Pulmonary Rehabilitation

Breathing comes naturally for most people, but those with chronic lung disease may struggle with every breath. Chronic obstructive pulmonary diseases such as asthma, chronic bronchitis or emphysema affect more than 12 million Americans and are the fourth leading cause of death in the United States. Treatment for the condition often includes pulmonary rehabilitation to help patients control symptoms and improve their quality of life. A pulmonary rehab program also may benefit patients needing lung transplants or other lung surgeries and those suffering from other lung conditions, including cystic fibrosis, bronchiectasis, abnormalities of the thoracic cage and neuromuscular disorders.

Pulmonary rehab usually lasts eight to 12 weeks. It may involve several components, including exercise training, psychosocial support, educational programs and nutrition counseling. Pulmonary rehab is a team effort in which patients may work with physicians, nurses, respiratory, physical and occupational therapists, psychologists, exercise specialists and dietitians. The primary goals of a pulmonary rehab program are to help patients feel more comfortable so they can better handle day-to-day activities and maintain their independence. As an additional benefit, pulmonary rehab also may reduce the need for hospital visits.

Pulmonary Exercise

The exercise portion of the program is designed to improve heart and lung function and strengthen muscles involved in breathing. Lower body training, such as walking or riding a stationary bicycle, can help increase muscle tone and flexibility so it is easier for patients to move around. Upper body training can help strengthen the arm and shoulder muscles that support the ribcage to allow for easier breathing. These exercises also help patients manage daily activities, such as making a bed, carrying groceries or combing hair. Ventilatory muscle training may be recommended for some patients who have weak respiratory muscles that cause breathing problems and impede exercise.

Psychosocial Support

Psychosocial support helps patients deal with emotional stress that may be associated with chronic lung disease. Some patients could become depressed or anxious about their health and have growing concerns about body image, loneliness, low self-esteem, lack of social support or relationships with others. Patients may be taught relaxation skills or encouraged to talk about their feelings to help deal with these issues.

Pulmonary Educational Programs

Educational programs for pulmonary rehab can cover a variety of topics. Information may range from breathing retraining and strategies for managing breathing problems, to how the lungs work and how to travel with lung disease. Patients can learn through one-on-one instruction, group classes, written materials or audio/visual aides. Educational sessions and counseling also may be available to help patients stop smoking.

Nutrition

Information about nutrition is typically given to pulmonary rehab patients because fatigue, difficulty swallowing or poor appetite could hinder their ability to follow a balanced diet. Nutritional counseling also helps with weight management and teaches patients how to prepare and time meals so they do not experience increased shortness of breath. For more information about pulmonary rehabilitation and how it can benefit you, talk with your doctor or call 561-637-5318 for a free referral to a physician near you.

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Speech and Language Milestones

In the first three years of life, children have an intensive period of absorbing sights and sounds, including language. Yet speech and language develop more quickly for some children and more slowly for others. As a parent, how do you know if your child is on track?

If you suspect that your child has a speech delay or difficulty understanding or communicating, there are resources available that can help.

Below is a development checklist for the first three years from the National Institute of Deafness and Other Communication Disorders.

Birth to 3 Months	4 to 6 Months	7 Months to 1 Year	1 to 2 Years	2 to 3 Years
Reacts to loud sounds	Follows sounds with his or her eyes	Enjoys playing peek-a-boo and pat-a-cake	Knows a few parts of the body and can point to them	Has a word for almost everything
Calms down or smiles when spoken to	Responds to changes in the tone of your voice	Turns and looks in the direction of sounds	Follows simple commands and understands simple questions	Uses two- or three-word phrases to talk about and ask for things
Recognizes your voice and calms if crying	Notices toys that make sounds	Listens when spoken to	Enjoys simple stories, songs and rhymes	Uses k, g, f, t, d and n sounds
Starts or stops sucking in response to sound when feeding	Pays attention to music	Understands words for common items such as “cup,” “shoe,” “juice”	Points to pictures, when named, in books	Speaks in a way that is understood by family members and friends
Coos and makes pleasure sounds	Babbles and uses many different sounds, such as with p, b and m	Responds to requests (“come here”)	Acquires new words on a regular basis	Names objects to ask for them or to direct attention to them
Has a special way of crying for different needs	Laughs	Babbles using long and short groups of sounds	Uses some one- or two-word questions
Smiles when he or she sees you	Babbles when excited or unhappy	Babbles to get and keep attention	Puts two words together
	Makes gurgling sounds when alone or playing with you	Communicates with gestures such as waving or holding up arms	Uses many different consonant sounds at beginning of words
		Imitates different speech sounds
		Has one or two words by 1^st birthday (hi, dog, mama, dada)

https://medlineplus.gov/speechandlanguageproblemsinchildren.html

https://www.nidcd.nih.gov/health/speech-and-language