Pulmonary Rehabilitation - quality of program

Find a different setting. Mine takes. BP, pO2, and pulse at beginning and pulse at the end. We were taught how to set the equipment then to use each for 10 minutes. If settings were to high she adjusts it individually, if 10 minutes isn't doable do what you can. Education is a part of each session.

By law regulation they have to check vitals in order to get paid by insurance company. Report this to the insurance company.

@denzie Agreed, my idea was to switch and ask questions first. I left a message for site "manager" who did get back to me so I told him my issues. He set me up with an appointment with the Respiratory Therapist to go over my plan and monitor my O2 on the machines .... I told them I expect a written plan, and daily progress reports and careful monitoring and coaching on breathing exercises. I already know how to use exercise equipment!. For people with lung / oxygen issues it is important to track O2 over time. I am always on the alert for worsening pulmonary fibrosis - right now I am fortunate because it is stable. But the fibrosis limits my options to treat the lung cancer so I require serious exercise plan as I need my lungs as good as I can keep them . I also sent an email to their Patient Relations who called me the next day after I had spoken to the site manager. They said let them know if I need something. If you don't speak up, things don't change by themselves. That is what they mean in by being your own advocate in healthcare!

@vic83 much respect for you and your advocacy. I'm doing Pulm rehab for the 3d time in 10 years. I've never seen anything as sloppy as the program you described. I hope others read this and learn from you.

@vic83 It’s been about a month since you posted some real concerns about the pulmonary rehab program you were in. Did you stick it out? And did the program make some changes to be more helpful and appropriate for your needs?

@ckscoville Yes, I reported my experience to Patience Experience and they called me. But after the Respiratory Therapist returned and has been working with me. What I did was go in with my own progress report format for them to fill out. I built it based on ChatGpt suggestions. I will post it later

Hi. I am glad I found this discussion as I have some of the same concerns.
I went for an intake appointment for Respiratory therapy and it was not what I expected. I know how to use a treadmill, stepper and free weights. I wanted to learn breathing techniques and hopefully expand my lung capacity following a chemical burn from chlorine inhalation.
I will ask for the Respiratory Therapist when I go for my first session and ask about a written plan and progress reports. Thanks for the tips. Lynn

Here is the Progress Report I take with me to Pulmonary Rehab (I used ChatGPT to create)
Pulmonary Rehab Tracking Template
1. Patient Baseline (first page – filled once)
• Diagnosis (e.g., pulmonary fibrosis, COPD, post-SBRT pneumonitis)
• Oxygen use:
o At rest: ___ L/min
o With exertion: ___ L/min
• Baseline vitals:
o Resting SpO₂:
o HR:
o BP:
• Functional status:
o 6-minute walk distance (if available)
o Dyspnea scale (e.g., Borg baseline)
________________________________________
📋 2. Daily Session Log (core of the program)
A. Pre-Exercise
• Date:
• Resting SpO₂:
• Heart Rate:
• Blood Pressure:
• Oxygen (L/min):
• Symptoms (circle/check):
o SOB / fatigue / cough / chest pain / dizziness
• Borg Dyspnea Score (0–10):
• Borg Fatigue Score (0–10):
________________________________________

B. Exercise Details
Activity Duration Intensity SpO₂ (lowest) HR (peak) Oxygen (L/min) Symptoms
Treadmill / Walk ___ min speed/incline ___% ___ ___ ___
Bike ___ min resistance ___% ___ ___ ___
Strength ___ reps weight — ___ ___ ___
Breathing exercises ___ min type — — ___ —
________________________________________
C. During/Peak Response
• Lowest SpO₂:
• Peak HR:
• Max Borg Dyspnea:
• Any desaturation < 88%? Y/N
• Recovery time to baseline:
________________________________________
D. Post-Exercise
• SpO₂:
• HR:
• Symptoms:
• Patient tolerance:
o Good / Moderate / Poor
________________________________________
📘 3. Education Tracking
Date Topic Instructor Patient Understanding (1–5) Notes
Breathing techniques (pursed lip, diaphragmatic)
Energy conservation
Oxygen safety
Medication use
Exacerbation recognition
________________________________________
🧠 4. Home Program / Compliance
Date Activity Done Duration O2 Used Symptoms Comments
________________________________________
📈 5. Weekly Summary (critical for decision-making)
• Average exercise duration:
• Trend in SpO₂ (stable / declining / improving):
• Oxygen needs (same / increased / decreased):
• Dyspnea trend:
• Functional improvement:
• Any red flags:
o ☐ Increasing oxygen requirement
o ☐ More frequent desaturation
o ☐ Reduced tolerance
o ☐ New symptoms
________________________________________
⚠️ 6. Red Flag Tracking
Track separately if present:
• Desaturation < 88% despite oxygen
• Increasing disease symptoms
• Chest pain
• Hemoptysis
• Rapid drop in exercise tolerance
________________________________________
🧾 7. Staff Documentation (quality control)
• Who supervised session:
o RT / RRT / PT / RN
• Was physician available? Y/N
• Any protocol deviations?
________________________________________
💡 What Makes a “Good” Pulmonary Rehab Log (Expert Level)
The log should allow you to detect:
• Subtle oxygen creep upward over weeks
• Earlier desaturation during exercise
• Decline in recovery time
• Increasing Borg dyspnea at same workload
Those are often the earliest warning signs of progression or treatment toxicity—well before CT changes.
________________________________________

@lynn611 I posted my report format which one can adjust. I am on oxygen so it is really important for me to track my oxygen levels at various points.