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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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!
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1 Reaction@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.
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