Transcription:
Pulmonary Rehab at Stoughton Health

Maggie McKay: If you suffer from a chronic lung disease, there are ways to manage it to improve your quality of life. Today, our guest is Melanie Pavolonis, a clinical exercise physiologist, here to talk about pulmonary rehab at Stoughton Health.

Welcome to Stoughton Health Talk. I'm Maggie McKay. Melanie, thank you so much for being here. I am so interested to hear more about what you do to help people with chronic lung disease. So first of all, can you please tell us about Stoughton's Pulmonary Rehabilitation Program and its mission?

Melanie Pavolonis: Sure, I can. Stoughton Health Pulmonary Rehab Program, we're here to provide a safe and comfortable exercise and environment for those that suffer with chronic lung diseases or other conditions affecting their breathing and help those individuals just learn how to breathe easier, improve energy levels, decrease hospitalizations, and overall just enjoy a better quality of life. At our pulmonary rehab program, we do provide both exercise and education to help them work towards those goals.

Maggie McKay: And what lung conditions do you treat?

Melanie Pavolonis: We work with people with a wide variety of lung conditions. Most common are those with the chronic obstructive pulmonary disease or COPD, and those would be things such as emphysema and chronic bronchitis and then other breathing conditions. We work with people with asthma, pulmonary hypertension, pulmonary fibrosis, and now even those with long COVID symptoms.

Maggie McKay: Just this weekend, Melanie, I was at a reunion and talking to one of my friends and his brother passed away from COPD, and he was so passionate about telling people not to smoke. Is that the main cause of COPD?

Melanie Pavolonis: For the most part, yeah, the environmental factors, especially smoking. Also, just long-term exposure to things like chemicals, air pollution, dust, and just other fumes they may encounter in their lives. And then also, there are some hereditary diseases such as cystic fibrosis. But definitely, for the most part, it's environmental.

Maggie McKay: Is anyone born with lung disease and is it permanent? And which ones are hereditary?

Melanie Pavolonis: So, there are a couple that I'm familiar with, cystic fibrosis people are born with. And then, there's something called alpha-1 antitrypsin deficiency. Again, something people are born with and those are long-term, there's typically no cure for that, though they have multiple ways to help deal with the symptoms.

Maggie McKay: And Melanie, you mentioned earlier about educating patients and helping them manage their condition and exercise, are those equally important?

Melanie Pavolonis: Yes, definitely. The exercise component and education together really is what's going to help these patients improve upon their symptoms and overall quality of life.

Maggie McKay: So, I'm wondering, when you have a lung disease, what exercise do you recommend for people like that?

Melanie Pavolonis: We do cardio and resistance training. So, we will have people on recumbent bikes or steppers, treadmills, and then we will do some light dumbbell resistance training. And then, balance and stretching is also involved.

Maggie McKay: And what are the most common symptoms and how do you reduce them or help increase your energy?

Melanie Pavolonis: The most common symptoms are shortness of breath, frequent coughing, wheezing, tightness in the chest, and fatigue. As far as helping ease those symptoms, we really encourage taking medications as prescribed, and that's something that we review with our patients quite a bit, how to take the medications, when to take them to give them the best outcome with those.

Some may be given supplemental oxygen to help them with their symptoms, and we also teach different breathing techniques, which will help them increase the air to get into their lungs and reduce that shortness of breath. And then, just other education to help them understand how their body is working. So, we'll talk about good nutrition and energy conservation. A lot of people with pulmonary disease, as I mentioned earlier, have a lot of fatigue and just have greater difficulty doing tasks like cleaning. So, we help them learn to conserve their energy.

Maggie McKay: And who qualifies for pulmonary rehab and what does it involve?

Melanie Pavolonis: Most insurance companies will cover pulmonary rehab for those with respiratory diseases. COPD, as I mentioned before, the chronic obstructive pulmonary diseases that are considered moderate or higher in nature as far as the degree of severity, and that is determined on a breathing test that the patient performs. But beyond that, they'll also cover other respiratory diseases that are causing persistent symptoms and are limiting them despite other medical therapy. It does require a doctor referral to get started. And then, we just have the patient come in for an initial appointment, so we can review their medical history and have them also perform a walk test so we can watch their blood pressure, heart rate, oxygen levels, and then that helps us to develop a plan for them.

Maggie McKay: Is there any way to prevent lung disease?

Melanie Pavolonis: Well, the most important thing is to not smoke or quit smoking if you are a current smoker. Otherwise, limiting exposure to those chemicals and strong fumes that I mentioned earlier.

Maggie McKay: And what treatments does your program at Stoughton offer to help improve lung function and restrictive lung disease?

Melanie Pavolonis: So, essentially, we're looking at doing the education and exercise. And treatment involves taking the medications that's prescribed, offering smoking cessation information, educating on minimizing their exposure to irritants, such as the air pollution or strong odors and chemicals. Again, going through the breathing techniques to help them get the air in their lungs. Good nutrition, we help the individuals understand the right mix of nutrients to help them breathe easier. Stress management is key, learning methods to reduce or relieve stress. They're feeling stressed, that's going to elevate blood pressure and heart rate and increase their rate of breathing as well.

And then, of course, exercise. Most people with lung disease find any type of activity challenging and a struggle. So, we individualize our patient's exercise plan to meet where they're at and help guide them through a structured and monitored exercise. And that exercise is going to help strengthen muscles and decrease their shortness of breath and just improve their ability to do their normal day to day task.

Maggie McKay: It sounds like you've got all aspects covered. Like you said, you meet people where they are health-wise.

Melanie Pavolonis: Correct. Yes. And that's important because everybody's going to be different as far as their level and capabilities. So, we want to make sure that we're paying attention to each individual and basing their program on their abilities and needs.

Maggie McKay: So, they're tailor-made for each person. How often does a patient have to come in for treatment or does it just depend on what they're being treated for?

Melanie Pavolonis: Our program is usually set for having them come in two to three times per week, and most insurance companies will cover up to 36 sessions.

Maggie McKay: Melanie, what would you like people listening to take away from this conversation?

Melanie Pavolonis: Well, I know for some patients with the breathing problems, just going out to grab their mail is a difficult task. So, coming to pulmonary rehab a couple times per week can sound scary to some of them, but I just want to assure them that we will not be trying to make them run a marathon or anything like that. But just through the education exercise at the levels that they can achieve and are capable of doing will help them in their daily tasks, simply, you know, going to grab the mail or cleaning their house. Help those things become less challenging. We can them manage and control their breathing, which will allow them to have a better quality of life and just overall well-being.

Maggie McKay: Thank you so much for your time and sharing this important information about pulmonary rehab at Stoughton Health. It's very reassuring to hear all the positives that you can do to at least raise people's energy who are suffering from lung disease or just give them a better quality of life through rehab.

Melanie Pavolonis: Right. And that's, I think, what most people want is just to have a good quality of life and be able to do activities without having to worry about if they're going to be able to get through that without getting real short of breath.

Maggie McKay: Absolutely. Again, that's Melanie Pavolonis, Clinical Exercise Physiologist.

If you'd like to find out more, please visit stoughtonhealth.com. That's S-T-O-U-G-H-T-O-N health.com.

That concludes this episode of Stoughton Health Talk. Please remember to subscribe, rate, and review this podcast and all the other Stoughton Health Talk podcasts. I'm Maggie McKay. Be well.