By the late Thomas L. Petty, MD
Former PERF Board Member
and prolific author of “Letters from Dr. Thomas Petty“
I doubt that many who read this believe that I’m serious about the title of this month’s message – but I am. Everyone is aware that patients with emphysema are short of breath whenever they exert beyond certain individual limits. Doctors have a term for this, Dyspnea (literally bad breathing) On Exertion, abbreviated DOE.
I prefer another use of the abbreviation DOE: DO or else! Let’s look at this concept. Patients with severe emphysema often don’t do much because they are indeed short of breath. It just doesn’t feel good to be short of breath during any activity of daily life.
Accordingly, it’s quite natural for patients to reduce their activities to protect themselves from this uncomfortable feeling. But in doing so their muscles become weaker and this includes the breathing muscles. Another thing happens. The brain gets used to this state of inactivity and certain good brain hormones called endorphins are not produced in full quantity. Endorphins are like opium. Endorphins are naturally occurring hormones which give us a feeling of well-being. We can stimulate the production of endorphins by exercise. That’s why athletes like marathon runners get a “high” midway in the race. Endorphins are the mood elevators that joggers seek each day.
But how about the emphysema patient? No marathon running or jogging here. Sure but just walking each day can do the same thing. You must walk far enough and long enough to get some dyspnea. It’s this dyspnea which finally brings out the endorphins. Now I’m sure you will say, “but I have this dyspnea every day. so why don’t I feel better?” Answer – don’t expect too much, but do a little more regular walking every day. Just plain normal slow walking is the best exercise. Walk twice a day, in the house, out-of-doors, around the block, in shopping malls in cold weather. Increase your goals slightly every day. Aim for the “magic mile.” You’ll feel good doing it and as you do, you can become an “emphysema athlete” and enjoy your own personal high!
Here’s to good walking every day.
Thomas L. Petty, M.D.
Professor of Medicine