Hope and belonging would be the words I use to describe what I believe pulmonary rehab provides for individuals with COPD. Receiving a diagnosis of a disease that you are told has no cure, that will only progress, that has caused you to give up many of the things that you enjoy, can make someone feel hopeless and alone. Many people talk about how family and friends don’t understand the disease, how they often feel overwhelmed with the “stuff” of everyday life without the tools to adapt to this new life.
In my experience, many folks are doubtful that pulmonary rehab will make any impact on their health, they are even nervous and anxious about exercising. Some of the nervousness comes from a fear that no one will understand their shortness of breath and that they will be embarrassed because their exercise capacity is so limited. But there is no reason to feel embarrassed – everyone is going through it together. Encouragement and support from the staff and fellow clients goes a long way to make new clients feel more comfortable and less nervous.
Pulmonary rehab is individualized for each person so the goals and results will vary from person to person. Most programs start with a short amount of time on several pieces of equipment – the chosen intensity is specific to each individual. As time progresses, the time is gradually increased to approximately 30-45 minutes, in addition to weight training by the end of the program. The thing about this type of rehab is that it is a slow and steady process that requires some patience. This can be a bit challenging in our current society where we are accustomed to instant access and quick fixes. For those individuals who persevere and stick with the program, they are thrilled with their progress.
I had one client, I’ll call him Tom, who was only able to walk 2 minutes on the treadmill before stopping and resting on his first day. By his last week he was walking 15 minutes on the treadmill without stopping, in addition to using 2 other modes of exercise for 10 minutes each (cycle and stepper), and weight training. When he first interviewed, he was doubtful that he could do it, he looked at the other clients and said, “There is NO WAY I will ever be able to do that with my shortness of breath.” I explained to him that everyone in the room started where he did and that each day we would be a little closer to our goal. I asked him to give it a try, that we all would support him and that he could stop if he felt this was not for him.
The first week was really rough for Tom – in fact, day two he told me he wasn’t coming back. The other clients overheard him and showered him with support. They shared with him how they often felt like him in the beginning but they kept at it and now feel so much better. They told him how some days they can do a lot and other days they have “bad days” and adjust their activity accordingly, but overall rehab has changed their lives. Not only was Tom elated with his progress in rehab, the increased endurance and management of his symptoms made a huge difference in his morning self-care routine. It was evident with Tom that the increase in endurance and improved control over shortness of breath truly restores hope.
Being part of a group that “understands you” provides individuals with COPD the opportunity to share knowledge, build mutual trust and support, and increase self-confidence. Belonging makes coping and adapting to this new life a little easier knowing there are others who share this common experience. The friendship and camaraderie that I see develop among the participants is truly heartwarming. This applies to both fellow COPD clients as well as the pulmonary rehab staff. In my experience, those who work in a pulmonary rehab facility place great importance on treating clients with dignity and respect and want to create an atmosphere that is welcoming and safe, where clients feel cared for and at ease. I too have learned much from my clients; they all have a wealth of wisdom and life experience that they are willing to share. From child-rearing, stock tips, secret family recipes, and a few dirty jokes – I have gained so much from those who surround me daily! I have developed a love for a wide variety of music from Swing, Do-Wap, Opera, and Broadway show tunes.
Another part of the job that is fascinating is learning about people’s lives – what they did before they retired, where they have lived, places they have traveled, how they have handled adversity. People love to talk about their lives and this environment allows for that dialogue. We become intertwined in each other’s lives. Many of the participants have knitted sweaters and blankets for my children, come to see me in the hospital, and invited me to their homes for dinner. I see many of them in the grocery store or in town and it is like running in to an old friend – we greet each other with hugs and kisses. This is why I love pulmonary rehab; I love the closeness of it, the intimacy, the sense of belonging.
I speak from the lens of someone who has treated patients in pulmonary rehab for almost twenty years, from my experiences and what I perceive as the benefit of pulmonary rehab. The best part of the job is showing clients where they started and where they are now and hearing them share their stories! One of the greatest gifts someone with COPD can give themselves is to be the best that they can be with a focus on the journey towards improved wellbeing and health, in spite of their chronic illness. Hope for the future and a sense of belonging.