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Exercise and Nutrition: Ways to a Healthier PH Lifestyle

August 12, 2008, Online Q&A Chat

We discussed a variety of issues regarding exercise, nutrition and PAH.

Chat Transcript

Moderator
PHA Medical Services Associate Robyn Duarte

Panelists
Michael Mathier, MD
Sidnie Hess, RRT AE-C

ModeratorRobynDuarte (Aug 12, 2008 11:58:39 AM)
Good Afternoon, I would like to give a warm welcome to everyone that has joined us to participate in the “Exercise and Nutrition: Ways to a Healthier PH Lifestyle” online question and answer chat. The purpose of this chat is to discuss a variety of issues regarding exercise, nutrition and PH.

ModeratorRobynDuarte (Aug 12, 2008 11:58:57 AM)
My name is Robyn Duarte and I am a Medical Services Program Associate with PHA. I primarily support the work of the PH Resource Network, a membership section for nurses, nurse practitioners, respiratory therapists, pharmacists and other allied health professionals. I will be your moderator for this chat, which means I will pass your questions on to our expert panelists.

ModeratorRobynDuarte (Aug 12, 2008 11:59:10 AM)
I would like to take a moment to introduce our speakers today, Dr. Michael Mathier, the Director of the Pulmonary Hypertension Program at the University of Pittsburgh Medical Center in Pennsylvania and Sidnie Hess, the Senior Pulmonary Rehabilitation Therapist in the Pulmonary Rehabilitation Program at the INOVA Fairfax Hospital in Virginia.

Speaker/MichaelMathier (Aug 12, 2008 11:59:44 AM)
I'm happy to be here and look forward to a lively discussion. Please feel free to ask any questions you may have.

Speaker/SidnieHess (Aug 12, 2008 12:00:44 PM)
Hello I appreciate this opportunity to visit with you

Ralf (Aug 12, 2008 12:00:59 PM)
Hello from Germany

Merle (Aug 12, 2008 12:01:14 PM)
Hello Everyone, sorry to be late

PHAWebmasterDiane (Aug 12, 2008 12:01:14 PM)
Hello everyone! This is PHA's webmaster Diane. Welcome!

jas (Aug 12, 2008 12:01:14 PM)
hi diane

MrsH (Aug 12, 2008 12:02:28 PM)
Hi Diane! Thanks for fixing the chat page.

Merle (Aug 12, 2008 12:03:11 PM)
Hi Diane

ModeratorRobynDuarte (Aug 12, 2008 12:04:44 PM)
Let us go ahead and begin the chat. Please feel free to ask any questions you may have about nutrition and/or exercise.

ModeratorRobynDuarte (Aug 12, 2008 12:06:37 PM)
Pre-chat question from Lori – I am on Coumadin 5mg, I will be starting a cardiac rehab program for Pulmonary hypertension. What vitamins should I take? Answer - A general multivitamin (along with a good, balanced diet) is probably all that is needed for optimal nutrition.

Speaker/MichaelMathier (Aug 12, 2008 12:07:47 PM)
Let's talk about pulmonary rehab programs. Are any of you who are on the chat enrolled in such a program? How do you find it?

MrsH (Aug 12, 2008 12:07:52 PM)
I am in a rehab program, since March of last year, and I feel better. Except today. But isn't that how things work?

JeannieTX (Aug 12, 2008 12:07:59 PM)
hi... I’m Jeannie from Texas... and I did the Pulmonary Rehab routine ... eight weeks about two years ago... it helped... a lot

Merle (Aug 12, 2008 12:08:06 PM)
I also had pulmonary rehab about 2 years ago and found it a great benefit

Speaker/MichaelMathier
(Aug 12, 2008 12:08:24 PM)
Jeannie, have you continued to exercise?

JeannieTX (Aug 12, 2008 12:10:03 PM)
hmmm... sometimes... but not like I should.

Speaker/MichaelMathier (Aug 12, 2008 12:10:10 PM)
Jeannie, that's one of the benefits of rehab: it keeps your nose to the grindstone.

JeannieTX (Aug 12, 2008 12:10:39 PM)
but I also no longer beat myself up for it... I’m 64 and I figure I’m gonna die no matter what... so now I do what I wanna do... most of the time...

Speaker/MichaelMathier (Aug 12, 2008 12:11:02 PM)
Sounds like you guys are ahead of the science on this one. We've seen studies recently showing that rehab is safe and effective so we hope it will be more widely used.

ModeratorRobynDuarte (Aug 12, 2008 12:11:07 PM)
Pre-chat question from Lori – How accurate are echocardiograms for detecting Pulmonary hypertension? I have had five, and all five have had different results. Answer - Echocardiograms are well known to have potential inaccuracies. This is one of the reasons that a right heart catheterization is essential for establishing a diagnosis of PH. The echo has other value, however, including giving important information about heart size and function.

kim (Aug 12, 2008 12:12:20 PM)
HELLO, MY NAME IS KIM. I AM NEWLY DIAGNOSED WITH PH. MY PULMONOLOGIST WOULD LIKE FOR ME TO LOSE WEIGHT QUICKLY-POSSIBLE GASTRIC BYPASS..MY INSURANCE DOES NOT COVER THE SURGERY. ANY SUGGESTIONS..

Speaker/MichaelMathier (Aug 12, 2008 12:12:38 PM)
Kim, we have had one of our patients with PH go through bariatric surgery with a good result but this must be done VERY carefully. Not sure how to navigate the insurance issue but I would ask your doc to try to help with an appeal letter.

MrsH (Aug 12, 2008 12:13:29 PM)
Yes, I have lost over 50 lbs since my diagnosis, part of that is rehab and part is the simple ability to be active again, after years of misdiagnosis.

Speaker/MichaelMathier (Aug 12, 2008 12:13:56 PM)
Again, that's great MrsH. An increase in activity is always a good sign.

Ralf (Aug 12, 2008 12:12:20 PM)
I can tell, that weight loss helps a lot. OK, it's no cure but I improved a lot after losing 32kg (65lbs?)

Speaker/MichaelMathier (Aug 12, 2008 12:12:56 PM)
that's great Ralf. I think moving toward and maintaining a healthier weight is always a good thing. Keep up the good work!

kim (Aug 12, 2008 12:14:05 PM)
RALF, HOW DID YOU LOSE YOUR WEIGHT? KIM

Ralf (Aug 12, 2008 12:14:05 PM)
lol, when I got my PAH diagnosis in 1996, our daughter was just 8 weeks old.

Ralf (Aug 12, 2008 12:14:27 PM)
I stayed at home to care for her and have been eating only light breakfast and baby food from glasses, she left over

Speaker/MichaelMathier (Aug 12, 2008 12:14:32 PM)
Answer to Tammycub's question- That's a common problem. It may be that your overall activity is lower because of the PH so you're not burning enough calories to lose weight. It could also be your food choices, so a consult with a nutritionist may be of benefit.

ModeratorRobynDuarte (Aug 12, 2008 12:14:37 PM)
Pre-chat question from Lori – How long should it take to lose a significant amount of weight? How many pounds per week? Answer - This should be individualized and discussed with your physician. In general, slow, steady weight reduction is considered best, no more than one or two pounds per week. Occasionally more rapid weight loss, when accomplished under the supervision of a physician, can be safe.

MrsH (Aug 12, 2008 12:14:57 PM)
When exercising, if I constantly get chest pain at exertion, should I continue to wear the O2 even if my saturations are in the mid-90s? Or is there a danger of oxidents with a lot of oxygen?

Speaker/SidnieHess (Aug 12, 2008 12:14:57 PM)
I know there are studies about oxidents when saturations are in the high 90's. However you are symptomatic with the chest pain, so I would not want you to not use your oxygen. you should discuss this with your doctor. it may be you need to warm up better or do more moderate exercise

ModeratorRobynDuarte (Aug 12, 2008 12:16:07 PM)
Pre-chat question from Lori – How much exercise should a person do having PH? Answer - There is no set answer to this...different patients will have different exercise tolerance. In general, consistent, low intensity exercise is best. This means daily (or at least 4-5 times per week) exercise that is not so intensive as to cause undo shortness of breath, chest pain or lightheadedness. The duration should be according to the patient's ability (and a slow increase in duration is a good goal). Entry in a rehab program can provide a patient a firm idea of what exercise they can perform.

kim (Aug 12, 2008 12:20:30 PM)
MY DOCTOR SID MINE IS MODERATE AND SAID I'D PROBABLY LIVE ONLY 5 YEARS SO THERE IS ACTUALLY HOPE...I'VE BASICALLY SAT DOWN IN THE RECLINER AND HAD A PITY PARTY..KIM

Speaker/MichaelMathier (Aug 12, 2008 12:22:05 PM)
Kim, no pity parties! Or at least only short ones. In this day and age many patients with even advanced disease do well for long periods. If you are not being cared for at a specialty center I might talk to your doc about considering a referral.

Colleen (Aug 12, 2008 12:24:36 PM)
Kim, I've been living with PH for 32 years, and most of that time there were no treatments. There are many now, and more down the pipeline. Keep your chin up and find a specialist who will treat you!

Speaker/MichaelMathier (Aug 12, 2008 12:25:03 PM)
Thanks for the encouraging words, Colleen!

Ralf (Aug 12, 2008 12:26:15 PM)
I've been active all 12 years (OK, I am lucky that I have been able)

Ralf (Aug 12, 2008 12:26:21 PM)
despite "severe iPAH"

jas (Aug 12, 2008 12:27:54 PM)
I tried snow skiing this winter

Ralf (Aug 12, 2008 12:28:16 PM)
which altitude Jas?

jas (Aug 12, 2008 12:28:44 PM)
I’m not sure

Speaker/MichaelMathier (Aug 12, 2008 12:29:04 PM)
Were you a skier before your diagnosis Jas?

jas (Aug 12, 2008 12:31:31 PM)
so I thought well I want to give it a try dx 7 years ago but hadn’t skiied in about 20

Ralf (Aug 12, 2008 12:31:56 PM)
I would like, but avoid higher altitude consequently, except short flights of >3h

Ralf (Aug 12, 2008 12:32:34 PM)
<3h

Ralf (Aug 12, 2008 12:32:41 PM)
I used to go skiing in the Alpes up to 3000m or 10.000ft, but since diagnosis I have never been higher than 600m

Speaker/MichaelMathier (Aug 12, 2008 12:32:50 PM)
I think it's smart to be cautious about altitude. I have had a few patients go to 7-8K feet and do well, but PLEASE talk to your docs first as this can be a problem.

jas (Aug 12, 2008 12:33:37 PM)
I find if I try to exercise my heart rate goes up quickly and is very fast , is that ok to continue to keep going

Speaker/SidnieHess (Aug 12, 2008 12:33:47 PM)
It would be important for you to know what your resting heart rate is and what your target rate is, it can be calculated by taking 220 minus your age and multiply it by .70-.75. You could also ask your doctor what a good heart rate range is for you

Merle (Aug 12, 2008 12:34:57 PM)
How would you know if you are getting too much oxygen

Speaker/SidnieHess (Aug 12, 2008 12:34:57 PM)
Your doctor prescribes oxygen based on your oxygen saturations and or a blood gas. They will also do a six minute walk test to see what your saturations are during exercise. you qualify for oxygen if your saturations are 88% or below. A normal oxygen saturation is 92-100 depending on altitude

jas (Aug 12, 2008 12:35:52 PM)
I had an oxygen altitude simulation test a month ago

Merle (Aug 12, 2008 12:36:04 PM)
I'm on 4 L and some days I feel like I need more -- some days less. Humidity is very hard on me

masonh (Aug 12, 2008 12:36:55 PM)
what is the lowest amount you want to be with your oxygen saturation while exercising?

Speaker/SidnieHess (Aug 12, 2008 12:36:55 PM)
At 88% we place our patients on oxygen,

Ralf (Aug 12, 2008 12:37:54 PM)
88% at rest or exercise? over the day or just time to time below that ?

Speaker/SidnieHess (Aug 12, 2008 12:37:59 PM)
any time your oxygen saturations are 88% or below you are putting your heart, brain , kidneys under stress. over time it makes your heart work harder and can cause right heart failure, that is why we encourage all of our patients to wear their oxygen as prescribed

masonh (Aug 12, 2008 12:38:57 PM)
I had a problem with my old doctor getting him to prescribe oxygen, with sats in the low 80's. Now my new doc has put me on it with any activity and I usually feel much better

MrsH (Aug 12, 2008 12:39:32 PM)
Is it ever unsafe to do mild exercise in six-minute-bits, not unlike our six minute walks?

Speaker/MichaelMathier (Aug 12, 2008 12:39:49 PM)
sure, that's a great strategy...rest in between can be very beneficial.

karen (Aug 12, 2008 12:40:00 PM)
how about swimming as exercise?

Speaker/MichaelMathier (Aug 12, 2008 12:40:18 PM)
Great, so long as it's not too intensive (causing excessive shortness of breath or other symptoms)

kim (Aug 12, 2008 12:40:49 PM)
I ALSO HAVE A HISTORY OF ATRIAL FIBRILLATION SO GENERALLY DON'T GET MY HEART RATE UP VERY HIGH DUE TO THIS.. I LOVE SWIMMING BUT DON'T HAVE MUCH ENDURANCE. I FIND THAT I CAN TREAD WATER AND SWIM ALITTLE...THANK YOU ALL FOR YOUE ENCOURAGEMENT..KIM

Speaker/MichaelMathier (Aug 12, 2008 12:41:09 PM)
keep up the good work, kim

karen (Aug 12, 2008 12:41:11 PM)
should oxygen be turned up when swimming?

Speaker/SidnieHess (Aug 12, 2008 12:42:11 PM)
Kim what has your doctor prescribed for exercise for you? Try and swim at a moderate level, perhaps similar to a walk were your saturations are in a good range. I have not tried to check someone’s saturations in the pool

JeannieTX (Aug 12, 2008 12:42:46 PM)
I have left heart diastolic dysfunction. my doctors don't seem all that concerned... my oxygen levels stay around 88 most of the time ... with any activity they drop. the PH specialist said she cannot help me. should I try another ph specialist?

Speaker/MichaelMathier (Aug 12, 2008 12:42:53 PM)
It's a challenging situation. We are just learning about the combination of diastolic dysfunction and PH. A second opinion is often valuable so I would encourage one.

ModeratorRobynDuarte (Aug 12, 2008 12:43:17 PM)
Pre-chat question from Tami - I have PH and I am afraid to exercise. I am on supplemental oxygen, but I find that when I walk at an advanced pace or for any distance, I desaturate very quickly. Any suggestions? Answer – Starting a safe exercise program in a supervised setting like pulmonary rehab helps to alleviate fear because they can help assure adequate oxygenation with different activities over a 6-12 week period. You should also discuss your oxygen prescription with your doctor. Know what your liter flow should be with activity, at rest, and with sleep. A six minute walk test will help your doctor determine this. You could also ask your doctor if a device called a pulse oximeter which measures your oxygen saturation is right for you.

kim (Aug 12, 2008 12:43:30 PM)
HOW EXPENSIVE ARE PULSE OXIMETERS AND DO YOU NEED AN ORDER FOR ONE?KIM

Speaker/MichaelMathier (Aug 12, 2008 12:43:35 PM)
several hundred dollars, though you can look on line and may get a better deal (be careful if there's no warranty). A prescription can be of help with some payers. If you have scleroderma an oximeter may not work well.

MrsH (Aug 12, 2008 12:43:57 PM)
Kim, you can get them for less than $150 US on E-bay.

Merle (Aug 12, 2008 12:44:25 PM)
I just received one today -- it cost $60... a pulse ox

JeannieTX (Aug 12, 2008 12:44:35 PM)
kim: my family doctor actually had some free ones once... from an oxygen supplier...

JeannieTX (Aug 12, 2008 12:44:42 PM)
you might ask?

PHAWebmasterDiane (Aug 12, 2008 12:44:45 PM)
where'd you get your pulse ox Merle?

MrsH (Aug 12, 2008 12:44:52 PM)
... and I have checked my PulseOx against Sidnie's and it works just fine.

Ralf (Aug 12, 2008 12:44:57 PM)
have a look at eBay

kim (Aug 12, 2008 12:45:04 PM)
MERLE, WHERE DID YOU GET YOURS?KIM

JeannieTX (Aug 12, 2008 12:45:53 PM)
kim: also... if the insurance company doesn't wanna pay for a pulse ox, try going to the doctor's office every day to have a check... perhaps they'd quickly see it would be cheaper for them to buy one for you!

Merle (Aug 12, 2008 12:45:58 PM)
hmm let me look it up it located in TX

Ralf (Aug 12, 2008 12:46:01 PM)
thank you

Merle (Aug 12, 2008 12:46:42 PM)
Portablenebs.com or 1 888 255-2509 prices range from $58 to $200 they have other items as well

kim (Aug 12, 2008 12:46:59 PM)
THANK YOU MERLE..KIM

Ralf (Aug 12, 2008 12:47:22 PM)
Would a lower heart rate be less stressful for the heart than a higher? Let’s say 60-100 with diltiazem compared to 75 to 115 with norvasc in my case. I tried both. Wonder, if the higher pulse would be more stress for the heart

Speaker/MichaelMathier (Aug 12, 2008 12:47:30 PM)
There's no clear answer to that. I wouldn't think that a modest difference like that would make a big difference. If it was 120 vs. 70 that's another story.

Speaker/MichaelMathier (Aug 12, 2008 12:47:56 PM)
One thing we haven't talked about is exercise to be avoided. PLEASE avoid heavy lifting (anything that makes you strain) or high intensity exercise!

Colleen (Aug 12, 2008 12:48:55 PM)
I can't even imagine doing high intensity! I walk on my treadmill for at least 6 minutes, more if I am able.

Speaker/MichaelMathier (Aug 12, 2008 12:49:25 PM)
Then that's right for you. You'd be surprised how some people try to take on more than they can manage.

Ralf (Aug 12, 2008 12:49:37 PM)
In my 12 years, I made 1 exception to the above rule. In 2005 we had some restoration works around the hose..I got worse, within 3 months.

Ralf (Aug 12, 2008 12:49:40 PM)
Never again, such an experiment.

jas (Aug 12, 2008 12:50:10 PM)
I tried badminton once , and only once just too much

Merle (Aug 12, 2008 12:50:38 PM)
Yes, we have those days when we feel a little better and try to do more than we should.... pay back comes too quickly

Ralf (Aug 12, 2008 12:50:46 PM)
Jas, yes same here.

Speaker/MichaelMathier (Aug 12, 2008 12:50:48 PM)
good example of a high intensity sport best avoided. You can always just knock the birdie around, though. Just can't compete in the Olympics!

JeannieTX (Aug 12, 2008 12:51:24 PM)
I just gave my treadmill away... per my orthopedic doctor. but I was surprised I never seemed to gain more tolerance... at my best I only walked about six minutes at a time... and tried to do 30 or so minutes total each day. now I use the recumb. cycle to do the same... and never seem to progress much past the 10 minute range

MrsH (Aug 12, 2008 12:51:41 PM)
Speaking of Olympics, what about the Lung Games?

jas (Aug 12, 2008 12:51:54 PM)
actually it was not intense

Ralf (Aug 12, 2008 12:51:57 PM)
suggestion: Sailing. I was on a sail trip in Turkey. The week after I was to PH check and my doc asked me, what I have changes, my heart shrunk first time ever.

Speaker/MichaelMathier
(Aug 12, 2008 12:52:01 PM)
Don't get discouraged. Even if you don't progress you're doing your cardiovascular system good.

Merle (Aug 12, 2008 12:52:01 PM)
My PH doc would only allow me to do an exercise program at my local hospital where I could be wired up and monitored...

Speaker/MichaelMathier (Aug 12, 2008 12:52:07 PM)
Merle, I think that's the safest way to start. Then once it's proved to be safe maybe you can continue in another setting.

Merle (Aug 12, 2008 12:52:09 PM)
well, my family bought me a treadmill for Christmas... it's doable

Speaker/MichaelMathier (Aug 12, 2008 12:52:16 PM)
just make sure you are given the go ahead by your doc first

Colleen (Aug 12, 2008 12:52:24 PM)
Are pulmonary rehab programs knowledgeable about people whose o2 sats are very low while exercising? That is one worry I have if I start a rehab program, since my sats are alot lower than most people during exercise. I don't want to scare any therapists!!

Speaker/SidnieHess (Aug 12, 2008 12:52:24 PM)
I cannot speak for all pulmonary rehab programs, but I can tell you that we work with PH patients and other restrictive lung disease patients that have normal saturations at rest but drop quickly with exercise. We will give our patients what ever devise and liter flow that is necessary. Your rehab should do an initial evaluation and six minute walk test and they should work closely with your doctor

masonh (Aug 12, 2008 12:52:38 PM)
my nose gets very stuff with oxygen, even with a humidifier.. What do you do if you aren’t getting the same amount of 02 as you would with a clear nose?

Speaker/MichaelMathier (Aug 12, 2008 12:52:45 PM)
It's usually from dryness. You can use ocean spray saline spray or another. If it persists talk to your doc about other treatments.

Cherie (Aug 12, 2008 12:52:50 PM)
The area I live in has had a lot of wild fires this last year on top of the normal poor air quality that we have. Does air quality affect PHer's?

Speaker/SidnieHess (Aug 12, 2008 12:52:50 PM)
Yes Cherie you will notice on those code orange and red days that you have a more difficult time breathing. We recommend that you exercise indoors on those days

jas (Aug 12, 2008 12:53:05 PM)
I find when it’s cold out I can’t go out for walks

Speaker/MichaelMathier (Aug 12, 2008 12:53:10 PM)
yes, cold, hot, humidity can all be difficult Ralf

jas (Aug 12, 2008 12:53:25 PM)
I do drop a little below 88 at times but I recover very quickly

Merle (Aug 12, 2008 12:53:31 PM)
yes, he said as long as it is set at a level -- and if I get "a little sob" I am to stop

JeannieTX (Aug 12, 2008 12:53:41 PM)
gee Ralf... you just described Texas!

Speaker/MichaelMathier (Aug 12, 2008 12:53:47 PM)
sounds right Merle

jas (Aug 12, 2008 12:53:50 PM)
I’ve really never had my 02 sat tested with exercise , just with a six minute walk in my house on flat surface , should I have this done with different form of exercise

Speaker/SidnieHess (Aug 12, 2008 12:53:50 PM)
Jas has your doctor done a six minute walk test with you at his or her office?

jas (Aug 12, 2008 12:53:55 PM)
no just my o2 company when they come to check my concentrator I use for overnight

Ralf (Aug 12, 2008 12:54:00 PM)
I often thought in winter, that an air heart would be very nice in winter

jas (Aug 12, 2008 12:54:04 PM)
I do drop a little below 88 at times but I recover very quickly

Ralf (Aug 12, 2008 12:54:08 PM)
for inhaled air..

JeannieTX (Aug 12, 2008 12:54:21 PM)
what is an "air heart"

Ralf (Aug 12, 2008 12:53:27 PM)
something to be invented - lol

Ralf (Aug 12, 2008 12:53:34 PM)
sorry typing error : ai heater

masonh (Aug 12, 2008 12:53:43 PM)
they say I might have Raynauds, and my o2 sats can be false. Is there anything I should watch for to be safe?

Speaker/MichaelMathier (Aug 12, 2008 12:53:52 PM)
I would check with your doc's office about whether a pulse ox works on you. Of course, with Raynaud's it varies according to how much vessel constriction you have. The oximeter can be placed on the ear or forehead and usually still get good readings.

Desert.Puffer (Aug 12, 2008 12:54:05 PM)
I get symptomatic doing just about anything, can't go out now due to the heat. What type of exercise can I do besides reclining the chair that will be low impact?

Speaker/SidnieHess (Aug 12, 2008 12:54:05 PM)
We often tell our patients that walking is so important because it is so functional when you lose your ability to walk you lose your independence, we suggest mall walking with a flat grade, you could also push a cart to make it easier and get a pedometer to make it more fun to challenge yourself

Ralf (Aug 12, 2008 12:54:06 PM)
I use a pedometer, it motivates

Merle (Aug 12, 2008 12:54:08 PM)
My PH doc says -- If you don't -- you won't....

jas (Aug 12, 2008 12:54:15 PM)
what should I do if my BP goes up while exercise , stop

Speaker/SidnieHess (Aug 12, 2008 12:54:25 PM)
You should talk to your doctor and come up with some guidelines, for example your systolic should not go above more than 20 from your baseline. Your diastolic or bottom number should remain about the same

JeannieTX (Aug 12, 2008 12:54:26 PM)
before I bought the treadmill... several years ago... I lived in a very small town and it is way too hot most of the year in Texas for me to really 'walk' outdoors... we had one small grocery store in the town and I would go there and just 'play like' I was mall walking... lol... at first I’m sure they wondered why this lady was walking circles around their store every morning... lol... they soon got to know me...

Desert.Puffer (Aug 12, 2008 12:54:33 PM)
How can Pulmonary Rehab work with us PHers, PH is from narrowing and constricting of the arteries and vessels of the lungs. How can pulmonary rehab help with that? That’s pushing it, I can see maybe Cardiac Rehab but now Pulmonary

Speaker/SidnieHess (Aug 12, 2008 12:54:33 PM)
In our pulmonary rehab program we work closely with you and your doctor to provide disease specific safe symptom limited exercise so that you can receive all the benefits from a safe exercise program

Merle (Aug 12, 2008 12:54:38 PM)
I have a very difficult problem with salt -- foods with salt -- I am also limited with my fluid intake -- cannot eat luncheon meat -- no biggie BUT I cannot eat pizza and other "normal" foods

Speaker/MichaelMathier
(Aug 12, 2008 12:54:52 PM)
A real dilemma...but I bet you know the price you pay if you take in too much: fluid retention and feeling bad. Try to limit the high salt foods, but I usually tell patients to allow a little indulgence once in a while. If there's something you really love, have a little as a treat. But be careful not to overdo. Also, over time, most people lose their taste for heavily salted foods.

Speaker/MichaelMathier (Aug 12, 2008 12:54:03 PM)
Jeannie, most stores, malls etc. like walkers. They know they're providing a useful service and also that it brings in business!

JenC (Aug 12, 2008 12:54:06 PM)
lose taste of salt?? I actually crave salt...probably just knowing I cannot eat a lot of it..LOL

Merle (Aug 12, 2008 12:54:07 PM)
I've lost the taste for salt but once I bought chicken and didn't realize it was injected with that solution -- I was sick for 3 days trying to get rid of all that fluid build up -- I order my food

kim (Aug 12, 2008 12:54:14 PM)
IS THERE A REASON TO LIMIT SOFT DRINKS WITH PFH?KIM

Speaker/SidnieHess (Aug 12, 2008 12:54:17 PM)
Yes, soft drinks have alot of empty calories if they are not diet sodas, if they are both have a great deal of sodium

Speaker/MichaelMathier (Aug 12, 2008 12:54:23 PM)
like so many things we all have different preferences where it concerns saltiness. Patients with more advanced PH often crave salt because of abnormal chemical signals in their bodies. So you're not crazy JenC.

JenC (Aug 12, 2008 12:54:37 PM)
Thx, glad I am not Crazy...hope all is reading that one..LOL

kim (Aug 12, 2008 12:54:44 PM)
HOW MUCH SODIUM SHOULD WE HAVE A DAY?KIM

Speaker/MichaelMathier (Aug 12, 2008 12:54:53 PM)
The FDA recommends 2,400 mg per day for all people and we recommend 2,000 mg per day for patients with PH or CHF

JeannieTX (Aug 12, 2008 12:54:57 PM)
okay... j en... we have it IN WRITING!

JeannieTX (Aug 12, 2008 12:55:02 PM)
from an expert!

JenC (Aug 12, 2008 12:55:03 PM)
I know Jeannie..Listen to the EXPERT you all..LOL

jas (Aug 12, 2008 12:55:11 PM)
I crave salt alot

jas (Aug 12, 2008 12:55:30 PM)
sweets I don’t care

Speaker/MichaelMathier (Aug 12, 2008 12:55:54 PM)
Right, Jas...because your body isn't sending out signals to make you crave them

Ralf (Aug 12, 2008 12:56:57 PM)
since Revatio, my craving went away from chocolate and sweets, towards sour (good side effect)

JenC (Aug 12, 2008 12:56:58 PM)
Ralf I hear that alot..I still want chocolate but crave salt as well with Revatio...

jas (Aug 12, 2008 12:56:59 PM)
I quit buying lays chips , just once in a blue moon now

kim (Aug 12, 2008 12:57:03 PM)
I LOVE SWEETS AND COULD SPEND MY DAY -IN BETWEEN NAPS-IN THE KITCHEN BAKING DELICIOUS DESSERTS..THIS IS PART OF MY PROBLEM WITH DIETING.KIM

JeannieTX (Aug 12, 2008 12:57:06 PM)
is it true that eating ice cream causes fat to freeze... then melt away while one sleeps?

Speaker/MichaelMathier (Aug 12, 2008 12:57:10 PM)
wish is was, but alas, no

Merle (Aug 12, 2008 12:57:33 PM)
I must admit I do crave salt and I do cheat once in a while but only when I have that urge -- when it's snuck in I pay the price

JenC (Aug 12, 2008 12:57:37 PM)
lol Jeannie I hope so..

Speaker/MichaelMathier (Aug 12, 2008 12:57:43 PM)
OK, folks, I'm going to have to go do some work. This has been fun. Keep supporting each other!

JeannieTX (Aug 12, 2008 12:57:43 PM)
okay... well... does spinach dip count as a vegetable?

Ralf (Aug 12, 2008 12:57:47 PM)
if it is just frozen water..

JenC (Aug 12, 2008 12:58:15 PM)
sure Jeannie...

ModeratorRobynDuarte (Aug 12, 2008 12:58:49 PM)
Unfortunately, our time has ended. Thank you all for your excellent questions. I would also like to thank our speakers Dr. Michael Mathier and Sidnie Hess, for sharing their time and expertise with us. If you would like to learn more about nutrition and exercise or access the transcript from today’s chat, please visit http://www.phassociation.org/Classroom/#exercise. Please join us for our next question and answer chat “Emergency 101: How to Prepare Yourself and Others for PH Emergencies” on August 26, 3-4 pm ET. You can find more information about this chat at http://www.phassociation.org/Classroom/#emergencies. This session will be a follow-up to the Medically Led Session Dr. Levine led at Conference. Those that missed this session will be able to learn about situations when pulmonary hypertension becomes an emergency, either because of progression of the underlying disease, because of some superimposed complication, like a blood clot or pneumonia, or because of a complication of a medication or the delivery

masonh (Aug 12, 2008 12:59:10 PM)
thanks for coming Dr. Mathier

JenC (Aug 12, 2008 12:59:13 PM)
Thx Expert.

jas (Aug 12, 2008 12:59:18 PM)
thanks micheal

Merle (Aug 12, 2008 12:59:22 PM)
Thank you so much and I'll see you Saturday...

Colleen (Aug 12, 2008 12:59:25 PM)
Thank you for coming! This was greatly appreciated :)

Speaker/MichaelMathier (Aug 12, 2008 12:59:28 PM)
My pleasure guys!

MrsH (Aug 12, 2008 12:59:36 PM)
BYE SID

Ralf (Aug 12, 2008 12:59:39 PM)
thanks to Dr. Mathier and Mrs. Hess

Desert.Puffer (Aug 12, 2008 12:59:44 PM)
Thx PHA for setting this up

JeannieTX (Aug 12, 2008 12:59:46 PM)
thanks to all of you

JeannieTX (Aug 12, 2008 12:59:51 PM)
fun to chat with you

jas (Aug 12, 2008 12:59:57 PM)
and thank-you Sidnie

PHAWebmasterDiane (Aug 12, 2008 1:00:06 PM)
Thank you everyone!

MrsH (Aug 12, 2008 1:00:22 PM)
Bye, Diane

Colleen (Aug 12, 2008 1:00:24 PM)
Thank you, Diane!!

jas (Aug 12, 2008 1:00:29 PM)
thanks diane

Speaker/SidnieHess (Aug 12, 2008 1:00:38 PM)
Thanks for all of your wonderful questions, contact your local pulmonary rehab program and start exercising

ChatMaster (Aug 12, 2008 1:02:02 PM)
This officially ends the chat. Good-bye! 

>>If you liked this chat, you may enjoy our recording on Eating Better

Kelly Scheller, RD, LD

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