Pulmonary Rehabilitation - quality of program
I would like to know about the experience of others. Especially if they are on oxygen. Did they have a daily progress report? Were they taught breathing before exercise? Were they given a special exercise program designed for them?
I was interested in developing better breathing techniques since I am oxygen dependent for exertion and sleep, have pulmonary fibrosis and a little pulmonary hypertension and I have a cardiac stent. So I signed up for pulmonary rehabilitation
I am wondering how exactly PR should flow since my experience seems strange......I am having doubts about the quality of this program because of my experience on two visits.
1) For the evaluation, the person insisted on taking my blood pressure over a heavy bulky sweatshirt. She said as long as she could hear my pulse it was OK....I know that is not the recommended way to do it and I offered to slip my arm out, but she said no.
2) They told me my first time, someone would teach me the exercises. After there is a class.
I went and someone (not RRT) came, she had my file but did not take my O2 or blood pressure before or after. No progress report is posted on MyChart.
There were no instructions, no warmup exercises no cool down exercise after nor any information on breathing techniques before starting.
She just gave me oxygen tank set at my prescription of 2 L, put an oximeter on my finger, and put me on treadmill and told me to go as fast as I could. She waited for the oximeter to stabilize then walked away and came back 5 + min later and my O2 was under 88. So she said "guess we should bump it up" and she set it at 4L
After she asked me what I wanted to do weights or rowing etc. I did sitting, moving arms and feet - she went away for 5 min and then came back and said oh should lower O2 setting back to 2L
I asked two questions 1)I have pulmonary fibrosis with a stiff chest, should I take off my bra during exercise - she said we should ask the respiratory therapist when she gets back from vacation
2) since I am breathless when I bend over, I asked if I could even do the rowing machine since that would cut off my breathing....she did not know
I am wondering if I should stop going.
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I went through pulmonary rehab last year, at the direction of my pulmonologist. I'm afraid I'm not what anyone would call a success story. Actually, the "workout"to which I was subjected did not differ at all -- as far as I could see -- from the regimen for those who were in there for cardiac rehab. I had expected some exercises on breathing and breathing techniques, etc., but there weren't any. Pulmonary rehab wore me out so completely most days that my wife threatened to pull me out of it, but I endured. One day my blood pressure dropped so low, that the nurse would not let me walk out on my own at the end of the session, and they called a wheelchair to take me down to the hospital entrance. Quite an advertisement for rehab: I walk in on my own, but have to be taken out in a wheelchair! Of course, my experience may have certainly been affected by my disease, cystic fibrosis, but I have to believe that some exercises specifically targeted at lung health and breathing would have been more helpful. A gradual increase in exercise length and intensity would also have been more appropriate.
@ckscoville Thanks for your reply. Cystic fibrosis causes damage leading to reduced lung capacity and inefficient gas exchange which is what pulmonary fibrosis also does to me.
Your Rehab experience sounds like mine. I have done cardio rehab after a stent and they are the same exercise machines. Only with Pulmonary rehab, one's oxygen should be carefully monitored. Google says they should provide an exercise program suitable to my needs and meet Medicare requirements. Tomorrow I am calling the Program Director.
@ckscoville Keep in mind that with your lung issues you should be careful where you go if you need general anesthesia or if you need to do so something like a stress test, either treadmill or pharmaceutical. I go to Mayo for my lungs and for things like a colonoscopy using general anesthesia etc., I don't do them locally but have it done at Mayo because of my high risk. I want MY Specialist close by!!!
@ckscoville One more question! Was it a class or individual pulmonary rehab?
Actually, mine was a "class" in that a group of us were being monitored/guided at one time ...although I was the only one, apparently, who was there for pulmonary rehab while the others were there for cardio rehab. This was actually at Mayo Clinic, and I had the impression that very few people were actually sent there for pulmonary rehab. I had expected my oxygen level, etc., to be monitored more closely but they were more concerned about my blood pressure. As a heart patient with three stents and a pacemaker, I've also gone through cardio rehab in the past and there wasn't much difference in types of exercises. I have to add: the staff were very nice and concerned about me; I just don't think the program was tailored to my needs as it should have been.
@ckscoville Is that Mayo Florida? I am in Minnesota and Mayo Rochester is 90 miles away so not very convenient to go twice a week for PR. Interestingly enough, my two Mayo Pulmonologists have not recommended PR to me, I had to ask. And if it isn't any better than what we experienced, then I understand why. I liked Cardio Rehab that I did locally 4 years ago, but not same place I went now for PR. I am thinking of going back there now. I thought this other place would have more qualified people, but guess not. There was no respiratory therapist present when I went in, 3-4 other "therapists".
@ckscoville read this:
https://www.bing.com/search
@ckscoville Here is how Mayo describes...
seems in FL it is combined, different in Minnesota
https://www.mayoclinic.org/departments-centers/pulmonary-rehabilitation-program/overview/ovc-20398578
@vic83 Yes, it was at Mayo in Florida, but there were no respiratory therapists or dietitians in the program I went through. I would have welcomed some education in addition to the exercise. Actually, all of my doctors (except for my primary care physician) are at Mayo, and I have been extremely grateful for all of them. The cystic fibrosis team at Mayo in Florida has really helped me tremendously. Lately, I have just started physical therapy for balance issues in a local clinic (not affiliated with Mayo or any other hospital), and that program has been excellent.
@ckscoville I know how you feel! I have a few doctors at Mayo. I was very lucky.... I retired in Southwest Florida and after ten years moved back to Minnesota. I begin to have mild shortness of breath. I decided to check it out because I had a trip planned...and I went from chest x-ray to lung cancer surgery in 7 weeks with Thanksgiving and Christmas in between. Mayo encouraged me to set up an account and send my scans because "doctors can move things around when they want" so locally I had CT and PET scans, then sent them to Mayo and the next day the Pulmonologist called me and asked if I could come in the next day! Surgery scheduled end of Dec -Stage 1 lung cancer. That was more than 4 years ago. My friends say it was destiny for me to move back when I did. I have multicentric (multifocal) lung cancer so I am a "recurring customer at Mayo" as there is always a nodule to watch
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