Pulmonary Rehab

What is pulmonary rehab like?  The words that come to mind are intense and exhausting.  I come home tired, so tired that  I have not been able to blog as much as I would like, nor read or play scrabble on-line or a myriad of other things I like to do when I have the energy.  Such a finite world full of choices that we live in.

Below is an extensive account of a fellow patients' lung transplant experience describing pulmonary rehab.  She paints with minute detail the picture of a typical day of pulmonary rehab, doing a much better job then I have the time and energy for at this juncture:

"I recently began actively making preparations for double lung transplant surgery by starting the intensive physical therapy program at Duke's Center for Living. All lung transplant candidates are required to attend 23 full sessions of Duke’s  specialized and personalized exercise program, which prepares patients for the actual surgery and recovery. These sessions are from Monday through Friday, 12:30 to 3:30,  and then 2-3 times a week we stay an additional hour for lectures. Many of the exercises are designed to strengthen the body in preparation for specific physical tasks and activities encountered during the time patients are in the ICU and Step Down  “In-patient recovery stages” of post-transplant hospitalization. For example...making us do squats will enable us to go to the bathroom by ourselves. Bet you never really thought about how strong your legs need to be in order to lower and raise your body from a toilet seat. Actually, by the time patients find themselves in end-stage lung disease, even the simplest of tasks become enormous mountains to climb over. Things we previously took for granted such as washing our hair in the shower, now take monumental effort and we are exhausted after bathing, brushing hair and re-dressing.

After checking in to the center by scanning my ID card, I grab a couple towels, head to the women's dressing room to weigh myself, stop by the counter and get a pair of medical gloves (required to help keep us free from passing or getting germs from equipment).  Once all that is done I take a seat alongside the other patients and wait for the staff to begin their routines. They come by with our medical charts in hand and start drilling us with questions.  "Do you have a clipboard yet? Are you in pain related to this program? Where? On a scale from 1 - 10 how would you rate the pain? Do you have to take your blood sugar?  What were your readings? How much did you weigh today? What level oxygen are you on right now? Give me your finger." (How much is my oxygen? I wonder.) "It's 96 percent. That's pretty good." (I think: 96%? Well, you shoulda took it when I stumbled through the door a little while ago!!!!)  "Okay,  let's get your blood pressure now." And so it goes...until all 35ish of us are done.

We all strap on leg weights…I am pretty strong so I started with 2 lb leg weights instead of one pound and I just got moved up to 3 pound this week.  They are NOT designed for walking…they (and therapy bands) are designed to provide resistance during leg lifts and ankle rotations. We also use the dumb bells to increase our arm strength. We have trainers who guide us through a solid non-stop one hour workout.

Duke Center for Living staff are the most awesome people I have ever met. They are helpful, knowledgeable, and determined to help you have a successful operation and recovery. They KNOW their stuff.  I like the fact that each day a different person leads the floor exercise instruction because each has their own specific style and area of the body they like to work out on.  The routines are all fairly similar, but the trainers add their own twists. We have days that seem tougher than others….because some trainers are “grueling and unmerciful” (again, thanks David) while others use a slower pace with more breathing opportunities built in. But you know the saying, no pain…no gain.  That goes for sweat too!  I finally found out what that is!  I have noticed how attentive the staff is to our needs: always checking the level of oxygen in our tanks, asking how we are doing, providing smiles of encouragement, assisting with equipment.  They just  represent customer service at its highest levels.  I have NEVER seen anyone grumpy or upset.  They all seem to really enjoy their work and it shows.

After floor exercise, we (or rather everyone else) must wipe down their equipment and mats and return them to the storage locations. It is not easy to pull an oxygen tank AND juggle a couple of mats, two leg weights and two hand weights and stop and clean them before hoisting them up on the storage rack.

 While we were on the floor, a white board has been set up with three groups identified: Walk, Weights and Bike. Each category has 15 or so names listed. The group has been split up into exercise stations that we will rotate through in a clockwise manner. Each day we are rotated to start at a different station. So, if I started at the weights today, then tomorrow I’ll start at bikes and the next day my starting activity will be walking. It breaks up the monotony that way. Another help in breaking up the routine is by alternately walking counter-clockwise around the track one day and switching to clockwise the next. If the group I am assigned to is walking, then first we must report in to the trainer desk. 

They verify that our tanks have sufficient oxygen in them to get us around track for our duration, if it is set to the proper oxygen level, and if we have our counting beads with us. On our first day we were presented with a cord of approximately 30 little plastic colored beads strung on. I tried using them a day or two. But I found them too small and easy to miscount with. I bought me some larger wooden beads with substance of varying textures, sizes and color tones and made my own counting beads. The trainers set a timer for 20 minutes, unless it is Tues or Thurs, and then we have to walk for 30 minutes. 
Next stop is the weight section and I don’t mean Biggest Loser weigh-in. It’s power lift time!  There we will alternate days between working on our upper body and lower body. The physical therapist has evaluated our abilities and developed a weights plan to gradually build our strength up.  We have about 4-5 different machines for upper body and 4 more challenges such as lifting hand weights, a cane, squats, etc. The next day involves much of the same designed for our specific lower body needs.

.  We call them bikes, but they are actually something called Nu-Step. We are seated in a recumbent position. Just like sitting in a car. Our feet are extended onto foot pads. Instead of rotating our feet in circular motion like a bicycle does, we use stepping motions to apply pressure on the mechanism that measures our distance, level of resistance, time, watts produces, steps taken, etc. There are also two handles that some people use to help strengthen the arms and assist with the force requirements.  We do this for 20 minutes."

This is my new routine.  

 For Susan Traxel Marvin's full account go to - www.dukelungs.org/Pulmonary_Rehab.html