I gave up cigarettes two years ago after 25 years of smoking around 30-40 a day because my breathing was becoming badly affected. From being a moderately active man - I used to play golf a couple of times a week and swim - I found that I couldn't even walk up my stairs without feeling out of breath. Even talking was occasionally a problem for me. My doctor felt sure my lung function would improve when I stopped smoking, but two years on, my breathing is virtually unchanged. My quality of life is now very poor - at 66, I can't even take a walk with my family because I'm so slow and breathless. Friends have suggested that some gentle exercise may help, but I'm too frightened to try in case I can't catch my breath. Is there anything I can do to help myself or have I left things too late?
The consultant
Dr Richard Russell
When someone has had a heavy smoking habit like yours, there's a significant risk of chronic obstructive pulmonary disease (COPD). This is a smoking-related lung condition which leads to progressive shortness of breath and a decline in lung functioning. Though the damage to the lungs can't be reversed, it is possible to maximise muscle function and make optimum use of the breath you have.
Quitting cigarettes is essential, so you've made a good start. Some inhaled medications help achieve more exercise capacity and relieve breathlessness, and surgery is possible for those who have local areas of damaged lung tissue. A few patients are suitable for single lung transplantation. The most effective treatment is pulmonary rehabilitation - a coordinated programme of exercise, education, medication review and support.
Go to your GP, get a diagnosis, then ask to be put on to a pulmonary rehab programme. With the correct help you can significantly improve your health and quality of life.
· Dr Richard Russell is a consultant chest physician at Wrexham Park Hospital
The physiotherapist
Matt Todman
Rehab physiotherapy can help people in your position, but you need to get thoroughly checked out by your doctor first. As you are able to walk, albeit slowly, I'd suggest walking as your first mode of exercise. Start with, say, five minutes of normal walking, then walk for five minutes at a pace-and-a-half, then back down to five minutes' normal walking. Over a period of time, increase the pace, so you walk normally for four minutes, faster for six minutes, then back to four minutes again. Pyramid interval training like this builds your cardiovascular fitness and breathing control.
As you feel more confident try swimming - it helps retrain the breathing cycle as well as improving fitness.
Finally, many smokers have stiff backs, the result of years of not expanding their lungs properly. So practise your golf swing, even if it's just in the back garden. This will encourage some thoracic spine movement and overall flexibility and give you an incentive to get back on the golf course for real.
· Matt Todman is a consultant physiotherapist at Sports & Spinal Clinics
The ex-smoker
Huw Morgan
If anyone can give you hope, I can. I smoked 20 a day for 40 years, and gave up when I was 65 for the same reasons as you. My condition deteriorated for years - I'm now 73 - but in the past six months I've had a miraculous turnaround thanks to an NHS pulmonary rehab course. Before rehab, I was so frail I couldn't even clean my own teeth without stopping for breath, and I was waiting for a major lung operation. Now my op is on hold and I feel fantastic.
I understand how you feel about being too scared to exercise - it's terrifying to think you won't catch your next breath - but at the rehab course you're taught breathing techniques so that you don't panic. When you've mastered those, you'll feel confident enough to start exercising. My programme started gently - standing up and sitting down, and push-ups against the wall - but now I'm rowing, cycling and using strength machines. But it's vital to be positive and committed. The course is twice weekly, but you need to do at least another two sessions at home too. I exercise every day and, hand on heart, it's given me my life back.
