Tag: exercise

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:

  1. 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.
  2. 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.
  3. Breathing techniques that take the work out of breathing and reduce recovery times post activity keep you moving through the day for longer.
  4. Exercise is an important way of preventing deconditioning. Less exercise/ activity can lead to more breathlessness.
  5. Meaningful activity engagement whether it be household chores, hobbies or social engagement are important motivators that keep us moving.
  6. Use oxygen as prescribed – exertional oxygen during activity, nocturnal oxygen while sleeping or continuous long term oxygen for at least 18hrs.
  7. 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.

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.

 

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!

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.

 

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!

Genetic Risk & Dementia

The good thing is that even if someone in your family has had a diagnosis of dementia you can reduce your risk of getting it regardless of genes by working on the modifiable risk factors: eat healthy, exercise, manage your BP/diabetes/depression effectively, don’t smoke, socialise and get out and about, keep learning and stimulating your brain by joining a chess club, learn a language, or learn a new skill.

Factors Affecting Breathlessness: Store Smart

Everyone knows that activity increases our sense of breathlessness especially if there is bending and reaching involved. So how do we make this simpler? How to we make things easier so we can still do the things we want to do?

One idea is storage. The things we use for an activity whether its making a cup of tea or doing the laundry can often be placed in awkward positions so the effort in using the materials is what makes the job hard, not necessarily the job itself.

Store heavy items low and light items high and well used items at waist height. This is a recipe for ease and simplification around the home. this reduces lifting, bending and reaching loads within each activity that you do. For example, keep mugs on a cup rack on the bench and the tea caddy next to the kettle. In the laundry keep heavy laundry containers on a waist high bench and put your basket of wet washing on a chair when hanging on the line. This way you can get to that all important cup of tea a lot more easily.

 

 

Factors Affecting Breathlessness: Doing Less Not Always Best

Breathlessness itself is fatiguing and its easier to sit and rest and let someone else do the job at hand. This is great in the short term and having friends and family assist gives us a lovely feeling of connectedness. But its a sliding scale when we begin to delegate more and more for others to do and we are engaging in less activity than ever before.

We can lose independence sooner than what could have been as arms and legs decondition and instability and weakness prevents access to things that use to bring enjoyment and engagement outside of the home.

The solution? Delegate the hardest things that involve heavy lifting or bending and manage your breathlessness as would an athlete in training to keep the moderate tasks to maintain fitness and mobility. Work out a plan with your practitioner and family to ensure you are maintaining your ability for good quality of life.

Factors Affecting Breathlessness: Reduced Activity

A big question  people with breathlessness face is how much activity is too much?

We need to take a look at what they are doing, how breathless they get and what measures are in place to manage that and return to a pre-activity level when the task is finished. The bottom line is the need to keep moving. If you say I’m breathless and stop then you will decondition and the breathlessness will increase. You need to be active to a level you can use techniques to control the breathlessness and not let it get out of hand in order to keep daily activities  maintaining muscle conditioning. Muscles that preserve your balance, help you breath and maintain mobility and independence.

Factors Affecting Breathlessness: Thoughts

Breathlessness can cause thoughts of anxiety and distress leading to greater levels of breathlessness. Relaxation is an important part of managing these thoughts. Try relaxed breathing, tai chi, light gentle exercise in your chair or go for a walk or even try some hydrotherapy with your exercise specialist.