‘Two sides’ to cardiopulmonary wellness
To talk to Ann Houser, RN, who serves as Heart of America Medical Center’s new Cardiopulmonary Wellness Coordinator, is to talk to an advocate.
Enthusiasm comes through Houser’s voice as she describes her work monitoring, motivating and educating her patients as they work to recover from cardiac events or stave off debilitating lung conditions.
Houser, hired by HAMC last summer, spoke of her work in a recent press release and a conversation with The Tribune.
“There are two sides (to cardiopulmonary rehab),” Houser told The Tribune. “There’s the cardiac and there’s the pulmonary.
“The cardiac can range from previous open heart (procedures), heart stent, heart attack, CHF (congestive heart failure); there’s the new PDA (peripheral arterial disease coverage through Medicare).”
“Then, you have the pulmonary side. Any COPD that’s moderate or greater; any interstitial lung disease, pulmonary fibrosis, lobectomies, those types of things are covered,” Houser continued.
Houser said patients typically begin the rehab process while still in the hospital for their cardiac event. This stage of therapy is referred to as “Phase 1.”
“If you have some cardiac (treatment) in the hospital, that’s a Phase 1 type, where they come in, get you up, teach you say it’s with open heart, teach you how to move properly, breathe properly, but those are just maybe only a couple of sessions. Nowadays, even with valve replacements, you’re in and out pretty quick.”
The second phase of rehabilitation is done on an outpatient basis at HAMC.
Houser said most insurance plans pay for 36 visits for rehab services after each cardiac event.
However, she said, “Pulmonary rehab is not as giving. Normally, it’s 36 visits in a lifetime.”
Because of the insurance limits for rehab visits, Houser said she works to motivate and educate patients.
“A lot of my pulmonary patients, I start them out teaching them breathing,” Houser noted. ” A lot of pulmonary patients have a lot of anxiety, because they panic because they can’t breathe. So, there are a lot of breathing techniques to keep them calm, because when you have pulmonary lung issues, you retain CO2.”
“And so, education is huge,” Houser emphasized. “Exercise is a big part of it, but education when they come in, they watch videos, and I send them home with pamphlets. A lot of them don’t know about their medications. One thing, from working in the medical field for 25 years, medication education is still not very good. So, we’re teaching them.”
Houser went on to describe another benefit of cardiopulmonary wellness visits: catching conditions that go undiagnosed in regular doctor visits.
“I had a patient come in who has Sjogren’s (syndrome), but she has basically an interstitial lung disease, and it’s causing her to have pulmonary arterial hypertension,” she recalled. “And so, when you go to the doctor, they just take your vitals and you don’t see anything else. When you exercise and are active, your blood pressure increases. So this patient, I couldn’t see right away; I had to have her go down and see her doctor.”
“So, there are just so many things caught. But it’s so beneficial, because even someone whose heart is now working fine, or their lungs, they need strengthening, and to be conditioned, and to show them just how to exercise.”
Learning effective ways to manage other health problems that may coexist with cardiac and pulmonary conditions is another side benefit offered by the program.
A press release from HAMC described how cardiopulmonary rehab services impact patients.
“Eleven months ago, when Marvel Thompson started cardiopulmonary rehab at Heart of America Medical Center in Rugby, she could pedal just two minutes on a NuStep bike set at level 2 resistance,” the release said.
“Today, Thompson can do 43 minutes on a bike set at level 4 or 5. Her goal before the year is out is to pedal for an entire hour. Not bad for someone who is missing half a lung and has Stage 4 chronic obstructive pulmonary disease (COPD). “
“I didn’t know what I was going to do here,” Thompson, a Bottineau resident said in the release, “but my friends think it’s great. I needed that help to get me going. Now that I know what I can do, when the program is up, I’ll keep exercising.”
The press release described Thompson as an active volunteer who drives from Bottineau to her appointments.
A retired Pierce County farmer, Gene Braaten, also sang the praises of the program in the press release.
“Since I started, I feel better, I really do,” Braaten said in the release. “Ann, she is so great. I can’t believe how much help she’s been to me.”
The press release continued, “With just a few weeks left in Phase II, Braaten’s current routine is: 15 minutes on the treadmill; up to 40 minutes on a NuStep bicycle; and several minutes of friendly banter with Houser. He plans to keep up the banter and the exercise at the HAMC Wellness Center through North Dakota BCBS’s Silver Sneakers program.”
Houser said patients can pay a $35 out-of-pocket cost for “Phase 3” independent use of the wellness center’s exercise equipment after their prescribed therapy is completed.
“There (are) studies evidence based that show once you have some type of intervention with your heart or lungs, that if you exercise, your life is prolonged, Houser noted. “These different studies show that your life is so much longer if you exercise versus if you don’t.”
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