By Matthew Avitabile
MARGARETVILLE — We interviewed Teri Osterhout-Paton RRT, CPFT, AE-C, Pulmonary Disease Educator, a Registered Respiratory Therapist at Margaretville Memorial Hospital. She said that much of her role involves respiratory education for the community, and hopes to spread awareness about respiratory health. This includes advanced training for the nursing staff at the hospital.
Osterhout-Paton said that during her earlier career, she had worked at a smaller hospital where there weren’t as many respiratory specialists. Respiratory therapists are often “jacks of all trades” who work at all parts of the hospital and need to be “competent everywhere.”
She trained for more advanced therapy as her career continued, allowing her to bring her expertise to multiple roles. She has been able to bring this knowledge to local events, including farmers markets. Osterhout-Paton said that bringing expertise to different places helps, especially in a rural area.
Osterhout-Paton started at HealthAlliance in 2017 and at Margaretville Hospital in April of 2023.
Respiratory health starts with the head, she said. If you’re congested, it causes drippage into the lungs, which causes problems throughout the body. As the body creates more mucus, it causes more inflammation and mucus, which sparks further inflammation. This often makes the issue worse and causes colds and congestion. Clearing the sinuses can help prevent drippage into the throat and lungs.
She added that simple handwashing can make a major difference. Just keeping your hands clean properly is essential. Osterhout-Paton does this at every level, including for children. This includes washing for a minute or minute and a half. This allows for the full circulation of soap, including under the nails under warm water. The faucet should be turned off with a paper towel rather than wet hands. Hand sanitizer can help, but the alcohol can cause issues for people with asthma.
She added that cell phones and door knobs can be dirtier than expected. Osterhout-Paton also cited escalators as “filthy.”
The winter is an especially important time to prioritize breathing health, she said. Wearing a mask or scarf can help to prevent issues in the cold air. It prevents the cold air from causing your airway to contract. Cold air can cause an asthmatic reaction, she said. Even covering your nose and mouth with your hand to breath back moist, warm air can help, Osterhout-Paton added.
Osterhout-Paton cited working with a patient who has issues with shortness of breath when walking. Focusing on breathing in through your nose and out from the mouth helps. Breathing out longer than breathing in assists. Getting the air out is important to prevent stacking air in your lungs. This stacked air “is sitting in there” and doesn’t help with respiration.
“There’s a bunch of air in your lungs that is not working,” she said.
Walking and talking can be difficult for those with breathing issues. Concentrating on breathing and taking short breaks can make a significant difference, she added. Leaning against a surface or sitting down and putting your arms on your legs can help relieve respiratory muscles. This “tri-poding” can make a difference in supporting these muscles so that “they’re not working so hard.”
She recommends exercising even while seated three times a day. Sitting while doing circles with your arms for 15-20 seconds can make a difference. Rotate these exercises for five minutes and follow with front-punches and arms above your head. This is followed by wax-on, wax-off like in the Karate Kid, and continue with further arm circles.
“For people who struggle with breathing, they’re not having to walk to do this,” she said. Even five minutes of exercise can make a difference, circulating their blood and strengthening their respiratory muscles.
There is an opportunity to strengthen the diaphragm, including practicing singing. This allows you to “learn how to use [your] diaphragm to breathe.” Holding a single note can as long as you can squeezing your belly increase breathing strength. The diaphragm is a person’s strongest muscle, she said. It can be practiced even while sitting, she said, “without having to do a lot of work.”
There are classes available at the Hospital and Zoom. There are yoga and nutrition classes, as well as talks about mental health. There are also peer-to-peer classes and talks from a doctor to help build confidence and knowledge. Osterhout-Paton offers a variety of discussions on common breathing issues, such as COPD and Bullous Emphysema, common medications, and how to take them properly. It’s good to practice how to take medication, because even some medical professionals forget and “get into bad habits,” she said.
“It’s a constant review of how to take the medicine,” she said. “And review again.”
She cited taking albuterol, including whether a person has a spacer. Many people don’t realize what a spacer is or use them. If you use a traditional puffer, a spacer attached to it will break down particle size and help to get more medicine into your lungs. If you taste the medicine, that means that it’s in your mouth and not in your lungs. If it’s in your mouth, you’re swallowing it. The spacer helps increase flow of medicine into your lungs by a factor of two or three.
For any dry powder medication, breathing quickly is essential, she said. For albuterol and similar medications, the key is to breathe slowly. Patients should wait between puffs, including up to ten minutes between each puff.
“No one waits that long,” she said. If you puff in quick succession, the second time is the propellant, not the medicine. If done within about 30 seconds, the lungs’ smooth muscles haven’t recovered yet and cannot absorb the medicine in the same way. Waiting five or six minutes can make a significant difference, and should be even later. Putting a mask on the end of the spacer and taking five or six breaths can help older people or children improve their breathing. Breathing slowly helps, she says. If the spacer whistles, it indicates that the patient is breathing too quickly.
“It’s the technique,” she said.
“When you can’t breathe, it’s scary,” she said. “What do you do?”
Those interested in finding out more or taking part in classes or events should call 845-517-6316 to contact Osterhout-Paton. All such programs are free and everyone is encouraged to participate. Community organizations interested in organizing talks about respiratory health should contact Osterhout-Paton. Breathing tests are covered by insurance when prescribed by a doctor.
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