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Pulmonary Rehabilitation Department Helps Patients One Breath at a Time

Saint Clare's Pulmonary Rehabilitation Department Excels

An integral part of treatment for those who suffer from chronic respiratory disease is pulmonary rehabilitation. Recently, both the American College of Chest Physicians (ACCP) and the American Thoracic Society (ATS) have recommended new evidence-based guidelines for a comprehensive pulmonary rehabilitation program for patients to help manage their condition and improve their health-related quality of life. For over 25 years, Saint Clare's Health System has had a long-standing and successful history in pulmonary rehabilitation. The program incorporates key components, including exercise training of the lower and upper body, educational programs and psychosocial support.

"Pulmonary rehabilitation is part of the treatment of every patient with advanced lung disease," said Dr. Mark Atkins, a pulmonologist and current Medical Director of the Pulmonary Rehabilitation Program at Saint Clare's Hospital/Dover. "Although it doesn't replace management with medication, it works in conjunction with that course of treatment. Pulmonary rehabilitation will not repair damage done to the lungs by years of smoking or other lung insults, but it will significantly improve the quality of life and functioning for those with chronic lung disease."

According to Dr. Michael Russoniello, a Saint Clare's pulmonologist, pulmonary rehabilitation also helps patients break the cycle caused by lung disorders that lead to inactivity, helps reduce the number and length of hospitalizations, and increases the patient's chances of living longer. "Pulmonary rehabilitation is focused on patients with chronic obstructive pulmonary disease (COPD) as well as those with respiratory conditions like asthma, cystic fibrosis, neuromuscular disorders, ventilator dependency, and a host of others, and is important both before and after lung transplantation, volume reduction, or cancer," said Russoniello. "As lung reserve declines, shortness of breath worsens and independent daily activity performance erodes. Pulmonary rehabilitation provides multidisciplinary training to improve the patient's ability to manage and cope with progressive symptoms."

Referrals to the Saint Clare's pulmonary rehabilitation program are made by a physician. The basic rehabilitation program has 20 treatment sessions that consist of both education and exercise. All patients are required to stop smoking before they enter the program. When a participant graduates from the basic rehabilitation program, they usually continue with a maintenance program at home, a gym or at Saint Clare's for one to two exercise sessions a week. A monthly support group, the Huff 'n Puffers, also meets.

According to the American College of Chest Physicians (ACCP) guidelines, six to 12 weeks of pulmonary rehabilitation will produce benefits quickly, but those benefits will decline gradually over 12 to 18 months. Longer pulmonary rehabilitation programs (beyond 12 weeks) may produce greater benefits than shorter programs. At Saint Clare's, some pulmonary rehabilitation patients have come to the maintenance program for 15 years.

The success of Saint Clare's program has been recognized by Dr. Vivek Ahya, medical director of the Lung Transplant Program at the University of Pennsylvania Health System. As head of one of the premier lung transplant programs in the nation, Dr. Ahya knows the importance of dedication, hard work and team work involved to successfully transplant a patient. "Of all the solid organ transplant procedures performed, lung transplantation is the most complicated and likely to be fraught with complications. Maintaining excellent functional status is one of the keys to a successful post-transplant outcome," says Dr. Ahya. "I was quite impressed by the dedication of the Saint Clare's rehabilitation staff, including respiratory therapists, nurses and physicians. Saint Clare's Pulmonary Rehabilitation program is one of the premier programs in the region, and the Penn Lung Transplant program looks forward to continuing this important partnership on delivering excellent care to our mutual patients."

Grace Bachmann, 67, a retired speech and language specialist, began the Saint Clare's pulmonary rehabilitation program in 2002, following a diagnosis of pulmonary fibrosis. After discussion with her pulmonologist, Dr. Atkins, she was referred to and accepted into the Penn Lung Transplant Program in 2003. In 2005, on a day where Bachmann felt she could no longer stay home due to her deteriorating condition, she went to the ER. Bachmann's husband telephoned the University of Pennsylvania to let them know Bachmann's whereabouts and was informed that a lung had become available. Bachmann got her lung transplant on December 3, 2005. Today, Bachmann is a vibrant testimony to the success of lung transplantation. She is no longer oxygen dependent, and continues her maintenance program at Saint Clare's.

Bachmann has believed in the value of a pulmonary rehabilitation program since she was first advised that she would still require oxygen after her lung transplant. "The exercise indeed helped me," she said. "This is such a unique program. The staff is great; they are there for education and support. It's not only about making us better, but improving the quality of our life. Now, even though I could exercise on my own, it's important for me to stay, so other patients can see what I can do and I am not only giving but getting from others."

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