Let’s Talk About Knowing Your Boundaries
I do not have COPD. But, as a kid growing up in the 1970s and 80s, I had severe asthma. Once I was told my lung function was 35-50%. And that was on a good day. So, unfortunately, I had to learn from a very early age how to deal with breathlessness. I had to learn when to push myself versus knowing my boundaries. So, that's what sets us up nicely, I think, to have this discussion.
Better asthma medications
By the time I became a respiratory therapist, better asthma medicines were around. Plus there were asthma guidelines to help doctors better manage their asthmatics. So, while I thought I'd be taking care of lots of asthmatics, that never happened. But, I do get to take care of lots of people with COPD. I get to know many of them very well.
Most people with COPD aren’t diagnosed until after the age of 40. So, in a way, I had a “one-up” on them: I grew up with this disease. I was short of breath from birth almost. So, since I grew up with it, I saw no other way. So, I didn't have to adjust to life with breathlessness. I just grew up with it. It's just the way it was.
But, like many of my COPD patients, I learned by trial and error how to deal with breathlessness.
I learned how to set boundaries
I learned how to live my life despite feeling short of breath. Or, I learned how to live my life despite knowing that what I’m about to do might set off a severe asthma attack. And, by golly, did I have some horrible ones. Like, yeah! I know what it’s like. I could tell horror stories. Someday I might. Well, I actually have on my blog if you’re bored enough to read about, "My Long Agonizing Night With Asthma.”
For instance, my brothers wanted me to play in the basement. I know I’m allergic to the basement. I know it will set off an asthma attack. How do I know? Because the last ten times I played down there with them I ended up feeling horrible. So, I learned not to go down there by trial and error.
For instance, my brothers wanted me to go outside and play football. The air was cold on Thanksgiving day. It was freezing, actually. There was smoke billowing from the chimney. So, they wanted me to play football in this. I knew by trial and error what would happen if I did.
I learned I had to set some boundaries. I just knew there were some things I wasn’t going to be able to do.
I also learned I had to push myself
So, you end up sitting around a lot. You do this because you feel short of breath. You also do it because you are afraid you MIGHT get short of breath. So, you don’t do anything. Then your muscles get all flabby. Then you feel even more dyspneic when you exert yourself.
So, you learn that, along with setting boundaries, you also have to learn to push yourself. You have to stay active somehow.
And trust me when I say, as a severe asthmatic kid, this was no easy task. Today you feel good. Today you don’t feel breathless. Your brothers want you to play football. What do you do? Well, this was when I decided I was going to be the quarterback. I decided I wanted to be in control of the ball.
First, of course, I had to make sure the weather was warm enough. I had to make sure there wasn't smoke billowing from chimneys. This is stuff normal folks take for granted. But, when you have a lung disease, this stuff can set off flare-ups. So, you have to be careful this way.
Finding ways to pace myself
As the quarterback, I could pace myself. I could move in short bursts, rather than running a lot all at once. I could pace myself. I was in charge. I was in charge of the ball. I was also in charge of my asthma. I was also, to use a metaphor, the quarterback of my asthma.
My brothers were very good about this. They wanted to be quarterback too. Who wouldn’t? But, they knew if I was going to play, I had to be the quarterback. So, that’s what happened. I was so happy to be able to be one of the guys. It made me feel normal. And, believe me, that was a good feeling.
Was I any good. Probably not. But, I was good enough. And we all had fun. And I knew it was important to do this. I knew it was important to push myself.
Setting boundaries for success
I knew because I was told, that you had to exercise despite having a lung disease. You must exercise. It makes your heart and lungs stronger. The more you exercise, the less dyspnea you feel with exertion. It also makes you feel better about life. It increases your confidence. It increases your overall sense of well being. It makes you feel better in so many ways. So, if I knew about the benefits of exercising despite lung diseases.
So, you have to do it. You have to push yourself. Even if it means just going for a walk. Even if it means just walking around your house. Even if it means just walking to the bathroom. You must stay physically active in some way.
Yes, I'm just an asthmatic. But, I have experienced this breathlessness thing. I wish I didn't have those memories. I wish I didn't qualify to have this discussion with you. But, it is what it is. And here I am, so many years later, writing about what I learned.
I am one of the lucky ones
I am one of the lucky ones. In my lifetime, better medicines were invented. Sure, I'm stuck taking medicine every day (just like you, perhaps). But, for the most part, I have normal lung function on most days. It’s a miracle, of sorts.
But, I still have it. I still have to set boundaries. And I still have to push myself. There are definitely setbacks. Still, I imagine it’s a lot harder when you’re an adult when diagnosed with a lung disease. You've lived your life. You've developed habits. And now all of a sudden you have to learn about a new disease. You have to adjust to it. You have to change. And you have to develop your own boundaries. You have to learn how and when to push yourself.
So, what boundaries have you set for yourself? How do you know when to push yourself? Let us know in the comments below.
Do you have a COPD exacerbation tool kit?