Caitlin Whyte (Host): In this followup episode of In Their Words, we sit down with Sandy Gates and Amy Borneo. senior respiratory therapists at UPMC Hanover Pulmonary Rehab who share their perspective on patient care and rehabilitation through the lens of Holly Brown's remarkable recovery story.

Having worked closely with Holly during her journey from severe COVID-19 complications to recovery, Sandy and Amy provide unique insights into the challenges and triumphs they witnessed daily in pulmonary rehabilitation. They discussed the intensive process of helping patients regain their strength and independence. From the first tentative steps to achieving major milestones, like breathing without supplemental oxygen, Amy and Sandy also pull back the curtain on their roles as senior respiratory therapists, explaining why UPMC Hanover's Pulmonary Rehab Program has become a beacon of hope for patients working to reclaim their lives after serious respiratory illnesses like COVID-19. This is In Their Words.

Amy Borneo: I'm Sandy Gates. I've been with UPMC Hanover for 21 years. I'm a respiratory therapist. I have been in respiratory and pulmonary rehab for 17 years. And I'm originally from Pensacola, Florida.

Sandy Gates: Good morning. I am Amy Borneo, and I have been with UPMC Hanover a total of about 13 years, two different stints here. I've been in pulmonary rehab on and off for probably about that long as well, 13. I've been a respiratory therapist for going on 26 years. I'm from, for the most part, Hanover, so I'm back in my hometown and in my community that I grew up.

Amy Borneo: I got into it 43 years ago. My dad had a surgery and we found out he had three different types of breathing issues. So, I saw a respiratory therapist every day at the hospital with him, and I thought it was interesting, so I applied and got in in 1981 school, January of 1981.

Sandy Gates: And, unlike Sandy, I did not know anything about respiratory therapy. I went to college to be a math teacher and circled around several different times. And with the encouragement of my parents, they said, "Go to the hospital and start shadowing. If you get into healthcare, you won't regret it." So, I was forced into a couple of days of shadowing different departments and stumbled into Respiratory and was lucky to have some really good mentors and preceptors. And I found myself in that program midway through and switched gears and been here ever since.

Amy Borneo: Well, in pulmonary rehab, you assess a patient first, you have a first meeting with them. You're with them about an hour and a half, and ask them a bunch of questions. They have questionnaires that they have brought with them that we sent them in the mail, they ask those questions, and just kind of start off very easy with them, and then the next thing, the next step for that is their first exercise session. And they do anywhere from 18 to 30 visits with us in pulmonary rehab.

Sandy Gates: All of our patients that are here with us in pulmonary rehab qualify based on having some sort of breathing problem, lung disease. And prior to COVID, it was mainly patients that had COPD, emphysema, chronic bronchitis, maybe some of our lung transplant patients, asthma at times, cystic fibrosis, and then along came COVID. And, as we all know now, that affected our lungs and our breathing and caused a lot of interstitial and fibrotic changes in their lungs. And so, that is a big part of our rehab and the patients that we see.

Amy Borneo: I met Holly initially for her first appointment. I spent about an hour and 45 minutes with her. And she was very short of breath. She was very scared. She didn't know if we could help her. She was also on oxygen at that time, all of the time. And after meeting with her and talking to her and her husband, she was willing to come in and try, and she did. And after, I know you've met Holly and talked to her, she did marvelous. She did everything we asked her to do, try everything we asked her to try. After she finished pulmonary rehab, she did come to the medical fitness center and was currently coming to the medical fitness center until they closed earlier this year, and she did great. Got off the oxygen during the day and did well. Gained her confidence back, went back to work. She was a great patient.

Sandy Gates: I actually met Holly pretty much in the beginning, after her initial interview she had with Sandy. And like all of our other COVID patients, there's just a different category, you know, because a lot of them are still working, they're younger than our normal patients that we would see prior to this pandemic. And I remember the fear and the anxiety associated with, "Am I going to get better? what's next? Can I get off of this oxygen? I want to get back to work." And right from the get-go, she was just all about giving us 100% effort because she wanted that to pay off in the long run to get better. And she gave us just that. She gave us great effort and started to trust the process that isn't just a quick in and out. Like Sandy mentioned, there's many, many, many sessions that our patients come to us. And so, we developed a relationship, developed a trust, and the process worked for her. And she just succeeded tremendously.

Host: When asked what it means to know that Holly was so grateful for the care she received from Amy and Sandy. This is what they had to say.

Amy Borneo: Well, for me, actually, it really doesn't get any better than that, when you have someone that she worked so hard to get to where she was. And in my opinion, we're coaching, we're making suggestions, we do education classes. Holly did all of those. When you have a person, though, that jumps into it and is so willing to trust somebody that she had never met before, and when she was so scared of how this had affected her life, and would it get better, and when you see somebody like that start from where they are to get to where Holly is now, it just truly doesn't get any better than that. That's success at the utmost to see somebody go from where she was to where she is now.

Sandy Gates: I agree with Sandy. There's a level of satisfaction that we feel when we see our patients succeed. And we're unique a little bit out here in pulmonary rehab from hospital care that you don't always see instantly that you have success. I mean, your numbers might not be able to be a huge improvement or, you know, it's not always tangible successes that we see, but to know that we impacted her life in this way. Because our goal out here in pulmonary rehab, regardless if it's COVID, or emphysema, or asthma, or lung transplant, is we want to get our patient's quality of life back to them. and. That's something that we talk to each and every one of them during the interview.

And when we have them discharge with us and we review that again and to see that her quality of life had come back, she was able to get back to activities, she was enjoying time with her family, she was back working, that just gives you such satisfaction and fulfills you greater than anything else that's tangible.

Host: Reflecting back on the height of the COVID-19 pandemic and its aftermath, Sandy and Amy remember the devastation and impact that was wrought on the Hanover community and beyond and how it impacted their work.

Amy Borneo: Well, for me, yeah, as you said, we didn't really know what to expect. And when we started getting the COVID patients, some of them were obviously they were sicker than the others. Some of them were not working anymore. We've had several that have been working and to see them be able to go back to work and the satisfaction of helping somebody get from where they came into us to the time that they were discharged, it's just a satisfaction that I really personally don't have words to describe.

Sandy Gates: There was so much unknown, you know, with COVID from the start to the finish and still continues, you know, whether you were somebody that was working in the hospital, whether you were here in pulmonary rehab, all aspects of our lives really, we were impacted some way, shape or form with COVID. And, as a respiratory therapist, we were greatly impacted. You know, our workload had changed. The way that we treated patients changed. There was not that evidence and studies yet that were out there that told us what we were doing was right or not right. We didn't know if we were going to be successful.

And so, kind of learning on the fly and figuring out as we went a little bit, I think as practitioners is it can be an uncomfortable feeling. But seeing that we had the success, seeing how greatly important pulmonary rehab became. Because once these patients were discharged from the hospital, a lot of them went home and were like, "Okay, now what do we do? I'm on all this oxygen, I'm not Working." They were scared, they were unsure of what was next. And having a place for them to come and us comfort them and educate them and keep them safe, I think It just changed everything for them. And so, it just really, really, really, after we got through the tough days, became such a satisfying place to be in.

Amy Borneo: I think I just want to say Holly put a 100% into helping herself. I personally was just a coach, held her hand along the way, encouraged her, and she gave a 100%. And everybody doesn't do that, but it was great to see her from day one until the day she completed the program.

Sandy Gates: Yeah, I agree with everything that Sandy had said. I miss seeing Holly. I miss some of the conversations that we would have when she was here at the Medical Fitness Center, getting to exercise on her own and just catching up with her. But I'm forever grateful that she came into our lives and crossed paths with us because I think, as respiratory therapist, I can speak for Sandy and I and the rest of our team, we're different. We're different after COVID and we're different, the way we care for patients, the way we look at things. And I think that she helped us to become better therapists and helped us to look at our program differently. I mean, I'm thrilled. I'm thrilled that she's doing as well as she is. So, I thank her for the props that she gave us, but she actually deserves all the props for what she did.

Amy Borneo: She was just great to work with. And to see the progress that she made because of her effort that she put into it, it's truly amazing.

Host: And that wraps up this inspiring episode of In Their Words. We hope Sandy and Amy's insights into pulmonary rehabilitation have shed light on the incredible dedication and care that go into helping patients like Holly reclaim their lives. Their stories remind us of the resilience of the human spirit and the profound impact of specialized care teams on the path to recovery. If you enjoyed this episode, don't forget to subscribe, share, and leave us a review. Your support helps us continue to tell these important stories. Thank you for listening, and we'll see you next time on In Their Words, where every story has the power to inspire.