Remember that a local pulmonary doctor was ahead of the Chronic Obstructive Pulmonary Disease (COPD) and EXERCISE debate over a decade ago.

The American Thoracic Society (ATS) recent annual meeting in San Diego brought out new study results from Dutch researcher, Annemie Schols, Ph.D., of the Maastricht University Medical Center in the Netherland, according to MedPage Today.

“”I think we should shift toward a personalized lifestyle intervention” for less-advanced patients, Dr. Schols told reporters.”
The long overdue study showed that pulmonary rehab for COPDers less advanced in the disease is both cost effective and had significant health benefits adding to the COPDer quality of life.
(“Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal”).

Over a decade ago, in the waiting room of my first pulmonologist, I picked up a brochure offering local pulmonary rehabilitation for lung patients. Well, that was me, a formally fit person who had trouble breathing when I moved. Ignorance made me slow down and I stopped moving much.

When I got in to see the doctor, I asked his nurse what she thought about the program and she surprised me. “Oh, no,” she said, “you don’t qualify. You aren’t advanced enough for pulmonary rehab.”

Disappointed, when I saw the doctor, I showed him the brochure and asked what good a pulmonary rehab program was, if, to qualify, the patient had to be so far gone they have one foot on a banana peel and the other in a grave? I asked why it wasn’t possible for me and people like me to go through such a program before we reached that point.
“It is possible and I’ll make it happen,” he promised. He did make Capri rehab possible for me and I will forever be grateful to him for that..

At rehab, one older man shuffled in pulling his oxygen tank and walker and had to be steadied and helped on and off the machines. I admired him and the other unsteady patients for their efforts, but I marveled at the patience and helpfulness of the staff.

I lived in another county then and drove over an hour each way two or three times a week to attend the rehab. Sometime during the program, I had a sudden decrease in breathing ability, a setback. The pulmonologist gave me a new prescription for another medication, inhaled steroids. He offered no explanation, but would have answered questions had I known what to ask.

Additional great news from the ATS Conference, according to MedPage Today, Dennis Doherty, M.D., moderated a press conference to discuss the study and announce the Centers for Medicare and Medicaid Services must have a fee schedule in place by January 2010. The motivator is for planned changes in reimbursement for pulmonary rehabilitation programs, leading, I hope, to increased early rehab programs in the U.S. Yes!

Dr. Doherty added that the Dutch study was “unusual in that very few interventions show a four-point improvement on the St. George’s scale. “It’s tremendously difficult in these patients,” he said.”

Over a decade ago, one of our pulmonologist already knew COPDers needed rehabilitation early on. Moreover, he made rehab a reality for at least one of his earlier stage patients. Wherever you are, doctor, thank you for that.

To all the doctors who take the extra time to advise their patients how they can help his or herself improve their own quality of life, thank you.