The third leading cause of death in the United States, chronic obstructive pulmonary disease (COPD), affects 11 million people in this country alone. Although the primary cause of COPD is smoking, a small percentage of people develop COPD due to a genetic component, alpha-1 antitrypsin deficiency, a protein lacking from birth. Long-term exposure to lung irritants such as chemical fumes or industrial dust can also cause COPD, as can chronic bronchitis.
Eisenhower Medical Center offers the unique, comprehensive Tamkin Pulmonary Wellness Program at Eisenhower Renker Wellness Center on its main campus. The benefits of pulmonary rehabilitation can feel miraculous to someone who struggles to breathe, day in and day out.
“The outcomes are so rewarding,” says Debra Fuller, RN, Coordinator, Eisenhower Rehabilitation Program. “We provide an eight-week comprehensive program of education and exercise. Participants exercise three days a week, and on two of those days, we include core classes on topics such as coping with the disease, infection control, breathing skills, nutrition, stress and panic control, traveling, activities of daily living, and more.
“When someone starts the program, we meet with them individually for about two hours. Based on the information we gather, we create a customized plan of care for that person. We also do a follow-up one-on-one session. Regardless of the stage of their disease, they’re treated individually with regard to their physical limitations and their respiratory function. ”
Pursed lip breathing for COPD
One of the most important skills participants learn through the program is pursed lip breathing. Pursed lip breathing can dramatically help those with COPD, allowing a longer exhalation to help remove stale air from inside the airways and air sacs. When stale air doesn’t move, those individuals can feel like they’re suffocating.
“We teach our participants the three Ps and the D of breathing — pursed lip breathing, pacing and posture,” explains Fuller. “The D is for diaphragmatic — deep breathing that is done by contracting the diaphragm. Air enters the lungs and the chest rises and the belly expands during this type of breathing. It’s all about retraining one’s breathing.”
According to Fuller, these lifestyle changes help the participants increase their oxygen level, allowing them to increase their level of activity and exertion.
“One of the goals of this program is to help prevent further lung infection which causes further lung damage,” says Fuller. “Exercise, education, breathing exercises and information about how to prevent lung infection greatly benefit people living with COPD.”
Other benefits of the Pulmonary Program include: reversal of anxiety and depression; increasing strength, balance and endurance; better compliance in taking medications; better quality of life; decrease in hospital stays; and often, less frequent use of a rescue inhaler through the use of breathing techniques.
For those with respiratory disease, optimum nutrition has a direct impact on respiratory function. Someone with respiratory disease can burn up to 10 to 17 percent more calories just breathing. Not eating enough, or eating the wrong foods, may result in malnutrition, causing changes in body mass due to protein and fat loss. These changes may decrease muscle strength and resistance, as well as decreased energy and an increasingly compromised immune system.
The nutritional component of the Pulmonary Rehabilitation program includes handouts and class discussion covering the goals of nutrition, nutritional strategies, inflammation-fighting foods, plus foods that cause or help eliminate excessive mucus — a sign that the body is in a state of agitation.
Getting into the program
Participants may enter the Pulmonary Program by getting a physician referral. If the referral is from a physician outside of Eisenhower’s Pulmonary Clinic, the patient will meet with Ronald Sneider, MD, Director, Tamkin Pulmonary Wellness Program.
“There have been a lot of studies showing that pulmonary rehabilitation helps the patient’s attitude, their feeling of self-control, and improves cardio pulmonary fitness,” says Dr. Sneider.
“Benefits include fewer hospitalizations, less morbidity due to an understanding of medications and the ability to handle flare-ups. This program has been in operation since 1976 and it has really grown and evolved.”
Participant Marianne Millican had great success in the Pulmonary Program.
“When I got to Eisenhower, I couldn’t believe what they had available to us,” says Millican. “The staff here is absolutely unbelievable — the nurses, trainers and respiratory therapists. For me, it’s been the best support group I could have. I’m from Cleveland, but no one has a program like Eisenhower.”
Millican continues to use Renker Wellness Center to maintain her exercise routine. “I think exercise is the answer. I do my breathing exercises and follow my medication regimen. My husband Jim and I feel like we landed in the right spot here at Eisenhower. I’m fortunate to have a partner like Jim, who supports me and keeps my family informed.”
According to Fuller, the Pulmonary Program participants who wish to continue exercising in the gym may join the Renker Wellness Center’s adult fitness program at a reduced rate. For those who need it, oxygen is provided while they exercise. “It’s hard to put into words what this program becomes for somebody,” explains Millican. “Considering that there is no cure for this disease and that it’s progressive…I just don’t know where I would be without it.”
For more information about Eisenhower’s Pulmonary Rehabilitation program, call 760.773.2082.