One of the things I love the most is meeting new people through my job in pulmonary rehab. I really take a genuine interest in every patient that I meet and try to see what ways in which I can best help them manage their lung condition. It is interesting to me to hear each person’s journey with their lung diagnosis and notice what areas need adjustment so that they can live the best life that they possibly can. In thinking about this blog, I thought about presenting it as a “case study.” People in the medical field LOVE case studies. It’s like a medical mystery show, but instead of figuring out the diagnosis... I am trying to figure out the ways I can improve someone’s life with their chronic lung condition. Cool right?! Well I didn’t think you all would be excited about a topic called “case study” so I entitled it “Making Small Changes for a BIG Impact When You Have a Lung Condition.” It’s definitely a more interesting title. I’m sure you will agree! Well, I think that you are going to love this so let’s get into meeting “Sam” and see how we are going to be making those small changes for a BIG impact.
***FYI the name of this patient has been changed in order to maintain his anonymity. I take patient privacy very seriously so along with it being the law, I will not divulge any detail that might lead anyone figuring out who the patient is.***
Just a little background, Sam is 70ish years old and newly diagnosed with COPD. He had been a smoker for years and yet much to his surprise, never had any major health issues. Sam has been active all his life, not really an exerciser per se but loves to do “projects” that involve woodworking and has never really shied away from a hard day of work. On first note, he has arrived at my rehab without using any assistive walking device and is not wearing any supplemental oxygen. Sam appears to be open minded and optimistic on how I can help him. In the last 6 months he has had 2 significant flare-ups and is a little disheartened that he doesn’t have the energy that he once had. His goal: build stamina
1. He claims to only use his rescue inhaler 2-3 times a month.
In looking at Sam’s pulmonary function test where they performed the test with and without using a bronchodilator (rescue inhaler), I could see that he had an almost 15% increase in some of the areas of his lung function after he had used the inhaler. He claimed that when he used his rescue inhaler that he did feel as though it gave him relief. My suggestion was that Sam should start utilizing his rescue inhaler prior to performing activities that may cause him to be more breathless. As I stated in last week’s blog post on “Getting the most from your inhalers,” I thought that using it beforehand would allow him to complete the activity with less breathlessness and possibly be able to accomplish more when it came to projects that he was working on etc.
2. He has a treadmill at home that he uses, however routinely walks only 8-9 minutes at a speed of 3.5 mph.
I applauded Sam for his commitment to exercising on a routine basis. He has the confidence to exercise on his own and has fully accepted that he needs the exercise to feel his best. My suggestion is that he work on lengthening his walks on the treadmill to a goal of 30 minutes. This will require him to cut back on his speed quite a bit in the beginning but will help build endurance on the treadmill thus translating to more stamina when doing the things that he loves. Our plan is that 3 days a week he will try for a longer slower walk and 2-3 days a week he will perform a 10-15 minute walk at a faster pace. He owns his own pulse oximeter, so I also suggested that he monitor his heart rate and oxygen saturations while exercising at home as well.
3. Frequent flare-ups and infections in the last year are setting him back.
There’s no doubt about it that every time Sam had a hospitalization or a flare-up that it set him back. He worries that the frequent infections are “scarring his lungs” and the experience of having to “rebuild” time and time again is affecting his ability to get stronger. One key education focus is going to be on tips to avoiding illness. I don’t want to create a sense of worry for Sam however, reviewing some infection control tips like hand hygiene and avoiding large crowds in the height of cold and flu season may help. Also, encouraging the daily use of his “controller” inhaler may help to keep airway inflammation at bay.
4. He gets very breathless while carrying anything.
As a guy who loves to do projects around the house as well as woodworking, Sam experiences breathlessness carrying anything. He also states that carrying in groceries can be a real challenge. If you have been reading my blog for a while you will probably note that my blog on “How to decrease breathlessness while carrying anything” is extremely popular. One of the things that I want to focus on in rehab as well as the days that Sam completes a “short walk” at home on his treadmill is upper body strengthening. Sam has resistance bands and a few hand weights at home. Focusing on strengthening the upper body as well as teaching and utilizing breathing techniques should hopefully help to make carrying anything a bit easier.
Final thoughts: I don’t suspect that I will need to work with Sam very long due to his confidence and dedication about exercising on his own. Hopefully fine tuning a few things regarding taking is rescue inhaler, adjusting his workouts, and avoiding illness will help him to continue to make improvements in his overall health and his ability to do the things that bring him joy.
Thanks for Reading!
If you enjoyed this blog, I invite you to check out some of the topics I have covered in the past
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:) Christina
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