A small team from palliative care services has developed a program to help patients with intractable breathlessness – a condition which affects up to 74 percent of palliative care patients.
Designed by Dr Buddy Mudugamuwa and Clinical Nurse Consultant Angela Munro, the ConqUeR Breathlessness (CURB) Program is based on the Cambridge Breathing, Thinking, Functioning model, an educational tool used to teach patients how to self-manage their breathlessness.
“When patients come in, we do an assessment so we can find out what it is about their breathlessness that troubles them,” Angela said.
“A lot of people become panicked when they become breathless. We find out what triggers them, then look at what strategies we can teach them so they can manage their breathlessness and reduce the anxiety that comes with it.”
One technique is the handheld fan. “We teach patients to blow the fan on their cheeks. The movement of air on the cheeks tells the trigeminal nerve that there is enough air around, there is fresh air available,” Angela said.
In the six months CURB has been running, 23 patients with conditions ranging from chronic pulmonary disease (COPD), MND and cancer, have benefitted from the education and techniques provided. Angela estimates from those 23 patients who have completed the program, only three have since presented to the Emergency Department.
“For a lot of these patients, the hospital would have been their first point of call. CURB aims to change that,” she said.
“With CURB, we wanted to change that. We want patients to take a step back, think about their breathlessness and draw on the techniques instead.”
Patient Ruby – who has lived with bronchial asthma for most of her life – has recently completed the program. After suffering a heart attack in 2022, she was referred to the program by Respiratory Nurse Practitioner Toni Hall.
“I was at home. All of a sudden I couldn’t breathe, so I called an ambulance,” Ruby said.
“I had no idea I’d had a heart attack until I got to the hospital. After the heart attack I got pneumonia, and my lungs didn’t get much better.”
Though Ruby requires an oxygen tank 24 hours a day, she said the techniques she has learnt means she can get back to being in the garden – and she hasn’t needed to call an ambulance since late 2022.
“If I do become short of breath while out and about, I don’t panic as much anymore. If I stop and think, the techniques calm me down,” she said.
CURB runs every Tuesday in the Palliative Care Day Program space. A referral is required from a GP or respiratory specialist. Contact: 5454 6262.