Alanna Simms, MSc, PT is a Physiotherapist with over ten years of practice with the Pulmonary Rehabilitation program at Vernon Jubilee Hospital. She leads the North Okanagan chapter of the BC Lung Association Better Breathers patient support group. Her degrees include a BSc (PT) from the University of Toronto and MSc. Rehabilitation from UBC. She is currently a co-investigator on a Pulmonary Tele-rehabilitation project with IH/ UBC.
How do people find out about your pulmonary rehab program?
It is difficult to get the word out. Many family physicians don’t refer patients to pulmonary rehabilitation. We’re trying to increase awareness. We’ve presented at family doctors education sessions at the hospital, but early diagnosis and referral remains an uphill challenge. Adding to the problem is that we don’t have a medical director for our program. We do have Dr. Yacyshyn, a lung specialist in Vernon, who refers to our program.
I’d love to see referrals to pulmonary rehabilitation become routine. Whenever someone receives a serious chronic lung disease diagnosis from their doctor, or presents to Hospital Emergency due to a lung disease flare up it should be on a checklist of information imparted. Fingers crossed that is coming. I know in some BC hospitals they routinely refer patients presenting with a flare-up of COPD (chronic obstructive pulmonary disease) or Pulmonary Fibrosis. There is so much we can do to help.
Ultimately, more often than one might expect, patients find us themselves by doing their own research. Then we ask them to go get an official referral from their doctor. There’s no cost, but we need an official referral on file to sign them up.
Are pulmonary rehab programs difficult to access?
As few as 1 in 100 Canadian lung patients have access to pulmonary rehab and supervised exercise maintenance programs. In fact, many of those able to attend our program drive as much as 45 minutes from neighbouring town to come to Vernon, as there are no programs nearer by.
A lot of recreation centres in the Vernon areas offer great programs such as Osteofit for people with osteoporosis for instance, but there isn’t anything specific for people with lung disease in the area except our program.
We need to keep trying to increase access, and I also think there’s still a lot we don’t know about delivering pulmonary rehabilitation to populations which require greater cultural sensitivity, such as First Nations communities.
And, there’s the question of sustained program funding. Within Interior Health we currently fund our program out of a community rehabilitation budget, but that can change year to year. I do wish there were a few more dollars available. We do the best we can, but we don’t have any sophisticated exercise equipment per say. No treadmills or bikes. Instead we use self paced walking around Kal Tire Place oval. We also use body weight and resistance band for strength exercise. We try to be resourceful and use different, affordable ways to help our clients improve their aerobic capacity, strength, and balance.
How does your specific program work?
We run programs six to ten pulmonary rehab or ‘LungFit’ programs a year. Each runs for six weeks, with patients coming in twice weekly for a two and half hour session. Basically Kristen, our Respiratory Therapist, and I, cover a range of topics.
At every session Kristen or I will take on a topic then we do an hour of exercise. Kristen will teach patients about their medications for example, or how to cope when your symptoms flare up. There’s a lot of information to impart, and one way or another we manage pretty well.
Can patients come for supervised exercise once they’ve finished the initial program?
Yes. We offer patients a continuing group exercise program called LungFit. Research suggests all patients should have at least 20 supervised exercise sessions in order to gain the confidence to continue on their own. It’s so important. If patients don’t continue to exercise, they lose the benefits gained.
How important is the sense of community pulmonary rehab programs facilitate?
Huge. Last year, when a client broke his ankle he couldn’t drive to Lung Fit class so a fellow participant offered to pick him up and we adapted his exercise routine. Currently, one of our clients is battling breast cancer in addition to living with a serious lung condition. She lives alone, and friends she made through our program are helping her cope, driving her to appointments and picking up supplies for her
Patients make meaningful connections. They support one another. Some are waiting to qualify or receive a lung transplant. They’re hanging on to hope. They share their worries. And those lucky to have had transplants, share their experiences.
How does air quality affect lung patients?
My patients are definitely finding the increase in wildfires a burden. When the sky is full of smoke, many or most can’t go outside. We urge them to watch the Air Quality Health Index and take preventative measures, such as avoiding exertion outside when the air is bad and making sure they have an action plan, and extra meds, in place to help if their symptoms worsen.
If there was anything else you could to improve life for those affected by chronic breathing problems, what would it be?
I also have one, perhaps far-out idea. Many clients I see haven’t left their house or neighbourhood for fear of getting ill and breathless. Struggling to breathe can be scary. You’re isolated, less mobile. And travel becomes more difficult. Then there is the question of more expensive health insurance and perhaps you’re someone who needs to carry an oxygen machine. It can be tricky.
Wouldn’t it be amazing if we could use available virual reality technology to transport people and take them into nature or wherever it is that would provide them with some joy. We could get them moving at the same time as a virual walk in the park instead of a hallway. We could deliver a fearless, memorable experience that their current breathing problems make impossible.
How did you end up in Vernon – and in pulmonary rehabilitation work?
I came out WEST to go snowboarding. I learned to love the outdoors; it is so beautiful here. Then I met my guy. Today we have two kids and a lot of sports equipment including 3 unicycles!
We’re all active. I like hiking and triathlon training. And the unicycles. Well, that all started one summer we went camping. My daughter’s friend had a unicycle. Within a short time we all had one. It’s fun way to exercise. My husband trained on his, riding 10km at a time. You can’t coast on a unicycle like you can on a bike.
In terms of my career, after I graduated in physiotherapy from the University of Toronto and moved here, I got started in a private practice. Then I moved into Vernon Jubilee Hospital and got to try a bunch of different types of physiotherapy work. Ultimately, I ended up in cardiac rehab, and then pulmonary rehab. That was almost 15 years ago now.