I am a man of 73 and a life-​long asth­matic. After a spell in hos­pital with pneu­mo­nia, I find climb­ing stairs dif­fi­cult because of breath­less­ness and wasted muscles. I also get slight angina if I over-​exert myself. Is it safe to increase my heart rate? I do not want to waste time and effort try­ing to achieve the impossible.

There’s no doubt, if you give up on exer­cise, your phys­ical con­di­tion will con­tinue to worsen and you will find every­day activ­it­ies becom­ing ever harder.

But your com­bin­a­tion of con­di­tions make it a real chal­lenge for you to win back fit­ness and strength. You’ll need great determ­in­a­tion, but I can assure you that if you are dili­gent and care­ful about how you exer­cise, the bene­fits will make the effort worth­while.

I strongly advise you to get some expert super­vi­sion to help you get star­ted safely. The asthma and angina both require you to set and mon­itor your exer­cise level pre­cisely, which really needs an expert on hand.

Ask your GP about “exer­cise refer­ral” schemes. Any of the fol­low­ing spe­cial­ist schemes would be suit­able:

• car­diac rehab­il­it­a­tion group
• COPD (breath­ing prob­lems) class
• GP refer­ral /​exer­cise on pre­scrip­tion scheme

If your GP doesn’t know, try call­ing your local NHS primary care trust or the council’s leis­ure depart­ment to find out whether such classes run loc­ally. Sometimes they are hos­pital based, in other areas they run at coun­cil leis­ure centres or gyms.

If there are no suit­able spe­cial schemes, con­sider hir­ing a per­sonal trainer for a couple of months. The Register of Exercise Professionals has a dir­ect­ory that you can search for a local trainer: be sure to look for one who has a GP Referral or Cardiac Rehab qual­i­fic­a­tion.

For you, the main bene­fits of exer­cise will be to help get the best effi­ciency out of your lungs and hope­fully reduce your angina symp­toms. You should also be able to strengthen those wasted muscles and keep your joints from stiff­en­ing up. Be aware that you may well feel more exhausted at first, until your body adapts to the exer­cise, but within a couple of months you should be noti­cing some improve­ments.

Here’s a few more self-​help sug­ges­tions:

• Do daily breath­ing exer­cises, such as pursed-​lip and dia­phrag­matic breath­ing, to help strengthen your lungs
• Walk every day. Even if you can only man­age a few minutes, do this, per­haps three times a day with good rests in between. Do not push your­self so hard that your angina pain comes on. Keep a diary, not­ing how long you walked for each time. Aim for 30 seconds or a minute longer the next day, so you build up very gradu­ally. Always carry your asthma and angina reliever sprays
• Make a big effort to relax every day. Anxiety and stress add to breath­ing prob­lems
• If your asthma will tol­er­ate the atmo­sphere, reg­u­lar walk­ing in chest-​level water at the swim­ming pool is a great all-​round exer­cise. Again, check first with the GP.