Breathing Exercises

1. Pursed Lip Breathing

You have probably noticed when an athlete has shortness of breath during periods of exercise, they tend to blow the air out of their mouths by puffing out their cheeks. You may have done this as well when you have exerted yourself. This is a normal response to shortness of breath, and it provides for a quick and easy way to improve breathing patterns.

What Does It Do?

• Improves ventilation
• Decreases air trapping in the lungs
• Decreases the work of breathing
• Improves breathing patterns
• Causes general relaxation
• How?

• Prolongs exhalation—slows down the breathing rate
• Causes a slight back pressure in the lungs that keeps the airways open longer
• Improves the movement of old air out of the lungs and allows for more new air to get into the lungs

 

Procedure

REMEMBER—Exhalation must be 3-4 times longer than inhalation, so do not force the air out.

1. Sit down but sit up straight and relaxed
2. Breath in, preferably through the nose
3. Purse lips slightly (as if to whistle)
4. Breath out slowly through pursed lips
5. Do not force the air out

Practice this procedure 4-5 times a day initially to get the correct breathing pattern. You should use pursed lip breathing when you are experiencing shortness of breath either at rest or with exertion or if you feel nervous or apprehensive.

IMPORTANT—You may experience a lightheaded feeling while doing pursed lip breathing. This indicates that you are over ventilating yourself and you should breathe more slowly.

2. Diaphragm Breathing

The most efficient breathing muscle is the diaphragm. Many people with COPD no longer use this important breathing muscle effectively. This exercise is designed to help you better use this muscle in the act of breathing.

IMPORTANT—You will notice it will take increased effort to use this muscle correctly. At first, you will get tired while doing this exercise. Keep at it, because in a short time, you’ll be rewarded by being able to do breathe with less effort.

Diaphragm Breathing:

• Strengthens the diaphragm
• Coordinates diaphragm movement when breathing
• Less effort and required to breathe

How?

• Correctly uses the most effective muscle for breathing. In the beginning, practice this procedure for 5-10 minutes, 3-4 times a day.

Gradually increase the length of your exercise period and perhaps the effort required by placing a book on the abdomen.

After you feel comfortable with this procedure, practice while sitting in a chair or while standing.

Procedure

1. Lie on your back in a bed with your knees bent.
2. Place one of your hands on your abdomen.
3. Place your other hand on your upper chest.
4. As you inhale through your nose, make your stomach move out and keep your upper chest as still as possible.
5. As you exhale through pursed lips, let your stomach fall inward. Keep your hand on the upper chest as still as possible during the entire procedure.

 

 

Hydration

Thick, sticky mucus is difficult to cough up, especially with a weakened cough reflex. It is important that you drink enough fluids to keep your mucus thin and loose. Check with your physician to determine how much fluid you should drink daily to keep your cough effective.

Humidify your home (at minimum, the room you sleep in and the room you spend most of your time in). Keep your humidifier clean as they are a possible source of infection.

Do not smoke because smoking takes moisture out of your mucus and makes the mucus thicker.

Cough

Remember, control your coughing as uncontrolled coughing can make you short of breath. Discuss with your physician which type of coughing exercise is best for you.

You should perform these coughing maneuvers whenever you feel the need to cough or as instructed by your physician. A good controlled cough is especially helpful when you first get up in the morning and about an hour before bedtime. Have a cup of coffee or tea first (or other drink recommended by your physician) and relax.

Sit up straight in a chair when attempting these coughing exercises. Have a tissue handy.

Exercise A

1. Sit up straight in a hard-backed, stable chair, and relax.
2. Take in 2-3 deep breaths through your nose and exhale slowly through pursed lips.
3. Fold your arms across your abdomen.
4. Take in a comfortable deep breath through your nose.
5. Lean forward, pressing your arms against your abdomen and cough while leaning forward.
7. Rest 5-10 minutes.
8. Perform again if needed.

Exercise B

1. Sit up straight, and relax.
2. Take in 2-3 deep breaths through your nose and exhale slowly through pursed lips.
3. Take in a moderately deep breath, hold the breath, and expel air while saying H or K once.
4. When you feel comfortable with this exercise, try to say the H or K 3-4 times while exhaling.

 

The following relaxation techniques can help relieve the tension and anxiety that often accompanies respiratory difficulties. This anxiety can even make you feel worse. By learning to relax your mind and body, you will feel better, and you will decrease the amount of oxygen that your body needs.

• To begin, lay down on a comfortable surface and place pillows under your head and knees. If you are more comfortable on your side, use pillows under your head and between your knees.
• Relax
• Lie quietly in a comfortable position. Take a slow deep breath through your nose. Hold the breath for several seconds, purse your lips, and slowly exhale. Relax.
• Take another deep, slow breath through your nose. Hold your breath and pull your toes towards your head and tighten your leg muscles (no longer than a count to 3). Feel the tension. Purse your lips, exhale slowly and relax your legs. Relax.
• Take another deep slow breath through your nose. Hold your breath and tighten your arm muscles. Feel the tension. Purse your lips, exhale slowly and relax your arms and hands. Relax.
• Take another slow, deep breath through your nose. Hold your breath and bite down as hard as you can and tighten your jaw muscles. Feel the tension. Purse your lips, exhale slowly and relax your jaws. Relax.
• Take another slow deep breath through your nose. Hold your breath and lift up your head and tighten your neck muscles. Feel the tension. Purse your lips, exhale slowly, let your head rest back on the pillow, and relax your neck muscles.
• Lay still and enjoy the relaxed feeling you’re experiencing. Do this relaxation technique several times a day.  You can even do it while sitting in a chair.

 

If you have ever experienced difficulty breathing, or if you have lung or heart problem, you have probably wondered about using oxygen at home.

Your physician has determined that you may benefit from the use of oxygen at home, based on your symptoms, physical examination or laboratory test.

Following are answers to some of the most commonly asked questions about the use of oxygen in the home.

What is oxygen?
Oxygen is a colorless, tasteless, odorless gas that is necessary for life. When we take a breath, we draw air containing 21% oxygen into our lungs. The oxygen passes from our lungs into our bloodstream, where it is carried in the red blood cells to all the organs and tissues of our bodies. Oxygen is needed by our organs and tissues to convert the food we eat into heat and energy and to maintain life.

How is oxygen made and stored?
There are three common methods for obtaining pure oxygen:

1. Air is cooled and compressed until it becomes a liquid. Then as the liquid air warms, the oxygen “boils” off and is collected. It is then re-cooled and compressed into liquid oxygen and stored in “thermos bottles” known as reservoirs.
2. The oxygen gas is compressed and stored in heavy steel pressurized tanks.
3. Room air is pumped through a fine filter that traps all but the oxygen, which is allowed to pass through. This is known as an oxygen concentrator or oxygen enricher.

How do I use home oxygen?
A small, adjustable plastic tube (called a nasal cannula), worn like eye glasses, is placed under the nose. This tubing, through which the oxygen will flow, is attached to the oxygen tank.

How do I order oxygen once my physician prescribes it?
Your physician, respiratory therapist, social worker, or nurse may recommend an oxygen supplier to you, or you may look in the yellow pages under “Oxygen.” When selecting an oxygen supplier, consider the following:

• Will the company deliver and install the equipment?
• Does the company have a delivery service 24 hours a day? Seven days a week?
• Does the company provide information on the use and cleaning of the equipment?
• Is a nurse or therapist available to answer your questions and come to your home if necessary?
• Will the company bill Medicare or your insurance for you? How much does home oxygen cost?

Will Medicare and/or my insurance pay for it?
The cost can vary greatly depending on your prescription. There is a variety of oxygen equipment available. Your physician decides how much oxygen you need. The supplier will help you select the most economical system to meet your needs and activities and should be able to give you an approximate monthly cost.

Medicare will pay 80% of approved expenses. Many private insurance carriers also pay for oxygen within the limits of their policies. To be sure your policy covers home oxygen, call your claims representative.

Why do I need supplemental oxygen?
Normally oxygen passes readily from the lungs into the bloodstream and is pumped by the heart to all parts of the body. When lung disease occurs, oxygen may not be able to pass as readily into the bloodstream. Heart disease may cause the heart to not be able to pump as much oxygen-carrying blood.

Either of these situations can result in not enough oxygen reaching the organs and tissues of the body, preventing them from functioning properly. This can cause many undesirable effects, such as decreased ability to exercise, difficulty breathing, fatigue, confusion, loss of memory, etc. Breathing supplemental oxygen increases the amount of oxygen that passes into the bloodstream and is carried to the organs and tissues.

Do all patients with lung or heart disease require supplemental oxygen?
It is estimated that over 4 million patients with lung or heart problems either are benefiting from or could benefit from supplemental oxygen. This is a rather small percent of the estimated 60 million Americans affected by lung or heart and circulatory disease.

How can I tell if I need supplemental oxygen?
You might suspect you need supplemental oxygen if you have one or more of the following symptoms: decreased ability to exercise, difficulty breathing, fatigue, or periods of disorientation or memory loss.

The only way to know for sure, however, is to measure the amount of oxygen in your blood with Arterial Blood Gas or oximetry. Your physician will evaluate your test results and symptoms to determine if you might benefit from additional oxygen. If you need supplemental oxygen, your physician will prescribe the proper flow rate and duration of use.

How can I tell if I am getting enough oxygen?
Too much?
You might anticipate that some of the symptoms you had before using the oxygen will start to go away as your blood’s oxygen level returns to normal. The only way to be sure you are getting the right amount of oxygen is to have the oxygen level in your blood measured while using the supplemental oxygen.

If new symptoms, such as headaches, confusion, increased sleepiness, etc., appear, you might be getting too much oxygen. Notify your physician. Do not change the liter flow or hours of usage without first checking with your physician.

Can I become addicted to oxygen?
Oxygen is not addictive. We all need oxygen to live. If your lungs and/or heart are diseased and cannot supply enough oxygen to your body from normal room air, you need to breathe supplemental oxygen. Should your condition improve, you may no longer require supplemental oxygen.

Will oxygen relieve my shortness of breath?
Oxygen frequently does help, but there are other reasons for shortness of breath. In such cases, oxygen may not relieve the condition. By itself, shortness of breath is not life-threatening.

Does the need for supplemental oxygen mean that I am dying?
Patients may live for years on home oxygen. Others require supplemental oxygen at home temporarily to relieve their discomfort after being hospitalized or experiencing other stressful situations.

Do I have to use oxygen all the time?
Your physician will determine how many hours per day you should use the oxygen. Note: Be sure to follow your doctor’s directions carefully for desired therapeutic benefit.

How do I get around in my home while using oxygen?
There is a variety of oxygen equipment available. Usually it will be placed where you use it most. Up to 50 feet of tubing can also be added to allow you to move about. Your home oxygen supplier will discuss with you the best choice of equipment for your activities.

Can I cook and eat while using oxygen?
You can carry on your normal activities as long as you use common sense while you’re using oxygen – don’t cook on an open flame; don’t smoke; and be careful that your oxygen tubing does not come in contact with hot burners, pots, pans or anything that could cause the plastic tubing to melt.

Using oxygen while eating may be beneficial in reducing the shortness of breath that many patients experience during and after eating.

Can I use electrical appliances while using oxygen?
Electrical appliances that get hot or spark during operations should be kept at least 5 feet away from the oxygen system.

Can I use oxygen around smokers?
Yes, as long as no one smokes within 5 feet of the equipment or the person using the oxygen.

What do I do if I want to leave my home?
There are small portable tanks, some of which hold enough oxygen to provide up to 8 hours of continuous use. If you’re traveling, additional, refillable tanks may be carried in your automobile. Your supplier may also be able to arrange for you to pick up oxygen en route and at your destination.

How heavy are portable tanks?
Portable tanks vary in weight from 6 to 15 pounds. These tanks may be carried in a shoulder bag during use or pull carts may also be available.

Can I refill the portable tank myself?
There are two types of portable tanks: liquid systems and high pressure cylinders. The liquid systems are designed to be refilled by the patient. They are simple to operate and very safe. Refilling small high pressure cylinders, however, can be hazardous and should be done only by an authorized dealer.

 

Can I drive a car while using oxygen? Or travel?
Yes. Again, all you need do is use common sense. When driving, secure the oxygen unit so it will not tip over. Leave a window open slightly for ventilation so the oxygen will not accumulate in the car.

You can also use public transportation while using oxygen.

Be sure to make reservations early, alerting the reservation staff to any special needs, so they will have time to accommodate them. Your supplier can help you arrange for your oxygen en route and at your destination.

What do I do if I run out of oxygen?
You will probably feel some of the discomfort you experienced before you went on your oxygen therapy, but this discomfort is not life-threatening. Call your supplier to replace or refill the container. You can reduce your discomfort until he arrives by resting your lungs. For example, you might sit or lie down and relax until the supplier arrives to fill your tank.

If your portable tank runs out of oxygen, return home.

Is there anything I cannot do while using oxygen?
You can do anything that you would normally do, unless an activity brings you within five feet of an open flame, a burning cigarette or an electrical appliance that sparks. You may find that you will be able to do some activities while using oxygen that you could not do without it.

Are there any hazards involved in using oxygen?
While oxygen does not burn, anything that can burn will do so more easily and more rapidly in an oxygen-rich environment. Therefore, do not use oxygen near an open flame, burning cigarette or electrical equipment that sparks during operation.

Do not use oil, grease, or Vaseline on your oxygen equipment. If frost forms on your liquid oxygen system, do not allow the frosted portions of the equipment to come in contact with your skin. Your home oxygen supplier will thoroughly explain all safety precautions related to your home oxygen therapy.

Be careful to follow your doctor’s orders when using oxygen, and never change the liter flow without his or her approval.
We hope this page has been helpful to you in providing information about oxygen in the home. If you have any further questions, please consult your physician.

 

Humidity

In the summer, it is sometimes hard for you to think of needing more humidity. But in the fall and winter months, humidity is extremely important. In fact, two related subjects are equally important – adding humidity to dry winter air and keeping your humidifying devices germ-free.

Your lungs require a great deal of moisture – actually 100% relative humidity – to keep their cleansing systems working and to keep you free of infection. The nose provides a great deal of this moisture to incoming air, but in wintertime, your nose is vastly overworked by very dry air.  Briefly, here’s why cold air is not capable of holding much moisture. When cold air is heating in your house, the warmer air is capable of holding more moisture, but the moisture is not present in the air, so the relative humidity drops exceedingly low–often as low as 6 or 7 percent relative humidity. Dry air can be extremely harmful to everyone. To children – it brings on continual winter sniffles. To people with chronic lung problems, dry air can cause serious and lengthy respiratory infections, which should be avoided if at all possible.

Here is what you should do:

• Drink plenty of liquids – your nose’s humidification system needs a lot. Try to drink 1 1/2 to 2 quarts of liquids every day. If this means having to make extra trips to the bathroom, drink lots anyway. The exercise will do you good! Drinking most of the liquid before your evening meal should minimize interruptions during the night. Drink water, juices and more water!
• Add humidity to the air you breathe. How much humidity you have to add is not easy to answer – but on the other hand, adding too much is almost impossible. Remember, the air in your lungs contains 100% humidity. Too much humidity can affect your comfort and furniture.  A good rule of thumb is to add humidity until water collects in excess on cold windows (some condensation is natural – just wipe it up occasionally).

Room humidifiers can cost anywhere from $5.00 to hundreds of dollars. Amazingly, the lower priced humidifiers may be better and easier to keep clean. There are 3 categories of humidifiers: 1) heated steam vaporizers; 2) cold spray type, or 3) evaporation plate/rotary belt humidifier.

Type number three can be most effective and automatic, but they can also breed dangerous bacteria if they are not kept absolutely clean. Daily cleaning can be difficult, so generally speaking, this system is not best suited for respiratory patients.

The heated steam and the cold spray type humidifiers are usually less expensive, $5-$25 and are relatively easy to clean each day. Which is better is hard to say. There has been a trend towards the cool spray type, particularly for apartments and rooms that run hotter than normal because steam vaporizers only add more heat.

• An unclean humidifier can do more harm than good. Bacteria grow well in moist, warm environments – such as humidifiers. Most harmful bacteria take longer than 24 hours to develop; therefore, your unit must be cleaned once a day. The cool spray units are probably easiest to clean. It is a good idea to get two units – one for the bedroom and one for living room. The one in use can be cleaned in minutes and left to air-dry.

Some other good living tips for wintertime:

Avoid drafts
Wear a sweater to keep comfortably warm. Open neck sweaters may be fashionable, but not warm. Try a high collar or turtle neck, particularly for going outdoors.

When outside
Breathe through your nose.  This will help warm the inhaled air. On cold days, wrap a scarf around your face.  That will help warm the cold, raw air before it reaches your nose. Also, when you first step outside, stop and breathe a few short breaths before proceeding – this can save you a few coughing spells.

If others have colds
Avoid them. Their germs are airborne. If they have to be near you, ask them to wear a surgical face mask (available from drug stores at a very low cost). Also be sure not to use their plates or utensils. The same thing applies to crowds. Avoid crowds when possible since there are always cold germs aplenty where there are groups of people.

Blow your nose
This may seem like an unnecessary statement to make. But not so– your nose works overtime in the winter in trapping out dust and germs. And it’s always a good idea to use fresh, disposable tissues (Kleenex) so you can throw them away, in paper bags not waste baskets.

Exercise
Many people think that when the weather gets bad, exercise such as walking is not practical. Daily exercise is extremely important all year, so when the weather is bad, walk around the house and climb stairs. Try to do as much as you would if you went outdoors, even though it’s boring. Exercycles are inexpensive and can give you ample exercise while you watch your favorite TV programs.

Breathing exercises are also important in strengthening the respiratory muscles. If you do not have information on these exercises, ask your doctor.

Dust-free air
With the dryness of winter comes a great amount of dust. There are several things you can do to minimize this problem:

• If you have central, forced air heating, replace the air filters before turning the system on.
• Dust frequently, but use a dusting agent (such as Endust) which will keep the dust on the cloth. Drapes and curtains should be laundered or dry-cleaned occasionally – take them down carefully to reduce the amount of dust. Vacuum or dust behind radiators. Change vacuum cleaner bags and filters regularly, before they look full or dirty.

Diet and Weight Control
Try to stay at or a little below your ideal weight. Since eating and digesting food can be exhausting, it is better to eat 5 or 6 small meals than 3 regular meals.

Flu shots
In order to minimize the chance of getting flu, many respiratory patients get an influenza vaccination in the fall, before the flu season begins. Ask your doctor if you should get one. Be sure to get plenty of rest 2 or 3 days before getting the vaccination.

Stay away from smokers
You probably gave up smoking years ago. But be aware that smoke from someone else’s cigarette can be irritating and as harmful to you as if you were smoking it yourself. Ask your friends not to smoke or at least smoke away from you, preferably in another room.

When to Call Your Doctor

• When there is an unusual increase or decrease in sputum production;
• when there is an unusual increase in the thickness or stickiness of sputum;
• when sputum is a new color or is tinged with blood;
• when you feel an increase in severity of breathlessness;
• where you have pain in the chest, fever, swelling at the ankles, extreme fatigue or unusual drowsiness;
• when there is a need for more pillows in order to sleep comfortably;
• when there is an unexplainable increase or decrease in weight;
• when you have is increased fatigue and lack of energy;
• where there are complaints of frequent morning headaches, dizzy spells, loss of libido and insomnia;
• where there is a development of confusion, disorientation, slurring of speech and somnolence.

 

Health care consumers who ask the right questions and are active in making decisions save money and improve the quality of care they receive. But knowing the right questions to ask can be difficult in today’s complex health care system.

This page discusses different types of oxygen systems that are available and what questions to ask when looking for the system that best serves your needs.

Only patients with blood oxygen levels below critical levels will benefit from home oxygen. This means that the prescribing physician must make a determination of arterial oxygen level before oxygen can be prescribed.

Types of Oxygen Systems Available to You

Concentrators
About the size of a window air-conditioner, these devices run on electricity and do not need to be refilled. They effectively concentrate the oxygen already existing in the room air by eliminating the nitrogen component.

• Suitable for low-flow prescriptions (not exceeding 4-5 liters per minute)
• Dependable
• Easy to operate
• Requires regular service checks

Liquid Systems
A liquid system has a thermos-like tank (about 40″ tall) filled with liquid oxygen. When oxygen is liquid, 860 times as much oxygen can be stored in the same amount of space, at a much lower pressure, than high pressure tanks. The liquid oxygen is converted to gaseous oxygen within the reservoir for breathing. A smaller lightweight portable unit can be filled from the reservoir so you can take the oxygen with you when you leave home. Liquid oxygen is especially good for active people who need to be out of the home frequently.

Liquid systems are:

• Suitable for frequently mobile patients, and/or high-flow need patients (above 4-5 liters per minute)
• No electrical costs to patient
• Regular refills necessary

High Pressure Tanks
Available in various sizes, gaseous oxygen is pressurized and placed in steel or aluminum cylinders, then released through a regulator.

• Suitable for low oxygen usage (such as for emergency or occasional use, occasional portability)
• Can be stored for long periods of time
• Careful storage is important so that the cylinder will not fall over

Questions to Ask

Discuss with your doctor what kinds of activities are best for you. To what extent can you go out from home? By knowing what activities you can do, the doctor can decide whether a stationary or portable oxygen system is best for you.

Some tips about services you may require:

• Select a supplier that gives you 24-hour service without additional charges.
• If you are able to travel, look for a company with multiple locations. They should be able to assist you in getting oxygen outside of your normal service area.
• Make sure the supplier provides clear, written instructions regarding your use of the equipment. Do they have trained representatives to instruct you and to demonstrate the equipment after it is delivered?
• Ask for a complete breakdown of costs and verification of what your Medicare or insurance will cover. Make sure the supplier takes Medicare “assignment” (accepts what Medicare pays for services). After you have paid your yearly deductible, Medicare will pay 80%. All oxygen suppliers in the region get paid the same amount for the same prescription.
• Does the supplier have a clinician on staff to assist you if needed? Do they have a follow-up program that the doctor can order?
• Find out if the supplier provides regular routine equipment maintenance. How often do they service their equipment? Do they provide you with information on how to keep it clean? Do they provide the disposable tubing needed on a regular basis? Are there any additional charges for this tubing?

Remember—

You have the freedom of choice. If you can’t resolve problems with your current oxygen supplier, look under “OXYGEN” in the Yellow Pages and the nearest Lincare location which can better serve your needs.

 

A moderate amount of a wide variety of foods is ideal. Your physical and mental well-being depend a lot on what you eat. There are no wonder foods. The wonder is that fresh foods possess the nutrients your body needs to perform its best. Eating right can improve your general health and protect you from diseases.

Ask your doctor which foods are best for your condition.

Every day you should choose foods from each group:

• Milk group (2 servings)
  • milk
  • yogurt
  • cheese
  • pudding
  • ice cream
• Fruit-vegetable group (4 servings)
  • dark green leafy vegetables
  • orange vegetables
  • citrus fruits
• Meat group (2 servings)
  • meats
  • poultry
  • fish
  • eggs
• Grain group (4 servings)
  • whole grain bread
  • cereal
  • pasta

Servings Defined

In the MILK group a serving means:
1 cup milk, yogurt or pudding or 1 1/2 oz. cheese or 1 3/4 cup ice cream.

In the MEAT group a serving means:
3 oz. meat or 3 medium eggs (limit to three a week).

In the FRUIT AND VEGETABLE group a serving means:
1/2 cup juice or 1 piece of small fruit or 1/2 cup vegetable.

In the GRAIN group a serving means:
1 slice whole grain bread or 1/2 cup cooked cereal or pasta or 3/4 cup dry cereal.

Are You Short Of Breath While Eating?

What you eat affects your body’s ability to resist infections. How you eat is equally important.  The way you eat may affect the way you breathe.
If shortness of breath interferes with the enjoyment of your meals, here are a few helpful tips.

• Eat slowly – pause occasionally, and put your utensils down between bites.
• Take small bites and chew thoroughly with your mouth closed.
• Eat six small meals and not three big meals a day. This meal pattern reduces the amount of oxygen you need to chew and digest each meal. There is no need to fuss over extra meals. Just eat the servings of milk, bread, and fruit or dessert between the cooked meals.
• Breathe evenly while chewing. Take a few deep breaths if you have to.
• Instead of skipping your morning meal because of shortness of breath, drink a liquid breakfast. Here’s an easy instant breakfast.

Breakfast shake
1 cup milk
1/2 cup plain yogurt
1 tablespoon honey or molasses
1 banana, sliced
Put all the ingredients in a blender and blend at high speed for about 10 seconds or until well mixed.

Consult your physician if you have any questions.

Do You Feel Bloated?

Some foods make your body healthy and therefore make breathing easier. Other foods make breathing more difficult. Avoid gas-forming foods that may bloat your stomach and make breathing difficult for you.

You can determine which foods affect you by having trial periods and observing the results.

The following fruits and vegetables could possibly be gas forming:

• Vegetables
  • Kidney beans
  • Lima beans
  • Navy beans
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Corn
  • Cucumbers
  • Kohlrabi
  • Leeks
  • Lentils
  • Onions
  • Peas, split or black-eyed
  • Peppers, green
  • Pimentos
  • Radishes
  • Rutabagas
  • Sauerkraut
  • Scallions
  • Shallots
  • Soybeans
  • Turnips
• Fruits
  • Apples (raw)
  • Avocados
  • Cantaloupe
  • Honeydew melon
  • Watermelon

Consult your physician if you have any questions.

Are You Overweight?

If you are overweight, your doctor will be happy to suggest a proper diet for your condition. Excess weight makes your heart and lungs work harder. Also, your extra body weight may interfere with your breathing and demand more oxygen.

The slimmer weigh
When you want to lose weight, you need all the help you can get. Here are some tips.

Shop slim

1. Shop after you’ve eaten a satisfying meal to avoid impulsive buying of fattening foods.
2. Shop from a list and stick to it.
3. Shop only for nutritious foods:
   • Lean meats, poultry, fish and legumes
   • Whole grain breads and cereals
   • Plenty of colorful fruits and vegetables

Cook slim

1. Reduce fat and avoid sugar
2. Prepare lots of bulky foods:
   • At least one fresh fruit at or between each meal
   • At least two vegetables at lunch and dinner

Eat slim

1. Eat more slowly. Chew your foods well. This also helps you to breathe easier.
2. Take time to sit down and enjoy your meals.
3. If you nibble while you watch television, take up a hobby that will keep your hands busy and out of the cookie jar.

Drink slim

1. Drink less coffee, teas and colas. Caffeine can stimulate your appetite.
2. Quench thirst with water, decaffeinated coffee or herbal teas without caffeine.
3. Watch out at cocktail time.
4. Avoid sweetened juices and drinks. Try mixing fruit juice with seltzer water. Just think—one cup of apple juice has the same calories as three apples!

Act slim

1. Engage in physical activity regularly.
2. Find some activity you really like to do and do a little each day. Exercise helps you lose weight faster and maintain your loss more easily. Exercise also has a calming effect, helping relax your muscles. You help yourself move and breathe more easily by exercising regularly.

Consult your physician if you have questions about your weight.

Do You Feel Weak?

If your condition has made you less active than before, your muscles may be getting smaller and weaker. To rebuild your muscles, you need vitamins and minerals from fruits, vegetables and grains. You also need extra protein.

The following foods can help meet your protein needs. Each item listed contains approximately 15 grams of protein. In order to get the daily recommended amount of protein (60-75 gms.), you need to eat 4-5 of the following items:

• 3 medium eggs (limit to once a week)
• 2 oz. natural cheese (Swiss, cheddar, etc.)
• 1/2 cup cottage cheese
• 2 cups milk or yogurt
• 4 tablespoons peanut butter or 1/2 cup peanuts
• 1 cup cooked beans (lentils, chickpeas, etc.)
• 3/4 cup cooked soybeans
• 2 cakes bean curd (tofu)
• 1/2 cup sunflower seeds

Weakness may also result from diuretics or water pills that cause the body to lose potassium. Other diuretics, however, keep your body from losing potassium. Check with your doctor. He may suggest that you need to add more potassium-rich foods to your diet.

Foods that are high in potassium include:

• Milk
• Oranges
• Orange juice
• Dried fruits
• Bananas
• Fresh pineapple
• Beef
• Legumes
• Potatoes

Consult your physician if you feel weak.

Are You Confined To Your Bed?

Conditions producing prolonged immobility can create problems. However, with adequate care, difficulty can be avoided.

Elimination
Constipation becomes a problem following prolonged immobility. Careful attention to the following simple measures is important:

Fluids: Drink 6-8 glasses per day. Include juices such as cranberry juice. Check with your physician.

Diet: Eat high fiber foods such as fresh fruits and vegetables and whole grain breads and cereals.

Laxatives: Prune juice with a little lemon juice to improve its flavor aids in elimination.

Kidney stones
Prolonged immobility may cause calcium depletion from the bones. There are many factors that affect the proper balance between calcium and calcium depletion. Normally, weight bearing and muscle use help maintain this balance. However, during prolonged immobility, calcium depletion increases. Certain exercises can prevent calcium removal from bones. Ask your physician what exercises he/she recommends.

Since kidneys are the main route of calcium excretion, the depletion of calcium from bones may cause formation of calcium stones in the urinary tract.

To help avoid stone formation, a low calcium diet of about 400mg. daily is recommended. This low level is achieved mainly by the removal of milk and dairy products from the diet.

Consult your physician if you have any questions.

How Can You Shake The Salt Habit?

Your doctor may have suggested that you restrict your salt or sodium intake. Salt refers to sodium chloride (NaCl). When it comes to your health, the real concern is with the sodium (Na) part of salt.

Your lung condition may have put a strain on your heart. Eating excessive salt may cause your body to retain extra water and therefore increase your blood volume. Your heart then has to work harder, and your breathing may become more difficult. Too much salt may also cause leg and ankle swelling.

Here are some tips on how to enjoy eating the low-sodium way:

1. Begin by not using salt at the table. Then, slowly decrease the use of salt in cooking. You’ll get used to the taste.
2. Use onions, garlic and peppers in place of salt. The uses of herbs and spices are limitless—from allspice to thyme.
3. If you’re uneasy about experimenting with low salt cooking, pick up a low-salt cookbook.
4. Use fresh meats and frozen vegetables. If you depend on processed foods, buy the low sodium or low salt versions.
5. Switch to lower sodium snacks like unsalted popcorn and nuts, yogurt, fruits, or crisp raw vegetables.
6. Read food labels and avoid or use sparingly products that have the word salt, sodium, Na, or soda in the first three ingredients listed.
7. Unless prescribed by your doctor, try to stay away from salt substitutes or “light” salts. Potassium has been substituted and there may be a danger of potassium overload in some people.

Sources of sodium or salt that you should limit or avoid:

• Salted or smoked meats such as ham, bologna, salt pork, bacon, sausage, corned beef, cold cuts or hot dogs.
• Food prepared in brine such as sauerkraut, pickles or olives.
• Condiments like soy sauce, steak sauce, garlic salt, onion salt, lemon pepper catsup, prepared mustard or MSG (monosodium glutamate).
• Snacks like salted popcorn, nuts, pretzels and potato chips.
• Processed foods such as prepared soups, canned vegetables, or cheeses.
• Beverages such as vegetable juices, club soda and beer.

Consult your physician if you have any questions or before making changes in your diet.

Do You Drink Enough Liquids?

Drinking sufficient amounts of liquids helps keep your mucus thin and therefore easier to cough up. When mucus does not accumulate, your breathing is easier. Also, the chances of having infections are lessened. You should drink 6-8 glasses of fluid a day unless you have a medical condition in which liquids should be restricted.

What to drink

• Water is our most vital nutrient and yet is often neglected. Use it as a beverage and in soups.
• Fruit juices, while not necessarily low in calories, provide essential vitamins and minerals.
• Decaffeinated coffee and decaffeinated tea will spare you most of the adverse effects of caffeine.
• Milk is a good drink, and contains most nutrients except iron and Vitamin C. Contrary to popular belief, it does not thicken saliva or cause mucus formation.

What not to drink

• Drinks containing alcohol are high in calories and have limited nutritional value. Too much alcohol may slow down your breathing and may inhibit your ability to cough up mucus.
• Soft drinks have no nutritional value and should not be used to increase your fluid intake, especially if you have a medical condition which requires you to restrict your calories.
• “Fruit-flavored drinks” are really sugared water with very little fruit juice in them. These sweetened drinks are not the best way to quench your thirst. The sugar actually increases the body’s need for water. Fruits, though juicy, contribute insignificant amounts to your total fluid intake.

Consult your physician if you have any questions or before making changes in your diet.

 

Do You Need A Multivitamin or Mineral Supplement?

Vitamins are organic substances from living matter—plants and animals. They are required in the diet in such tiny amounts that all the needed vitamins together add up to about an eighth of a teaspoon a day. If you regularly eat a variety of fresh and not overly processed foods, you do not need a multivitamin or mineral supplement.

Unfortunately, you probably don’t eat this way, so you may benefit from a low-potency, well-balanced multiple vitamin and mineral supplement, especially if you:

• habitually follow a poorly balanced diet.
• eat out often.
• depend on highly processed convenience foods.
• eat high fat and high sugar snacks which displace nutritious foods.
• omit meals regularly.
• frequently consume fewer than 1500 calories per day.
• have or are recovering from an illness, anemia, or an injury.
• take medicines daily (e.g., certain antibiotics, anticonvulsants, diabetes drugs).
• smoke heavily.
• have a lot of stress.
• are pregnant or take oral contraceptives.
• consume alcoholic beverages excessively.

If you want to know how much you need, compare your supplement with the Recommended Daily Dietary Allowance table at the end of this document.

Purchasing bottles of individual vitamins or minerals is not a smart idea. This practice is costly and there is also the danger of overdosing. This is especially applicable with Vitamins A, D, and C and minerals like iron, zinc, and copper. Use only low-potency, well-balanced multiple supplements and take no more than one daily.

You may have heard that “natural” supplements are better than so-called synthetic ones. There is no difference. The only natural vitamins are found in foods.

Supplements are most effective when taken with meals since food helps their absorption and use in the body. Also, smaller doses are absorbed more effectively than one large dose. Therefore, a supplement with the daily dose broken down into two or three tablets is the most effective–if you can remember to take them.

Finally, supplements can never take the place of a healthy diet of fresh, unrefined and not overly processed foods.

Consult your physician if you have any questions about supplements.

Are You Getting Enough Fiber?

Fiber is the portion of vegetables, fruits, grains and beans which passes through the digestive tract into the large intestine almost without being digested. Once in the large intestine, about half of the fiber is fermented by intestinal bacteria.

What fiber can do for you

Bowel function
Fiber is able to absorb many times its weight in water and increase the bulk of stool. Diets higher in fiber are used to treat and prevent hemorrhoids and diverticulosis. Fiber acts like a sponge in the large intestine, drawing water into feces, making the stool larger and softer to pass. However, patients with bowel disorders should not start a high-fiber diet without first consulting their physician.

Weight control
Fiber itself has few, if any, calories. Many fibrous foods, especially fruits and vegetables, are themselves lower in calories. It also takes a long time to chew most of the fibrous foods. This slows down the process of eating, allowing time for signals of “fullness” to reach the brain before you have overeaten.

Heart disease
Some types of dietary fiber have the ability to lower cholesterol levels in the blood. It is not yet known, however, whether this in turn will reduce the risk of heart disease.

Diabetes
Another recently demonstrated benefit of dietary fiber is its effect on blood sugar levels and insulin requirements. Fiber seems to slow the absorption of carbohydrates, and some carbohydrates may actually pass through the digestive tract unabsorbed.

You know that you are getting enough fiber by using your built-in feedback mechanism: your stool. Large, soft stools are the result of a high fiber diet. Small, hard stools result from a diet low in fiber.

Foods that are high in fiber include:

• whole grain breads and cereals—bran, whole wheat, rye or pumpernickel
• fresh fruits
• fresh vegetables and salads
• legumes: chick peas, lentils, dried beans, peas, etc.

Consult your physician if you have any questions.