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Scott Webb: Whether it's due to COPD or other lung issues, pulmonary rehabilitation is a comprehensive and multidisciplinary program that involves more than just exercise and can profoundly help folks who suffer from chronic lung issues. And joining me today to discuss pulmonary rehab in the many benefits is Dr. Aaron Bruns. He's a board certified physician in pulmonary sleep medicine and critical care. This is the Franciscan Health DocPod. I'm Scott Webb.

Doctor, thanks so much for your time today. We're gonna talk about pulmonary rehab and I sort of know what those two words mean and probably what they mean when you put them together, but it's great to have your expertise. So let's start here. What is pulmonary rehab?

Dr. Aaron Bruns,: There are a number of people out there that have lung diseases. I think most commonly COPD is the one you hear about the most. But there are others. And a lot of these people, even despite being on inhaler and medication therapy still have lots of problems with shortness of breath while trying to do activities. And it can cause a pretty significant effect on their quality of life. Some of them aren't able to do normal everyday activities, clean the house, go to the grocery, and it can be quite debilitating for them and the inhalers and other medications only do so much.

So pulmonary rehab is a program designed for people with the goal of improving this shortness of breath in improving their quality of life. And it does this with exercise training, education behavior changes breathing exercises, psychological support, nutritional support for these patients.

Scott Webb: Yeah. And so it sounds like we're talking about basically that we're generally talking about lung disease, right? So when we think about pulmonary rehab, is there a specific type or types of lung disease that can be improved with pulmonary rehab?

Dr. Aaron Bruns,: Most of the data and the most common reason that we send patients there is for COPD or emphysema. However there are other diseases such as pulmonary fibrosis or interstitial lung disease or possibly even asthma. And these people could also benefit it from it also.

Scott Webb: Yeah. And you mentioned exercise earlier, and I know it's not just exercise, and it's a whole team of healthcare providers. So tell me about the team approach to care?

Dr. Aaron Bruns,: So in addition to the exercise portion of it there's various educational activities. They will go through the patient's inhalers, make sure they're using them properly, make sure they understand why they have to do it, education about their lung disease in general nutritional information, a lot of these patients. They have trouble getting around. So they don't eat properly. Their nutrition status is not very good. Smoking cessation for patients who are still smoking to try and help them quit. In addition to the exercise in general. So a lot of programs will have a nutritionist there. Some of them will have. Mental health professionals, but that's not as common. In addition to just the exercise.

Scott Webb: Yeah, I see what you mean, right? When you think about people who struggle to breathe, right? They may have to choose not to leave the house, choose not to go to the store because it's too difficult. And if they're not going to the store and they're not shopping, then perhaps they're diet begins to suffer. I'm trying to connect the dots a little bit. Is it, do I have that right?

Dr. Aaron Bruns,: Yeah, I think to some extent, and that can obviously take a toll on your mental health also. And a lot of these patients will struggle with anxiety or depression in addition to their physical limitations.

Scott Webb: Yeah. And maybe just the self-imposed, if you will isolation on top of that, something that we've unfortunately, all learned about the negative effects of isolation and social distancing and all of that. What are some of the improvements? Obviously, we ultimately we want people to be able to breathe better. Right. But generally, what are the improvements that patients get from pulmonary rehab?

Dr. Aaron Bruns,: They generally will get overall improvement in the quantity of life. By the time they complete the program, they should be able to do more, more activity than they could when they started. A lot of times I have a better understanding of their disease, which can take away some of the anxiety and stigma associated with some of these diseases. Their mental health typically improves some how that they're able to do more. They regain some of the confidence that they've lost. It also can help keep them from having flare ups or exacerbations or getting hospitalized frequently.

Scott Webb: Yeah, doctor, when we think about exercise, I'm sure some folks are thinking to themselves. Yeah I, maybe I could benefit from exercise, but I can barely walk to the mailbox. I can't walk around the grocery store. So how in the world could I possibly do exercise? So maybe you can kind of help them understand that, there are some things there for folks who are able to do more like treadmills and things like that, but there's also other things that they can do in the realm of exercise. Right?

Dr. Aaron Bruns,: Yeah. Most of these programs have a variety of different exercise equipment. they will have treadmills, but there are a lot of people who just can't walk on a treadmill. They'll have recumbant bikes, they have hand bikes for those who have. Difficulty walking much at all, and all of these things can help them improve their endurance. They also do a lot of muscle strengthening exercises, particularly in the legs. A lot of people, if they can't breathe, they don't do a whole lot. And then their legs get weak and that kind of compounds the issue. So they have to regain that strength also. So there's a lot of different things that they do. And they realize that everybody that's in this program has lung disease and has limitations on what they're able to do. So you're not alone.

Scott Webb: Doctor, it's just a natural human thing. When folks hear the word rehab or rehabilitation, sometimes they have some negative connotations, whether that's, anecdotal things they've heard from other people, maybe you could just put everyone's minds at rest or minds at ease when it comes to pulmonary rehab, the benefits far outweigh suffering and not being able to breathe. Right?

Dr. Aaron Bruns,: Oh, yeah. And I think to clarify, this program is an outpatient program. And typically they will have classes two or three times a week. And then we usually have the patients do somewhere between 22, 25 sessions. And so they come in for their class and they go home, there are rehab centers where people stay. And so I just wanna clarify that's not what this is. So it can be difficult if the patient has transportation issues then there may have to look at other options. Most of the people that I enroll in these programs really like it and are very happy with the results.

Scott Webb: Yeah. So folks are struggling, obviously want them to speak with their providers, right? So maybe start with their primary care providers, maybe be referred to a pulmonologist, discuss what's going on. Consider pulmonary rehab, consider all the benefits that you've talked about today. So good stuff. Thanks so much, doctor you stay well.

Dr. Aaron Bruns,: Yep. You too. Thank you.

Scott Webb: And to find a doctor or pulmonologist visit Franciscanhealth.org and search find a doctor. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.