Better Breathing: A Respiratory Therapist Explains Pulmonary Rehab

After I received my single-lung transplant in December 2015, I was required to participate in a pulmonary rehabilitation program to build up my strength and lung function.

I had a choice of several programs in my immediate area, and through my research, I found the best center for me. University Hospitals St. John Medical Center is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation, and Lynn Gorton is the on-site respiratory therapist.

Lynn and I had an immediate rapport. I respected how she treated her patients and pushed them to maximize their performance during rehab. I think that Lynn appreciated the effort I put into each class as well.

I am grateful that Lynn agreed to answer my questions for this week’s column. Lynn is committed to helping her patients breathe better. I am impressed by her skill at explaining the breathing process in a way that people who aren’t medical professionals can understand.

In her role, Lynn assists patients who have pulmonary fibrosis (PF), chronic obstructive pulmonary disease, lung cancer, and other lung diseases. I asked her if PF patients are given different expectations than their fellow participants of what they can achieve with the program. She replied, “Yes, they often breathe faster and more shallowly, and they need more breathing retraining and cough suppression. Depending on their severity, they may need to rest more frequently and use more oxygen which could include a non-rebreather mask or an oxymizer cannula.”

I frequently struggled to breathe before my transplant. I asked Lynn how patients can reduce anxiety about their breathlessness. She recommended methods such as chair yoga and mindfulness to calm the breath, which increases carbon dioxide in the lungs. She added, “Keeping a little more CO2 in the airways relaxes the bronchial smooth muscle and makes it easier to breathe.”

I had believed that low oxygen saturation led to my coughing attacks. However, Lynn told me that “deep breathing, mouth breathing, chronic secretions, and habit” are the usual causes of coughing.

Before my transplant, I could not perform any exercise while standing, because when I was upright my heart rate would accelerate into the 130s, and my oxygen saturation would drop below 88 percent.

Many patients who go through the St. John Medical Center rehab program have PF, the same condition that I had. Lynn said that each patient’s exercise plan is tailored to fit their needs. Individualized programs are designed to increase exercise capacity, stamina, and strength. Even if the patient is unable to stand while completing their exercises, they can still fulfill their rehabilitation needs.

Lynn facilitates two support groups at the hospital: the Better Breathers Club and the Second Wind. I regularly attend the latter, and I occasionally join the other one, too.

In the Better Breathers Club, Lynn uses the Buteyko method to help patients control their breathing. She also uses mindfulness, chair yoga, and other forms of meditation. Lynn explained how the Buteyko technique calms and relaxes the airways. Nasal breathing moistens, filters, and warms the air flowing into the lungs, helping to reduce the inflammation caused by mouth breathing.

I feel fortunate to have gone through phase II pulmonary rehabilitation with Lynn and her team. During the period following transplant, it is crucial to strengthen your muscles and increase your endurance, while conditioning the transplanted lung or lungs. I experienced considerable improvements in my lung function and overall conditioning over my 36 rehab visits.

I’m currently participating in a phase III program. This phase incurs an out-of-pocket expense, and participants carry out their exercise routines independently rather than in a group setting. I don’t anticipate any problems while I’m exercising, but I feel reassured that Lynn and her team are present to help me if needed.

Each of us has a reason for choosing our career. I was curious to find out why Lynn chose respiratory therapy. She replied, “My niece had a tracheostomy, and I took care of her.” Her passion for helping people to be better breathers comes from recognizing that she can make a difference. I hope that anyone with a lung disease who is required to attend a pulmonary rehabilitation program is fortunate enough to have someone like Lynn in their corner.

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