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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!

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..

Everyday In Every Way I’m Getting Better

Memories are special. The ones you want to hold onto need to be filled with detail to lessen the chance of losing it.

A good memory I have of one of my patients, and friend, is of an elderly gent sitting at his dining room table in a blue checked flannel shirt tightly tucked in, oxygen tubing stretched across his pale creased face, his side burns extra short from a recent “lowering of the ears” ,the skin on these patches almost white. The hair combed back and still wet from grooming himself that morning. His face intently focused on the pen in his hand making sketching’s in his pad of a horse in mid flight racing round the bend at a high stakes meet, all the while talking about his week, the incidences of daily life, the difficulties, the appointments, and then he pauses and looks up and with interest and intent in his eyes he says “And how are you?”

Always asking about other’s stories and lives giving pearls of wisdom in the form of his own experiences, he had a focus on optimising his self improvement throughout the course of his chronic illness. He often shared and was deeply interested in the works of:

  • Emiold Coue a French psychologist known for auto suggestion – every day in every way I’m getting better was the mantra he found helped him.
  • Maxwell Maltz who was an American cosmetic surgeon and author of Psycho-Cybernetics (1960), which was a system of ideas using self talk that he claimed could improve one’s self-image leading to a more successful and fulfilling life.
  • and lastly the Serenity Prayer, a source of inspiration that often helped him get through the roller coaster of ill health.

My memory of conversations about his work as a Posty, his interest in bands and the great musicians of his time ….., his drawing and painting of iconic characters, military scenes and horses, a recent interest in one line portraits,  all the while scribbling in his drawing pad as we talked, shaping and forming pictures from his minds eye whilst he thought on the issues that mattered most to him; grieving the loss of old friends , and caring for his wife, family and friends. He will be sorely missed.

 

Singing Improves Breathing Symptoms in COPD

I have just read an interesting article on a study conducted in Kent, UK, on a group of participants with Chronic Obstructive Pulmonary Disease (COPD) that had completed a 10 month community singing program learning breath control, relaxation and breathing exercises whilst singing weekly as a group –  https://www.ncbi.nlm.nih.gov/pubmed/29160737 .

Any activity that you find meaningful can distract you from the odious task of purposefully exercising muscle groups for health management. We all find it difficult to motivate ourselves to continuously do the actions required to maintain muscular strength and mobility when we are unwell.

Here is an activity that brings relaxation , enjoyment, friendship, mental dexterity and challenge whilst improving respiratory symptoms. I can personally vouch for the mental dexterity part after being involved in a Sing From Scratch with Schubert’s Mass No.2 in G Major in Germanic Latin! The study reported that the majority found their symptoms improved over the 10 weeks as well as their mental and social well-being.

A timely reminder as many choirs around the world are presently involved in practicing and performing parts of Handel’s Messiah for Easter celebrations.