WORKING OUT WHEN SUFFERING FROM PH?

Monitored excercise can support having an overall better status

My PH-specialist has been nagging me about losing some weight for the past months.

I know that she's right about it and it's essential especially when it comes to a possible lung transplant. Luckily I'm not neccessarily needing one right now. My overall status is pretty good and the figures currently show a low risk. Nevertheless, I'm far away from a TX BMI of 30.

That's why my physician kept encouraging me to seek assistance with the obesity outpatient's department. I wasn't impressed. I guess she kept mentioning it everytime I was a the hospital for getting a refill for my implanted infusion pump.

Then, one of the male doctors did the refill as my usual physian was on holiday. He did mention the obesity department as well and I felt really fed up and while watching him putting on the sterile disposable scrub, I noticed his chubby belly and thought „He's giving advice to others to lose some weight when he could lose some weight himself“. As if he read my thoughts, when he removed the disposable scrub after the refill was done, he caressed his tummy and said „Yeah, I know … I should better lose some weight myself!“

Oh my god … I felt so awful. I mean, I didn't say it out loud but still. Even thinking about it made me feel guilty.

So this was the incident which made me realise I should go for it. This doctor had so much empathy, it wasn't just giving advice but he admitted that it wasn't easy and I believed him that he meant it in a good way.

I was really impressed with him and therefore thought I would prove I could do it.

That was back in October 2018. I started nutrition advice and also received a prescription for physio therapy in form of minorly lifting weights.

Losing weight is working out okay. I haven't lost too much, it's just that you change your eating habits and keep monitoring WHAT you eat. Keeping up an eating diary helps loads as you stop eating all the junk inbetween or at least keep minimising them.

I've lost around 4,5 kgs since late October and my PH-physician was thrilled to bits about this achievement when she did the refill for my infusion pump around a week ago. I use to joke that my goal is, to lose 1 kg every 4 weeks, so I can kind of brag to her when I go for the refill next time.

Anyway … but this blog shouldn't be about losing weight in the first place but about working out when suffering from Pulmonary Hypertension.

As I mentioned, I have special physio therapy twice a week also at the Universitätsklinikum Hamburg-Eppendorf UKE where I'm under medical treatment at.

This special lung sport programme was set up by the chief physician of the PH department and with one of the physio therapists.

It works wonders for me and I really enjoy it! Over all, I'm sure it supports me massively in losing some weight and a nice side effect is also, that I have less body ache since starting to work out. It's probably just the sheer fact, that I use more muscles and keep them from degenerating.

Many people will probably argue that it can be very dangerous doing sports when suffering from such a severe disease like PH is. It sure is. But you also need to do some exercise to keep fit.

So instead of overdoing it, this programme is really light activity & weights. The bottom line is to watch your saturation and pulse throughout exercising. As we all know, saturation shouldn't go anywhere below 90 %. The important thing about the pulse/heartrate is, that it shouldn't rise higher than 120 bmp. Furthermore it is essential that you keep doing PLB / pursed lip breathing while exercising, trying to breathe normal and regularly. If you start rapid heavy breathing while pushing weights, the resistances are too high.

With this blog I will try to explain what I'm doing when working out and what the differences to a normal gym are.

Healthy people often lift higher weights or work out with higher resistance, while doing few repeats.

The difference with my programme is, that I lift minor weights & resistance while doing more repeats. That means two sets with 25 repeats each at every gym machine with a minute of relaxation inbetween before you start with the second set.

Before I start it's essential to warm up by cycling on the ergometer for around 10 minutes at 25 watts. Then I'm doing my round at the physio gym by using the following machines:

• Leg Extension Machine
• Crunch
• Leg Press
• Adductor & Abductor
• Pec Deck (butterfly)
• Chest Rowing Machine
• Pulldown Dip (I usually skip that, due to the catheter of my implanted infusion pump)

There is always a physio therapist there to assist me or checking on me and my health status or asking how I'm feeling. I am monitored!

When I started this programme, I started with a resistance of around 25 – 50 newton depending on the machine I was working out.
10 newton are around 0,981 grams which means, 25 newton are approx. 2,5 kgs. I will round it up.

Many people probably start laughing when they read that I „lift weights“ of only 2,5 kgs. It's the repeats and the breathing which are important.

I have also realized, that exercises at thorax level, for example the pec deck are more exhausting than doing the leg extension machine. Working out with the legs is overall less tiring.

At the moment, I'm exercising with around 125 newtons (which are rounded up 12,5 kgs) at most machines except for the pec deck, where I only do 75 newtons. The leg press is also an exception, I manage to push 300 newton here, as you usually have loads more power in your legs than in the rest of your body without feeling worn out.

I will add some video for you to see, maybe it inspires you to start your very own training as well.

The most important thing is that you discuss all this with you PH specialist BEFORE you start doing anything. Ask her or him, whether you can do sports and which sort of sports and maybe which maximum restistance or other things you need to pay attention to.
I guess the reason that I am allowed to do it or even able to do it, that my current overall status is pretty good.

Leg Extension Machine:

 

And here is how the monitor of this machine looks like. Other machine's monitors look similar.

It shows the resistance in newton you are working out with as well as the current repeat you are at from a total of 25.
The blue bar is showing you the speed in which you should exercise. The white bar shows your speed and it would be best, if they move in syn. They ARE usually in syn, but when filming this, I was distracted and didn't watch the monitor for a while.

Crunch:

Leg Press:

Adductor & Abductor:

Pec Deck (Butterfly):

Chest Rowing Machine:

Wishing everyone of you loads of energy and motivation to start doing it and sticking to it.
Maybe it helps you feeling better as well.

It helped me loads. My next check up with heart ultra sound is at the beginning of march, maybe it will then also show a positive result of my training?!