• ERS and Rehab Around the World
  • It was especially nice to see Dr. Jan Zielinski of Warsaw, Poland. Dr. Zielinski has been a good friend since visiting us back in 1985. He started his own pulmonary rehab program shortly after that visit, which was the first in Eastern Europe. He was honored at this meeting for his many outstanding contributions to the field of pulmonary medicine and gave a superb lecture. We’ll have more exciting news about Dr. Zielinski in the next newsletter.

  • Shino Sakae in Durnstein, Austria
  • It was wonderful seeing Shino Sakai of Teijin, Japan’s largest oxygen supplier. She was Mary Burns’ interpreter during her two-week tour of Japan and has been responsible for writing some books on rehab for health care personnel in Japan. She compared notes with Annet Rysgard of AGA of Norway who was Mary’s guide during her two visits to Norway. Our topics of conversation? Why, oxygen, pulmonary rehab, and when they would next visit California, of course!
  • Dr. Audhild Hjalmarsen of Tromso, Norway, 500 miles above the Arctic Circle, was there also. Their pulmonary rehab program, and promotion of portable liquid oxygen, is highly successful. They also are working to promote rehab and oxygen in the areas bordering Russia. In speaking with some physicians from other areas of Russia, it appears that this is the only section of that large country with rehab and oxygen. Heavy smoking remains a big problem in Russia as in many other countries.
  • Dr. Juan Antonio Mazzei of Buenos Aires, Argentina greeted us with Latin warmth and enthusiasm. We were delighted to hear that pulmonary rehab has “taken off” in that country. Mary had the honor of delivering some lectures on pulmonary rehab at a World Conference of Cardiac Rehab in Buenos Aires several years ago, when rehab in Argentina was just beginning. Dr. Mazzei is also responsible for translating our booklet on Essentials of Pulmonary Rehabilitation into Spanish. We hope to have an updated version on our website soon making it available for anyone to download. We still have original copies available in English as well as Spanish, but would suggest a contribution of $2.50, if possible, to help defray costs of printing and mailing.
  • It was wonderful seeing these friends but even more exciting to see the successful spread of pulmonary rehabilitation around the world. The European Respiratory Society (ERS), as well as the American Thoracic Society (ATS), have both acknowledged the importance of rehab. GOLD, the Global Initiative for Obstructive Lung Disease, also states that pulmonary rehabilitation is part of the standard of care for respiratory patients. This was considered a very controversial statement back in 1990 when Dr. Rich Casaburi, Dr. Andy Ries and Dr. Bob Chang were the first to assert this in a position paper for the California Thoracic Society (CTS). It is wonderful to see the rest of the world now also sees the value of rehab! These position papers are very helpful in getting 3rd party reimbursement for pulmonary rehab programs, so remember them if you are having problems with funding.
  • Just as great as the big push to promote pulmonary rehabilitation, is the effort to curb the “tobacco epidemic”. In twenty years, it is felt that tobacco use will be the greatest single cause of death in the world. Respiratory disease will become the 3rd largest cause of death, the only major disease that is increasing.
  • The scope of this problem was evident in seeing the many physicians from Eastern Europe who still smoke. A lovely pulmonary physician from Romania told us that she didn’t work with victims of chronic obstructive lung disease because there was nothing she could do for them. 70% of adults still smoke she told us, including many physicians and almost all teenagers. Not only was there no pulmonary rehab, but also there was no government coverage for inhalers and most respiratory medications. She told us that many patients died of polycythema. That is so hard to believe. Polycythema is an excess of red blood cells, which makes the blood thick. We rarely see it anymore in the United States. It can be caused by a chronically low oxygen level in the blood stimulating the bone marrow to produce extra red blood cells. Red blood cells carry oxygen around the body. Polycythemia is the body’s attempt to carry more oxygen to the body when the lungs do not work well enough to get oxygen to the blood stream. The prevention of this condition is providing oxygen. But, there is no home oxygen in Romania. We know that using oxygen, or your inhaler, or all the pills you have to take, can be annoying. We don’t blame you for being irritated. But, the next time you are grumbling about the inconvenience, try to remember some of these poor people in other countries of the world. Perhaps it will give your day a better outlook.
  • There were 3,720 presentations at this meeting with 384 major scientific presentations. A lot of information is being exchanged, and a lot of research is going on all over the world. The future is bright! Keep reading the Second Wind and we will keep trying our best to inform you about the latest developments.