I Can, Take Charge of My Health Education Day: Dr. Janice


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10170263175_da527170b0_kOur Winnipeg office held their I Can, Take Charge of My Health Education Day in March. Dr. Janice Richman Eisenstat, a Pulmonary Rehabilitation Medicine and Palliative Respiratory Care Specialist in Edmonton, was one of the speakers. Dr. Janice as she is known, is an Associate Clinical Professor in the Pulmonary and Neurology Divisions, Department of Medicine at the University of Alberta. Three years ago, she and her colleagues started the first multidisciplinary neuromuscular clinic for adults in North America.

Dr. Janice spoke to families about the importance of respiratory care including exercise such as lung volume recruitment to maintain healthy lung volumes. Dr. Janice also touched on non-invasive ventilation options. Below are the main points Dr. Janice’s presentation:

  • Respiratory failure is the number one cause of death in patients with neuromuscular disorders
  • Respiratory muscle weakness leads to poor quality of life
  • Early intervention with focus on a strong cough and breathing improves quality of life
  • Clients should get a respiratory assessment to determine where their respiratory stats are at
  • A weak cough is a sign of poor airway clearance. Use a peak flow cough to measure cough, anything under 270 L/min means you are at risk for impaired secretion clearance. Anything under  160-180 L/min means you should seek help immediately
  • Cough assist techniques
    • Breath stacking – frog breathing,  lung volume recruitment (LVR)
    • Manually assisted cough
    • Mechanical In-Exsufflator or CoughAssist
  • Non-invasive ventilation:
    • Bi-level – back up rate required; NOT cpap
    • Mouthpiece ventilation
  • Invasive ventilation:
    • Via tracheostomy
  • Use O₂ Therapy with Caution


You can learn more about these points in our Respiratory Care Guide, or by speaking with members of your healthcare team.

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