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An Interview with an Exercise Physiologist
I recently interviewed Jessica Sedlacek MS, CES for my column, “Gonna Live My Life” on Pulmonary Fibrosis News. Jessica is a Certified Clinical Exercise Physiologist and a member of the cardio-pulmonary rehab team at UH St. John in Westlake, Ohio. I have had the privilege of knowing Jessica since February of 2016. This was when I began my phase II pulmonary rehab about 2 months after my single lung transplant. The complete interview with Jessica is below.
What made you choose the profession of exercise physiologist? I knew from a very early age that I wanted to do something in the medical field. I always enjoyed learning about life science, but also knew I enjoyed helping others. I was also an athlete and enjoyed the sports medicine arena. In my senior year of high school, shortly after I was accepted into the Sports Medicine program at Mount Union, my grandmother died prematurely from a myocardial infarction (heart attack). I knew then that I wanted to go the clinical route in my Sports Medicine program, following the cardiac and pulmonary rehabilitation pathway.
When you are on the floor I notice you exhibit passion for your job. Where does this passion stem from? Deep in my heart, I have a passion for connecting with people. It is how I was raised in my family, to treat others with respect and empathy. I try to put myself in my patients’ shoes, and treat them as I would want someone to treat my loved ones. I feel incredibly fulfilled when I can see patients make progress with their health and confidence. This is not just a job to help others improve physically, but also to greatly improve their mental health. Being a witness to others getting their lives back is the greatest gift, driving my passion each day.
Are you ever involved in phase 1 of cardio-pulmonary rehabilitation? Throughout my 17 years at UH St John Medical Center, I have only worked in our Phase 2 and Phase 3 Cardiac and Pulmonary Rehabilitation Department. Due to scheduling, I have never been a part of our Phase 1.
Is your approach different between a cardio patient and a pulmonary patient? I approach all patients the same initially, until I see what each patient needs as an individual. As for prescribing exercise for the different populations, each disease state has their own guidelines and recommendations. For pulmonary patients, we are not only helping to improve their breathing with the use of breathing retraining, but also to increase strength and stamina/endurance so as to improve their ability to perform ADL’s.
Many patients exhibit anxiety when they begin cardio-pulmonary rehab, how do you help your patients alleviate their anxiety? Many patients present to us with an anxiety component, this is very normal for a patient with pulmonary disease. Initially, I try to make the patient feel very comfortable in our setting, introducing them to fellow patients, informing them of expectations, but doing so with genuine kindness and a smile. Having patience with each individual also helps to ease their anxiety.There is not one specific exercise prescription for pulmonary patients. It is individualized based on what each patient needs, however a complete program should include cardio/endurance training to work stamina, resistance training to facilitate muscular endurance and strength and stretching/balance training to help with flexibility and fall risk reduction.
In the pulmonary rehab class there may be patients with a diagnosed lung disease and a patient who was recently transplanted. Would you change your approach for each patient? We have multiple lung diagnosis within one Pulmonary Rehab class. Those patients attending PR for diagnosis such as COPD and ILD, exercise will include resistance training for strength improvements and increased ability to perform ADLs. However, most exercise is aerobic based for cardiopulmonary improvements with stamina and overall exercise tolerance. Post lung transplanted patients also need aerobic exercise, and often tolerate it well due to improved lung function and less reported dyspnea. These patients, however, need increased resistance training because of decreased quadriceps strength and overall muscular atrophy from years of inactivity due to progressive lung disease.
Your program is accredited. Please tell me your duties in the accreditation process? UH St John Medical Center Cardiac and Pulmonary Rehabilitation Department is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. As a certified program, we are held to great standards and must re-certify each program (cardiac and pulmonary) every three years. My role in this process is to be an effective exercise physiologist, counseling on lifestyle behaviors and exercise training, to allow for the best outcomes. Being part of the CR and PR team, means I must provide sound advice and information to help our patients improve and meet goals, both personal as well as those set by staff. Our accreditation is based on effective policy and procedures as well as measured outcomes. We work as a team to accomplish all of this together.
Can you tell me what an exercise physiologist does during a pulmonary rehab class? As an exercise physiologist, working in Pulmonary Rehabilitation, I often work with patients during their actual exercise sessions, prescribing their exercise modalities and workloads. I assist the patients through their exercise prescription, helping to move them to each exercise device as well as setting/modifying exercise workloads (if necessary). I also actively participate in counseling patients with home exercise planning. Education is a vital part of the pulmonary rehab sessions, I teach the exercise topics, which range from home exercise guidelines, resistance training and flexibility, overcoming barriers to exercise and ways to stay motivated, just to name a few.
What is an exercise physiologist? As an exercise physiologist, I utilize science based rationale to design, implement and supervise exercise as a modality for disease management for those with cardiac and pulmonary disease.
I know that you periodically teach college courses. Can you tell me what courses you teach? I have taught introductory health care classes at Cleveland State University, but I have not done so in the last 4-5 years.
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