DEAR DR. DONOHUE: I am a COPD patient and spend most of my time sitting and watching TV. I know this isn’t good for me, but I can’t do much else. When I am active, I get so short of breath that I feel like I am choking to death. Do you have any ideas about what I can do? – L.P.

ANSWER: COPD, chronic obstructive pulmonary disease (emphysema and chronic bronchitis) does make people sedentary for the exact reason you gave. However, exercise is quite necessary. Not being active weakens muscles in a short time, and weak muscles compound breathlessness and make COPD patients less and less able to get around. If there is a pulmonary rehabilitation program in your local hospital, enroll. If there isn’t one and your doctor agrees to an exercise program for you, begin one on your own. If you need oxygen during exercise, take it with you.

Start with walking. If you can walk only for a few minutes, that’s enough for a beginning. Breathing correctly will help you. Inhale through your nose and take two seconds to do so. The “one Mississippi, two Mississippi” count can be your way of clocking two seconds. Exhale through pursed lips. Take four seconds (a “four Mississippi” count) to blow the air out. Pursed lips keeps the airways open and lets you completely empty your lungs. Also bend a bit forward. Emphysematous lungs crowd the chest. Bending slightly forward gives them more room and gives you more air.

Repeat the walk a couple of times a day if you’re walking only a few minutes. Every couple of days, extend the duration of your walk. The goal is to walk for 30 minutes at least three times a week, more if you can.

Once you’ve become stronger and are breathing better, add to your program some light weightlifting for both your arms and your legs.

Faithfulness to an exercise regimen will give you energy you thought you would never again have.

DEAR DR. DONOHUE: When you do push-ups, where should your hands be? My dad says they should be under your shoulders. Is he right? – D.D.

ANSWER: Your dad is right, but there’s more to it. You can vary your hand position to work specific muscles. If you put your hands closer to each other, you work the triceps muscle more. The triceps is the muscle on the back of the upper arm. A wider-based push-up gives the chest muscles a greater workout.

For those not familiar with a push-up, it’s the exercise done lying on the floor on the stomach. The arms push the body upward to full extension of the elbows, and then the person lowers the body back to the starting position.

DEAR DR. DONOHUE: Does it hurt to drink ice water during exercise? I heard you shouldn’t drink it if you’re hot and sweating. It can cause cramps. – M.L.

ANSWER: The digestive tract doesn’t absorb iced drinks as quickly as it does cool or tepid ones. That’s the only negative I know for drinking such liquids. If you’re not in need of rapid hydration, then you can drink whatever you want, at whatever temperature pleases you.

DEAR DR. DONOHUE: I have an 11-year-old son who is interested in developing arm and leg strength to enhance his skills in soccer and basketball. I hesitate to take him to a gym, as it could be overwhelming. Is it possible to have a good program at home? Is 11 too young to start? – A.D.

ANSWER: Eleven is not too young to start, if an adult supervises the boy. It’s quite possible to have such a program at home. You can join him.

The first thing to do is to visit the local library for books on weight-training. If you want to purchase one, bookstores are filled with such books.

The boy should observe strict form in lifting the weights and should not try to lift heavy weights. He should choose a weight that he can lift 15 times consecutively and perform three sets of 15 lifts. When he can do so comfortably, then he can add a little more weight.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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