By Denise Williams | News & Views

Before beginning pulmonary rehabilitation in early 2021, Patrick Perkins of Los Gatos, California had accepted what he thought was his unchangeable fate. “I was sitting around waiting on ‘The End’ because I didn’t know what else to do,” he admits.

A heavy smoker for 35 years, Patrick finally kicked the habit in 2004 after an unrelated hospitalization exposed his COPD and sleep apnea. While the symptoms were manageable for the next decade or so, exacerbations landed him back in the hospital for back-to-back stays in 2014 and 2015. After the last episode, doctors put him on oxygen – 24 hours a day, 7 days a week.

Even with the oxygen, his disease progressed. Another exacerbation in 2019 meant another week in the hospital, including three days in ICU, and an atrial fibrillation event followed that. Through it all, Patrick found himself struggling more and more. It was a serious challenge, he says, just to walk the approximately 150 steps from his apartment to his vehicle – even if he moved slowly and took two or three breaks. “I was almost in crisis by the time I could get out to my car,” he recalls. “I was in pretty bad shape.” Told that he had essentially exhausted his treatment options, the retired manufacturing process engineer started preparing mentally for the worst.

From Resignation to Resolve

When a pulmonary interventionist took over his case, resolve began to break through the resignation. The specialist believed a bronchoscopic lung volume reduction could deliver some relief but, first, Patrick would have to complete three months of acute pulmonary rehab. Although rehab had been suggested a few times before then, Perkins had balked at the recommendations. It was no longer a choice, however, if he wanted the lung volume reduction.

Considering that even light activity was an ordeal, Patrick was still somewhat apprehensive about the idea. “Not knowing quite what to expect,” he explains, “I was really nervous about going someplace where they were going to have me doing a bunch of exercises.”

Those fears evaporated when Patrick reported to the Cardiac & Pulmonary Wellness Center at El Camino Hospital in Mountain View, California, for his first day of rehab in January 2021. His jitters were calmed largely due to the reassuring and attentive presence of multiple nurses. It also helped tremendously, he adds, that they told him what to expect. Every aspect of his session – 30 minutes of aerobic exercise, 30 minutes of strength and balance training, and a stretch and cool-down period – was explained in great detail and, even more importantly, carefully monitored.

The setting itself also put Patrick at ease and made him more receptive to pulmonary rehab. “I started to feel really safe there,” he shares. Before COPD started taking a toll on him, he had patronized commercial gyms; now, he wouldn’t feel comfortable in that environment. Instead of “a bunch of healthy people trying to outdo each other,” the rehab space was filled with people who were facing the same kind of issues. “I realized it was not a competitive atmosphere plus I had all these nurses on duty,” Patrick shares, “so I said ‘OK, let’s DO this!”

Back From the Brink

Patrick successfully completed the three-month acute PR program, underwent the lung volume reduction procedure in April, and within a week began rehab maintenance two times per week.

As he approaches the one-year anniversary of his PR graduation, Patrick almost doesn’t recognize himself. He’s achieved measurable weight loss, can walk to his car without going into crisis, is able to manage short walks in his neighborhood, and doesn’t have to rely on the supplemental oxygen when at rest.

While the lung volume reduction surely helps, Patrick believes he would not have achieved the same level of improvement without the exercise and therapy. “My stamina is better,” he is happy to report. “I can exercise more; I can exercise longer. And if I’m careful, then I don’t get all blown out and winded.”

He credits the lessons he learned during the “classroom” portion of pulmonary rehab. “They re-educated me on what my condition really was and started teaching me how to deal with it,” he says. “How to deal with a situation where I’m short of breath and how to recover from that. How to exercise the right way.”

Speaking matter-of-factly, Patrick credits pulmonary rehabilitation for literally saving his life. “It’s one of the best things that’s ever happened to me,” he declares. “It was really low on hope before I started it. But it’s given me hope and makes me want to do more.” He has no plans to ever discontinue PR maintenance. “My pulmonologist says that as far as exercise is concerned, ‘the less you do, the less you can do,’” Patrick quotes. “I put a positive spin on it and say ‘the more you do, the more you can do.’”

As he continues to build progress, Patrick is no longer taking a dim view of the future. Instead, the amateur photographer is looking forward to enjoying his retirement – especially the day when he can rise before dawn and once again take his camera out to a wildlife reserve or park hillside to capture a beautiful sunrise.