management – 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

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.

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.