April 26, 2018

How to grade your return following an exacerbation

Janine Hoult, Occupational Therapist, Inlifetherapy

Most of you would have experienced an exacerbation or flare-up of symptoms when all your symptoms surface in a way that is overwhelming and debilitating. Your confidence lowers and anxiety increases as you withdraw from activities and social meetings. How do you start the road back? A visit to your health professional or emergency centre will get your symptoms in hand and medication doing its job. But what next? How do you get moving again? You know you need to move for better health, but your motivation and confidence may be low.

It’s important to take it one step at a time and grade your return, by prioritising activities from low to high energy tasks with breath management and monitoring in a self-management plan. Your health professional, such as an occupational therapist, can talk to you about fatigue management and charting your weekly activities to identify the lower energy needs that are a priority for you, such as watering the garden or making a cup of tea. You need to recognise how you are managing your breath in these tasks and monitor it, so as you increase your energy requirements you can be confident of success.

If you have completed pulmonary rehabilitation, you may have heard of the Modified Borg Scale and its effectiveness in identifying your level of breathlessness during an exercise or task. It is a simple scale of 1 to 10. Find out more about the Modified Borg Scale in our Better Living with COPD guide at lungfoundation.com.au/better-living-with-copd-a-patient-guide/
Knowing how you rate your breathing in a task can help grade your return by doing the lowest rated tasks first and building from there.

As you develop an increased awareness of how the various tasks affect your breathing, you can increase the energy needs in the tasks by adding, bending and reaching elements. Your occupational therapist can assist you in establishing good breathing patterns during your tasks which can increase your capacity to complete the task at hand.

Strategies to reduce your energy needs such as simplifying the things you do and correct breathing management, can make the return to your regular activities a manageable experience for both you and your family.