Breathe easy – looking after your lungs

People with primary immunodeficiencies (PIDs) can be especially prone to respiratory infections such as sinusitis, bronchitis and pneumonia.

In some extreme cases, these infections can lead to unpleasant feelings of breathlessness, even after short bursts of activity. As a result, it can be tempting to take the easy option and give up trying to lead an active life when you are well and free from infections. Don’t! This in itself can pose problems: to your physical well-being, to your mood and to the way you feel about yourself. Isolating yourself and being confined to the home is not much fun for anyone.

Strange as it may seem, the solution lies not in stopping all exercise but in ensuring that you get enough exercise. Just a few simple exercises performed for a few minutes a day can make all the difference to your physical and mental well-being. Remember though, when you do have an acute infection it may not be wise to exercise.

Remember, the information on this page is intended only as a guide. Always consult your own doctor or physiotherapist before you start an exercise programme.

Important things to remember before you exercise

Here we list some things you should remember before you start exercising.

  • If you use a bronchodilator inhaler, use it 5 minutes before you begin exercising.
  • If you have a small amount of sputum, you may be able to clear it by doing this sequence of exercises for 5 or 10 minutes while you are sitting in a chair. However, if you develop an acute infection that causes an increase in sputum, you may need to do the exercises lying on a firm surface for about 10 minutes, first on one side and then on the other.
  • Always try and clear your chest every morning. A hot drink may help you if you wake feeling dry.
  • If you have a lot of sputum, clear your chest in the evenings as well, before going to bed. This may help you sleep.
  • If you have bronchiectasis, seek advice from your doctor and physiotherapist about what positions to use and how often during the day you should do physiotherapy.
  • Remember, if you have any questions about your chest condition, contact your doctor, immunology nurse or physiotherapist.

Get active again

"Exercise? You must be joking! I can't even run 10 yards without gasping for breath!"

Breathlessness is common in people with PIDs and is particularly disabling in cases of severe bronchiectasis (abnormal widening of one or more airways). Indeed, many people avoid trying to become breathless because it is an unpleasant feeling and they believe it is harmful. Unfortunately, this can lead to a vicious circle of inactivity as they tend to avoid taking exercise, which results in a loss of physical fitness, which in turn leads to worsening breathlessness on exertion, which results in... and so on.

In this way, people may progressively restrict their activities until they feel unable to work or even leave the house.

However, this does not have to be the case.

Almost anyone with a PID can benefit from an exercise programme, whether or not they have lung damage. Getting puffed easily does not necessarily mean that you should not take regular exercise. You may simply have become unfit.

Remember, the right sort of exercise does you no harm at all and can do you a great deal of good. Even when it causes breathlessness, exercising can:

  • increase the fitness of your muscles
  • reduce the fear of breathlessness
  • reduce the feeling of breathlessness
  • increase your ability to exercise
  • improve your well-being and self-confidence
  • break the vicious circle of inactivity.

However, if you experience any chest pain or severe breathlessness while exercising, stop immediately and consult your doctor before starting again.

Exercising to make you and your lungs fitter

"I have common variable immune deficiency. I am in my fifties and I did my first triathlon last year. Keeping fit has made a big difference to my health, and winter 2012 was the first winter since 1992 that I had not been ill."

Not everyone can aspire to such levels of fitness, but most of us can go part of the way.

The key to improving your fitness is to take the right sort of exercise for you and to follow an exercise programme. Keep it simple and start off slowly, then build it up.

Don’t forget you can exercise almost anywhere: around the house, in the street, on flat ground or using the staircase at home. If you are able to get out and about, you may be able to swim, go for bike rides, exercise in the gym or do aerobics.

Don’t go mad all at once though. Check with your doctor or physiotherapist first if you haven't done any of these for a long time.

You can design your own exercise programme to meet your needs and facilities. Just follow these simple guidelines.

  • Exercise regularly: ideally every day, although three times a week is better than nothing.
  • Don't be too ambitious at first! Build up your exercise programme gradually. This will prevent painful muscles, unnecessary breathlessness and loss of confidence.
  • Get someone to buddy with you. Having company while you exercise can be motivating.
  • Begin by exercising for a few minutes, enough to make you slightly breathless, but not enough to make you stop.
  • Gradually increase the distance you cover or the time you spend exercising as the days and weeks go by. Often, you can double the amount of exercise you take in just a few weeks.
  • Set yourself weekly targets and keep a record of your progress, so that you can see how you are getting on.
  • Take a positive attitude to life.

Your child and exercise

Useful exercises for young children include trampolining, skipping, star jumps and squat jumps. A child's exercise programme should always be enjoyable and safe, and should avoid excessive breathlessness.

"At the age of 14 I was selected for both the school hockey team and the local hockey team."

If you are the parent of a child with a PID, encourage your child to participate in PE and games at school where possible. However, make sure that the teacher or instructor is aware of your child's limitations.

Remember, the school has an obligation to be as inclusive as possible in all the activities it offers, and that includes making special arrangements as needed for your child’s inclusion in sport and sports days.

Joining a sports club is another possibility. Sharing an activity, such as going swimming together, is a good way to maintain the physical fitness of the whole family.

If you have severe chest problems

"I'm 50 and my consultant says that because I wasn't diagnosed for a long time, my lungs have been damaged. I can barely walk from one room to another, so all this talk of exercise is pointless!"

If there has been a delay in diagnosing a PID, your lungs may have been damaged through persistent and severe respiratory infections. In some cases the airways (bronchi) become distorted and produce large quantities of infected sputum. This condition is called bronchiectasis.

Two of the symptoms of both bronchiectasis and less severe lung damage are:

  • breathlessness
  • excessive sputum, often accompanied by coughing.

These symptoms can reduce your ability to exercise actively and you will need more specific exercises to relieve them. 

There are some simple exercises you can do to improve your breathing and clear sputum from your chest.

These include relaxed breathing control and deep breathing to improve your breathing, and exercises to clear sputum. 

This page has been reviewed by the Medical Advisory Panel, April 2013.