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Scott Webb (Host):  Did you know that COPD is the fourth leading cause of death in the US? And in 2020, COPD is projected to become the third leading cause of death. An estimated 35 million Americans have COPD and there are millions more that are undiagnosed as they are in the beginning stages and have no sought healthcare yet. My guest today is Jeanette Keegan. She’s a CGH Respiratory Care Practitioner and Pulmonary Rehab Coordinator.

This is the About Your Health podcast from CGH Medical Center. I’m Scott Webb. Okay so, Jeanette, thanks for being on today. it is really a pleasure to have you. Let’s start here. What is COPD?

Jeanette Keegan, RCP (Guest):  COPD is a chronic obstructive pulmonary disease broken down, it is explained this way. Chronic is persistent. The disease that won’t go away. Obstructive is the airways are partially blocked by the swelling of membranes and mucous. Pulmonary is in the lungs. And the disease is the sickness. COPD is a condition characterized by a progressive, disabling, deterioration in lung function, breathing becomes more difficult over time. COPD is an umbrella term for two respiratory illnesses, chronic bronchitis and or emphysema.

Host:  Okay Jeanette, I think I have got it. So, what causes COPD?

Jeanette:  The causes of COPD could be cigarette smoke, pipe, cigar and other types of tobacco smoking. Passive exposure to cigarette smoking, occupational dust and chemicals, or air pollution and some genetic factors.

Host:  And so it does seem that there’s some obvious ways to help control COPD. But why don’t you take us through those.

Jeanette:  Well by staying active, daily activity helps your body function more efficiently and keeps you mentally alert. You can also use what we call pursed lip and diaphragmatic breathing to help increase blood oxygen levels and decrease shortness of breath. You can watch your diet. You want to try to maintain a normal weight. You need to drink plenty of fluids, preferably water. You need to take your medications properly and in a timely fashion. You want to prevent infection, avoid contact irritants. You want to relax. Fatigue and tension can contribute to shortness of breath. And of course, pulmonary rehab is a huge benefit.

Host:  Yeah, so let’s talk about pulmonary rehab or sometimes known as PR. Who typically benefits from that?

Jeanette:  Well if you have a chronic lung condition such as COPD or restrictive lung disease such as interstitial lung disease; that is a scarring of lung tissue, pulmonary hypertension. This is a type of high blood pressure that affects arteries in the lungs and the heart. Or pulmonary fibrosis which is chronic and a progressive lung disease where the air sacs in the lungs called alveoli become scarred and stiff making it difficult to breathe and get enough oxygen into the blood stream. So, if you have these things, your doctor may recommend you to start a pulmonary rehabilitation program which combines exercise and education.

Host:  Okay, that sounds good. And how does the program work? How many times per week, how many weeks and so on?

Jeanette:  Pulmonary rehabilitation meets three times a week on Monday, Wednesday and Friday. We will go for six to twelve weeks. If you meet certain medical criteria; some of the cost of the program is covered by Medicare and many private insurance carriers will also cover some of the cost. Your exercise program is fine tuned to you based upon the results of your six minute walk, your walk test or your pulmonary function test results, your medical history and any personal needs or goals you may have.

Host:  Okay, got it. and maybe I should have asked this question before; but what exactly is pulmonary rehabilitation?

Jeanette:  Pulmonary rehab is a program that can help you learn how to breathe easier and improve your quality of life. It has two parts. Exercise training is to help you exercise safely by strengthening your muscles and getting your energy back. Also education and counseling to help you understand and manage your lung condition. Pulmonary rehabilitation also known as respiratory rehabilitation is an important part of the management and health maintenance of people with chronic respiratory diseases who remain symptomatic or continue to have a decreased lung function despite the standard medical treatments. It is a broad therapeutic concept. The purpose of pulmonary rehab at CGH Medical Center is reduce and control the symptoms and complications experience by patients with moderate to severe pulmonary disease. We do this program of education on diet and exercise.

Host:  Diet and exercise. That’s good. So, I’m assuming that people need to have reasonable expectations and there’s probably a list of things that pulmonary rehab is not. What are some of those things?

Jeanette:  Well that’s a good thing because pulmonary rehab is not a trip to the gym where you do a compulsory intense exercise. Pulmonary rehab is not a program that is one size fits all. Pulmonary rehab is not to get you off your medications or your oxygen. Pulmonary rehab is not a judgmental environment. We’re here to help you.

Host:  That’s good to know and no judging. So, Jeanette, what are some of the key concepts covered in pulmonary rehab?

Jeanette:  Medication management is a huge concept. You need to find out how your medications work and get advice on when you should take them. The potential side effects. If you need to rinse, gargle and spit after a certain medication. Your long acting bronchodilators, your short acting bronchodilators, your rescue inhalers. Also corticosteroids. You can have controlled breathing with pursed lip breathing or diaphragmatic breathing. We will teach you how to climb stairs safely, exhale with exertion while improving your functional capacity.

Breathing exercises can help you learn to increase your oxygen levels by using the oxygen monitor we put on your wrist, you can visualize the improvement while you purse lip breathe. You might also learn more about how and when to use supplemental oxygen. Meal planning, a healthy diet can help you achieve and maintain a healthy weight. You will learn how to make nutritious meals without growing too tired or stressed. We have guest speakers with lunch and learns with our registered dietician, Michelle Rogers. Also, exercise. You may learn more about how to modify exercise for your safety as well as learning how to monitor your breathing as you work out. Here, we utilize the services of occupational therapy and or physical therapy to help meet the individualized patient goals and we also have lunch and learns with these folks as well.

Host:  That’s all really great, not that you want to necessarily have COPD, but it does seem like everything you are doing can really help people deal with it. So, who is eligible for these programs?

Jeanette:  Eligibility is based upon the following:  It has to have a diagnosis of moderate to severe pulmonary disease. The results of your pulmonary function tests show the severity of your disease and the results show be no older than one year. A nonsmoker or participating in a smoking cessation program and we can help you with that as well. To ensure success, you must be motivated to participate, and you must continue to use all that you will learn even after your rehab sessions have been completed. After completion, you can continue to be supported by us through our Phase three program.

Host:  Awesome Jeanette. So, how do we get started?

Jeanette:  Well all services are provided on an outpatient basis. You need to talk to your physician. Those interested in participating in CGH’s Pulmonary Rehab Program must receive approval from their physician.

Host:  So, it sounds like it’s really just as simple as speaking up if you want to get involved. Is there anything else you’d like to add Jeanette?

Jeanette:  The CGH Pulmonary Rehabilitation Program was recently recertified by the American Association of Cardiovascular and Pulmonary Rehabilitation. CGH Medical Center takes pride in this certification and AACVPR is a highly recognized and valued certification. This certification is recognized by Medicare and all insurance companies. CGH Medical Center Pulmonary Rehab must follow certain guidelines and criteria to maintain the status. This certification is in recognition of CGH’s commitment to providing the best possible care so that our patients can expect the best possible outcomes for their therapy.

Host:  That’s great Jeanette. Thank you so much for being on today. I really appreciate your time. For more information visit www.cghmc.com or call 815-564-4847 to make an appointment for a pulmonary rehab interview. This podcast is intended for educational and informational purposes only. Please consult with your healthcare professional for specific recommendations About Your Health. Thanks and we’ll talk again next time.