Among the many rehabilitation services offered at The Bond Wellness Center is Pulmonary Rehab, a program that includes a mixture of education and exercise. The program is currently led by Pulmonary Rehabilitation Specialist Essy Moverman and includes one other staff person.
Pulmonary Rehab begins with a physician’s referral to the rehab department, where Essy does her own evaluation. She’ll begin with an interview to determine how that patient’s condition has effected his or her life, what the patient can or can’t do, and the best course of action toward rehabilitation. “I try to get a sense of how much they know about their problem and an idea about their motivation because this is something we’ll do together,” she says.
The majority of people referred to her have chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. Another big group has asthma, while other conditions include restrictive lung disease and problems caused by occupational lung disease such as asbestosis. Lately she’s been seeing quite a number of people who’ve been referred through the hospital because they’ve had recurring pneumonias.
“When they’re referred to me, they have something that’s chronic, which means it can’t be cured, but that doesn’t mean they can’t improve,” Essy said.
After her assessment, she works out a plan that includes education and exercise. An asthma patient may need to better learn how to use the medicated inhalers that may improve his or her breathing. Someone may need to learn relaxation techniques to deal with the anxiety that comes from not being able to breath.
“There are lots and lots of techniques people can learn, and interventions we can use to make sure somebody’s functional status and quality of life are improved and that’s what it’s all about,” Essy said.
One thing that often comes up in her assessments is a revelation that the person may be suffering from sleep apnea, in addition to their chronic lung problem. They might not have realized their sleep problem or they considered it unimportant to mention to a doctor, Essy says, but it can be a contributing factor in many persons with lung conditions. Once they get proper treatment for that, they can improve dramatically.
With a multi-disciplinary approach in the rehab department, Essy can often determine that the participant may have other problems that need to be dealt with—uncontrolled diabetes or depression, for example—and she can make the proper referrals to other professionals who may help in those areas.
At the beginning of rehab, the participant will do a 6-minute walk test around the Wellness Center track, while Essy assesses their progress and measures heart rate, blood pressure and oxygen saturation afterwards. At the end of their rehab period, approximately 10 weeks, they are assessed again.
The exercise component of Pulmonary Rehab includes one and a half hours of work twice a week in the medical rehab gym. Essy says the group aspect of this is very important to participants. “I can tell them they’re doing great, but they might assume I’m just getting paid to say that,” she said. “When they hear it from their peers, and see that they are not alone in fighting their problems, it’s very helpful.”
She often sees improvements after a few weeks and dramatic changes in a person’s affect. They might begin wearing make-up or become more cheerful because they’ve discovered they now have more energy for what they want to do.
The important milestones she sees in rehab participants include many who are able to wean off oxygen. “That’s big,” she says. “They are released from the hospital with this tank and they feel their life has ended. Rehab can help many of them.”
Recently, one participant who had not been able to work for some time was able to return to work part-time. Another was able to return to driving. She had been afraid of losing her breath while shopping or out to lunch, but she had learned techniques to better deal with those episodes. Another returned to riding a bike outdoors on the bike paths.
“We just work constantly toward restoring that person back to their highest level of function,” Essy says.
The Pulmonary Rehab services also include tobacco cessation counseling on a one-on-one basis with Essy. Participants here have to be referred by a physician as well.
In this program, Essy will make sure she understands why the person smokes and what other issues might be present. “People smoke for very individual reasons. Everybody’s got their own story,” she said.
She does not make the person quit. Her process includes making sure they keep a diary of the times when they smoke and, quite often, that is revealing to the smoker. He or she hasn’t realized exactly how much they were smoking. That knowledge often helps them move toward being able to quit.
ShareThis
I look forward to started my rehab.