Caring approach, proven results

Pulmonary Rehabilitation Program helps patients improve airway disease symptoms, quality of life

Ferman Milster is a believer in the idea that “if something works, stick with it.”

For Ferman, “sticking with it” means at least three visits each week to the University of Iowa Health Care Pulmonary Rehabilitation Program at University of Iowa Hospitals & Clinics. This nationally certified program provides evidence-based care to patients with many types of chronic lung diseases.

For the past several years, it’s been Ferman’s go-to place after experiencing serious cardiopulmonary problems—health issues that ultimately led to heart bypass surgery and a single-lung transplant.

“I wouldn’t be here today if it wasn’t for the pulmonary rehab program,” says Ferman, who lives in Iowa City. “They, along with the doctors and nurses who helped save my life, gave me the structure and the positive feedback to keep going, especially when things didn’t look so good.”

In 2010, Ferman was diagnosed with idiopathic pulmonary fibrosis (IPF), a scarring of lung tissue that prevents the lungs from working properly. IPF is a serious, rapidly progressing disease with no specific cause and no proven cure. Many people live only a few years after diagnosis.

Ferman, now a retired engineer, worked in industrial settings for 40 years, which may have contributed to his condition. He also has lived for years with gastroesophageal reflux disease (GERD), also known as acid reflux, which some studies suggest may also be a risk factor for IPF.

Working with UI Health Care pulmonologist Alicia Gerke, MD, Ferman was able to participate in several clinical trials—studies of medications aimed specifically at pulmonary fibrosis patients.

But first, he enrolled in the outpatient pulmonary rehab program—24 sessions of structured exercise and monitoring to give his care team a clear indication of his lung function, cardiopulmonary health, and progression of his symptoms.

“Those first rehab sessions were really important,” Ferman says. “I was exercising with high-flow oxygen at the time, but over those sessions I showed a marked improvement in my walk test and overall strength and endurance. It was just a great team effort between the pulmonary rehab program and Dr. Gerke. I could tell they really cared about the progress I was making.”

When he finished the formal outpatient rehab sessions, Ferman transitioned to the Keep Moving Program. It’s an independent exercise regimen where patients monitor themselves during exercise, under the general supervision of the Pulmonary Rehabilitation Program staff.

Ferman continued with the Keep Moving Program until late 2014, when he was evaluated for a lung transplant. It was during these tests that he learned he had coronary artery disease, a build-up of plaque that closes the arteries that supply heart muscle with blood.

“I had three blockages, although I had never felt any chest pain,” Ferman says. “The real problem was that my lungs weren’t strong enough for heart surgery, and yet I’d probably ‘stroke out’ if they tried to do the lung transplant surgery. It was like a Catch-22.”

To perform the complex and high-risk double-procedure, Ferman’s UI Health Care team referred him to the Cleveland Clinic. In June 2015, Ferman underwent a successful left lung transplant and a quadruple coronary bypass operation. By August 2015, he was discharged from the Cleveland Clinic and back home in Iowa City.

Ferman returned to the UI Pulmonary Rehabilitation Program for post-surgery therapy, and again transitioned to the Keep Moving Program for exercise and monitoring.

Today, he continues to participate in the program—for the physical benefits as well as the boost to his mental and emotional well-being.

“They care. They get to know you, and they provide some accountability,” Ferman says. “If I wake up and it’s cold outside, or if I don’t feel like going, I think about the pulmonary rehab staff—the personal connection they give you, the genuine interest they show in their patients—and it helps me get up and go.

“They’ve helped me adjust to the post-transplant medications I’ll take for the rest of my life. They’ve helped find answers to my questions, and they’ve helped me stay focused,” he adds. “For me, it's more than a rehab and exercise program. I mean, I could go to any gym for exercise. Here, I’m a star!”