This is What I Would like for COPD Patients
In an Ideal Situation this would happen. —– The Patient gets a first possible diagnosis of COPD. Within one week, a Lung Function Test (LFT) is performed, X-ray images are taken, blood gases are tested, a full blood test is done. Within one month, an interview with a Specialist Thoracic Consultant is arranged to confirm or deny COPD, using the images and test results. If confirmed, the patient would be given appointments for further tests, scans and follow-ups as deemed necessary, and enrolled onto a continuously running Pulmonary Rehabilitation Programme.
The Pulmonary Rehabilitation Programme should be a continuously run course of exercise sessions, two or three times a week, consisting of sitting, standing, and walking exercises, including bikes, stretch bands, weights, and treadmills. Once a week the course should have an educational talk added, to include many aspects of what affects COPD sufferers, rotating on perhaps a three month cycle. The course should be overseen by a combination of nurses, physiotherapists, and physical trainers, who have been trained to recognise the needs and limitations of COPD patients. Each patient should have a record so that improvement can be recognised, or problems identified at an early stage.
Before each session, the patients would have their blood pressure (BP) recorded, and also oxygen level and pulse rate (SATS). Also in comments, any recent changes in medication, or the occurrence of infection, etc. During the session, for each exercise performed would be recorded the name of the exercise, the number of repeats, the the patient’s SATS and degree of breathlessness at the end. Also to be recorded in comments would be any difficulties encountered. A one hour session with perhaps ten different exercises should be sufficient for each patient. Each session should start and end with a sequence of exercises designed for warm-up and cool-down, done as a group, and afterwards a time for a drink (coffee, tea, or a cold drink) and a light snack, and chat.
Once a week, after the exercise session should be an educational talk for about an hour, either interactive, or with a Q & A period after. Subjects could be (not an exhaustive list):
1. What is COPD, what causes it, and how does it progress? ++ By a consultant or a doctor, or a Respiratory Nurse.
2. Explanation of a Lung Function Test. ++ By a consultant or a doctor, or a Respiratory Nurse.
3. Drugs used for the control and relief of COPD. ++ By a Pharmacist.
4. Nutrition and the importance of diet in COPD. ++ By a Nutritionist.
5. Mobility and Mobility Aids. ++ By an Occupational Therapist.
6. Benefits. What is available and how to claim. ++ By a CAB advisor.
7. Advanced COPD. Treatments and possible procedures. ++ By a Respiratory Consultant.
8. What happens when an ambulance is called to a person with breathing difficulties. ++ By Ambulance Staff.
9. Exacerbations and panic attacks, and how to deal with them. ++ By a Respiratory Nurse.
10. Carers and support for them. ++ By a Local Authority Social Services Supervisor.
11. Oxygen. Benefits, equipment and use. ++ By a Respiratory Nurse.
12. Pulse oximeters and blood pressure monitors. ++ By a Respiratory Nurse.
Perhaps this could be on a basis of a period of one rotation of talks free on prescription. Continuation sessions can be attended for a small fee to help defray costs or help with equipment replacement etc.
Run as many courses in a week as is necessary to serve demand. Run evening courses for those able to stay in work.
What is central to this concept is that there are personnel whose job is specifically to run these courses, in a dedicated clinic. Another idea perhaps would be to include cardiac patients into the courses, and include talks and demonstration sessions relevant to them. The mobility restrictions of cardiac patients are similar to lung disease patients, as are their requirements to improve fitness, particularly before and after surgery. Many people suffer from both lung and heart problems, and so one course could help with both.
Education of the patient is essential for their motivation. If people know the reason for the exercises, the drugs, and what help is available, then they are better able to help themselves to be fitter, and healthier.
breathe easy, everyone