Cathinka Guldberg Hospital Lovisenberg rehabilitation for heart and lungsickness

What is this?

Cathinka Gulberg Hospital is Norway's most modern and accessible highly specialized rehabilitation centre. Here, patients are examined, treated and rehabilitated.

They have offers for heart and lung patients.

The teams consist of: doctors (specialists in lung, heart, occupational medicine, physical medicine and rehabilitation and general medicine), nurses, nursing assistants, physiotherapists, sports educators, occupational therapists, psychologists, clinical nutritionists, work consultants/social scientists and bioengineers, many of whom have specialist expertise and extensive experience with heart and lung patients.

Since I was in a ward for lung patients, I tell mostly about this.

You can apply for a place if you have: Do you have a lung disease such as severe COPD, asthma, pulmonary fibrosis, sarcoidosis in the lungs, or have you been injured after severe Covid-19 or have undergone a serious illness that has damaged lung function? Your doctor can then apply for a rehabilitation stay with us. If you have an unexplained cause of shortness of breath, you can apply for a stay for investigation and clarification.

I was on General pulmonary rehabilitation: So a 4-week stay for you with round-the-clock rehabilitation in the specialist health service.

What you can get out of your stay:

During your stay, you will gain increased knowledge about your own health, what challenges you have now faced and how you can get back to everyday life again. Everyone receives follow-up with a doctor, nurse/assistant nurse and physiotherapist.

Many lung patients have heavy breathing and are afraid that it is dangerous to exercise. At Cathinka Guldbergs Hospital, we thoroughly map your health situation before you receive an individually tailored exercise plan.

Expectations for the stay:

Experience shows that those who participate in rehabilitation are better able to cope with everyday life and working life, and that insecurity and anxiety are reduced. In the physical activity program, you get to test your own limits.

Through teaching from the interdisciplinary team and conversations with others in the same situation, you learn a lot about how others have mastered their challenges. Better insight and understanding create security and a better quality of life. For more information read here: https://www.lovisenbergrehabilitering.no 

My experience:

I was offered rehabilitation, as the lung disease made it difficult to do various things, such as e.g. exercise and live a full life, by managing and doing things, even breathing.

I drove to the rehabilitation and had the picture there: It costs NOK 170 a day to park for patients who are not in rehabilitation and NOK 100 a day for patients who are in rehabilitation.

First I went to reception and got checked into the room that I was to have during my entire stay.

The room

Private room with private bathroom

On the first two days, there are mostly surveys, interviews and tests. I came on a Tuesday. Had income interview with a nurse, then with a doctor. Here you must say what you are struggling with, which medicines you are using, and talk about goals and expectations for this. On Wednesday, there are mostly tests: blood tests, weight, (ECG, if you need), X-ray, income interview with a physiotherapist and test, as well as breath tests.

I was given a binder with information and an activity plan for the team, here I was on team 9. In the folder are the times for the various examinations, information on infection prevention measures if necessary, where the teaching rooms and meeting rooms are, as well as information on source sorting.

The work plan lists all the activities for the team you end up on, and it will be a combination of training, lessons and discussion groups. You will also receive individual follow-up by a doctor, nurse/assistant nurse and physiotherapist/sports educator. The other specialist groups (clinical nutritionist, occupational therapist, psychologist, social worker and work consultant) can be offered if you need this.

You get guidance, tips and advice, but you have to do the work yourself.

You have internet there, but are often logged out of it so you have to log in again.

The food: You must call and let us know if you have any allergies before you start your stay. The food is based on the Norwegian dietary guidelines and collaboration between the kitchen and the clinical nutritionists at the house. So the food is healthy.

You can wash clothes at the house: You go to the reception by the front door and buy time in the washing machine that costs NOK 30, and then you get both clothes washed in the washing machine and tumble dryer. Soap is already in the washing machine, so you don't need to take it with you.

There are meeting rooms, teaching rooms, fitness rooms, strength rooms, gymnasium, pool, spinning and yoga rooms.

Every day we had a fixed attendance time for the sofa group for team 9, when I was on this. To see if we were there and had a good time, as well as handing out information and any changes to the activity plan. Our times were 8.45am and 6pm on weekdays, and 11am and 6pm on weekends. At the weekends, you could take leave for a couple of nights (in other words, go home for a trip before coming back again) as long as you let us know at the meetings first.

Activity plan:

The activity plan runs from week 1 to week 4 and continues in the same order. I arrived when the activity plan was in week 3, I arrived on a Tuesday so started on Thursday with activities.

Exercise:

We had training with a physiotherapist, then teaching about allergies, then circuit training. Some training sessions are optional, so you can take them if you want to work out a bit more.

Some activities can be working out with a physiotherapist in the conditioning and strength room (in which case it is often an individual scheme that has been agreed with the physiotherapist you have been assigned to), gymnasium with a physiotherapist (in which case it is a joint scheme, e.g. with elastic bands). You can have an hour with a psychomotor physiotherapist (together), or alone (if necessary).

Optional working out sessions can be a group trip outside, then those who wish from the various teams go on a trip (there are three different trips, short, medium and long), so you go at the level you want and are at. Trim 1: Training with stools (exercise sitting), Trim 2: Without stools (Circle training, i.e. strength and fitness). Medical yoga (some yoga exercises that focus mostly on breathing and relaxation).

There can also be extra training such as an open pool (free pool, that you can do what you want, or exercise in the pool). There may be spinning classes as well (interval training on a bicycle), but it depends a little on the different physiotherapists you have.

Individual training: 

You get a training program adapted to your physical form and your abilities. My main goal in training was to manage and train, as well as learn and breathe without holding my breath and get enough oxygen when I trained. We started with cardio training, warming up approx. 10 min, then intervals, started by walking and rather increasing the hills on the treadmill, eventually I was able to run 1 min on the intervals. After conditioning, we went to strength training on the same day. Here they adapted exercises to what you were able to do, what you wanted, and adapted exercises to places where you were in pain.

Lessons:

Teaching about allergies, changing dietary habits, gaining weight courses, information from LHL, oxygen teaching, teaching about medicines, physical activity and health, about living with lung disease, what to do when it gets worse, coping with daily tasks, inhalation technique, healthy health promotion diet, teaching about asthma, teaching about COPD, the patient representative's information for lung patients. Here you have to adapt the kind of lessons you attend to your own needs, for this is more general, for example I didn't need Kol's lessons, or up in weight courses and a few more. So didn't show up for them, only showed up for those that were relevant to me and my health.

Talkgroups:

The conversation groups are with your own team, so only the people who are included here. The topics at the meetings were Boss in one's own life, good health in case of chronic illness, family and friends - problem or resource?, and coping with heavy breathing. Here you will get tips and tricks on how to cope with everyday life, and if you wish, you can say a little about your own experience, about, for example, what you are struggling with, or how you did something about it. And is often at the team meeting place, our team meeting room looked like this:

In the hallway to team 9 there is usually a board with information about the day, various activities and any time for doctor's visits.

Evening activities: approx. at 17 then there is no more programme. But there may be activities such as Quiz, Bingo, music, possibly a concert if it is hired, you can play board games that you can borrow, you can play Botcha. Go for a walk, train if you want this (after 4 p.m. the training rooms are finished for each team and you can train alone since this is free).

Close by are i.a. Jessheim shopping center so you can go there if you want, there are ski slopes and in the summer you can rent a bike.

Extra tests and conversations if you need this

Since they weren't quite sure what made me so bad, I took a lot of extra tests as they wanted to find out.

Then took the spirometry test: Spirometry is a medical examination of a person's lung function. It is performed using a device called a spirometer. The test is carried out as follows:

1. Sit down: You will be asked to sit in a chair in an exam room in the doctor's office.

2. Deep breaths: The doctor or nurse will instruct you to take a deep breath in and hold your breath for a few seconds.

3. Forceful exhalation: You then breathe as hard as you can into a breathing mask that is connected to the spirometer.

4. Repeat the test: You will want to repeat this process at least three times to ensure that the results are consistent.

Spirometry provides information about the amount of air you breathe in and out, as well as the speed of your breathing. It is particularly useful for assessing lung function in conditions such as asthma and COPD. Read more here: https://nhi.no/siktoorde/lunger/undersokelser/spirometri 

Methacholine test: To carry out a methacholine test, follow these steps:

1. Preparation:

• Make sure you are symptom-free at the start of the test and have not had an asthma attack or respiratory infection in the last two weeks.
• You must be able to carry out a spirometry, which is a breathing test to measure lung function.

2. Execution of the test:

• The test starts with a normal spirometry where you blow before the start and one minute after each dose of methacholine.
• Methacholine is given via a nebulizer in escalating doses.
• A test leader will constantly explain what happens during the test.
• After each dose, a report is written which may be important for further assessment of the test result.

3. Results and advice:

• The test result will be reviewed, and you will be given advice on further medication.
• The methacholine test provides information on the degree of hypersensitivity in the airways and can be useful both for making the diagnosis of asthma and for assessing the effect of treatment.

Read more here: https://www.oslo-universitetssykehus.no/behandlinger/direkte-bronkial-provokasjonstest 

Treadmill test: EKG, blood gas, spirometry tests along the way, blood pressure.

Started by lying on a bench in tights and a bra when they had to attach electrodes to the EKG. Here there was a lady (nurse) and a man (doctor) who were there. The nurse put electrodes on me and took an EKG, my heart rate was a bit high as I was a bit stressed. Got a mesh jersey over this again so the electrodes stayed in place.

Then I was told that I had to take blood gas, which is a puncture in the main artery in the arm. They were going to insert an IV there. The doctor gave me an injection with anesthetic first, then he stabbed me where it should be, he inserted a needle with a wire, when I was about to let go and be stabbed several times. Before, during and after the test, I took spirometry (blowing into a mask that I was wearing). They took blood from the cord before, during and after the test. The same with, among other things, blood tests, blood pressure and pulse. They checked me properly!

After the test I felt dizzy and had to sit down on a chair. Had to be in there for a while after the test too. They then took out the venipuncture and held it tight where the blood was coming out for a little while. Then got two rounds of cotton, and a bandage that I had to wear for 3 hours. I had to wear the cotton until the next day.

Sleep test: Since I slept so poorly, I have to measure whether I breathed at night without stopping breathing, so I took it. They measured my heart and pulse, as well as whether I snored, breathed or hyperventilated when I slept. Was something around the stomach, around the arm and oxygen tube in the nose (without oxygen). Had it on from the time I slept until I woke up. (picture below)

They found out quite a few things while I was there. It turned out that I had received the wrong diagnosis, and had used medication that did not work for this. When I arrived I had a certain maximum dose of medication, and when I left I had no more medication. The side effects of the meds I took that I didn't really need could be making me worse again. But because of the new diagnosis I received, it is important that I practice breathing correctly with the correct breathing technique, and that I am good at training, as well as practicing relaxation and unwinding.

All in all, a unique and exciting experience that helps you figure things out, find solutions for yourself, and answers to why you feel this way, as well as how to get out of rehabilitation and live a full and good life. Now it must be said that you can't fix everything in 4 weeks, you have to continue and train on what you've got when you get home, but you've got the resources you need to be able to do this.

At home: The hardest part is actually coming home and having to manage this myself. In a way, you have no one to ask who can help you if you are struggling. You have to do and use the resources you've got yourself, and it's a bit difficult at the start. But it works in the long run.

The link to read more about the offer can be found here: https://www.lovisenbergrehabilitering.no