Our Approach to Care
If you have pulmonary problems, Gaylord’s Outpatient Pulmonary Rehabilitation is designed to help you develop new strategies for monitoring and controlling your symptoms. Under the supervision of our pulmonary specialists, you’ll develop the knowledge and skills you need to increase your strength and endurance. You’ll also reduce the number of times you experience shortness of breath and require hospitalization. If you have been diagnosed with emphysema, chronic asthma, chronic bronchitis, pulmonary fibrosis, cystic fibrosis, or some other pulmonary disease, our individualized approach to treatment can help you successfully return to work, master routine, daily activities, and lead a more active life.
Frequently Asked Questions
Who is a candidate for Outpatient Pulmonary Rehabilitation?
Often, our patients enter the Outpatient Pulmonary Rehabilitation program following a hospital stay, because they need additional care and treatment. Many others, however, enroll at the suggestion of their doctor, because they are experiencing difficulties with strength, endurance, or breathing techniques as the result of a pulmonary illness or injury.
What services are included in the Program?
We use a comprehensive and individualized approach to helping our patients build their pulmonary strength. Depending on your particular needs, our services may include:
- Ventilator management and weaning
- Tracheostomy care
- Oxygen management (including high flow modalities and pulse oximetry)
- Pulmonary rehabilitation and education
- Passy-Muir valve (Gaylord is a Center of Excellence for the Passy-Muir valve.)
- Vapotherm Center of Excellence
- Pulmonary function testing
- Exercise tolerance studies
- Sleep testing
Are there techniques I can use to improve my breathing?
There are techniques you can practice to help improve your breathing. One of them is called “Pursed-lip Breathing.” Pursed-lip Breathing helps open up airways and slow breathing.
- Pursed-lip Breathing helps you exhale more fully, so that you can take in more oxygen-rich air when you inhale through your nose.
- You should use pursed-lip breathing anytime you start to feel short of breath.
- Pursed-lip Breathing should also be used to prevent shortness of breath when you exert yourself …
- Climbing stairs
- Bending over
- With regular practice, this technique will seem natural to you.
- Practice every day, so you will know how to breathe.
This technique helps open up airways and slow breathing. It also helps air trapped in the lungs escapes, letting in fresh air. Follow these steps:
- Breathe in slowly through your nose, keeping your mouth closed. Hold your breath for about 3 seconds. (It’s not necessary to take a big breath; a normal breath is fine.)
- Purse your lips as if you were going to whistle.
- Breathe out slowly through your pursed lips for about 6 seconds. You should make a soft whistling sound while you breathe out. In general, breathing out should take 2-3 times longer than breathing in.
- As you breathe think about smelling the roses (gentle, long inhale) and blowing out the candles (gentle, steady exhale).
- DO NOT breathe forcefully. Take relaxed, but full breaths.
- Always exhale twice as long as you inhale.
- Always exhale during exertion, or the most difficult part of an activity.
- NEVER hold your breath.
Diaphragmatic Breathing is another technique you can use to help prevent shortness of breath. It increases the movement of the diaphragm, so you can get more air in and out of your lungs. Follow these guidelines:
- The diaphragm should contract when you inhale.
- The diaphragm should relax when you exhale.
- Use the following technique:
- Lay down on your back with a pillow under your head. Bend your knees (or put a small pillow under then) to relax your stomach.
- Put one hand on your stomach, just below your rib cage. Put your other hand on your chest.
- Slowly breath in and out through your nose, using your stomach muscles. If you do this correctly, the hand on your stomach will rise and fall as you breathe in and out. The hand on your chest should hardly move. Time your breathing, so you can breathe out for about twice as long as you breathe in.
- The hand on your chest should not move. If it does, you’re using your chest muscles for breathing.
- Work on Pursed-lip Breathing as you perform this exercise.
- Always exhale twice as long as you inhale.
- Once you’re able to do this technique, you can practice it while sitting, standing, walking, or eating and with Pursed-lip Breathing. You can also use this technique while you meditate. Over time, your muscles may become stronger and your breathing easier.
I am often anxious about my breathing, how can I control my stress?
Anxiety is a common side effect of many pulmonary disorders and can interact with your breathing to keep you from meeting your goals. Many people find these techniques helpful in controlling stress …
Progressive Muscle Relaxation
- This involves tensing and relaxing muscle groups one at a time. Begin with your facial muscles. Frown hard for several seconds, and then relax. You should feel a difference between tensed and relaxed muscles. Move on to other muscle groups – such as your shoulders, arms, chest and legs – until you’ve tensed and relaxed your entire body.
- Give yourself a “vacation” by closing your eyes and imagining a relaxing scene, such as a sandy beach. Picture yourself there. What do you see? What do you hear? What do you smell? Focus on the scene for about 15 minutes.
- Close your eyes, breathe deeply into your abdomen and think about a calming thought, word or object. If you have trouble staying focused, try repeating a word or sound over and over. (Some people find it helpful to play soft music while meditating.)
- These are great ways to improve your breathing. But they can also help beat stress. Some strategies work better for one person than another, so pick one that most appeals to you. Then practice when you feel okay as well as when you feel stressed, to get better control of the technique. No matter which technique you choose, start by finding a quiet spot where you can sit or lie comfortably. It might be a favorite chair, your bed or even a park bench. You may need to practice a technique for a few weeks before you begin to feel the benefits. Remember: Anxiety is treatable, and developing strategies that help distract you from anxiety or pain, while you relax your mind and body, is the best place to start. Don’t give up!
Are there techniques I can use to prevent fatigue and breathlessness?
The Gaylord Outpatient Pulmonary Rehabilitation Program will help you develop techniques to minimize your fatigue and episodes of breathlessness. For example …
- Plan your day. Do the most important activities while you have the most energy. Don’t do high-energy activities back-to-back. Use lightweight pots and pans for cooking. Keep frequently used dishes out, rather than putting them away.
- Plan rest periods of about 5-15 minutes between activities. Sit while performing tasks, such as washing dishes, bathing, brushing your teeth, etc. Use a shower stool.
- Use a cart to move objects around the house. Push or slide objects instead of lifting them. Let dirty dishes soak – don’t scrub them. After washing dishes, let them air dry.
- Gather your clothes together before you get dressed. Sit down while dressing. Don’t bend over to put on your shoes and socks. Instead, bring your feet up, or use a long-handled shoehorn to put on your shoes.
- Keep items you use often at waist height to avoid having to reach, bend or lift. Consider home modifications or renovations that reduce effort or strain.
- Put everything you need in one spot before starting an activity. You won’t have to get up as often.
- Reduce shopping stress by keeping grocery bags light and easy to carry. If you have someone to carry them for you, consider buying nonperishables in bulk, so you won’t have to shop as often.
Will it help my breathing if I quit smoking?
Absolutely. Smoking causes or worsens many lung-related diseases including cancer, COPD (chronic obstructive pulmonary disease), emphysema and chronic bronchitis. Smoking also worsens asthma symptoms among children and teens. Quitting will provide both immediate and long-term benefits to your health. Several cessation treatments are available. Choose one that works best for you. For more information, call 1-800-QUIT NOW (784-8669).
What about exercise, can that help my breathing?
Exercise can help your body use oxygen, strengthen muscles, and improve your state of mind. Consult with your health care provider before you start any exercise program. Ask about medications, too. Your health care provider may prescribe oxygen therapy, increase your flow rate, or prescribe medication you can take before you exercise so you can breathe more easily. Follow these tips when you’re ready to exercise:
- Warm up before you exercise. For example, do breathing exercises and walk at a slow pace for about 5 to 10 minutes. Then, do some stretching. (Do not stretch first. You could damage muscles that are not warmed up.)
- Set goals you can reach. Reaching goals, even small ones, will give you a sense of success. Set your goals higher as you get stronger.
- Choose activities you enjoy. If you’re bored, you’re less likely to stick with your exercise program. If you like to walk or garden, make those activities part of your exercise plan.
- Exercise with a friend. It will push you and give you a chance to talk and laugh.
- Don’t overdo it. Set a pace that’s comfortable for you.
- Cool down when you’re done. Like your warm-up, your cool-down should include stretching, breathing exercises and moving at a slower pace for 5-10 minutes.
- Reward yourself. After you reach a goal, do something nice for yourself. That will give you motivation to stay on track and reach your next goal.
- IF YOU HAVE A PROBLEM, STOP AND REST. If you get dizzy, feel short of breath or have pain, seek medical help right away.
How do I make an appointment?
A physician referral is needed to enroll in our Outpatient Pulmonary Rehabilitation Program.Download our Outpatient Referral Form and bring it with you to your primary care provider. Our staff would be happy to assist you in making any necessary arrangements.
Outpatient Pulmonary Rehab: (203) 741-3351
Gaylord Pulmonary Education Manual
Outpatient Pulmonary Rehabilitation Program brochure