Breathing easy

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Great-grandmother Lynn Turchin was just 12 years old when she smoked her first cigarette. Although she would like to take that day back, she kicked the habit 45 years later but the damage was already done. She suffers from emphysema, a life-threatening condition that left her short of breath after just a few steps. Today, she describes each day as a “breath of fresh air” thanks to home oxygen therapy.

“In my day, smoking was considered cool. We had no idea the damage it was doing to our health. I’m not happy that I need home oxygen but I’m happy to be on it,” says the 70-year-old Oshawa resident. Her condition was so severe that she began receiving home oxygen the very day she received her diagnosis two years ago.

Together with encouragement from her Registered Respiratory Therapist (RRT) at Lakeridge Health (LH), home oxygen therapy turned Turchin’s life around. RRTs monitor, evaluate and treat individuals with respiratory and cardio-respiratory disorders, including Chronic Obstructive Pulmonary Disease (COPD) – which includes emphysema and chronic bronchitis – and other disorders such as sleep apnea and pulmonary fibrosis.

“Durham Region has a very high population of COPD, which is on the rise, particularly among women,” says Susan Ord, Patient Care Manager of the Inpatient Respiratory Program at Lakeridge Health. “Smoking is a leading cause of COPD but it can also be caused by industrial pollution and secondhand smoke. In most cases, COPD can be managed by lifestyle changes, medication, a non-smoking regime, and pulmonary rehabilitation programs.”

Through its Outpatient Community Respiratory Services, LH’s team of homecare RRTs and medical gas technicians have served thousands of patients since it was established in 1998. About two-thirds of those clients have respiratory disease that requires home oxygen therapy or care for permanent tracheostomies, while the remaining third suffer from obstructive sleep apnea (OSA).

“Our focus is to provide timely access to the highest quality of respiratory care possible,” says Community Respiratory Services Manager Fred Cashin. “We believe that to do that, we must deliver a full continuum care for our complex respiratory patient. This includes patients who are in an acute-care setting and need follow-up care to transition back home or to a community centre.” LH established Community Respiratory Services to serve patients requiring home oxygen therapy, which is generally delivered as a gas from an oxygen source such as a cylinder.

The patient breathes in the oxygen through small nasal prongs that fit into the nostrils or through a mask that covers the mouth and nose. This additional oxygen raises low blood-oxygen levels, easing the strain on the body and making breathing easier. Oxygen therapy can lead to a longer and better quality of life, the Canadian Lung Association notes.

Community Respiratory Services has evolved to include a Continuous Positive Airway Pressure (CPAP) store. The assisted-devices sponsored program primarily provides equipment to patients with OSA – a serious breathing problem where patients stop breathing during sleep. “Compared to many medical specialties, the science of sleep medicine is still relatively new, but more and more research-based evidence is clarifying the role OSA plays in either causing or worsening many other chronic disease conditions,” says Cashin.

“People suffering with sleep apnea rarely get the rest they need to function and stay healthy, but it goes way beyond that.” CPAP is the best treatment for OSA, the Lung Association reports. It involves wearing a special mask attached to a CPAP machine, which blows a steady stream of air that creates enough pressure to keep the airway from collapsing, allowing you to breathe properly.

It is estimated that more than 50 per cent of all COPD patients are not yet diagnosed. “We strive to support people throughout our community to not only improve their quality of life, but also to help reduce the incidence of the disease and decrease their need for re-admittance to hospital,” Cashin says of Community Respiratory Services. “Our approach and ultimate goal is to support the patient so they can self manage their condition.”

For Lynn Turchin, home oxygen therapy is a lifesaver, as she was at risk of respiratory failure. LH delivers oxygen tanks to her home each week and her RRT visits her home regularly to conduct a full patient and equipment assessment.

“It’s a frightening feeling when you can’t catch your breath,” says Turchin. “With oxygen, I immediately regained my freedom. I’m out every day and enjoy things like going to the Canadian National Exhibition each summer. Early on, my therapist encouraged me to get out and enjoy life. It’s a message I live by.”