British Lung Foundation
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Query on Respiratory Physiotherapy

I was recently referred to hospital for respiratory physio, but I was a little disappointed, as the therapist just had me doing extensive walking followed by "marching" on the spot. No hints on how I should breath etc. She was very interested in how long I could manage to do things, and if I asked to stop she said "no keep going". I found it all very hard, as I get so short of breath, and I had no oxygen on hand, although I had taken my portable unit with me. In the end my Husband, who accompanied me (as I use a wheelchair) said to her "I think she has had enough, especially the "marching". She wasn't happy but I did sit down as I was beginning to feel light headed and faint. I should mention I have had two hip operations, one in 2005 and one July last year, also I have Osteoporosis and Rheumatoid Arthritis, which I have had for over 40 years. I should also mention at this point I am also partially sighted following a cornea implant. This doesn't help from a balance point of view. I am 76 years old, and in my younger days was a dancer, so you can imagine, being immobile is quite a hard thing for me to come to terms with. I just wanted your advice as to the way I was pushed, is this reasonable and common practice for patients with IPF. I am trying really hard to get my mobility better, and walk around our bungalow using a 4 wheel walker or sometimes a stick.

I do have a Macmillan nurse visit me on a monthly basis, and I frequently have a Physiotherapist too, she helps me with basic exercises and my walking.

I would really appreciate your opinion and advice.

Regards

Sylvia Hanington (nansyl)

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I don’t think I can answer your questions but your post made me feel so sad. I don’t think any therapist should make a patient feel like this. You’ve been through a lot and it sounds as though you’re doing your best. We need to understand why we’re doing something, and what it’s about. I suggest you contact your Macmillan nurse and talk it through with her. Your breathing may be compromised and your mobility very limited and both of those are really hard to deal with. You are still a human being and are entitled to respect, including your dignity being maintained. Keep in touch. Sue xxx

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I had similar problem I have arthritis in both hands several operations and still in pain seeing consultant on regular basis. But the therapist kept pushing and pushing on the climbing frame pulling hands backwards and forwards kept asking if I could stop

My breathing by then was a mess have copd. Kept telling her I was in a lot of pain. But wouldn't.i am a quiet person and luckily my husband was there and bought my oxygen to help plus several goes on inhaler my chest was sore everyone made me sit down therapist Saif why are you sat down you have to do exercise hubby had words and complained for someones first day she was very harsh. I was on the verge of tears. But managed take her name so that when I went the following week hopefully she wouldn't be there.luckily she wasn't. Sorry to say if she had been there I had already said to hubby I wouldn't go again. I felt so upset it nearly put me off going again luckily got lovely lady and made new friends who had all said I was badly treat. If there next week I will ask for another member of staff to help me

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It must have been a horrible experience for you. Is it a group or class? I’m wondering if you’ll get any opportunity for feedback. You say you’re a quiet person and I imagine you’d find it difficult to complain but if you don’t it will happen to others. I hope you enjoy the rest of your sessions and it’s good that you’ve made friends. xxx

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Know it's not the same being in a gym with other people. But decided after what happened I would work on my breathing exercise from home.goy loaf of information on line and my hubby joins on

My breathing not good at best of times so try my best

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I can’t say I blame you! BLF do a very good excercise DVD which is for people with all stages of fitness or otherwise. It’s on their website. Do you have a Breathe Easy group near you? That would mean you’d meet and be able to make friends with other people with lung problems. It sounds as though you have great support from your husband. Good luck and keep in touch. Sue xxx

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Bizarre,if you are prescribed ambulatory o2 you should never be asked by any Physiotherapist to do exercise without that to hand,you have it for a reason and i think you could make a justifiable complaint as to the procedure you were put through to avoid a repeat of it..................regards Ski's and Scruffy x

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In total agreement with you there.

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Seems a good example of someone who can't think for themselves so follows the protocol to the letter despite what the patient - in this case you! - is experiencing and telling them.

And like skis and 2G, i wonder why on earth she would make you do stuff without your O2 which has been prescribed as it has been deemed that it's not appropriate for you to be exercising without it. So what a bozo, sorry you had this experience.

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I'm OK came out the the other end

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This doesn't sound right to me either. It's like the therapist has a set procedure and carries it out regardless of age or infirmity. x

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It makes you wonder what sort of training some of these “respiratory therapists” get - did she really think your oxygen cylinder was just something you liked to carry about for the fun of it? I have been on 2/3 pulmonary rehab courses and never been asked to do any exercise/walking without using my oxygen.

I would certainly make a complaint and tell your MacMillan nurse too who will know who best to contact. All the best.

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I have had respiratory Physiotherapy and it wasn’t at all like that. The concentration was on breathing technique with an emphasis on diaphragm breathing. In fact I did not need it as I was taught good breathing as a child with asthma and kept on using it for asthma attacks throughout my adult life, and found the principles were still relevant for my current problems. I really think you should talk to her line manager.

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I was surprised to read this too as when I see a respiratory physio it is for practising breathing techniques.

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She was more interested in me going up framesetc.luckily I have always practised breathing exercise since I was diagnosed

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Honest. This is a joke. In the past I have had. Bad. Feeling with. Rehab staff. Some are good some very bad. Never ever let Them treat you with out respect. My . God. Where did this happen she should be sacked. Please. Report her. As she sounds. Very bad. Poor you

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Hello Sylvia

That sounds like that 6 minutes walk they all start with to evaluate your lung capacity and breathlessness.. but she didn’t seem very tactful and should have explained the reason why she was marching you up and down.

It can be quite strenuous if you are unwell.

Once you get that hurdle over, and they have measured your physical state and oxygen levels under effort, they usually offer a rehabilitation programme so you can improve.

When I met Helga the local hospital physio for the first time I thought I had joined a boot camp! The girls and I exchange silly laughs and looks when she drives us on from one machine to another!

Good luck with the next appointment x

Fran

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Hi i do agree that this seems poor treatment. But you have to consider wether she had all the information about your health or just a note saying rehab. I think you need to give her a chance next time i think you need to explain everuthing to her first before doing any exercise. Good luck with it.

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If you a given oxygen on prescription to actually not give it as prescribed is a drug error as it was given to ensure your physical welfare. The important question here is was her oxygen saturations monitored during this assessment?That would a vital safety consideration. Your wife's other conditions should have been taken into account. I would contact PALs as your description of events leave many questions as to her competence to carry this assessment.

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OH has tried pulmonary rehabilitation on more than one occasion but now declines. Like you, he felt that they pushed him too hard. At our respiratory unit there are gentle classes for less able people and that sort of thing might suit you. Maybe ask the physiotherapist about this or exercises that you can do at home. Do your physio at home - get up and walk around every hour, do some stretching exercises etc. OH gets exercise by doing the morning vacuuming with the Gtech cleaner. If you like singing, join a group. Simple things like these examples might help.

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She's a Bully, Report her immediately, I know of this and they have to be stopped. Good Luck.

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Thank you all for your comments and help. Have decided to attend next appointment in 2 weeks time, but will certainly let her know that for 3 days after last session I was very uncomfortable, and my hip sore, which hasn't been the case even early days after my surgery. I am walking around as much as I can in the bungalow and in the garden weather permitting, but always a little unsure when outside in case I fall. I think one looses confidence when outside in case I fall. Couldn't face another hip operation, especially as have to have it under epidural, as can't take general anaesthetic !!!!! Anyway will let you know how next session at "boot camp" goes. I am going to ask if she can give me any tips on general breathing technique, and will definitely ask if I can use oxygen when on my "route march"! It is lovely to share with you all, knowing you understand. LOL Sylvia.

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Hi Sylvnan

I agree with the others you have been sent to a Phsyio who instead of helping you has subjected you to physical and mental abuse. You must make a formal complaint to try prevent others being in receipt of her abusein the future. I was lucky, when I went to Pulmonary Rehab I was under a good team. The six minute walk test was fully explained. During the test the physio kept checking I was okay and when I reached my limit she said well done with a smile. All members of the course were treated the same and if any off us struggled with an exercise we were immediately told to rest and if necessary did a substitute exercise in the future.

Good luck.

Andy

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Stick with who you know. Your mac nurse will advise you best. It should have been breathing exercises and gentle examples of progression . Never mind you did your best.

Dan

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I am a little confused, from how you have described your experience, i would think that it was a pulmonary rehab initial meeting that you attended part of this is a six minute walk test when you would have been allowed to use your oxygen. At this meeting they usually go over your medical history usually before you do the walk test. They then usually tell you all about the sessions that you will be attending if accepted and the start date. All of this usually takes place about two or three weeks before classes start. I have attended three rehab courses they last for two hours the first hour is spent excising the second hour is when breathing techniques are shown , each week there is a different theme relaxation, drugs, etc. Please before you go again find out if you are going to the right classes for you. You mention in your post respiratory physio to me that would suggest breathing techniques and breathing exercises. Whereas pulmonary rehab suggest exercise, walking, marching. to breathe correctly. I have had physio at home after being in hospital as part of the respiratory care at home , I had a physio visit me to show me how to breathe and use my lungs correctly she came a few times. I do hope you get the help you need and if you feel that you have not been treated well then you must complain. Just re read your post and can see that you do have a physio at home to do the breathing with. even more confused now please keep us updated.xx

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I have just finished a pulmonary rehab course. The physios who run the programme give us five minutes doing different exercises. They have O2 bottles for those who need it, and if anyone appears to be stressed, they make them stop the exercise and have a rest. We are encouraged to set our own pace, and a check is kept on how we feel after each routine. This gives the physios an indication of our progress, and if a change in routine is required.

At the end of the course, we are encouraged to return once a week for maintenance. I think that is just to keep us in touch with friends we have made, and also encourage use to be more active.

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Hello sylvnan . 🌷🌻

You and my mum are almost the same age, and if she had been treated this way I would be very upset. I am sad that you had to go through this, considering your condition (s) . I have been to rehab too, though this is in Japan. They were always very mindful of making me feel comfortable and not stressed out. Even for the six minute walk test, they kept telling me how much time was left for me to walk and how well I was doing. I always thought it was about encouraging the patient to keep moving. NOT intimidating them to do so. I'm any circumstances, to any patient the therapist should be respectful and considerate.

I am not sure why the therapist was this way. I am guessing the training she or he received promoted this kind of behaviour regardless of the situation and circumstances of the patient. At any rate, I hope you are not put off of going to rehab because of this one incident. Hopefully, you will find a therapist who understands your needs.

Sending warm wishes to you.

Cas xx 🌹

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