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Site Admin Joined: 21 Dec 2002 Posts: 214 Location: WA

(As published on the original Huff n Puff website, written by Mike, the original site administrator.)

The Pulmonary Rehab Connection

What is pulmonary rehab? What does one do at a pulmonary rehab? How long does it last? Who should attend a pulmonary rehab? Is it helpful for someone with IPF? These are some of the questions people have about pulmonary rehab. Let's take them one at a time to give you some idea of the whole picture.

What is Pulmonary Rehab?

Pulmonary rehab is a medically supervised program designed to help people with lung disease cope with their illness and live the best quality of life they possibly can. It may be offered through a hospital or be in a free standing clinic. Pulmonary rehab can be staffed by respiratory therapists, physical therapists or registered nurses. Many pulmonary rehabs offer a multidisciplinary team with the services of physical therapists, occupational therapists, respiratory therapists, registered nurses, social workers, psychologists, dieticians and exercise physiologists.

What Therapy is done at pulmonary rehab? (What does one do there?)

This can be really variable. However, research shows that pulmonary rehabs that offer education and exercise are more effective than education alone so most offer some combination of education and exercise. Also recent research shows that patients who are involved in some long term follow up do better. Since breathing problems are what bring people to pulmonary rehab there is a focus on learning compensatory breathing patterns to help with shortness of breath. In addition many people have lost a lot of strength and endurance so most programs use a combination of exercises such as lifting small weights, walking and bicycling to increase strength and endurance. Due to shortness of breath, fatigue, cough, etc. many people have abandoned many of their social activities and sometimes even their activities at home. For this reason many pulmonary rehab programs teach energy conservation and work simplification techniques to allow a return to some activities. Another important area for people with lung disease is taking medication—including O2—correctly so that is another area that is covered by pulmonary rehab programs. Not all rehab programs cover all of the areas. However, if a person is in rehab and has a particular need the therapist may be able to work with the doctor to get another service involved to help with the problem.

How Long does pulmonary rehab last?

The initial program can last 4 to 12 weeks. Most average 6 weeks. The 4-8 week time frame is long enough to provide basic breathing retraining, get a person started on an exercise program and give some basic education. When breathing is the weak link in the chain that time frame is not nearly enough to gain physical fitness. Some authorities have argued that people with lung disease cannot get "fit" but newer information indicates that perseverance does pay off in the fitness area. Many rehabs offer a long-term exercise program after the basic program to help people attain a better level of fitness or maintain what they started in the basic program.

Who should attend pulmonary rehab?

Everyone with lung disease should attend pulmonary rehab. Of course I am biased! I also think that people should not wait until they're really disabled to get involved. Pulmonary rehabs are one of the most practical services available. They get down to the nitty gritty of day to day life to help you live as full a life as possible.

Does it help those of us with IPF?

Breathing techniques help anyone with a breathing problem. Energy conservation techniques are especially important to IPF'ers. Using O2 and other medications correctly is essential to our well being. Having someone to show us tiny steps to success and cheer us on is very helpful. Having someone who has time to answer questions and assess our symptoms is invaluable.

Joined: 25 Jun 2003 Posts: 1 Location: Seattle, WA USA

Greg,
Having gone through Pulmonary Rehab myself, I understand why you are biased! It's the best thing I've done for myself since my diagnosis (except for retiring). I started with 5 minutes a day on the treadmill. Now I turn my oxygen up to 4 lmp and do 45 minutes of walk-aerobics. My pulmonary function tests have improved significantly. The Pulmonary Rehab group I went to was started for the National Emphysema Treatment Trials, so most of the education was focused on emphysema, but I still got a lot out of it. I would encourage everyone to find a pulmonary rehab and go for it!
Jane

Joined: 22 Dec 2002 Posts: 569 Location: New Castle, NH

Jane, I couldn't agree with you more! Based on my oxygen saturation test at the beginning of an 8-week rehab program I was using 2L of supplemental 02 while doing my aerobic workout. By the time the 8 weeks had been completed I was doing a full 40 minutes of great exercise. My improvement in my post assessment was extraordinary. For the past 5 weeks in the maintenance program I have not had to use any supplemental oxygen for my workout! My saturation level stays in the mid-90s and usually my level is better when I walk out the door than when I walked in.

I feel that I have been extraordinarily fortunate in the benefits I have gained. But even if I were still using the supplemental 02 for exercise I would still be extolling the value of rehab because of the wonderful improvement it brings to your life. If my disease continues to progress I will someday have to back on the oxygen, but that's okay, I've been there already. I will never give up rehab.

Joined: 07 Jul 2010 Posts: 5

Just reading these stories from pulmonary rehab has given me hope and I am determined to feel functional again. I'm still trying to deal with my disease and grieving my healthy life that I was used to for so many years. I see my primary doctor on Friday, tomorrow. I'm going to ask her to refer me to pulmonary rehab. Thanks for sharing everyone. Eileen

Joined: 06 Aug 2009 Posts: 99 Location: Tallahassee FL

There are no pulmonary rehab programs near where I live. I have a treadmill at home, should I just walk on that using my oxygen? Is there anything special that I have to do or know?

Joined: 31 Dec 2002 Posts: 1503 Location: Maryland

In a pulmonary rehab program you are monitored by a RT. They check your blood pressure twice during each session and also listen to your lungs at the beginning and end. Your Sats are checked after each activity and oxygen increased if necessary.
I think that you can do pretty much that at home just start slow and be sure and warm up first. You can probably print out some warm up exercises off the net.
I would get my heart checked out before I begin and start slow no more that 1.2 m/h until you see how it goes with your sats.

http://emedicine.medscape.com/article/319885-overview
also cool down afterward