activity – Inlife Blog.

World COPD Day

On this day World COPD Day 2019, https://goldcopd.org/world-copd-day/ bringing awareness of COPD, it’s important to remember some key self management strategies that you need in the community to prevent unnecessary admissions and stay at home independently:

COPD plans must be filled in by your allied health professional or GP to better understand how and when your medications are to be used and left where family/housemates are aware of your needs when you are too breathless to talk yourself.
Correct inhaler device and spacer use means the medication is effectively going into your lungs and not lining your mouth and causing side effects such as thrush. Asthma relievers if used more than 2 in 7 days is not under control, please seek help from your GP or your breath management health professional.
Breathing techniques that take the work out of breathing and reduce recovery times post activity keep you moving through the day for longer.
Exercise is an important way of preventing deconditioning. Less exercise/ activity can lead to more breathlessness.
Meaningful activity engagement whether it be household chores, hobbies or social engagement are important motivators that keep us moving.
Use oxygen as prescribed – exertional oxygen during activity, nocturnal oxygen while sleeping or continuous long term oxygen for at least 18hrs.
Bush fire smoke reduction – close doors and windows, air conditioning on recycle, rest and hydrate, avoid strenuous exercise, P2 respirator masks, emergency evacuation plan to reduce exposure.

Occupational Therapy Assists with Breathlessness

Occupational Therapy Week 2019 is here! How can we help you improve your quality of life?

Occupational therapists help you deal with health issues that impact on your activities by:

looking at ways we can do the activities differently,
teaching you skills that will help you do the activity,
using adaptive equipment or
changing the environment you are doing the activity in.

For example I see patients with breathlessness. Someone who has trouble sweeping the floor may need to use a long handled broom and dustpan to eliminate bending which worsens their symptoms. They can also learn breathing techniques that take the effort out of breathing and reduce the time it takes to catch their breath during and following the task. When a person understands the nature of their condition and ways to alleviate symptoms they feel less anxious and their confidence to self manage improves.
Go to https://www.otaus.com.au/find-an-ot to get back on top of your activities today.
#THISISOT

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.

The Language of Breathing

The MacMillan Dictionary lists 10 different words to describe breathing or difficulty breathing (https://www.macmillandictionary.com/thesaurus-category/british/to-breathe-or-to-have-difficulty-breathing) . The simple function of taking air in through your nose or mouth and then letting it go again is often not an easy thing to describe or relate for a patient.

People often have difficulty identifying if they have the breathlessness described and seen by their GP or case nurse. Their wording and explanations may not align with my use of the word breathlessness and may be more meaningful to them if explained with the words gaspy, or puffy…

The language we use in terms of words is one thing but then to be able to describe such fleeting changes that we experience with breathlessness in our activities can also be equally challenging. The only way forward is to use standardised activity to assess and then repeat to capture the initial ability and then review for change post treatment.

The patient learns to notice and become more aware of their breathing state, how to express it and how to rate it. In order to seek effective and timely treatment this becomes an invaluable addition to their chronic disease management toolkit.

Hill over Everest

Everyone has new year resolutions, whether it be in the realms of fitness, budgets,or new behaviours. People I work with all tend to have one constant aim and that is to not lose what they have.

This could be activities, independence, to breath freely after exerting themselves, or to get back to work. In order to keep this they need to devote themselves to something that needs repeating , may not be enjoyable and may have some level of difficulty. I think we can all relate to this.

The way to navigate towards what we want is to set a goal.

How to set a goal?

It must be personal and meaningful – own it – My goal is…
It must be specific – detail – walk 30 min in the shopping centre, 3x per week
It must be measurable so you know when you’ve achieved it
It must be achievable – no point setting an Everest, choose a hill you can climb
It must be realistic – don’t look at Ferrari when Holden is a better fit for you
It must be timely – don’t overload yourself

Start with one goal and go from there.

Don’t forget when you reach that goal to reward yourself for a job well done!

The Christmas Rush

Christmas can be a time of of scheduled events, family and friend catch ups, gift and food shopping, racing round to see those lights. For me its a time of thankfulness, blessing and promises fulfilled and I like to make sure I have moments to stop, rest and enjoy the togetherness of family and friends.

Christmas is also a time of traditions and habits , things we do every year because we have always done so. I have spent my time this year assisting my clients in developing healthy breathing and activity habits and hope that they continue into the new year seeing the fruits of their labour.

I heard recently that we can be so caught up in being busy that we think that this alone is enough for justification of our time. Instead we need to stop and look to see if, and what, we have actually achieved, and if we cannot see something for our efforts then we need to re-calibrate and be more purposeful in our actions and not just busy.

I saw a video recently of Bill Gates talking about time and of a friend who had showed him his diary with spare days in it instead of every one filled with appointments. He had said to Bill, “I can buy anything I want but I can’t buy time”.

So this Christmas try to slow down and simply breathe…, noticing the breath in ….and out…, feel your muscles release and relax…. and give your time where it can be purposeful and make a positive difference.

Scouts Motto : Be Prepared

I have such wonderful conversations with my patients that often have lessons for both patient and therapist. The best patient centred relationship is one where we learn off each other.

We were discussing relievers and spacers and how research has proven the improved dispersal of the reliever when a spacer is used. My patient then went on to say that she has taken to travelling with her reliever and the hand held fan as a kind of mini pulmonary toolkit that gives her the confidence of knowing she is prepared for every circumstance.

It reminded me of a situation I was in last week whilst travelling in Tasmania.

Cradle Mountain, world heritage area of majestic beauty but also a place of extreme weather and unpredictability. I was climbing to the Mt Marion Lookout and found that half way up in the cold and floating rain I had trouble catching my breath.

Exercise induced asthma has little warning I find. As every good explorer should do I had a snack in my pocket and my bottle of water and was rugged up in beanie and coat against the cold.

However just shy of the top things got a little uncomfortable. That need to fill the lungs but not getting as much as I’d like coupled with the knowledge that I was literally in the middle of nowhere and my nearest reliever was , you guessed it, in the car park an hour and a half away.

There was no way I was going to turn around and miss getting to the top so I used what I had to get relief. I stopped and leaned forward, blowing out through pursed lips and took a rest break to get my breathing under control. After a few minutes rest and hydrating with my drinking water I started up again pacing myself this time, keeping up the pursed lips as I went.

I made it and with a little sprint to compete with my 13 yr old daughter I got there ahead of the family and promptly claimed the seat to lean forward and recover my breathing once more.

To say the least, my patient was wise in her preparation and a puffer in my pocket next time will be part of my good explorer ensemble.

Noses, odours and memories

A recent article that I was made aware of through social networking has found that breathing through the nose significantly increased memory recognition. Olfactory sensory neurons detect the pressure created by the airflow into the nose and send this on via the olfactory bulb and on to the hippocampus, an important centre for memory function in the brain. In lay terms what does this mean?

nose breathing enhances the encoding and retrieval of memories
core brain functions can be impacted by breathing patterns

What this is leading to clinically is in the hands of researchers but I for one like the fact that as I teach breath management that promotes nose intake over mouth I find it a wonderful thought that perhaps I am positively influencing the patients olfactory senses and strengthening memory pathways to the brain’s heart, the hippocampus.

In older age memory is something that is an important part of who we are as individuals so next time you are out smelling the roses take a moment longer to really breath in through your nose and strengthen those neural pathways that keep our happy memories alive.

Occupational Therapy Week 2019!!

It is Occupational Therapy Week!!

The age old question of what is an OT has had much written about but to keep it simple after 24 years of being an occupational therapist the easiest way is to ask you: Do you do activity? Is illness or disability preventing you from doing this activity on a regular basis? If you answered yes to both these questions then an OT can help you.

There are many different types of OT’s as there are many people doing different activities affected with many different types of illnesses and disabilities.

I focus on breathlessness and fatigue in pulmonary and cardiac conditions.

I have heard my patients blame old age when I first see them and then they always say “But I’m 80 something (or 90 something), it’s too late you can’t do anything for me”.

We start talking to find the root source of their breathlessness and I then assess their movements and breathing as they do a simple house chore. With my findings we begin to explore new ways for them to manage. They start to see how they can make things easier and keep doing the activities they find rewarding for longer than they anticipated.

I think that is priceless.

The Humble Dressing Stick

Recently I met with a patient who was frustrated over her difficulty in removing a pair of trousers with ankle elastic. Breathlessness and inability to bend for sustained time was the source of anxiety. There sitting on the shelf unnoticed and looking rather understated was the dressing stick awaiting its moment of glory.

Sliding it down directly over the heel through the pant leg and with a slight raise of the bent knee was all it took to remove the offending piece of clothing.

We all like to be independent and manage things without resorting to aids but take a moment and consider the humbleness of this simple stick with a hook and give it the glory due. No matter your age, this stick can make your life just a little simpler.