For Kay Bramble, climbing a flight of stairs is a challenge. At 54, she is one of more than 12 million Americans living with chronic obstructive pulmonary disease (COPD), a term that refers to a group of progressive lung disorders that make breathing difficult.
A former smoker, Bramble was hospitalized in 2003 following a severe asthma attack, the first in a series of serious health scares that she describes as “drowning in air.” The following year, she was referred to the Shore Health System Center for Cardio-Pulmonary Fitness and Wellness for help in exercising her lungs and strengthening her muscles, key elements to controlling COPD symptoms.
Bramble, who lives in East New Market, attended the program for nearly four years at Dorchester General Hospital in Cambridge. She Three times a week, for one- to two-hour sessions, she did warm-up stretches and cardiovascular activities on the treadmill, stationary bike, arm peddler and recumbent stepper. She strengthened her upper body muscles with light hand weights followed by a cool-down routine. Bramble’s oxygen level, heart rate and blood pressure were closely monitored by the staff of nurses throughout each session.
“It wasn’t until I took a year off that I realized how much it was helping me,” Bramble says.
Within a few months of leaving the program, Kay required more frequent physician visits, had an increase in medications to control her elevated blood pressure and heart rate, and experienced further physical weakness.
“Patients with COPD often avoid activities because of shortness of breath. This inactivity leads to de-conditioning, which in turn will require more effort by the heart and lungs for the same level of physical effort,” says D. Greg Oliver, MD, a pulmonologist and medical director for Shore Health System’s Pulmonary Rehabilitation Program. “Although exercise does not improve lung function, it does improve oxygen utilization, work capacity and state of mind for many COPD patients.”
Bramble has always had difficulty gaining weight. When she returned to the Cardio-Pulmonary Fitness and Wellness Program in June, 2009, she weighed just 93 pounds. In addition to her physical conditioning program, Kay took advantage of the program’s nutrition education component to learn more about eating a balanced diet, how to add a variety of protein to meals and the benefits of eating small meals throughout the day. “I’m back to the program for life now,” she says.
While there is no cure for COPD, improving overall physical conditioning and learning to breathe effectively can help COPD sufferers lead full, satisfying lives.
According to Dr. Oliver, taking a cardio-pulmonary stress test is the first step. This will indicate how much air is moving in and out of the lungs when exercising and serve as a benchmark for developing a plan of care. While the specifics of each person’s medically-supervised program vary, the basic components may include medical management, exercise, breathing re-training, education, emotional support and nutrition counseling.
“In pulmonary rehab we help people with COPD restore their highest functional capacity while helping to improve their overall quality of life – physically, emotionally and socially,” says Sally Worm, RN, Program Manager for the Shore Health System Center for Cardio-Pulmonary Fitness and Wellness.
Dr. Oliver and Worm oversee individualized programs in coordination with patients’ referring physicians, a team of nurses, respiratory therapists, dietitians and an exercise physiologist at The Memorial Hospital at Easton and Dorchester General Hospital.
“I’ve become friends with others in the program and it really helps me as they truly understand what it is like to live with this condition,” says Polly Yowell of Easton, describing how individuals benefit from interacting with other program participants.
Yowell, 68, was diagnosed with bronchitis and asthma in 2003. A former smoker, environmental changes she experienced when moving to the Eastern Shore worsened her condition. She is now on continuous oxygen therapy. Since May 2004, Yowell has been attending the pulmonary rehabilitation program at Memorial Hospital.
“Exercise was new to me so I cannot say enough about the direction and support the staff provides,” Yowell says. “I’m so pleased that my medication has not increased at all since entering the program and I’ve been building muscle for the first time in my life.”
Yowell adds that she has also taken advantage of the educational component of the program from discussions with pharmacists on medication “do’s and don’ts” to learning proper breathing techniques and the benefits of meditating.
Individuals with COPD usually are current or past smokers over the age of 40 with a history of shortness of breath upon physical exertion and chronic productive cough. “I cannot overemphasize the importance of obtaining an early diagnosis of COPD through pulmonary function tests,” says Dr. Oliver. “With early diagnosis comes early treatment that can help slow the progression of the disease and improve daily life,”
For more information about pulmonary testing and rehabilitation offered by Shore Health System, contact the Center for Cardio-Pulmonary Fitness and Wellness at Dorchester General Hospital, 410-228-5511, ext. 8201 and at Memorial Hospital, 410-822-1000 ext. 5208. Visit www.shorehealth.org/services/cardiac for a full list of cardiovascular and pulmonary services available through Shore Health System.