we turn out heads left and right…up and down; raise our trembling arms and legs; march while laying on our backs with our feet up in the air; raise our butts and make the best arch bridges that even the US Army Corps of Engineers can’t compete with, and do whatever our trainers instruct us to do…within reason… for one entire solid hour until “It is finished!” Okay, so it is not aerobics or cardiac stress we are engaging in, but by the time we finish, I know I have stretched muscles I never knew I had and in some kinda way, it feels pretty good. At least right then. Now tonight, I may think differently. I lay there and wonder how did I ever find myself in this predicament, but I know it is all for my own good. What we sow….we reap, and I am paying my dues for some unhealthy eating and lifestyle that caught up with me in a big way.
After floor exercise, we (or rather everyone else) must wipe down their equipment and mats and return them to the storage locations. It is not easy to pull an oxygen tank AND juggle a couple of mats, two leg weights and two hand weights and stop and clean them before hoisting them up on the storage rack. (Yep, I figured there would be a whole lot less energy involved in rolling up my own personal germ-covered mat real quick and carrying it by the strap over my shoulder. I’m also not real patient when it comes to waiting my turn and fighting for position…)
We return to our seats and take a break. Many folks like to pull out an energy bar, a bottle of water, some fruit or some yogurt. A little pick me up. I generally just swig a little water, gnaw on a couple of nuts and I’m ready to go. I’m on a roll, I want to get this stuff done, so I can go home and sleep!
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The first group doesn't have to clean and put away their equipment when they are pooped from the workout...I guess that is a privilege of being a graduate. But after a couple of classes of wiping down other people’s equipment, spreading towels out on the mat and afterwards juggling to put it all away…I just went to Wal-mart and bought my own weights and mat. Voila! I no longer have to worry about spreading my germs and can save my energy to use somewhere else. I don’t have to wait in line to put my stuff away. I can go sit and start my snack while others tend to their clean up. Selfish perhaps, but I just see it as being wise. I plan on exercise being a major component in my future, so buying the equipment is an investment towards my future health…in more ways than one!
And now the REAL work begins.
On day number one, we have to just sit in a chair and observe everyone else. That way we will have a better time of understanding instructions the following day while lying on the mat. On my first day. I chose to raise my arms and legs along with the group while sitting in the chair. It was hard just sitting. I was really antsy to get down on the floor too. I have been doing exercise at home on my treadmill and bike, workouts with Christian Fitness TV and tapes, and rehab one day a week at my local hospital for two years…so I was really raring to start.
We all strap on leg weights…I am pretty strong so I started with 2 lb leg weights instead of one pound and I just got moved up to 3 pound this week. They are NOT designed for walking…they (and therapy bands) are designed to provide resistance during leg lifts and ankle rotations. We also use the dumb bells to increase our arm strength. We have trainers who guide us through a solid non-stop one hour workout. Every day a different staff member leads us thru the workout from their mat in the middle of the gym, which is surrounded by a circle of dozens of mats spread more than arm distance apart. The patients tend to set up where they find space and after a couple of days they inevitably lay unspoken claim to their turf. I flipped and flopped the first week or so while I tried to “find” my space. Some locations I laid my mat under were in direct line of the air vents. Anyone who really knows me KNOWS I can’t stand being cold. I survived the exercises by placing my towel over me like a blanket. I used more calories and did more wiggling trying to adjust the towel with each exercise than the weights probably used up. LOL Other times, I found myself directly under a light. Again, anyone who knows me KNOWS bright lights hurt my eyes. - To get enough light needed to brighten up the gym requires way more “Brightness” lumens than I am comfortable with. Even with eyes closed it seems to penetrate the fine skin of my eye lid. I didn’t want a headache, so I used my stretchy thera-band as a pseudo blindfold by draping it over my eyes. If it was thera-band time…I used the towel that was supposed to support my head as a face covering instead. I think the staff finally figured it out because they use mood lighting most of the time now. (Thank you staff, especially David!)
Back to the trainers. Duke Center for Living staff are the most awesome people I have ever met. They are helpful, knowledgeable, and determined to help you have a successful operation and recovery. They KNOW their stuff. I like the fact that each day a different person leads the floor exercise instruction because each has their own specific style and area of the body they like to work out on. The routines are all fairly similar, but the trainers add their own twists. We have days that seem tougher than others….because some trainers are “grueling and unmerciful” (again, thanks David) while others use a slower pace with more breathing opportunities built in. But you know the saying, no pain…no gain. That goes for sweat too! I finally found out what that is! I have noticed how attentive the staff is to our needs: always checking the level of oxygen in our tanks, asking how we are doing, providing smiles of encouragement, assisting with equipment. They just represent customer service at its highest levels. I have NEVER seen anyone grumpy or upset. They all seem to really enjoy their work and it shows.
I have to laugh sometimes because you can really tell that, although they are all respiratory /physical therapists, none have them have apparently ever been short of breath before. They are “normal” breathers and sometimes their instructions reflect this “handicap” of theirs. I mentioned to a fellow patient one day that I love the work-outs but the breathing rate is a joke. Who amongst us can honestly breath like them at our stage? They like to give us step-by-step instructions via microphone so we all can lay and do it without having to look to see what they are doing. The instructions are, for the most part, well-choreographed. It is very important that proper breathing be utilized instead us all developing habits of holding our breath during difficult times, so they provide breathing guidance.
I don’t know if the reader has ever dealt with breathlessness, but in order to balance our oxygen and carbon dioxide exchange, particularly for COPD patients, it is important to use diaphragmatic breathing. We breath in through our nose for 2 counts (because we don’t have enough lung volume space left for taking any long deep breaths) and we exhale for 4 counts through pursed lips, which provides a positive pressure. This breathing technique linked together with tightening of the abdomen during the inhale helps strengthen the diaphragm.
Test your own breathing. Place one hand just below the rib cage and at the belly button. Only the belly should be rising and lowering - not the upper chest moving. Make your hand rise when you inhale deep through your nose and then drop when you exhale through pursed lips. That is the proper way to breathe. Breathing in the upper chest are requires using auxiliary muscles in your neck and shoulder and invites rapid shallow breathing, which can lead to shortness of breath.
The trainers will tell us to take a deep breath the whole time we slowly lift our leg (4 sec) and breathe out while we slowly lower our leg, or arm. The problem is they want us to take in a long 4 count breath…and a long 4 count exhale. Meanwhile, we are gasping for breath and literally taking two breath cycles to their one…. It’s actually kinda comical as I observe new arrivals struggling to breath at the instructed rate before realizing they have to breath with their own pursed lip breathing pattern in order to prevent panic shortness of breath.
So, long story short…we turn out heads left and right…up and down; raise our trembling arms and legs; march while laying on our backs with our feet up in the air; raise our butts and make the best arch bridges that even the US Army Corps of Engineers can’t compete with, and do whatever our trainers instruct us to do…within reason… for one entire solid hour until “It is finished!” Okay, so it is not aerobics or cardiac stress we are engaging in, but by the time we finish, I know I have stretched muscles I never knew I had and in some kinda way, it feels pretty good. At least right then. Now tonight, I may think differently. I lay there and wonder how did I ever find myself in this predicament, but I know it is all for my own good. What we sow….we reap, and I am paying my dues for some unhealthy eating and lifestyle that caught up with me in a big way.
After floor exercise, we (or rather everyone else) must wipe down their equipment and mats and return them to the storage locations. It is not easy to pull an oxygen tank AND juggle a couple of mats, two leg weights and two hand weights and stop and clean them before hoisting them up on the storage rack. (Yep, I figured there would be a whole lot less energy involved in rolling up my own personal germ-covered mat real quick and carrying it by the strap over my shoulder. I’m also not real patient when it comes to waiting my turn and fighting for position…)
We return to our seats and take a break. Many folks like to pull out an energy bar, a bottle of water, some fruit or some yogurt. A little pick me up. I generally just swig a little water, gnaw on a couple of nuts and I’m ready to go. I’m on a roll, I want to get this stuff done, so I can go home and sleep!
Click here to continue reading
Duke Lung Transplant Friends
Center for Living
Center for Living
by Susan Traxel Martin