By Carolyn Comeau
Michael Nakamura’s “can do” attitude is contagious, but until he signed on as a participant in Angel Medical Center’s Pulmonary Rehabilitation Program, he was anything but energetic. “In 1999, I got diagnosed with chronic obstructive pulmonary disease, or COPD, a disease that makes you struggle for air,” said Nakamura. “It got worse and worse, until I was at stage 4. The first moment I felt at all winded, I’d rest for the remainder of the day.”
Facing New Challenges
Nakamura, age 68 and a veteran, was unceremoniously cut off from doing the things he loved, one by one, as his COPD progressed. He’d always loved fishing, hiking and biking, but eventually even a walk through the supermarket proved impossible. “Home maintenance was out, too. We had to hire a handyman and yard care person. I did so little that my quality of life suffered tremendously. It was devastating,” said Nakamura.
The worst part by far was no longer being able to travel to see friends and family, especially his beloved grandchildren. “Flying was out of the question,” said Nakamura. “I couldn’t walk through the airport, and in-flight air pressure changes can worsen COPD.”
The challenges mounted as Nakamura’s wife faced her own health problems, including an epilepsy diagnosis and two knee replacement surgeries. “I didn’t have the luxury of getting too discouraged, because as her caretaker, I couldn’t let her down,” explained Nakamura.
A Ray of Hope
Nakamura’s luck shifted when his VA Hospital pulmonary specialist approached him about the Angel Medical Center (AMC) Cardiopulmonary Rehabilitation Program. “I’d tried everything medicine had to offer, from nebulizers to bottled oxygen. Nothing prevented my flare-ups,” said Nakamura. “I was averaging monthly or weekly trips to the ER, so I decided to give rehab a shot.”
Nakamura connected with Amanda Pack, RN, Cardiopulmonary Rehabilitation Program manager, who invited him to the rehab center to learn more. “When I saw all the equipment, it was slightly intimidating. Then I thought if something went wrong, the nurses were there to help me,” said Nakamura.
Pack considered Nakamura a perfect rehab candidate. “Our program treats both cardiac and pulmonary patients. Treatment and care are patient-centered, and that contributes to their success,” said Pack. “We set out to educate our patients about the physical and emotional aspects of their condition, empower them to partner with their caregivers in managing it and always provide support and encouragement as they strive to reach their goals.”
The vast majority of COPD diagnoses are the result of long-term tobacco use, but advancing age and exposure to secondhand smoke and occupation-related toxins are also risk factors. Patients don’t typically show symptoms until the lungs are quite compromised. Symptoms include: breathlessness, wheezing, tightness in the chest, a lasting cough accompanied by colored mucus, swollen ankles or feet, listlessness and a blue cast on the lips and underneath the nails.
It’s All Good
Pack explained that Nakamura would set his own goals, learn COPD management strategies and be supported throughout the program. “From the first time I stepped on the treadmill, there was no pressure from Amanda,” he said. “We set it at a comfortable level for me. I was hooked up to monitors that measured my oxygen level and blood pressure. The wonderful staff carefully watched my exertion level.”
Rehab became Nakamura’s safety net as he set ambitious goals for the 36-session program: to increase his stamina and endurance, and to walk one mile, uninterrupted, by his final session.
Pack was impressed by Nakamura’s commitment. “It’s key,” she said. “We’re privileged to watch patients’ confidence increase during the program.”
At his 26th session, Nakamura announced that he’d attempt his one-mile goal early. “After 20 minutes, my oxygen level nosedived. But, I wanted to try to work through it. My nurses were right there and helped me work through my symptoms with breathing techniques. They stayed by me constantly, assessing how I felt and monitoring my oxygen level and heart rhythm. At 26 minutes, I reached a mile. It felt like winning the lottery!” he said.
A New Lease on Life
Nakamura’s most treasured rehab-related dividend was visiting his grandsons in Virginia and Los Angeles. “It was the first time since my grandsons’ births I’d been able to play and keep up with them,” he said.
Nakamura will feel pride wearing the festive inflatable gold crown that rehab graduates sport, but wistful, too, because he’ll miss his rehab teammates and the staff. He also plans to spread the word about the program to fellow VA patients.
Pack couldn’t be happier for Nakamura. “When Michael started with us, he could barely walk 25 steps, let alone a mile. He’s been a rock star,” she said.
“I’ll never be free of COPD,” Nakamura acknowledged, “but I’ve gone from fearfully coping with the disease to joyfully living a richer life despite it. And, that feels incredible.”
Amanda Pack, RN, is Angel Medical Center Pulmonary Rehabilitation Program manager.