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Q. What is pulmonary rehabilitation?
Q. What are the demonstrated outcomes of pulmonary rehabilitation?
Q. Who should consider a CF specific pulmonary rehabilitation program?
Q. What if I'm on oxygen? How do I know if I'll require oxygen while exercising?
Q. How does your CF exclusive program differ from other conventional pulmonary rehab programs?
Q. Why not just exercise at a local gym?
Q. Where are you located?
Q. Does your pulmonary rehab center offer care for individuals without CF?
Q. What are some the educational topics one can expect to encounter during their pulmonary rehabilitative care?
Q. Will my insurance pay for pulmonary rehab?
Q. How long is the pulmonary program?
Q. What happens if I'm unable to attend as a result of a hospitalization or pulmonary exacerbation?
Q. What times are available?
Q. Why is the program so long?
Q. Is there life after pulmonary rehabilitation?
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Q. What is pulmonary rehabilitation?
A. Pulmonary rehabilitation was defined in 1974 by the American College of Chest Physicians and adopted by the American Thoracic Society in 1981 as:
"Pulmonary rehabilitation may be defined as an art of medical practice wherein an individually tailored, multidisciplinary program is formulated which through accurate diagnosis, therapy, emotional support, and education stabilizes or reverses both the physio- and psychopathology of pulmonary diseases and attempts to return the patient to the highest possible functional capacity allowed by his pulmonary handicap and overall life situation."
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Q. What are the demonstrated outcomes of pulmonary rehabilitation?
A. The following are merely some of the demonstrated outcomes of pulmonary rehabilitation:
- Reduced hospitalizations
- Improved quality of life
- Improved quality of sleep
- Reduced respiratory symptoms (i.e. shortness of breath)
- Improved psychosocial symptoms (reduction of anxiety, depression, and
- Improved self-efficacy
- Increased knowledge of pulmonary disease and its management
- Increased exercise tolerance and performance
- Enhanced ability to perform activities of daily living
- Increased survival in some patients (i.e. transplant candidates)
- Return to work for some patients
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Q. Who should consider a CF specific pulmonary rehabilitation program?
A. The following describes potential pulmonary rehab candidates:
- A patient with a history of cystic fibrosis.
- A patient with CF in need of monitoring pulmonary status while increasing strength and /or endurance.
- A patient with CF in need of education regarding the disease and techniques to improve the management of the disease process.
- A patient with CF whose disease process has affected the patient's quality of life through loss of independence, decrease in physical activity or issues of psychological adjustment.
- A patient with CF who is awaiting lung transplant and who would benefit from increasing exercise tolerance and requires monitoring oxygen saturation with exercise.
- A patient with CF who is oxygen dependent.
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Q. What if I'm on oxygen? How do I know if I'll require oxygen while exercising?
A. A respiratory therapist will conduct a series of tests to determine if you will require oxygen during exercise. Specifically, he will recommend oxygen therapy to your physician for any patient whose oxygen saturation falls at or below 90% during any portion of the tests performed.
Oxygen is provided by the rehab center in the event an individual meets this criterion or is ordered by their physician to exercise with oxygen.
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Q. How does your CF exclusive program differ from other conventional pulmonary rehab programs?
A. Many pulmonary rehab centers are geared towards addressing COPD and are therefore very broad-spectrum in their approach to education and physical therapy of the pulmonary patient. Our program differs in that it was developed to address the specific needs/challenges CF patient face as a result of their disease process. One-on-one, individualized therapy and education is provided and tailored to fit those specific needs, learning styles, physical capabilities, and pace each individual presents.
Our center utilizes two separate training rooms as an additional precaution to prevent close patient-to-patient contact, which can result in serious cross-contamination repercussions. The classroom, exercise training rooms, and equipment are cleaned and disinfected immediately following patient use to ensure the highest level of patient safety.
Finally, absolutely no patient may exercise or begin classroom training until the prospective room has been sanitized thoroughly for patient activity.
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Q. Why not just exercise at a local gym?
A. CF patients present unique challenges in response to aerobic and anaerobic exercise. Symptoms such as dyspnea (shortness of breath) accompanied by anxiety, hypoxia (low oxygen in the blood), paroxysmal coughing episodes, ineffective breathing patterns, hypertension, hypoglycemia, malabsorption issues, and increased susceptibility to infection are just a few of the challenges the patient with CF faces when being involved in an exercise training regimen. In some instances, one or more of these symptoms could prove life-threatening if not responded to quickly and appropriately; therefore, these symptoms must be identified and treated immediately to ensure patient safety.
Unfortunately, your average health club cannot offer the resources, staff, or equipment required to accurately diagnose and treat these problems when they present. Therefore, it is critically important to receive a monitored, progressive training regimen only a pulmonary rehabilitation program can provide. We feel this serves to maximize patient outcome and ensure patient safety.
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Q. Where are you located?
A. The Jennifer Ann Hartung Memorial CF Pulmonary Rehab Center is located in Tulsa, Oklahoma at 7471 E. 46th Place. (Between Memorial and Sheridan on 46th Place)
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Q. Does your pulmonary rehab center offer care for individuals without CF?
A. Presently, our pulmonary rehab program is devoted to one-on-one, individualized training for the patient with cystic fibrosis.
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Q. What are some the educational topics one can expect to encounter during their pulmonary rehabilitative care?
A. The following are only some of the pulmonary rehab educational components you can expect to discuss:
Hospital/Doctoral Care
- Understanding Laboratory Tests
(CBC's, Chem. Panels, ABG's, Urine Tests, Throat Cultures, Sputum Exams [C&S], ECG, Six-Twelve Minute Walk, Pulmonary Exercise Stress Test, Bronchoscopy, PFT's, Total Lung Capacity, Diffusing Capacity, etc.)
- How To Get The Most Out Of Your Hospital Stay Or Doctor Visit
- Protecting Yourself While In The Hospital
- Patient Rights
- How To Avoid Bogus Medical Charges
- Understanding The Importance Of Routine Doctor Visits
- What Are All Of These Medications For?
Learning More About Your Body
- An In-Depth Examination Of The Following Organs In Health and CF
A. Lungs (Upper/Lower Respiratory Tract, Accessory Muscles of Inspiration/Exhalation, Diaphragm, etc.)
B. Heart
C. Stomach
D. Pancreas
E. Liver
F. Intestines
G. Reproductive Organs
- Differences in the Upper Respiratory Tract
- Factors/Processes Influencing Respiratory Infection
- Understanding Chronic Respiratory Infections
- Challenges Of Pulmonary Changes (Symptoms/Treatment Of)
A. Hemoptysis
B. Pneumothorax
C. Atelectasis
D. Hypoxemia
E. Digital Clubbing
F. Hypertrophic Pulmonary Osteoarthropathy
G. Arthritis In CF
H. Respiratory Failure
- The Simple Yet Critical Role Of Airway Clearance Therapy
A. Accapella
B. Active Cycle Of Breathing
C. Autogenic Drainage
D. Chest Physiotherapy & Postural Drainage
E. Positive Expiratory Pressure Therapy (P.E.P. Therapy)
F. High Frequency Chest Wall Oscillating Therapy (VEST)
G. Exercise
- Stomach
A. The Road To Digestion/Absorption
B. Gastroesophageal Reflux (GEFR)
- Pancreas
A. Naturally Occurring Pancreatic Enzymes
B. What Does It Mean To Be Pancreatic Insufficient
C. Why Are High Fat/Low Carbohydrate Diets Encouraged In CF
D. The Importance Of Fat Soluble Vitamins
E. CF Related Diabetes (Symptoms/Treatment) (CFRD)
- Liver
A. Fatty Liver
B. Blocked Bile Ducts
The Importance Of Nutrition In CF
- Monitoring Growth And Nutrition
- Dangers Of Malnutrition
A. Factors Influencing Malnutrition In CF
B. Signs Of Malabsorption
C. Inadequate Caloric Intake
- Role Of Essential Fatty Acids
- Symptoms Of Iron Deficiency
A. Iron Rich Food Sources
- Signs/Symptoms Of Vitamin A, D, E, & K Deficiency
A. The Role Of Vitamins A, D, E, & K
B. Good Sources Of Vitamins A, D, E, & K
- Signs/Symptoms Of Magnesium Deficiency
A. The Role Of Magnesium
B. Good Sources Of Magnesium
- Tube Feedings Advantages/Disadvantages
A. Tube Feeding Options
Lung Transplantation
- History Of Organ Transplantation
- Who Should/Should Not Be Considered For Lung Transplantation
- The Role Of UNOS & OPO's
- Transplant List Placement
- Waiting On The List
- Active vs. Inactive Status
- General Facts Concerning The Transplant Procedure
- Living Related Lobar Transplantation
- Commonly Asked Transplant Questions
- Challenges/Side Effects Of Immunosuppression
- Complications Of Lung Transplantation
- Acute vs. Chronic Rejection
- Health Maintenance Following Transplant
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Q. Will my insurance pay for pulmonary rehab?
A. Most insurance companies understand the value and benefit of improved health maintenance and often cover the cost associated with pulmonary rehab. However, obtaining a letter of medical necessity from your physician as well as a prior authorization from your insurance is strongly recommended and often required.
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Q. How long is the pulmonary program?
A. The program is comprised of thirty-six training sessions. The individual will attend three hours a day, three days a week until all thirty-six sessions are completed.
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Q. What happens if I'm unable to attend as a result of a hospitalization or pulmonary exacerbation?
A. To obtain maximal benefits from the program, regular attendance is strongly encouraged. However, we also realize CF exacerbations are sometimes hard to avoid. Therefore, in the event of your absence, make-up days are scheduled. To graduate from the pulmonary rehab program, a patient must have completed all thirty-six sessions.
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Q. What times are available?
A. Three time schedules are available and have been considered by most to be very accommodating. The individual time slots are:
Q. Why is the program so long?
A. Many pulmonary rehab programs last only six weeks. Programs that offer education and exercise both are far more effective than when education or exercise is offered alone.
Evidence has proven the 4-6 week period is barely long enough to provide basic breathing re-training, get the individual acclimated to a routine exercise regimen, and offer very basic patient education. Therefore, when breathing is the "weak link in the chain," achieving optimal results in a period less than twelve weeks is not practical.
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Q. Is there life after pulmonary rehabilitation?
A. Once a patient has completed the program they are encouraged to continue their self-tailored exercise regimen at the rehab center where their progress and bio-physical parameters are monitored closely. This additional service is offered absolutely free of charge to all graduates of the J.A.H.M.P.R.C. pulmonary rehab program.
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