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Boosting Every Breath
Frances Gonzales (Top left) , Robert Becker (center left) and Rodney Rust (right) benefited from the many services offered by the UT Allied Health Therapeutics outpatient rehabilitation facility. The facilityís multi-disciplinary approach to patient care sets the facility apart from others.

Boosting Every Breath

March 2007

by Tina Luther

Eight months ago, Frances Gonzales sat in front of a box fan trying to take in some air. For months, this was her regular routine when she was feeling short of breath.

But this time, it was different. Gonzales couldnít breathe.

Panicked, her daughter rushed her to the hospital. Gonzales was diagnosed with pulmonary hypertension, and needed oxygen 24 hours a day. Although not common, pulmonary hypertension can be very disabling, causing severe shortness of breath and fatigue. Other diseases that severely interfere with a personís breathing, such as emphysema and chronic bronchitis, also called chronic obstructive pulmonary disease (COPD), and pneumonia, are the leading causes of hospitalization in Texas for people ages 65 to 79. COPD is the fourth leading cause of death in the United States. The demand for research and patient services is great.

In August, Gonzalesí physician, Marc Chalaby, M.D., assistant clinical professor of pulmonary diseases at the Health Science Center, referred her to UT Allied Health Therapeutics, a comprehensive outpatient rehabilitation facility housed in the Health Science Centerís School of Allied Health Sciences. There, she received pulmonary rehabilitation.

"When I first arrived at the facility, I was pushed in a wheelchair," Gonzales said. "I couldnít even stand up on my own." She also could not cook, dress or bathe herself.

The goals of pulmonary rehabilitation are to provide patients with relief of symptoms, improve exercise tolerance and endurance, increase strength, reduce fatigue, improve health knowledge and improve patientsí ability to participate in activities of daily living.

What sets the UT Allied Health Therapeutics outpatient rehabilitation facility apart from others is the multidisciplinary approach to patient care. The facility is a one-stop shop. Services, including respiratory therapy, physical and occupational therapy, social work, nutritional assessment and speech language pathology, are provided by licensed professionals under the direction of a board-certified physician.

"Pulmonary rehabilitation is critical for the longevity of patients and for their independence," said Pamela Miller, facility administrator and director of clinical operations for the School of Allied Health Sciences. "Our goals are to decrease the frequency of visits to the doctorís office and to keep patients out of the hospital and out of the nursing home by assisting them in improving their health. We want to help them recapture an overall better quality of life."

Pulmonary rehabilitation patient Robert Becker said he awoke one morning to find himself suddenly crippled by severe emphysema. "It hit me like a light switch," said Becker, a former smoker for nearly 40 years. "One day I was working and the next day I couldnít do anything." This past August, his doctor referred him to UT Allied Health Therapeutics.

Upon arriving, Becker used a scooter to get to and from his vehicle. During his first visit, he could only lift arm weights. Slowly, he built up his strength. Today, he walks to and from the parking lot and is able to do many other things he loves to do, including playing with his dogs. In addition to the arm weights, Becker now uses an arm bike with ease, shoots hoops with a basketball, walks on a treadmill and pedals an exercise bike.

Although he has finished initial therapy, Becker now maintains his health by driving from his home in New Braunfels to the facility three times a week for two-hour maintenance sessions. "If I didnít have this, I would be in the hospital," he said. David Vines, M.H.S., R.R.T., assistant professor and program director for respiratory care, concurs. "The benefit of pulmonary rehab would be lost if Mr. Becker would not come in and continue his work. He would lose everything he gained in a matter of six months, maybe less."

Patient Frances Gonzales set a goal at the beginning of her therapy: to climb the bleachers of HarlandaleMemorial Stadium to see the Frontier Bowl football game in November. With an individually tailored rehabilitation plan of treatment, the clinical expertise and encouragement of Jennifer Sikkema-Ortiz, respiratory therapist, and Joy Gonzalez, physical therapist, - and personal dedication to push herself - that dream came true. "Now I go to all of my grandchildrenís football games - elementary, middle and high school," she said. "I donít miss a single game!"

In conjunction with the September 2006 opening of the comprehensive outpatient rehabilitation facility, located on the first floor of the School of Allied Health Sciences building at 8403 Floyd Curl Drive, the department of respiratory care has begun an investigational research study to evaluate the effect of a pulmonary rehabilitation program on physical functioning, quality of life and cost of care for elderly patients with COPD.

Part of the research exercise protocol is to help patients improve what they would do at home. Examples include sitting, standing, increasing walking tolerance on a treadmill, exercising on bikes, weight training, moving cans from the cupboard, and shooting basketball hoops to increase upper body strength and hand-eye coordination. These tasks work to improve the patientsí quality of life and their ability to complete activities of daily living. Another major part of the program is patient education that focuses on improved management and understanding of the disease process, and proper medication usage.

The co-principal investigators of the study are Helen Sorenson, M.A., R.R.T., assistant professor of respiratory care; Ruben Restrepo, M.D., R.R.T., associate professor of respiratory care; and Angela Hospenthal, M.D., pulmonary physician at the Audie Murphy Division, South Texas Veterans Health Care System. With funding provided by the Berneice Castella Endowment for Aging Research and Geriatric Science, Dr. Hospenthal, Sorenson and Dr. Restrepo are recruiting patients older than 65 who will meet established admission criteria and are referred to the study by local physicians for eight weeks of pulmonary rehabilitation.

For more information about participating at no cost in the COPD research study, contact Helen Sorenson at (210) 567-8857 or send an e-mail to sorenson@uthscsa.edu. For additional information on UT Allied Health Therapeutics, contact the staff at (210) 567-8612.


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