DEAR DR. DONOHUE: My wife’s mobility has been quite limited by her breathing difficulty from COPD – chronic obstructive pulmonary disease. Are there some measures you might suggest that could enable her to start very gradually on an exercise program to build some muscle strength, especially leg-muscle strength? – E.M.

ANSWER: Emphysema and chronic bronchitis are the two chronic obstructive pulmonary diseases. Most people with COPD have a touch of both illnesses. Emphysema is a destruction of the lung’s air sacs. Shortness of breath on slight activity is its hallmark symptom. Oxygen cannot get into the blood through damaged air sacs, so people are constantly short of breath. Chronic bronchitis is irritation of the airways, the bronchi. Cough with thick sputum is its major symptom.

Exercise isn’t easy for people with COPD, since they become breathless so quickly. Exercise is necessary for the very reason you state. COPD patients tend to sit most of the time. Their muscles become deconditioned, and that’s another impediment to these people being active.

Interval exercise usually can be tolerated. On a stationary bike, interval exercise means pedaling somewhat quickly for only 20 seconds and then slowing down for the next 40 seconds. Repeating these cycles as many times as possible builds muscle strength and helps COPD patients achieve mobility. The same kind of training can be done while walking or swimming.

Breathing through pursed lips helps a person with COPD. These people should inhale through the nose to a count of four then exhale through pursed lips to a count of six. Pursed lips are lips held like one would do when whistling.

While exercising, COPD patients should lean slightly forward at the waist to give the lungs more room to expand.

DEAR DR. DONOHUE: I strained my upper leg muscles. My coach calls it a groin pull. What exactly is that? How long do I have to stay out of play? I am a guard on our school’s football team. – R.R.

ANSWER: Groin injuries are the favorite diagnoses of TV and radio sportscasters. I wonder how they can make this diagnosis so far from the field and the injured athlete. The groin is the area where the thigh joins the lower abdomen.

A groin pull, a common football injury, is a strain of the adductor muscles, the upper thigh muscles that bring the legs together. Muscle fibers are stretched beyond their limit, and some have been torn. You can expect a full recovery in about two weeks. You shouldn’t play if the groin hurts, and if it’s not getting better, you should have the family doctor examine you to be sure the diagnosis is correct.

You’re too late for the first two days of treatment for this injury. It is icing the strained muscles for 15 minutes, three times a day, to keep swelling to a minimum. After that, heat to the injured muscles speeds healing. A towel soaked in hot water works well. Apply the heat for 15 minutes at a stretch, again for three times every day.

DEAR DR. DONOHUE: I have a touch of arthritis in my hands. It makes unscrewing jars very hard for me. Can you suggest an exercise that will build up my hand strength? – A.K.

ANSWER: You need a firm rubber ball, not one that’s rock-hard but one that you can push in. Hold the ball with one hand and squeeze it hard. Hold the squeeze for four seconds. Relax and take a short rest. Then repeat nine more squeezes, with a rest between each squeeze. Switch hands and repeat the exercise.

As you get stronger, do two or three sets of 10 squeezes with each hand. If a rubber ball becomes too easy for you, use a tennis ball. Tennis balls are hard to compress.

If these exercises hurt your hands, don’t do them.

DEAR DR. DONOHUE: I am a male, 5 feet 11 inches tall, slim and in my early 30s. After I take a fourth helping at meals, people at the table say I am going to have health problems. I am very active physically. I have never weighed more than 152 pounds. If I don’t eat like this, I lose weight. I make sure that two-thirds of my plate is vegetables, but the quantity is still plate after plate after plate. I have to eat like this, or my weight plummets. – H.F.

ANSWER: There must be a question in there somewhere, but I have missed it. If you’re worried about eating too much fat and plugging up your arteries, you have a legitimate concern. Saturated fat and trans fat are the kinds of fat you want to minimize. Saturated fats are the fats found in meats and the fats in dairy products. Go easy on your meat consumption and your use of whole-fat dairy products. Trans fats are the fats used in deep-fried, fast foods. Many fast-food chains have eliminated them. Patronize those places. Trans fats are also found in commercial baked goods and packaged snacks. Look on labels and avoid foods with much trans fats in them. These two kinds of fats are the ones that raise cholesterol and create artery blockages.

If you’re worried about the amount of food you eat, you don’t have a big worry. Your weight is not a problem. You must be very active or have a very high metabolic rate.

To put your mind at rest, have your total cholesterol, LDL cholesterol and HDL cholesterol checked.

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