Choosing the Right Chair

Many times I see a client sitting in a chair that is a really bad fit. Not only that, it is often not assisting them in the primary functions it is being used for.

A chair is for sitting in – Does it fit your body? Is it supportive of your sore back, long legs? Does it provide support across the width of your hips or does it sag?

A chair is for standing from – Does it have arms above the seat that help you push up from sitting? Is it a good height off the floor, or is it too low? Is it stable to push up from or does it rock and move as you transfer your weight?

A chair needs to be comfortable – What is it made from? Will it last for as long as you need it to? How long will you be sitting in it?

A good chair provides relief from aches with good posture, it brings rest and comfort. It needs to allow you to sit for long periods of time and then help you get up when you’re done with it.

Non supportive

Supportive

That First Step is a Doozy!

Have ever wondered where this saying came from? Well I can’t answer that but I can tell you why it makes sense.

Did you know that the first 3 steps of any ascent or descent are the most unsafe. This is for various reasons such as concentration, distraction as to where or why you are climbing the stairs, foot accommodation on the tread, change in step pattern or stride…

The way to be safe is to use a rail, but many rails don’t start or finish where they are supposed to. The standards we set for handrails in Australia take notice of the above concerns and specify that rails need to start before the steps do, and finish after they do. This way as you reach the landing on either end you still have something to hold to steady yourself on arrival.

Be confident that your arrival at your destination is always a safe one by making sure that your rail is with you throughout the entire journey.

Safe travels!

COVID – the long haul virus

Research is coming internationally on the long term effects of COVID-19. There has been an appalling trend for thousands of COVID survivors to remain debilitated by severe fatigue, brain fog, and tachycardia with a resulting inability to return to work. The economic implications of this with huge numbers of the 20 to 40 year old’s unable to work is hard to ignore, this accounts for 10-30% of those affected by the virus.

Amazingly some headway is being made into how to rehabilitate these patients. Unfortunately it is not a quick fix with a pill or a vaccination. The team at Mount Sinai Centre for Post COVID Care have found these people have developed ‘Dysautonomia’ or a dysregulation of the autonomic nervous system. Meaning their body is out of balance and struggling to cope with the smallest everyday actions, a bit like chronic fatigue syndrome or an immune disease.

This lack of balance is impacting on heart rhythm, blood pressure, temperature, fight and flight responses and a myriad of other functions such as digestion, cognition and breathing.

So how have they been making a positive change in these people’s lives? Well apart from dietary changes, stress management and individual rehabilitation programs they introduced a new breath management system called ‘Stasis’ which helps to regulate the body with interval breathing practice morning and night. This works to coach the body back into a regular rhythm and start to restore balance needed for them to get mobilising again without shallow breathing and spiking heart rate leaving them bedridden.

Good news for those who are struggling after contracting COVID-19 to get back to work and their daily routines. At least they can put a name to it and know that they are not malingering and seek help from a breath management service.

Therapy Service News

Thank you to all my patients, colleagues and network for being a part of Inlifetherapy Occupational Therapy this year of 2020. Along with everyone else who has had to adapt and change practices I have added telehealth and generic occupational therapy services and minor home modifications to my profile this COVID19 year, which has been a great positive along with all the amazing online learning and meetings that have kept us all connected and supported. Wishing you all a wonderful Christmas with family and friends and see you all in 2021!

Services for Home modifications and Falls equipment

This week its OT Week 2020. The theme is Rebuild, Recover , Reengage. I have taken a moment to reflect and think about the changes that COVID19 has brought to my practice this year.

Many of my patients have withdrawn behind closed doors to wait out the situation, some have used my new telehealth services and others have continued with face to face using protective equipment, social distancing and treatment out of doors.

It has brought with it an opportunity to change the practice and extend my services not only geographically to the southern Brisbane suburbs around Greenbank and Mt Warren but in treatment provision to include minor home modifications such as rails and bidets in bathrooms and non slip surfacing, and larger pieces of equipment such as high back chairs, electric recliners and a greater focus on falls prevention equipment such as sensor lighting, non slip mats, wheeled walkers, and incontinence aids such as bedding and chair pads and pressure and back care cushions.

It has reminded me of the extent of an Occupational Therapist’s ability to assess a persons capacity, their environment at home and the tasks they wish to engage in and assist them in self maintaining these tasks and interacting with their environment in a safer manner.

This week alone has been a varied experience of wheelchair belts, bottle openers, incontinence bedding, non slip mats, electric recliner trial, walking reconditioning, transfer out of bed aids, and breath control practice.

Wonderful to work with a larger population of seniors in the community and looking forward to meeting more of you and enabling your lives for quality living.

A Focus to Slow the Rate of Breath

I have recently been working with a patient who describes herself as a person who likes to just get in and get the job done. We have had a bit of a journey to find a tool that helps her to slow her rate and gain control not just physically but mentally when she gets breathless following exertion.

I have been using patterns of breathing, with oxygen saturation and heart rate monitoring, to influence the recovery rate of the individual during and post activity. There is much in the literature about resonance breathing to help you relax faster when stressed using the natural respiratory pause at the end of the extended exhalation. Shooting and marksman sports use this natural pause to steady themselves.

Adding a visual cue to this patterning such as used in the breath in a box technique can give a focus mentally and a rhythm to follow that can help slow the rate and help the person relax more easily. Everyone’s condition is different so it is important to find the rhythm that is comfortable for you and improves your self management in the moment of breathlessness. Daily practice will help you to improve.

Using the respiratory pause to slow your rate

Unblock with Humming

Did you know that humming is good for your health? Especially if its combined with nasal only breathing. (Refer Weitzberg and Lundberg “Humming Greatly Increases Nasal Nitric Oxide”). Naturally produced nitric oxide in the sinuses is the one of the keys in the regulation of inflammation and immune defence. Blocked noses also benefit. Recently had a patient who used a set of 4 humming exercises every day with her usual relaxed diaphragm breathing and she has found her usual drip and block has cleared. Wonderful result for anyone with asthma who dreads the seasonal changes and the accompanying nasal overload.

Try this exercise on for size: For 2-3 minutes inhale 4 counts, exhale 6 counts with a hum and hold nose for 4 then repeat. If its a bit hard then lower the numbers and build slowly.

Of course regular use helps greatly. If anyone has difficulty with shortness of breath, assessment and individual plans are recommended.

Inlifetherapy Telehealth Remote Treatment (now available)

As part of Inlifetherapy’s COVID-19 Response Plan in line with Department of Health and WHO guidelines, strategies for treatment provision will include the following: use of outdoor areas for treatment, social distancing , use of hand washing, cough etiquette, hand sanitiser and use of minimal contact treatment methods / assessment tools have been put in place for home visits. Phone calls will precipitate all home visits to check health status and that an area for treatment that allows social distancing is available. Every referral will be assessed on an individual basis as to what is the best form of contact to be observed.

Treatment at this stage of the escalation pathway will not be provided to confirmed cases in order to protect patients who are not symptomatic.

Privately funded patients who have access to internet connected devices such as a desktop, Ipad, tablet, or smart phone will be able to seek treatment remotely from home without visitation if this is what they prefer.

On the 28 March Medicare Chronic Disease Management (CDM) plans have been approved for bulk billed funding of video or phone telehealth services by Occupational Therapists.

From the 1st April DVA has approved video or phone telehealth services by Occupational Therapists for referred patients.

Instructions for video telehealth can be emailed to you prior to your online appointment. If needed, it might be handy to preempt any difficulties by having a tech savvy family member or friend sit with you when you download the app or attend your first appointment.

Therapy aids will be emailed or mailed for appointments as required.

I am looking forward to this next phase of technical adaptation as a way to further enhance the quality of your health care and continue to help you meet your goals.

Breathing Well Checklist for COVID-19 Part Two

As we discussed in the previous article it is important to consider a few factors so you are a good scout and prepared. We have already discussed trigger awareness, use of management plans, up to date scripts, correct inhaler technique, hand hygiene, and cough etiquette. As they say forewarned is forearmed! Take a look at these next ones:

  1. Keep your distance – when you are aware of others with symptoms, putting some space between you can reduce the risk of infection. On the other hand if you are symptomatic then help stop the spread of infection by minimising your movements and take to time to recover at home.
  2. Hands off – when friends and family are unwell then reducing the physical contact can help in reducing the risk of infection – save the hugs and kisses for when they are feeling better.
  3. Breathing efficiently – can help when things get tight in the chest and that mucous starts to build up. Try some pursed lip breathing and forward leaning postures. Refer to earlier blogs on ‘Factors Affecting Breathlessness’.
  4. Keep active – as exercise helps shift mucous build up and maintains conditioning. This can be as simple as doing a few household chores, going for a walk or going to the gym. Pace yourself and don’t overdo things if you are feeling unwell.
  5. Sleep well – rest gives you balance to your daily activities by repairing and energising us.
  6. Stay hydrated – our bodies are happier when we keep a balance to our intake of fluids.
  7. Immune support to help your body fight infection is often overlooked but can be a useful tool in your arsenal – check with your GP or health professional for more information.

As you can see there is a lot of self management that you can be in control of to lower your risk of illness this winter season.

Breathing Well Checklist for COVID-19 Part One

There has been a lot of media in the last few weeks that would make even the strongest person feel worried. But to keep it simple here are a few tips I will be sharing with my regulars that I thought would be useful for pulmonary/respiratory/cardiac/anyone with breathing problems, breathlessness, or shortness of breath difficulties:

  1. Know your triggers – awareness of what sets off your breathlessness is pivotal in forming a management plan. Knowing your own symptoms and having your COPD/Asthma management plan in place is a starting point. https://lungfoundation.com.au/wp-content/uploads/2018/12/Information-paper-COPD-Action-Plan-Kit-Feb2019.pdf or https://asthma.org.au/wp-content/uploads/2020/01/341-NAC-Written-Asthma-Action-Plan-2015_Colour.pdf
  2. Make sure your scripts are up to date and you have a supply of medication with your spacer with you ready when needed.
  3. Know your inhaler technique – if you need to check then go to the Lung Foundation website to view videos on how to be effective in using your devices or ask your allied health professional. https://lungfoundation.com.au/resources/?search=technique
  4. Hand Hygiene – important in reducing the risk of infection. Check out this Department of Health publication on how to wash your hands. It should take you 15-20 seconds to complete the task of hand washing, try singing a song with your children to help them stay at the basin longer. https://www1.health.gov.au/internet/main/publishing.nsf/Content/A1CCE88EB168930CCA257E35007F6927/$File/wash_dry_hands.pdf
  5. Cough Etiquette is equally important – coughing into your hand and then spreading the infection through touch can simply be avoided by following precautions such as using a tissue or coughing into your sleeve. Check out this poster at https://www.nqphn.com.au/wp-content/uploads/2019/05/00883-Cough-etiquette-poster-A3.pdf

Spend the time making new healthy habits, lowering your risk and improving your self management. Remember to keep a look out for Part 2 of this article..