I once had a patient who declined a blood transfusion for religious reasons. His hemoglobin was too low for exercise, yet the he wanted to get stronger. Are there any exceptions to the hemoglobin rules for exercise?
Answer
Absolutely. In one of the hospitals where I work, they do have bloodless treatment options. Sometimes the patients receiving them have very low blood values, but want to exercise. Exercising these patients must be considered on a case by case basis, and you need to confer with the doctor. We do see patients exercising with very low values. I do not think that there is any evidence out there which states the effect of this form of treatment. If patients are opting against blood transfusions, and they are still functioning in the world, meaning that they are not in bed and are doing some forms of activity, sometimes pushing the envelope might make them feel better. Again, you would need to clear that with their doctor.
Andrea Branas, PT, MSE, MPT, CLT
Andrea Branas is a lead physical therapist at Good Shepherd Penn Partners in Philadelphia, PA. Andrea works in the Abramson Cancer Center at the University of Pennsylvania Health System providing patient care, education, leadership and training in the area of cancer rehabilitation. Andrea’s areas of clinical expertise include lymphedema, pelvic floor rehabilitation, breast cancer rehabilitation and exercise for cancer related fatigue. In her current role, Andrea uses her expertise to help cancer survivors reach their physical potential by promoting rehabilitation starting at the time of cancer diagnosis. She is currently a collaborator on an NIH Funded Dissemination grant to look at strength training for survivors of breast cancer. Andrea has served as a guest lecturer for women’s health and cancer content at Arcadia and Widener Universities and the University of Medicine and Dentistry in New Jersey DPT programs. Andrea received her Masters degree in Physical Therapy from the University of the Sciences in Philadelphia in 1998 and her Master’s of Science in Engineering degree from the University of Pennsylvania in 1991. She is currently working towards her transition DPT at Arcadia University.
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This course focuses on medical screening for the physical therapist and is Part 3 of a four-part series on screening. Part 3 addresses pathology in the adult portion of the lifespan. Part 1 is recommended prior to part 3.
Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 2 hours of Direct Access CE credit.
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