Breathing easier: Rehab program helps people live better with lung disease
WILLMAR — These days, Judi Lauer can climb the stairs without getting breathless. She feels better. She even plans to buy a bicycle this spring.
None of this was the case three months ago, when a severe exacerbation of adult-onset asthma landed her in the hospital and on a ventilator for five days.
Lauer credits pulmonary rehabilitation with helping her regain her life.
"I've learned that asthma doesn't control me. I control my asthma," she said.
The pulmonary rehab program at the Rice Rehabilitation Center targets individuals with respiratory conditions such as chronic obstructive pulmonary disease or asthma.
By the time patients are referred for therapy, many have been struggling for months. Even everyday activities such as walking to the mailbox are often difficult. They may need supplemental oxygen to get through their day.
Fatigue often further erodes their quality of life, said Keri Ohren, a respiratory therapist at the Rice Rehab Center.
"Breathing takes a lot of energy," she said. "Sometimes all they can do is breathe."
But with a tailored program of education and exercise, most will see fewer symptoms, improved stamina and a better ability to carry out their day-to-day routine.
Ohren said she tells her patients that rehabilitation is "a stepping stone."
"It's a monitored program to give them the confidence to be able to continue exercising," she said. "We're not going to cure their disease process, but we're hoping to give them tips and techniques."
She works with a wide range of ages and conditions — from teenagers to the elderly, from asthma to chronic obstructive pulmonary disease (more commonly called COPD), restrictive lung disease, pulmonary fibrosis and lung cancer.
As Lauer found, it's often a sudden and frightening worsening of their condition that sends them to rehabilitation.
"They're trying to figure out a way to not have that happen again," Ohren said.
Lauer, a nurse at the Willmar Regional Cancer Center, was diagnosed five years ago with adult-onset asthma. Inhalers were prescribed but after the first couple of years, "I started to not use them as often," she said. "I felt pretty good. I was kind of in denial."
Then things went downhill. She was in and out of the emergency room at Rice Memorial Hospital three times. The crisis came in early December when she ended up in intensive care.
"I lost five days out of my life. I have no recollection of it at all," Lauer said. "It was probably hardest on my family."
The real work came afterwards.
At her first meeting with Ohren, she received training in how to use her inhaler correctly. Rehabilitation therapy was suggested, so she began going to the Rice Rehab Center twice a week. The closest similar programs are in Montevideo and St. Cloud.
Once she left the hospital, there were still many unknowns, Lauer said. "I wondered how much can I do? How much can I push myself? You can't imagine what it's like not having enough air."
The rehab therapy sessions provided constant monitoring to assess her breathing, her pulse rate and how she felt. Along with the education, it helped restore her confidence.
By mid-February, she was able to comfortably walk from her workplace at the cancer center to the rehab center across the street. "It gives you back your control," she said. "I'm not afraid of that walk."
The benefits of pulmonary rehabilitation are well documented, said Dr. Ken Flowe, an emergency physician and medical director of the Rice Rehab Center's pulmonary rehab program.
"I see these people in the emergency department. Then two months later I see them here and it's amazing to see the turnaround," he said.
Awareness of the program and its benefits often is lacking, however — a situation he wants to see changed.
Heart patients are automatically referred to cardiac rehabilitation after an acute coronary event but this isn't typically the case for lung disease, which may develop over many years and can go unrecognized until the later stages, when therapy is less likely to significantly improve lung function.
Early referrals offer the best outcomes, Flowe said. "The milder the loss, the greater the benefit. We have plenty of capacity and plenty of need. We're just trying to get the word out."