Thursday 8 August 2013

With Pulmonary Rehab, you are Investing in your future!


Priyankka recounts her fathers struggles from diagnosis to living with IPF and COPD. While offering a caregiver's perspective, she also talks about dealing with a lack of awareness of the disease and the important role pulmonary rehab plays in improving a patient's lifestyle.


It was a really long time back. I was probably 15 years old when I realised my father wasn't as strong as I thought he was. They were subtle signs, but they were always there. I would see him get mildly out of breath after climbing a flight of stairs, after our evening walk or after he beat me in a match of table tennis. He would look at my concerned face, brush it off and say look, I'm developing a paunch - your old man's just plain unfit. I,d heave a sigh of relief and think yeah, it's the sedentary lifestyle we lead. He just needs to exercise!

Slowly, as months passed he started to get a little more breathless. It was more pronounced. We decided it was time to see our GP. Our GP suspected it was asthma. Back then, we lived in Chembur in a place which was the heart of pollution. It's just the quality of air here that causes asthma, I would hear people say.

He was just given an inhaler for emergencies for when he had an 'asthma attack'. He would use the inhaler every time he got breathless , but honestly it gave him little relief. This went on for years - in fact three years.

It wasn't until the summer of 2003, when we realised something was amiss. This had to be more than asthma. My sister was getting married and dad was playing the perfect stressed yet excited father. He was running around trying to ensure everything went off smoothly. During the wedding rituals, he developed an uncontrollable bout of cough because of the smoke. My mom, sister and I exchanged worried looks and this time, the alarm bells in our heads started ringing.

Right after the wedding, we forced him to see a chest specialist. Dad underwent a series of tests - X-rays, CT scan, PFT ( pulmonary function test), sputum tests and multiple blood tests. The doctor looked at the reports and announced, this is a case of idiopathic pulmonary fibrosis and mild copd. Worried expressions crossed my parent's faces." Parts of your lungs have become fibrotic and this gradually decreases the ability of your lungs to take oxygen from the atmosphere. You should take care, prevent infections, regularly exercise and monitor your health as this condition has the tendency to get worse with age" the doctor said.

We had been in denial thus far and somehow still continued to be in a bit of denial. We didn't necessarily follow all the rules. Sometimes 6 month check-ups extended to a year and sometimes chest physiotherapy ( twice a day was the order) schedules went for a toss. While dad couldn't exert himself too much and did suffer bouts of infections, he continued to go about work and life as normally as possible for a few years. It wasn't until 2012 that his body started showing signs of deterioration.

I had moved abroad to study and hadn't seen much of him for two years. On my return, I saw a marked difference. He looked weaker and was struggling with recurrent infections. In 2012,  He went through a series of hospitalisations and required a tracheostomy and oxygen therapy. This was when he started getting treated by a specialist who continues to play an active role in helping us manage the ups and downs that this disease comes with.

It was at this point that we realised the importance of physiotherapy and pulmonary rehabilitation in managing this disease and the sheer importance of having a doctor who is approachable and answers your questions however silly they may sound.

As a caregiver and relative of a pulmonary patient, there are a few lessons I have learnt. If you get out of breath often, don't assume it's just lack of fitness. It's always safer to get tested to prevent future complications or at least address and manage any existing disease.

Secondly, there is a dearth of information and lack of awareness around diseases like ipf in India, but the Internet is a saviour. Yes it does throw up a ton of negative information related to diseases, but it also provides a wealth of information around treatment, cures and most importantly patient stories and experiences. You just need to use it smartly - pick the useful bits and ignore the inconsequential stuff.

Lastly, take your health seriously. If you suffer from IPF, COPD or other pulmonary issues, pulmonary rehab should be a big part of your treatment. It can greatly improve your lifestyle and help you breathe better. It's an investment for the future - FOR YOUR FUTURE!

Sunday 7 July 2013

Breathing quality back in to the lives of respiratory patients

Dr Poorvi Shah – Chest Physiotherapist and founding team member of the Pratibha Prabhakar Pulmonary Rehab Center talks about how the center came in to existence and how the team (backed by leading pulmonologist, Dr Prabhudesai) continues to help patients with lung diseases improve their quality of life
Dr Poorvi Shah

The term “ Pulmonary Rehabilitation” was not new for me, as my thesis had centered around pulmonary rehabilitation in chronic respiratory patients. But the idea of starting a new venture of a pulmonary rehabilitation centre in Mumbai was rather new for me.

With a Masters in Physiotherapy (specialized in cardio-respi) , I was more than aware of how beneficial pulmonary rehabilitation could be to patients with respiratory disorders. 

However, doubt still clouded my mind. The huge lingering question was - wheather this idea or concept would work here in india, and in Mumbai?

Dr. Prabhudesai
A huge challenge was thrown at me when one of the best and most renowned chest physicians, Dr.Prabhudesai (Chest Physician, Lilavati Hospital) asked me to help him set up and run a pulmonary rehabilitation centre.

While a part of me was instantly excited to take on this task, another part of me was very confused, nervous and unsure about bringing this concept to a country as nascent as India, which unlike the west had little or no awareness in this space.

Moreover, leaving behind a good secure job at a big tertiary hospital to start something in an unexplored area of physiotherapy practice could have proven to be a risky move for my career.

After mulling over it and weighing the pros and cons, I decided to listen to my heart.  My gut feeling said that I should do this. With god’s grace & my brother’s encouragement, I took upon the challenge & went ahead with setting up the Rehab centre along with Dr. Ashwini Sansare (who is now pursuing her masters degree in USA).

The idea, which was born in May 2011 began to take root and materialize as we started work towards the development of the centre.

The team of doctors at the center
With a vision & aim to help respiratory patients improve their quality of life, we started the centre & saw our first patient on  11th Jan 2012. The inauguration function was held on 29Th Jan 2012 and since then there has been no looking back.

From JULY 2012 , Dr. Priyanka Jain & Dr. Nicole Pinto joined our team and we now work together towards fulfilling Dr, Prabhudesai’s dream. We are thankful to him and continue to peruse it under his guidance and encouragement.

Seeing my patients who note a drastic improvement in their quality of life, months in to the rehab program, reassures me that I couldn’t have made a better decision when I chose to be part of the team that started the Pratibha Prabhakar Pulmonary Rehab Center.



To know more about our pulmonary rehab program, call us on +91-9892038213, 022-28713081 OR drop in at 101/1st floor, kesarinath building, opposite Vijay Sales, s. v. road, Goregaon (w), Mumbai, Maharashtra, 400062


Saturday 1 June 2013

Pulmonary Rehabilitation


What is Pulmonary Rehabilitation?


    Pulmonary rehabilitation, also called as pulmonary rehab or PR is a broad program that helps improve the well being of people who have chronic ongoing breathing problems. When you develop a lung condition, most people find it difficult to continue with their regular routine activities without getting breathless. Getting out of breath could make one anxious and worsen your breathlessness. Pulmonary rehabilitation program helps you with just that. Although the program does not improve your lung functioning, it allows you to make the most of the limited lung function you have.


    Benefits:
  • Improve your quality of life
  • Increases your ability to exercise
  • Reduce symptoms of your disease or condition
  • Manage anxiety or depression



Who is eligible for Pulmonary Rehabilitation ?


  • Moderately severe COPD and Asthma patients.
  • Patients with Interstitial Pulmonary Fibrosis.
  • Patients with Chronic Asthma or COPD prior to major Abdominal , Cardiac or Pulmonary surgery.
  • Post operative patients with compromised lung functions


The Pulmonary Rehab programme includes:



  • Exercise and strength training
  • Advise on yoga and life style changes
  • Psychological Counseling / Group support
  • Nutritional Counseling
  • Role of Oxygen therapy and BIPAP
  • Education on your lung disease and how to manage it
  • Breathing strategies
  • Preventive aspects such as vaccinations
  • Teaching you to prevent recurrent infections
  • How to reduce breathlessness in acute exacerbations
  • Motivating talks, group therapies and discussions
  • Energy conservation techniques


The Pulmonary Rehab programme includes:



  • The patient enrolls with us.
  • When a patient starts with pulmonary rehabilitation, the rehabilitation team will prepare a plan tailored to the patient's abilities and needs, considering the medical condition.
  • The patient is likely to attend the program thrice weekly over a period of 3 months
  • We provide guidance on home rehabilitation. We believe in total commitment and hence make it a point to periodically follow up with all our patients even at home, if required.
  • The exercises help improve your abdominal and diaphragmatic breathing. Exercises also include Pranayam and Yoga. Often spirometers, balloons etc are used to improve breathing techniques. Sometimes Oxygen and BIPAP machines are used to enhance exercise performance.
  • Exercise also includes training the respiratory and upper girdle muscles because these (when strong) make easier the work of breathing.