A TGB READER STORY: Sow’s Ear Guacamole
A TGB EXTRA: Happy Halloween

Conserving Energy in Old Age

As you know, earlier this year I was diagnosed with COPD in addition to the cancer I have been living with for more than two years. For now, the cancer seems to just sit there slowly growing and doesn't get in my way day to day.

COPD, however, affects all my life when I'm not sitting or lying down. To not lose my breath, I walk slowly now - indoors and out - and when I forget, I pay for it, heaving to get my breath back as I grab for the rescue inhaler.

In old age, being short of breath might happen to anyone even if you're not a former cigarette smoker. A long time ago I read somewhere that after age 20 or so, people lose about one percent of their lung capacity each year, and when I asked one of my physicians about that, he told me that's basically correct.

So an occupational therapist has been added to my list of medical providers. It's her job to help me make the most of my life by showing me how to do everyday things that have become more difficult with impaired breathing.

At my first visit, she gave me a two-page list of instructions on how to conserve the limited supply of energy I now have, and I was surprised at how much of this I already do, have always done.

Things like avoiding unnecessary steps, mixing up heavy with light physical tasks, sliding objects instead of lifting them. Even the obvious things on the list are useful as reminders and I do them now because I must rather than, as before, because I can be monumentally lazy.

The section of the instructions that was mostly new to me and therefore most valuable was on stress management. I had noticed that when I'm running late or trying to control my anger (nay, rage) at the difficulties in sorting out my Medicare Part D options, I lose my breath even while I'm sitting still.

Stress, it turns out, causes shortness of breath. You may know that but I didn't.

Here are the instructions for stress management that appear to be simple, even obvious, but things I need to relearn in this new context. Maybe they are helpful to you too.

⏺ Set realistic goals
⏺ Live in the present, not the past or future
⏺ Think about what you can do, instead of what you cannot do
⏺ Accept what cannot be changed
⏺ Practice good posture and breathing techniques
⏺ Eat nutritious food
⏺ Learn from your successes AND your mistakes
⏺ Listen to your body
⏺ Save time and energy for fun
⏺ Ask questions; take control of your illness; don't let it control you

The instructions also cover Scheduling, Pacing, Simplifying, Organizing in addition to Stress Management. They are from the Physical and Occupational Therapy department at Oregon Health and Science University. Click below to download it.

Download the Energy Conservation instruction page


COPD has got to be scary! I didn't know non-smokers could get it nor did I know that stress could effect our breathing. I used to have to use an inhaler when I lived with a smoker and thought that was all behind me. But from what you're sharing here, I'm guessing now that might not be true.

Thank you for sharing this information with us. Many good ideas there as I continue to be the caregiver for my husband.


Thank you for providing the useful information that is not found elsewhere. Sharing your current journey is a template for the rest of us.

I don’t need this now, but I may in the future. Is there some way to access your archive by doing a word search? I had a very difficult time finding your articles on taking psilocybin, which I wanted to share with a friend.
And will we be able to access your blog in the far future? So many helpful ideas that may become more relevant as we advance in age. I wish this was in a book I could keep on my shelf and refer to as needed!
All the best to you.

It’s good to know that having a history of being “monumentally lazy” has actually stood you in good stead! Decisions like NOT running for that bus but waiting for the next one is in fact a wise decision not a sign of laziness after all.
I’m personally glad to learn this! x

Ronni - your readers might appreciate a reminder that every state has a Medicare insurance counseling and information service. It has different names in each state. In California it is the HICAP (Health Insurance Counseling and Advocacy Program). The local Area Agency on Aging can provide people with its name and local contact information. Our local HICAP (I just learned this a few weeks ago) will let you email them your list of prescription drugs and it will email you back a list of the three best Part D plans for your situation. I am definitely going to do that even though my situation is fairly simple!

Thank you for writing about COPD. Although it is the 3rd leading cause of death, it has the least funded research of any of the major diseases. Many believe that discrepancy is because of the shame attached to COPD and the notion that you caused your own problems by smoking. I have had COPD for several years and now have less than 30% lung function, which puts me in the most serious category of Stage 4.

At age 79, I have already lived several years past my "shelf life." I can't tell you how many times people have ask me "were you a smoker?", implying that I brought the whole disease on myself. People don't ask "were you overweight?" to folks who contract diabetes, or "are you a Type A personality" to those who have heart attacks. I have read that medical personnel treat people dying of lung cancer more compassionately than people dying from COPD.

Nevertheless, I persist. Reducing my own stress is essential for me to be able to continue living. Here are some things that help:

Let yourself off the hook: When accepting an invitation for a future event, always let them know that you may not make it because of a sudden worsening of your condition. Tell that to yourself, too. You may have to last minute cancel, as I have, airline tickets, symphony tickets, etc., and console yourself with Netflix.

Ignore the uninformed impatience of others, they know not what they do. COPD is invisible on the outside, especially for those of us who are not helped by adding oxygen. That means ignore the disapproval of people in the parking lot who can't fathom why you have a disabled sticker for your car, people who are behind you on the stairs, even impatient family members who have not quite accepted your limitations.

Find ways to help other people. Bring water bottles to the homeless, sponsor a child's education in Tibet, volunteer in places where you can just sit.

Keep your chin up. For me that means letting go of the guilt, facing the reality of my condition, and persisting in what I can do. Sounds like Old Age, 101, eh?

The stress management list is a great reminder for all of us. Thank you. I had an occasional cigarette in my twenties but was never a real smoker. But I was exposed to second-hand smoke from birth to age 17 as my father was a pack-a-day smoker. I sometimes wonder what that portends.

Thank you for this good information. I had no idea of the rate of lung capacity decline in adulthood. That means that at nearly 70, I've probably, just by living this long, lost a significant amount despite never having been a smoker (although like others here I grew up in a household with a parent who smoked like the proverbial chimney).

I wasn't surprised about the stress connection. It seems as though almost everything is adversely affected by that. Whenever I get stressed out, I can feel that my breathing becomes more shallow and difficult -- hence the popular advice, "Just breathe!" I do not have COPD, but I intend to take a closer look at your list and try to be more proactive to keep it at bay.

A great list Ronni, thank you. I have COPD and asthma and all three of my younger sisters are experiencing signs of the same thing. Both our parents smoked. We all lived in big cities much of our lives. I am on anti-anxiety meds for stress for my COPD. I laughed when MD prescribed it but I went ahead and now I'm surprised that I feel more comfortable. I will share my list with my sisters. It is immensely stressing to run out of air, we are literally suffocating, plus we don't think well during an occurrence because it deprives our brain of oxygen.

I'm pretty sure that if our condo board were more transparent, AND when the US elects a good and decent president and Senate and House, my ability to breathe well will increase. For the former, I doubt ever. For the latter, we must try.

AND if you notice this -- and I can't post the link -- the new New Yorker (11.4 issue - "A Critic at Large" by Arthur Krystal) has a great column on aging -- much of what we've discussed here and with even more resources. It made me cry -- I'm in the Zeke Emanuel column of not wanting to live to 75.. not like this.

I'm grateful I live in a place that has compassion in dying.

Useful info. I'm an introvert. I conserve my energy because I'm easily drained by people, places and things.

I saw Ranulph Fiennes speak at the Chicago Humanities Festival years ago for the theme "Work & Play". He said he never took anyone to the arctic who was older than 39 because the lungs change at that age.

Great article and comments as always. I do have a minor tip on saving energy: I use my rolling office-type chair to move stuff around inside the house; I'm lucky enough to have one with a large enough seat that it can hold a pretty decent amount of boxes or whatever.

This discussion leads me to think of the fires that are now raging through Southern and Northern California. We don't hear as much about air problems as we do about evacuations and destruction of homes . However , there are untold numbers with asthma and COPD who are fighting for every breath they take. Let us hope that relief comes to all soon.

Hmmm, my doctor keeps telling me to move MORE, not less ... because I have bad bones, not bad lungs. But I hear you about stress. After I retired my stress levels went way down, and my back felt much better. In any case, your advice about stress can help out all of us.

The most important thing I learned about stress management is don't sweat the small stuff. If you burned the toast, scrape it off and keep eating.

Verify your Comment

Previewing your Comment

This is only a preview. Your comment has not yet been posted.

Your comment could not be posted. Error type:
Your comment has been posted. Post another comment

The letters and numbers you entered did not match the image. Please try again.

As a final step before posting your comment, enter the letters and numbers you see in the image below. This prevents automated programs from posting comments.

Having trouble reading this image? View an alternate.


Post a comment

Your Information

(Name and email address are required. Email address will not be displayed with the comment.)