Dear COPD Coach,
My sister-in-law has COPD and is quite overweight. She and my brother go to the gym at least 3 times a week and he had her walking up to a mile and she rests as needed. Suddenly she’s back to only being able to take a few steps before being out of breath and the doctors have been running tests – she’s had reactions in the past to some of the medications.
I know it is important to maintain an exercise program and not to become discouraged or depressed, so I suggested yoga, but don’t know if that is right for a person with COPD. I realized that she couldn’t do some of the advanced poses, but yoga is so good for stretching and strengthening muscles and lowering anxiety. Can you tell me if it is appropriate and recommend some yoga poses for her?
–Concerned Sister
Dear Concerned,
Weight is always a concern and often a problem for many people with COPD. While the reason is not generally known, some people with COPD tend to gain weight, while others have a very difficult time gaining weight (also known as “COPD wasting“). While there are studies under way to establish the reasons for this, there are no definitive answers at this point. People who have either condition share in facing significant challenges. Being overweight requires the lungs and heart to work harder to accomplish even the simplest of tasks and causes orthopedic stress, particularly on the knees and back. Being underweight generally creates a problem with the body retaining enough nourishment to replace the calories required not only for activity, but also to breathe.
The currently prescribed treatment for both types of conditions is actually the same. Eating the right foods, in the correct amounts to assure that the body has the nutrients it requires. When the disease progresses, the lungs become hyper-inflated and can actually push down on the stomach. This can cause a bloated feeling after eating, and actually make breathing more difficult as the stomach pushes up against the hyper inflated lungs. The answer to this is to eat several smaller meals throughout the day.
In the case of your sister, her digression in activity might be related to experiencing an exacerbation (a time when your COPD flares up). It could well be temporary, or signal a general worsening of her condition. Carrying a great deal of extra weight would definitely present additional challenges. It’s good to know that she’s seeing a doctor who is trying to figure out what has brought on this change.
A COPD patient in Pulmonary Rehab
If it’s determined that she’s not having an exacerbation, the important thing is that activity not be eliminated, but modified. This is where participation in a pulmonary rehabilitation program can become an important tool. A good pulmonary rehabilitation program can design an exercise program for your sister that can lead to significant strides in restoring her activity level. I strongly encourage you to ask her doctor for a referral to a certified pulmonary rehabilitation program. The staff there can guide people with COPD in improving her fitness even if they are too heavy to use some of the equipment.
Yoga can be a good tool not only to exercise but can also provide significant help in dealing with mental health issues that often arise when dealing with COPD. Many of the chair exercises designed for COPD are based on yoga techniques. However, a word of caution: before starting any exercise program you should first discuss it with your doctor or a qualified respiratory therapist! There are videos online with various chair exercises. An additional source of information is our Big Fat Reference Guide.
You might also consider talking with a nutritionist experienced with COPD to design a diet to begin reducing the weight. If your sister is extremely over weight you also might consider getting a referral to a bariatric specialist.
The bottom line is that dealing with COPD is not the same for everybody, and every person with COPD will experience different challenges. Some of the medications available can cause weight gain (steroids) while others have just the opposite effect. People will also react differently to certain medications. You are certainly on the right track having your sister’s doctor review her medications.
If your sister is in fact experiencing an exacerbation, it might well be possible to restore her past activity level. Each time a COPD exacerbation occurs, it causes a set-back to some degree. I guess the best analogy is it is like climbing a hill. You may be making progress towards the summit and then experience a slip. But it is very important that you continue the climb!
I really hope this helps, and please accept our very best wishes!
The COPD Coach
Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice.
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