Richard ZuWallack, M.D., Pulmonologist

Expert point of view: Lifestyle choices for living better with COPD

by Richard ZuWallack, M.D., Pulmonologist

Living better is a whole attitude toward COPD. Getting you out of the house, doing things you enjoy, is really the ultimate goal.

I'm a pulmonologist at St. Francis Hospital in Hartford, CT. In addition to being a full-time hospital physician I'm also a professor of medicine at the University of Connecticut. My major interest is lung disease, specifically COPD.

We have medicines to treat COPD. However, there are also things you can do as a patient that can have an impact on the course of your disease, and more importantly, your life.

How COPD gets worse

The problem with this disease is that it leads to shortness of breath. To avoid this unpleasant feeling you begin to avoid certain activities — which makes you get out of shape. And this leads to even more shortness of breath. It just becomes a vicious circle. But a healthy level of activity can help interrupt this vicious circle.

Managing your COPD

The first thing we try to do is optimize the medical care you are getting. We do this by giving you maintenance and rescue medicines to help your lungs work to help you breathe better. And by getting you to quit smoking cigarettes.

We also want you to be as active as you comfortably can. Get off the couch, do things around the house. Talk with your doctor about what level of activity is right for you. If after doing these things you still have symptoms such as shortness of breath when you do everyday activities, or if you have tiredness that limits your activity, then you may be a candidate for the next level of care, which is pulmonary rehabilitation.

What is pulmonary rehabilitation and how can it help?

By pulmonary rehab, I mean coming in for a structured set of services two or three times a week for six to twelve weeks. It involves exercise training under the supervision of a healthcare professional, education about self-management strategies, nutrition, how to partner with your doctor, and how you can apply what you learn at home. Motivation is key. The more you as the patient put into it, the more you will get out of it.

Over time, you realize if you exercise a little bit and get short of breath, it's not the end of the world. If you slow down it goes away. After a while you learn to pace yourself. Before long you are able to do more exercise without shortness of breath. And that may take away some of the dread or anxiety you feel about it.

Our goal is to get you into the best physical shape that you are capable of. And then have you be able to maintain that condition on your own. Pulmonary rehabilitation helps you by stopping and reversing some of the de-conditioning related to COPD. This helps make you feel stronger and able to do more with the lung function you've got.

One more reason for you to get up, get out of the house and do things. It's never too late to start.

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