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.

 

Inhaler Myths vs Techniques

One thing I’ve found is that there are a lot of ideas floating around about how to use inhalers but they are not necessarily the right ideas. Things get foggy as time passes since you’ve been shown how to use your inhaler or it may be that you were shown a technique years ago that has since been updated and changed after more recent research findings. When techniques are used effectively more medication reaches your lungs.

The other reason for incorrect technique is simply that your illness has outgrown your methods. The constant tightness or inflexibility of your lungs means you can’t take a deep breath anymore and gentle tidal breathing with a spacer or nebuliser may be the way to go from now on.

There are lots of devices and medications out there so it’s important to check annually, when you do a GP review of your COPD plan, that the way you are using your inhaler is the most effective way for you to get the medication into your lungs, after all that’s the main point isn’t it?

If you’re not sure, get in touch with your Doctor, Community Nurse, or Pulmonary Allied Health professional and ask them for a demonstration. The Lung Foundation has a patient resource page with videos and fact sheets on techniques specific to your device at: https://lungfoundation.com.au/resources/?search=inhaler%20device

Don’t leave it to work itself out but be pro active and self manage your way to effective use of your medications with good inhaler technique.

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.

 

 

From the Horses Mouth

A recent Lung Foundation Seminar at Chermside had two lovely ladies give their knowledgable tips on coping with chronic breathlessness. Thank you to Lyn McDade and Joanne Smith! Have a try of these top 10:

  1. Understand your limits by listening to your body
  2. Go gently on difficult days but keep going.
  3. Connect with peers, friends and support groups
  4. Stress management and meditation
  5. Avoid foods that increase inflammatory responses in the body
  6. Complimentary medicine pathways
  7. Quiet Time and Prayer
  8. Exercise – walk groups, yoga, massage, hydrotherapy
  9. Self care as a prevention tool – layering for cold sensitivity
  10. Avoid ill acquaintances and high risk situations – busy crowds in flu season!

Health Education: Pneumonia Awareness Week 13-20 May

Keeping warm as the temperature drops morning and afternoon is key to staying well this week in Brisbane but we also need to keep an eye on our friends and family for symptoms that could be ignored as a simple cold.

Awareness of the symptoms Pneumonia, a serious condition, is one way you can help those you know and love who are considered to be at risk –  those with a chronic medical condition, a smoker, if they are 65 years or under 12 months of age.

Encourage them to get a medical check up with their practitioner if – difficulty breathing; fever; chest pain; cough; and fatigue. And if in doubt get it checked out, anyway.

For more information you can find a brochure on the Lung Foundation website at: www.lungfoundation.com.au/wp-content/uploads/2018/03/Lung-Foundation_Infographic_Pneumonia_Final.pdf