Gary Cooke
Special to The Union

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June 23, 2014
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Breathing confidence back into life Pulmonary rehabilitation helps individuals with COPD

There are many ways to measure success.

For Penelope (Penny) Cochran, of Grass Valley, it’s a 2-mile walk.

Until she took part in the Pulmonary Rehabilitation Program at Dignity Health Sierra Nevada Memorial Hospital (SNMH), she would have been afraid to go even a fraction of that distance.

Cochran, 58, has chronic obstructive pulmonary disease (COPD), sleep apnea and asthma, and she didn’t know if she’d be able to breathe if she walked any distance at all. She also had a bout with pneumonia last summer. But the 16 classes, offered on Tuesdays and Thursdays over eight weeks, taught her about lung function, exercise, and medication management, and left her filled with new confidence.

“I learned so much in that class,” she said. “I really would recommend it.”

She even used her knowledge while volunteering at the Living Well thrift store.

“A woman came in and became anxious, and was having trouble breathing,” Cochran said. “I think she was a bit panicky. I talked her through it, and helped her get her breathing under control. It was all from knowledge I learned from the hospital’s class.”

Suzanne Belew, RRT NPS, clinical specialist in respiratory therapy, described the class as “a medically supervised program of exercise and education for people with lung disease.”

“Our goal is to provide clients with an increased understanding about the disease process so that they can decrease their symptoms and realize the significant health benefits of a daily exercise program,” she said.

Education includes nutritional counseling, learning about one’s disease or condition, energy-conserving techniques, breathing strategies, psychological counseling and support from other clients in the program. The second half of each session is devoted to monitored exercise.

In fact, the program has recently been revamped to strengthen client physical conditioning and exercise, Belew said.

“In most other pulmonary rehabilitation programs, the respiratory therapists teach both the education and exercise sessions, but have limited training in the exercise component,” she said. “This year, we added specialized staff to oversee the exercise sessions. Our new instructors include Laura Fornecker, physical therapist, Karen Hughes, exercise physiologist, and Jamie Kearns, cardiovascular technician. They have added a tremendous quality that makes our series very unique from other pulmonary programs.”

“Research shows when you strengthen the legs, you can help improve endurance because you are using your muscles more efficiently. All of our clients show some functional improvement,” Fornecker noted.

Cochran’s mother had asthma, and one of her four daughters, Prudence, is on the staff of the hospital’s Emergency Department. Even so, Cochran said she learned much she didn’t know about lung disease, nutrition and medicine management through the program. The exercise component helped her get past her fear of walking too far, she added.

“Before, I didn’t know how long I would be able to breathe, so I didn’t walk,” she explained. “You get afraid. Now I know my capabilities, and I can control my breathing and I’m not afraid. I never thought I’d be able to go 2 miles.”

Cochran said she also sleeps better now, has lost weight, and enjoys her nine grandchildren.

“These classes were so beneficial to me,” she said.

People with a wide variety of pulmonary issues might also benefit, Belew said. The program is designed for people with COPD (which includes the diagnosis of chronic bronchitis, emphysema, and chronic persistent asthma), pulmonary fibrosis, and postoperative lung surgery. Belew said it is also helpful to other disease syndromes where restrictive or obstructive conditions exist, like advanced scoliosis.

As part of the program, local pulmonologist Dr. John Lace participates in an “Ask the Doctor” session, which allows clients to seek answers in a casual atmosphere, Belew said. In addition, a medical social worker does a presentation on the social and psychological aspects of living with a lung condition. Clients are also informed about beneficial programs and services available in Nevada County.

“Maintaining physical strength and function is key to living well with chronic pulmonary disease,” states Dr. Lace. “Pulmonary rehabilitation demonstrably improves patients’ quality of life and physical endurance. It decreases their shortness of breath, improves their health status, and may reduce their risk of premature debility and death.”

Enrollment in pulmonary rehabilitation requires a physician referral and a recent pulmonary function test, Belew noted. It is approved by Medicare and various private and group insurance, and the hospital can help coordinate insurance coverage for anyone who is eligible.

The next series of classes begins Aug. 5. For more information, call 530-274-6084.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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The Union Updated Jun 24, 2014 10:59AM Published Jun 24, 2014 01:35PM Copyright 2014 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.