Posted on March 12, 2018
March 11-17 is National Pulmonary Rehabilitation Month
Sponsored by the American Association of Cardiovascular and Pulmonary Rehabilitation, Pulmonary Rehabilitation Week is designed to help the nation understand how important pulmonary rehabilitation programs are to the health and well-being of lung disease patients. This week is also a chance to honor healthcare professionals, specifically respiratory therapists (RTs), who guide and support the rehabilitation of patients all over the country.
This year’s theme, “Improving Life, One Breath at a Time,” honors individuals who struggle to overcome shortness of breath and the pulmonary professionals who work every day to alleviate that struggle and improve patients’ everyday life.
Lung Disease and Rehabilitation
Lung disease refers to any disease or disorder where the lungs no longer function properly. It is the third leading killer in the U.S., responsible for one in seven deaths. Some lung diseases, like asthma and emphysema, involve a narrowing or blockage of the airways resulting in poor air flow. Others, including pulmonary fibrosis, pneumonia and lung cancer, are caused by a loss of elasticity in the lungs that produces a decrease in the total volume of air that the lungs are able to hold.
As you can see, lung disease comes in many forms and pulmonary rehabilitation (PR) is designed for those who experience issues such as:
- Chronic Obstructive Pulmonary Disease (COPD);
- Chronic bronchitis;
- Pulmonary hypertension;
- Pulmonary Fibrosis;
- Interstitial lung disease;
- Lung cancer and lung cancer surgery; and
- Lung volume reduction surgery before and after lung transplantation.
PR involves a long-term commitment from the patient and a team of health care providers and can include exercise classes and education about lung disease, diet, exercise, stress management, breathing techniques, medications, and oxygen therapy. PR can improve a patient’s ability to function and quality of life. The program may also help relieve breathing problems. Even with advanced lung disease, patients can benefit from the program.
Who Needs PR?
Your doctor may recommend PR if you have an ongoing lung disease or if you have a condition that makes it hard for you to breathe and limits your activities. For example, you may benefit from PR if you have:
- Chronic obstructive pulmonary disease (COPD). COPD includes emphysema and chronic bronchitis. Symptoms include coughing (either a dry cough or a cough that expels phlegm or mucus), wheezing, shortness of breath, and chest tightness.
- An interstitial lung disease. This type of disease causes scarring of the lung tissue over time and can lead to coughing and shortness of breath. Examples of interstitial lung diseases include sarcoidosis and idiopathic pulmonary fibrosis.
- Cystic fibrosis (CF). CF is an inherited disease that causes thick, sticky mucus to collect in the lungs and block the airways. It can cause coughing and frequent respiratory infections.
Your doctor also may recommend PR before and after lung surgery to help you prepare for and recover from the surgery. For example, people who have surgery for lung cancer or COPD may benefit from PR. It can also help people with muscle-wasting disorders that may affect the muscles used for breathing, such as muscular dystrophy.
PR works best when started at a time the disease is in a moderate stage. However, even those with advanced lung disease can benefit.
A Three-Step Process
At the start of PR, your medical team will want to learn more about your health. The National Heart, Lung, and Blood Institute offers a pretty detailed explanation of the entire process. You’ll most likely have lung function tests to check your breathing and to measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. You may also be given a test to see how far you can walk in a given time period. Or, you might be asked to walk on a treadmill while your oxygen levels, blood pressure, and heart rate are measured.
Doctors might also review all medicines or therapies, such as the use of inhaled bronchodilators. Questions may include inquiries into your weight and height, food intake, and general nutrition. A blood test may be given to assess the loss of muscle mass. All the data collected will help create a plan tailored to your specific needs.
Once treatment begins, programs may include:
Exercise training: Doctors will design the best plan to improve endurance and muscle strength, so you’re better able to carry out daily activities. The regimen will likely include exercises for both your arms and legs. You might use a treadmill, stationary bike, or weights to do your exercises. If you can’t handle long exercise sessions, your plan may involve several short sessions with breaks in between.
Nutritional counseling: The data your PR team gathers when you start the program will show whether you’re overweight or underweight. Both can make it hard to breathe. If you’re overweight, the team may recommend a healthy eating plan to help you lose weight. If you’re underweight, the muscles used for breathing by be extremely week. The team may recommend a healthy eating plan to help you gain weight and possibly recommend supplements to help you avoid loss of muscle mass.
Education on your condition and how it can be managed: Part of PR involves learning about your condition, including situations that may worsen symptoms, such as breathing in cigarette smoke or air pollution. Learn how and when to take your medicines to achieve your best result. A self-management plan can be used to help you discover how to relieve uncomfortable symptoms on your own.
Energy-conserving techniques: One way to help prevent symptoms like shortness of breath is to find easier ways to perform daily tasks. PR programs can give you tips on how you can conserve energy and breathe easier; tips like ways to avoid reaching, lifting, and bending. Stress also can use up energy and make you short of breath. Many PR programs teach relaxation skills and ways to avoid or relieve stress.
Breathing strategies: While in PR, you’ll learn strategies to improve your breathing. For example, you may learn how to take longer, deeper, less frequent breaths. One example of this type of exercise is pursed-lip breathing. This method decreases how often you take breaths and keeps your airways open longer. This allows more air to flow in and out of your lungs so you can be more physically active.
Psychological counseling and/or group support: Those with chronic lung diseases are more prone to depression, anxiety, and other emotional problems. Because of this, many PR programs offer counseling or support groups. If your program doesn’t, your PR team can refer you to such services.
At the end of your program, you’ll undergo a few more tests and answer questions. Some of these tests, such as exercise tests, will be the same ones you had at the start of your program. The data gathered at the end of the program will show whether your symptoms, physical activity level, and quality of life have improved.
If you see little to no improvement, talk with your doctor—she might want to change your medical therapy. Or, she might recommend more tests that can show whether or not you have another condition inhibiting your breathing.
New Bern Internal Medicine Specialists is committed to developing long-term relationships with our patients. We provide high quality, compassionate, comprehensive, and personalized health care that will meet your changing health care needs. We encourage you to call our office to setup an appointment to meet with one of our providers at 252-633-5333. For additional information, visit www.cchchealthcare.com.
(Sources: American Association of Cardiovascular and Pulmonary Rehabilitation; American Association for Respiratory Care; National Institutes of Health; National Heart, Lung, and Blood Institute; MIJA Innovative Pressure Solutions; and Nebraska Methodist Health System.)