New cardiopulmonary rehabilitation program at Okanogan Douglas Hospital

An exercise and rehabilitation program is an important part of coming back from a heart attack or coping with chronic obstructive pulmonary disease (COPD). Alas, the idea behind a rehab program can be a little tricky to implement-supervision is crucial in making sure patients get the maximum benefit, and it can be pretty time-consuming under the wrong conditions, say, when the nearest program is an hour's drive away. Okanogan Douglas Hospital will open a new program next week designed to address those glitches.

The "Rehabilitation for Life" program will start treating patients Monday, Sept. 8. It's actually two programs, one for people with chronic pulmonary (respiratory system) problems, the other for people who have suffered heart attacks or other cardiac problems. Both are based in a mix of education and exercise, said Colton Pearson, who's in charge of the program. The idea is to help people live longer and increase the quality of their lives, he said.

People who have "any kind of a diagnosis of lung disease" are eligible for the rehabilitation program; the guidelines for cardiac patients are "a little more specific," Pearson said. Cardiac patients must have had a heart attack within the last two months, a coronary bypass or a valve repair or replacement, a stroke, stable angina, procedures like angioplasty or heart stents. Patients must be recommended by a physician to be accepted, Pearson said.

Heart attacks, strokes and pulmonary diseases are the first, second and fourth leading causes of death in the United States, Pearson said. Hospital officials did some research while they were setting up the program, and-going by national percentages-up to 1,500 people per year in the hospital district could experience those problems. "That's a lot. That's why we knew we needed to do this," he said. Before hospital officials started Rehabilitation for Life, the nearest program was at Central Washington Hospital in Wenatchee.

Regaining physical strength is important, but rehab patients usually need emotional support as well, Pearson said. A heart attack, a stroke, respiratory disease is a sign the old way of living is gone for good, "and now everything you've ever done has to be altered," Pearson said.

Patients enter the rehabilitation program anywhere from three to six weeks after their illness, Pearson said. (Patients are referred by a specialist in the disease, and sometimes by the primary care physician. Cardiac and pulmonary specialists from Inland Cardiology in Spokane and Central Washington Hospital and Wenatchee Valley Clinic in Wenatchee have been very supportive of the hospital's efforts to start a rehab program, Pearson said.) The program is two to three days per week and lasts 12 to 18 weeks, depending on how often patients make it to rehab.

Current medical thinking is that the sooner a patient gets back up and moving again, the better. So the rehab program requires a lot of movement. Patients take tests to establish a baseline, Pearson said, which "basically tells what their daily living is like," and the goal is to expand on that baseline.

Exercise almost becomes another medicine; the exercise program is "specifically designed for individual and disease," Pearson said. "It's called an exercise prescription." All exercise is carefully monitored-in fact, patients are under observation every minute, and they're hooked up to monitors throughout every exercise session. "Every beat (of the heart) is being recorded," Pearson said. The entire rehab program is monitored by physicians; Larry Smith, an internal medicine specialist at the hospital, is the director, with Keith Hanson, a family practice doctor, is the assistant director. There is a physician's assistant onsite during exercise sessions.

Part of the grant money went to purchase exercise bikes, a treadmill, a stair machine and an elliptical machine, free weights, exercise balls and resistance bands. (Really nice ones too-those are reclining exercise bikes and stair machine, and the exercise bikes have swivel seats for easier access. "There's even a water bottle holder," Pearson said.