George (Smokey) Bondorff's greatest enemy is exertion.
If he does enough physical work to perspire, the 62-year-old retired construction worker may find himself gasping desperately, unable to satisfy his body's craving for air. Even making a bed too vigorously can be an exhausting, frightening experience, he said.
You would think that the last thing Bondorff, who suffers from emphysema, would ever want to see in his home would be an exercise video. But two months ago, he starred in one.
No Jane Fonda-esque acrobatics are on the tape, to be sure, but for those like Bondorff who are afflicted with chronic lung disease, the video may be valuable in helping them to increase their breathing efficiency at home. Produced for the Orange County chapter of the American Lung Assn., the video features a series of warm-up breathing techniques, simple exercises and a final "cool-down" period, all designed to help those suffering from emphysema, bronchitis and other chronic pulmonary diseases to breathe easier.
The video, "Armchair Conditioning for Better Breathing," is expected to be distributed through hospitals, clinics and lung association chapters nationwide within a month, said Diane Masseth-Jones, director of the Orange County chapter's adult patient education and services program.
Dr. Raymond J. Casciari, a pulmonary specialist and a vice president of the Orange County chapter, said the video is an extension of an idea that has only become fully accepted by the pulmonary medical community within the last nine years: that patients with chronic lung disease can greatly improve their breathing through rehabilitation and exercise.
"About nine years ago, nobody was doing pulmonary rehabilitation," Casciari said. "No one believed it would work. But it's been shown that the average improvement in exercise tolerance in patients after a rehabilitation program is 104%."
One of the most dramatic cases he observed involved "a lady who never went out of her house. She didn't believe she could even walk down to the corner. But after she went through a (rehabilitation) program, she was walking all over, getting out all the time. After a while, we began to get post cards from her from all over the world."
Still, said Casciari, in any pulmonary rehabilitation program, "you're asking people to change their life styles, and that's hard for some of them to do."
Mild Tasks Leave Them Gasping
The 30-minute video is designed to ease that process by allowing patients to perform their own rehabilitation exercises at home, sitting in their own chairs, said Jo Sokolo, a registered nurse, pulmonary clinical specialist and volunteer with the lung association. For people with chronic lung disease, she said, even mild physical tasks can severely tax their pulmonary system and leave them gasping and starved for oxygen.
With an improper exercise program, Sokolo said, "it's possible to wind up in someone's emergency room. With the video, we keep you out of trouble and help you to exercise safely. The tape helps the patient to control his or her life, and it helps them achieve that at home."
And, said Bob Wilson, a pulmonary nurse at St. Joseph Hospital in Orange, the video gives patients who are learning breathing techniques "motivation to continue on, a little extra push."
Uses 'Pursed Lip' Technique
Common to each exercise on the tape is the "pursed lip" breathing technique, performed by inhaling through the nose and exhaling through tightly rounded lips, as if blowing through a straw.
"Combined with exercises, (the timed breathing) is the same sort of thing Jane Fonda or weightlifters do," said Wilson. "The major difference is these exercises are paced in order to conserve energy."
The exercises on the tape, led by a therapist and followed by three pulmonary patients, are performed while sitting in a chair. Movements are slow, easy and controlled. Perhaps the most strenuous of them involves lifting small food cans as if they were dumbbells.
Loosens Chest, Neck Muscles
"Even though you may think it looks terribly slow, it's just the sort of thing these people need," said Joan Nehls, a respiratory therapist at Hoag Memorial Hospital Presbyterian in Newport Beach. "For instance, the chest and neck muscles of someone with chronic lung disease can get very tense because of the work they're doing to . . . breathe. The exercises help loosen them up."
The video, which the lung association's Masseth-Jones said will sell for $25, ends with what she called "guided imagery," soothing directions from the therapist designed to relax muscles, narrated over images of placid outdoor scenes. John Meermans, 76, of Balboa, who lost a lung to cancer, said the video is helpful in overcoming the fear of lack of air.
"It's frightening to run out of oxygen, real frightening," he said. "It's like you've got a bag over your head, cinched up tight."