Brain Training for Asthmatics

Brain Training for Asthmatics : Born to Breathe

Are you asthmatic? Do you know someone else who is asthmatic?

Are you happy taking drugs to manage your asthma?

Would you like to take less drugs, and experience fewer symptoms?

This guide has arisen from two goals, one is to simply describe my personal experiences as an interesting and in someways amazing transformation. Secondly to provide some pointers and details about how I achieved that and to look at opportunities to copy my experience. The Mobile and web based applications that I’m developing alongside this guide are also aimed to help others to have the same positive experience.

I believe that there are many opportunities for great improvements to be made to our everyday life and consumption of things by offering simple to access and easy to use alternatives. This is really my personal vision, that the opportunities provided by our mobile applications, social networking and cloud services are simply enormous. This write up represents my first and very personal attempt to demonstrate some opportunities.

My experience raises serious questions about when we should use drugs to help. About the design of these systems and the extent to which the motivation exists to encourage independence, growth and learning, or perhaps with the twin guardians of risk and health and safety we can lead the human race towards dependence and the belief of the need for the promotion of crutches.

At present it’s my belief that this approach is particularly appropriate or easier to apply for those who are interested in or are already taking regular exercise. It’s my personal experience that hard exercise helps in managing breathing. Otherwise I believe it’s possible for breathing to become established at an uncomfortable level.

Clearly we are all born with the capacity to breathe. But it appears that we don’t all breathe the same, and that some of us breathe more than others. Humans are supremely adaptable, there’s a core in the way in which human beings operate that means that we are extremely adaptable and ‘soft’ controlled. The downside of this is that we can learn the wrong behaviours.

1.) Introduction : My personal experience

I was 40 years old.  I was a lifetime asthmatic. I was taking salbutamol (blue) inhalers just about every day, and on occasions or on recommendations from my GP or their breathing clinic I was increasing my consumption of inhaled steroids to be every day, so that I didn’t have to take the salbutamol every day – (more of a risk according to the GP). In general I try not to take any drugs of any sort on a regular basis, and I’d started jogging and running about 2 years before. I was doing a few regular runs and had attempted to do a single marathon. When I went running I always took a puffer with me. My daughter of 5 years old had also started to get Asthma on an occasional basis, and I couldn’t bare the thought that she was going to be brought up to a lifetime of Asthma and steroid use as well.  We went to a party where three things happened: We met someone who’d used the Buteyko breathing technique to control their breathing, my Daughter had an Asthma attack and we met a Doctor who told us that we needed to seriously look at increasing the amount of steroids that my daughter took.

Anyhow I decided to do something about this, and booked myself onto a Buteyko breathing course – taking my daughter along for the ride.

There are a range of different techniques that you are taught and we’ll go into those below, but I was immediately struck by the core approach..

You are breathing too much, your response to having an asthma attack should not be : “Help – how do I get more air into my lungs!? .. Quick!?”, but instead it should be about trying to control and restrain your breathing. Even perhaps to holding your breath.  Wow! .. and I just about immediately felt that this made sense and that it could work.   Is this how it feels to you? Can you quickly feel that you ‘get’ this technique?

The course structure allowed me to learn some techniques and then practice them on my own for the following week, and then come back to try and see how they are going, and what progress was being made.  The other beauty of the approach we’re going to present here, is that it is really really easy to conirm whether you are making progress or not.

Over the next 3-6 months I gradually took up the technique and found some improvements.  There were some fascinating sign posts along the way.

Using your nose as nature intended

Having done this course – I immediately realised that it was extremely rare for me to breathe through my nose.  I would start off with good intentions as I left the house and then suddenly notice that I was breathing through my mouth again on the bus, or at work. Making sure that the nose is used for all breathing is another first base choice here. Entirely straightforward, and easy to adopt – you’ll be keeping out allergens, you’ll get fewer colds, and the air you inhale won’t be so cold.  An all around win.

My First Night with a taped up mouth.

One the techniques that is commonly provided is to put some surgical tape over your mouth when you go to sleep.  This ‘encourages’ you to breath through your nose.. which is another part of the whole process.  IE get your nose working as intended – it’s a filter, and by breathing through it, you’ll likely be breathing less.

So when you first put it on your mouth you might feel a little bit fearful.  There were a range of different experiences on successive nights. First night – managed to fall asleep – and then when I woke up in the morning – the tape was nowhere to be found, until it attached itself to my socks!

Another time, I awoke feeling that I could not get enough air.  So I started trying to breath around the side of the tape…. Anything to get a little more air in, feels like trying to cheat..but as any of you try this will discover, it’s hard.

And then finally I had one night where my nose was working great, I slept through and woke up in the morning, feeling how wonderful it was to be able to breathe.  How amazing breathing is, and with this real sense of this inspiring breathing process where the air comes in to your lungs.  Not imagining a simple mechanical process, but something more amazing that.  It felt like a wonder of life… which of course it is.  No matter we all do it, after all each of us has been born, this doesn’t make any one of our births – ordinary.

Struggling to slow my breathing

.. and then the other experience I would raise was a few months later when on holiday in the states, staying in a new and unfamiliar house.  This was my first holiday after learning how to breathe better.. but some combination of dust and holiday nerves I just remember spending what felt like the whole night trying to slow down my breathing.  Like holding a lid on a pot that wants to boil, I just couldn’t get my breathing to slow.  It was tiring and frustrating, although after this one point I never again had such an experience I felt that I had managed to train myself to breathe properly in a way that I’d been unable to do before.  I was really training my brain and lungs a new way, resetting my lungs to tolerate more CO2, and beginning a new life with less drugs.

So what now?  I take no Asthma medication whatsoever on a regular basis.  My Asthma was always caused by different things – exercise induced, but also high impacts on high pollen days, both during the height of summer, but also in autumn with the fungal season.  (When I’d had one of those tests on the arm – 80% of them rose up with large welts!)  But I do retain a full puffer, and I plan to on a regular basis.  I’ve found that there may still be 1 or 2 times during the year when the pollen count is high, or I have some sort of cold that makes me still particularly susceptible to having an asthma attack.  So it would be wrong to say that I am cured or that I am no longer an asthmatic. But it would be true to say that my use of Asthma medication has reduced over 90%, and that there is no element of my lifestyle that is altered as a result of my asthma. (N.B. I’ve made personal choices not to live with any animals – this might have been a further challenge for me – I don’t know. It FEELS to me that I am more resistant to all types of allergic response. It’s also easy to imagine that simply by using your nose better in an environment with animals, you’ll inhale less allergens (e.g. Dog hair etc. and so likely have a better experience in that way too.))

2.) Improving your breathing experience as an Asthmatic

What to expect, how to achieve it, how difficult will it be.

a.)Accepting that breathing less is good and can feel good

b.) Start with your nose…

c.) Monitoring // keep slowing it down

d.) The Hard Yards

e.) What to do during an attack

f.) keep listening to your body

Can this method work for you?

While having some type of breathing stress, see how it feels to try and breathe less.  You may like me, immediately have the sense that you’re onto something here. It should be counter intuitive but it feels right.

Rating your current breathing.

How much are you currently breathing. Distinct from the medical method of confirming lung capacity – which is done through an exhalation, this method tries to assess the amount of oxygen that is held in your lungs at any one time.

All of these exercises are aimed at getting your lungs used to having more CO2 in them, as it is the level of lung CO2 that acts as the trigger to take another breath. We will be getting your lungs used to a higher level of CO2, first of all consciously, but then more and more subsconsciously or automatically. Slightly resetting one of the homeostatic balances in your body.

So to find out where you are currently, get into a comfortable position, standing or sitting as you prefer, ensuring that you are keeping your back long, if sitting. Then either entirely without taking any inbreath, or taking in a small inbreath, put your hand over your nose and hold your breath. Using a timer of some sort count how long you can hold your breath for. Don’t go mad, but hold it to the point at which it really starts to hurt to hold it any more, and your lungs start to scream.

Record how long you held your breath for, and then try two more times.

What average value did you achieve, across the three tests?

0 – 20 Suggests you’re breathing a lot, and will be able to improve dramatically using this technique.

20 – 30 Not too bad, substantial improvement possible.

30—45 Borderline asthmatic

45+ – Should be broadly symptom free. At 45 seconds of breath holding

In general those with regular asthma will find that they are in the level 1 group. You will be breathing a lot – easily four times more than someone with no Asthma, a lot of air going in and out of your lungs.  There will be some substantial variability due to the time of day, whether you’ve just had medication or not. It’s revealing how much retained air is in your lungs at any one time.

This taking of your breathing pulse or rate will become a key indicator of your breathing health from our perspective, and the test itself can become a very useful technique to work on your breathing.

Getting your nose working as it should

One of the observations about breathing is that people who breathe through their nose seem to breathe less, so this is what we’re going to encourage you to do.

Getting the nose clear. Many people have continuously blocked noses, and breathing through your nose is one of the ways in which you can learn how to keep it clear.

There is a specific technique to help you clear it if it is blocked, where you can shake your head side to side while holding your nose. This should unblock it .

There’s some Youtube videos to show you how you can do this.

Start thinking about whether you breathe through your nose or not. Monitor it regularly, and aim to always breathe through your nose. Think about it while you’re driving, when at work, etc. etc. and you’ll keep catching yourself reverting back to breathing through your mouth. Try to catch that and stop it whenever you can.

When you first start this, you often find that you can start, but after a short while just feel that you’re not getting enough air, and then have to go back to mouth breathing.  Try and control it and slow it down. Think about how you feel about this, and consider that air is a wonderful and precious gas that you just want to sip.  In trying to improve and getting your breathing back to an easier rate it takes time and patience, just becoming aware of how you’re breathing and aiming to keep your nose clear is a great start. You may notice that you find different activities harder or easier to control your breathing through. Something about the extent to which you’re relaxing. Sometimes after strenuous exercise you’ll find that your breathing has really slowed.  Don’t get on your case about this too much, if walking somewhere see if you can breathe through your nose between lampposts etc.

If walking or doing regular exercise, you should always be able to breathe continuously through your mouth. When doing hard running, and maximum exercise, you may find it too difficult to use your nose and have to breathe through your mouth. This is fine, so long as it is not actively triggering any asthma. Otherwise for a period you can try slowing your exercising down to the rate at which you can continue to breathe through your nose.

Using the rating test to improve your CO2 tolerance

Having started to wake up and use your nose as it was designed, now we’ll focus on the key exercise that you can use to improve your breathing. You did it before when trying to determine your current breathing rate, and now we’ll try just the same thing.

So take a small inbreath, and then hold your nose, and your breath. See how long you can do it for. When I first started this I couldn’t get much beyond 10-15 seconds, and this is common.

Now we’re going to try and hold our breath for a bit longer. The important thing is to do it so you’re not scared or too uncomfortable, but perhaps to think of it like a muscle stretch. We’re just trying to get your lungs to be used to having a little more CO2 in them than before. To slowly and comfortably reduce your breathing rate.  As you’ll discover, sometimes it’s just too hard, your body is screaming for more, and it is too much of  a struggle. Other times you should just view it as a lung stretch – hold them for a little bit longer than is comfortable and when you restrart your breathing  … always try and breath in through your nose, and see if you can keep it going for a while.  I would recommend that when you try this you aim to do it three times and attempt to push yourself in some way that is comfortable to you.

What I found was that how hard it feels is very variable and only partly related to how long you can hold your breath for. I live in London and would commonly do these tests when on my way to work on the tube. The amazing thing I found that as I gradually improved my time away from the 10-20 second period, sometimes I would suddenly being able to hold my breath upward of a minute. Suddenly it’s possible to do.  (Given that some people can hold their breaths for 4-5 minutes – it’s clearly possible to do – I love the woman …who swims with whales.)

Slowing your breathing while you sleep – to tape or not to tape

So you’ve got your nose working. You’re starting to breath through your nose on a regular basis. You’re testing your breathing rate on a regular basis. You should be seeing some improvements.

Now what about when you sleep at night?

Since you’ve probably been breathing through your mouth at night, you probably quite regularly get a sore throat, or pick up throat infections quite often. You may also snore too. What we want to encourage you to do now, is to breath through your nose all night. Now clearly if you struggle at all times during the day, this could be a lesser or greater stretch. Because we now want to ensure that you’re breathing is slow at night too. Since your body should be relaxed and comfortable, your actual breathing could be slower too. One of the recommended ways in which to do this is by using a small amount of tape placed over the lips. This encourages the use of the nose. It does look a bit weird, and if you sleep with someone else can only be done when you’ve stopped talking!

You should put your tape on at the last moment before you switch off the light. You can test it at other times, if it brings on any type of panic or fear.  This has to be your choice, I found that the experience of breathing through my nose at night the first few times gave me both a better nights sleep and deep sense of relaxation.  It can be quite funny, the lengths you’ll go to early on to keep breathing through your mouth, around the tape, and sometimes you’ll discover the tape in some inappropriate place first thing in the morning. So see how you get on. You’ve got to imagine the tape being something that you want to do. To encourage yourself, to stop your mouth just dropping open. I’m never quite sure, but after a few months, I felt that I no longer needed it, and I think I’m keeping my mouth shut at night.

We’ve now covered the three core things to do to improve your breathing.

Using your nose, and breathing through it normally all of the time

Improving your lungs CO2 tolerance by holding your breath on a regular basis

Slowing your breathing while your asleep

If you’re doing these 3 things, you should very rapidly start to see some improvements. How much may depend on your type of asthma, what your allergies are, and the extent to which you’re exposed to these allergens on an everyday basis.

Keeping improvements going

There are many overlaps with this technique and what you’ll discover about breathing through yoga. Your body can really work out what air it needs, and somehow it seems that in our mental efforts to improve our breathing experience we’re pushing ourselves out of whack!

During an attack

In the first few months of this change and the exercises you’re still an asthmatic and will have attacks etc. It’s important to try and see what you can do to stop an attack while it’s happening, and you may find that sometimes you’re successfully able to slow your breathing without medication.  But in general this approach is preventative, and if it hasn’t worked then it’s probably best to just take the medication that you like to use. It’s fine to lose the odd breathing battle, just keep going during the war with the approaches mentioned above. I know I spent a few nights when I was asthmatic, and I felt as though I spent the whole night trying to stop breathing so much, trying to use my nose – it was really exhausting. I think I had one noticeable success at night, but I think it’s important to use your medication at this point. After nearly 10 years of practising this method I now find that I have perhaps two attacks during the year – and still use my medications at these times.

Persistently struggling with breathing

We’re trying to do something natural here, but if it’s not working or not right for you – and actually not feeling good, then best to leave it.  If you don’t do any exercise, I recommend starting jogging particularly as I think getting your body used to exercise will eventually help you with improving your breathing.  Once you’ve picked this up, perhaps you can come back to this method and see if it feels better.

3.) Asthma Summary – a background

How you should use this book… personal story and history … plus a range of exercises and things to look at..

My goal here is to present my experience as an opportunity for others to learn from what I’ve done and hopefully to experience the same dramatic reduction in drug use and drug dependence as a result of being over 90% symptom free all of the time.

Many causes but common symptoms

Triggers

4.) The Science behind..

What did I just do?

By following these exercises, all you’ve done is to train your lungs to tolerate a larger amount of CO2 before needing to take a new breath. The total volume of air that’s going through your lungs will have reduced by up to a factor of 5.  Overall you won’t be working so hard to breath. Simple as that.

There are many other benefits to reducing your breathing, and particularly other health benefits to having more CO2 in your lungs.

You can find a reference to these here:…. My personal focus is to enable you to  be less drug dependent and suffer fewer breathing symptoms, scoop up the wider health benefits as you may.

5.) Exercises to try

Controlling in and out – to a particular rhythm

Holding breath: Breathing checkpoints

Keeping a log of breathing over time

6.) Buteyko history

What do we know of Buteyko himself.

Professor Konstantin Buteyko was born 27th January 1923 in Ivanitsa (about 150km from Kiev) Ukraine. In 1946, he enrolled into the First Medical Institute in Moscow to train as a medical doctor. In 1953 Buteyko was given a practical assignment which involved monitoring patients’ breathing, and spent hundred of hours recording their breathing.  His research was into the breathing of people who were dying and he realised that he was able to predict the time of death based on how much they were breathing. He started to realise that it was possible to change the health profile of a range of different people by reducing the depth of their breathing. He was then surprised to turn to asthmatics and to realise that the same elevated level of breathing was occurring in these people too.

He died on the 2nd May 2003 at the age of 80. By then there had been founded a number of groups in Australia and the UK focussing on his techniques, and their training.

He  experienced a difficult relationship with the Russian medical establishment, and at one stage when requesting funding and support from them was told that he had to prove the technique on the hardest cases. These would be individuals with truly chronic breathing conditions. He was able to demonstrate that even in these cases his method could be extremely successful.

7.) Resources

http://www.buteykoclinic.ru/english/smi_ours_02.php

The healthy person, at rest, should breathe, on average, about 5 litres of air per minute. This is the norm. But when the ventilation is 6-10 litres at rest, this is hyperventilation. As a result, there is a lack of carbon dioxide in the lungs. It is known that CO2 is the final product of metabolism. Metabolism is continuous; hence carbon dioxide is constantly produced in the cell. It travels to the blood, from there to the lungs and is expelled into the outer air. During this long route, it regulates main metabolic reactions. And since the large part of our immunity is based on the proper metabolism, then CO2 deficiency and disturbances in the metabolism unavoidably cause the first error of immunity – the allergic reaction.

Here it is: we know that deep breathing decreases the concentration of carbon dioxide in the blood, lungs and cells. Russian scientist from Perm Verigo discovered, already at the end of 19-th century, the law, which is, as it seems, strange: fall of carbon dioxide increases the chemical link between oxygen and haemoglobin. As a result, it is more difficult for oxygen to get from the blood to the brain, heart, kidneys, and other organs. In other words, the deeper the breathing, the less oxygenation of the cells in the brain, heart, and kidneys. This law is in the foundation of our discovery. CO2 deficiency causes constant spasms in all organs. Hence, it is necessary to learn right breathing.”

Try to keep your breathing after normal exhalation as long as possible. Monitor the second arm of the clock. If the maximum pause is only 10 seconds, then carbon dioxide value in the lungs is only 4 percent. The organism hardly struggles for life. 20 seconds is also bad; from 20 to 40 seconds – satisfactory, from 40 to 60 – good, more than 60 – excellent. By the way, there is a dissertation, which proves that the maximum pause, among other indicators of health state, including X-ray analysis, is best. I insist that the Health Ministry issued a Directive about measurement of the maximum pause and its addition into medical charts of medical institutions. If a doctor does not measure the pause, fire him. Besides, I would survey the population if they know that deep breathing is dangerous and that diseases should be treated by normalization of breathing. In Novosibirsk the method of elimination of deep breathing is known only by 1 percent population. I want that all people of the region know that the deeper the breathing – the sooner the death, the less the breathing – the healthier the organism. However, the training must be done under supervision of our practitioners and doctors.

samurais: breathing should be done in such a way that, if one has feather under his nose, its displacements are not noticed!

  • Helps to utilize Oxygen in our tissues
  • Regulates the Acid/Alkaline balance in the body
  • Has a dilating effect on airways and blood vessels
  • (IE CO2 is itself a broncodilator!)

Other thoughts on content:

My personal history 2

As I mentioned before I was a lifetime asthmatic. I was also one of those kids who had knock knees and a pigeon chest. A really great specimen! I had other allergies too, suffering from quite severe eczema and taking regular steroid creams and ointments to aid with them. I discovered I was allergic to fish at age 3, and I’d start to scratch when my mum cooked it. My parents always had dogs, and we spent quite a bit of time in the country, where I pretty much always got asthma.  It was endemic in my family, so we didn’t believe we could cure it – my father had been a sufferer too (although somehow it didn’t stop him from being a Royal Marine in World War 2!).

One of my earliest memories was of trying to use my Dad’s SaltPetre cure. I think my Dad bought it somewhere, and the method was that you put boiling water in a bowl, placed the saltpetre (which looked like some bloating paper that has been soaked in salt) burning near by (!?) and then breathed in with a towel over your head. God it was horrible, and didn’t really work. I remember sitting one evening meal by our massive black boiler in the kitchen desperately trying to see if this would help.

You tended to get used to the sequence of an Asthma attack it seemed to pretty much always follow a common shape. You’d start with the beginnings of the attack, you’d try and get through it, and then you’d have 1-2 days of extremely severe breathing stress when if you were taking medications they tended not to actually stop the asthma, ie at some point during the attack the medication was no longer powerful enough. Although with Salbutamol sometimes it would feel slightly better and perhaps enough for you to fall asleep. The stress on your lungs is hard, and you realise that you’re engaging all of the muscles of your shoulders and chest in order to try and breath. You have this common look to you – hunched shoulders, it’s really hard work and quite exhausting. Eventually the attack passes, you can relax and your breathing slows down again.  ** Add in the pic of me..

I was also one of the first to be on a trial of Inhaled steroids using the wonderful Intal with it’s innovative spinhaler, taking it while being overseen by University College Hospital. They were so cool, and the first summer that they came out I remember having a really transformed breathing experience.   I really don’t want to create the impression that I haven’t experienced enormous benefit from these drugs and that they haven’t helped, just that I’ve now found something where I experience less symptoms, I think am at less risk, and do not need any drugs most of the time.

Having a breathing attack over night, particularly when your medication is low is particularly challenging. I remember many nights, staying awake with my breathing, and reading all night, or working through my breathing until eventually – commonly as it would start to get light, you find somehow you could finally relax, and fall asleep.   It’s amazing how your physical experience changes your emotions, I remember once in France at my in laws house – the smell of the house, cob webs, a dusty room – all so atmospheric – and for me impossible to breathe through. I’d like to think that were I to experience this now I’d be more resilient, but it still might be too strong a trigger for me to control entirely. I’m getting the impression that year after year my Asthma is receding further – my lungs less twitchy. Although I’ve never had a year without one or two recourses to puffers in the height of the pollen season, or when I’ve had a cold.

You just had to try and find a way to get comfortable and go through the experience, how to hold on to it etc.  It’s amazing the physical release that salbutamol – or if too severe a nebuliser gives you once you’ve got to this stage.  It really makes you love the medical profession for how much they can help you.

I was amazed when I did my Buteyko course to realise that Salbutamol is actually adrenaline – it makes you think of the scene in Saving Private Ryan when they jab the adrenaline injection into the injured soldier. Amazing to think that you’re really giving your lungs this sort of kick to get them cleared out and breathing faster.

My course work – Asthma and stress etc..

My studies and Asthma

I did a Human Sciences degree at university – a wonderful degree combining both physical (genetics, animal behaviour) and social (Sociology, Demography) sciences. A true multi-disciplinary degree. I found it fascinating and inspirational – the better tagline for it is the Social and Biological basis to mankind. But there’s a classic – Jack of all trades Master of none risk to it, and of course there is so much temptation to look at the potential to take methods, processes or ideas and try them in other fields.

** Link to the current degree **

You can come into it from many fields, and I did not do any science subjects at Advanced level and I think that means there’s a lightness to the depth of my scientific understanding.  But it’s also all about the choices that you make and what you find more interesting. My father had practiced all of his life as a Psycho analyst and this gives you a particular perspective on whether facts or thoughts about facts are really more important to understand.  But I am left now with a feeling that I’m not much better than a layman scientist – bare with me.

As part of my course you had to write a long essay of 5-10,000 words and I chose to write it about Asthma.  I was particularly interested to look at the mental aspects of asthma treatment, and what it’s causes really were. The first thing to strike me was the fact that there is no single cause of Asthma – but there are many. IE there are allergic reactions, but there is also the asthma caused by running on cold mornings.

Despite the different causes however the symptoms seem to be very consistent. At the time that I was studying this (the early 1980s), there were examples of really substantial increases in the incidence of asthma – particularly New Zealand as I remember, and a fascinating study looking at the population of East Timor – where they’d had to move Island and after this experience the incidence of asthma increased many fold. So there’s clearly genetic effects – you’re more likely to get it if your parents or grandparents had it (It came from both sides for me), there were allergic and non-allergic reactions. There were some environmental factors – town vs country – and not purely allergen related, different countries, the potential for there being certain trigger effects. A number of women developing late onset asthma following pregnancy for example. It could also be affected by stress. Stress has many different impacts on an organism, and there were some very interesting studies at the time. One of my favourites was one that focused on a young boy who developed Asthma – so they tried removing any possible sources of allergens from his house – and yet he still developed asthma. They moved the family to another house, and he still developed asthma. Then they moved his parents out – and his asthma stopped! – The specific researchers named it a “Parentectomy” – there are many teenagers who’d vote for this operation I’d suspect. The causation behind this impact was not divined, other than a general link to stress. At the very least my research gave me a broad understanding of the range of causes. One of my most memorable pieces of research was when consulting with a local specialist pulmonary consultant, he told me that he realised that however many patients he treated for lung disease over a period of time, none of this would match the reduction in disease from an increase in the taxation on cigarettes!

Being as arrogant a student as it was possible to be I was disappointed not to have discovered a unifying theory of all asthma causes and symptoms, nor really made the case for any specific mental impacts that might be relevant to treatment.  More specifically I was very interested in that core area where the brain can impact the physical development of the body.  A feeling that the Stress studies provide an insight into the mechanism by which the brain plays a role in accentuating or mitigating environmental effects. Yoga and other relaxation techniques seem to commonly reduce diabetes symptoms for example. Well I really didn’t get to this. From my psycho-analytical experience I knew it as the capacity to somatise, ie to take an emotion, mental state or experience to turn it into some type of physical bodily response.  Characterised brilliantly by Woody Allen as he develops a rash on his arm when anyone is being pretentious.

Clearly in the lay person world we experience these types of things all of the time – from the child avoiding school, others avoiding sex the brain gets engaged with the bodies state, but a clear model of causation simply hasn’t been made.

The control of the breathing is under what is called the Autonomic nervous system, along with heart rate etc. There is then what is called the Sympathetic and Parasympathetic nervous system. With the sympathetic nervous system being responsible for flight or fight responses, and the creation of internal adrenaline to prepare the body for one or the other. These complex and subtle systems are both involved in controlling the human body’s responses to stress, allergies etc.   My experience as a runner puts me very strongly in touch with the power of our brains to override so much about our bodies. As an Information Technology consultant I can’t help looking at human’s as being heavily software rather than hardware controlled.  The boundaries between Hardware and Software – the so called Firmware layer. [Models // History & Philisophy of Science//What we know vs what we think we know /// World of Corporations and marketing..Hidden persuaders etc.]So I believe the role of the brain in complex activities such as breathing (but I’d also include running here too!) is enormous. But it also means that we’ve often lost touch with being normal or possibly even having a normal. IE as humans we have a particular capacity for our bodies to take on and learn new forms of feedback or response.  (I always find it astonishing that when people learn to scuba dive, they end up using their lungs and therefore controlling the actual amount of air in their lungs in order to control their depth in the water – how would we know that we still have that capacity!)

In my search for running improvement (it never stops!) I looked at the Alexander Technique – there’s some really good books on this,

..link…but my reference here is to the common focus in Alexander technique of not doing something  – ie you have to stop intervening in order for the natural movement or primary position to take over. It’s a very interesting approach – and again acts as an interesting bridge to what Konstantin Buteyko discovered.)  When trying to use this technique and focussing on how to run on a treadmill, and watching myself in the mirror – I then completely lost the ability to run – as you realise it’s just far too complex to control consciously.  It has to be natural and learnt for it to work properly. There’s another great example of this in the film shine – where David Helfgott – is told that he must learn every single note of the Rachmaninov Piano Concerto No 3 – so that he can forget them!  IE you have to be note perfect so that you can then realise that it’s not about the notes!

What do we have to learn then so that we can breathe naturally? But what this section has served to highlight is how careful one must be in doing this technique – as quite genuinely – you could lose the ability to just breathe.

So for me the really interesting thing here is that Buteyko has discovered a practical technique to right our breathing. There seem to be a whole range of different ways in which our breathing goes out of whack, but in the Buteyko technique we have a smallish standard set of techniques which if you follow are pretty much bound to bring your breathing back to a steadier pattern.  In reading…. Matt Fitzgerald’s book – Brain Training for Runners, it struck me that what we’re really doing here is coming up with a set of Brain Training rules for Asthmatics – hence the title.   What this approach is trying to do is to bridge the gap between the brain’s conscious thoughts and to work the body to be able to follow the best form.  To devise a series of drill and thoughts. I’ve attempted to put a few of these together in the section above. I think it’s probably essential to look at the help and support you need as you bring your breathing down. It’s really like trying to learn how to stop a kettle boiling. It’s difficult, stressful and hard! Then there’s the regular good behaviour – checking your breathing rate, and keeping up the pressure using regular monitoring. Then it’s going to be about managing chance, exposure to new allergens, changes in fitness etc.   My biggest motivation is that in doing this not only can you become 90%+ drug free, but that you can also learn more about what it is to be human.  It encourages and supports a better approach to your own body.  Clearly this won’t be for everybody. For some people and in some guises the medication is really like the magic or silver bullet. IE it targets the precise symptoms of the asthma you have and requires no more involvement that to just take that puffer.  Lie back and just take the medication. Don’t think about your overall health, how you breath, managing your breathing – just take your puffer and get on with it. It feels a lot easier!  If it really was the case that you simply take the drug and you’re done that would be one thing, but this doesn’t seem to be the most common patient experience.

Buteyko stated that Stress, over eating, eating rich foods, learned behaviour from others, inactivity were all things that on their own could lead to overbreathing.

“”The role of the brain… – the potential to brain train… the central governer theory of exercise..””

Is Asthma not a disease but an inappropriately learned behaviour? – if it really is then why are we devoting £15billion of the earths resources to it’s medication when we could be getting healthy.

So here I am a lifetime asthma sufferer (sorry to go on!), and after 3 months of relatively hard work, but improving fitness I barely need my medication.  My years of search from my college long essay, have led me to a simple physical exercise, backed by a relatively sophisticated understanding of the medical condition that leads to this breathing.

I then looked around and looked at this as a technique to see why it’s not more pervasive and who’s been doing what with it.

As a technique it is set against the existing medical orthodoxy – particularly because the Buteyko view is that the standard method of measuring asthma – peak flow – can in itself trigger an asthma attack!  But I truly believe it is revolutionary, so why isn’t it being picked up en masse?

I’ll review 3 hypotheses for why this hasn’t happened:

  • There is no medically sufficient proof that it improves asthma
  • It requires expensive personal/individual training or counselling to achieve
  • The Pharmaceutical industry has a vice like grip on us all and would rather medicalise us. They want us to use their crutches and not learn how to walk.

Medical evidence.

There is a genuine standoff between what Buteyko can do for you and the medical view.  That is that despite reducing symptoms etc. a peak flow test will probably still show that there is a ‘weakness’ in the lungs, and that the peak flow of an asthmatic remains low. It’s absolutely true that there is nothing in the Buteyko technique which tries to focus on peak flow. Buteyko is not trying to improve this. The peak flow is really an indicator about breathing strength. I think that likely over a few years it would improve (my personal impression again. I don’t believe that there’s been a long term study into this.)

One of the most amazing and inspirational practitioners of the Buteyko technique is Jill McGowan.  She was a nurse working for an Asthma consultant.  But she suffered from Asthma herself which became increasingly severe requiring her to use nebulizers daily. Her consultant suggested that she investigate Buteyko. The results were exceptional, and within a few months she was off nebulizers and was taking up marathon running!

Jill was so impressed by this experience that she gave up her existing job, raised a loan against her house in order to run a set of clinical trails. With her background as a medical nurse she wanted to prove that the technique really worked.

Thorax Medical Journal (Dec 2003 Vol 58 Sup III) “Health Education in Asthma Management – Does the Buteyko Institute Method make a difference?”

This report describes the results of the Glasgow Buteyko trial.The trial was designed for 600 adults with asthma aged between 18 and 69 years. 384 of the initial 600 participants (64%) completed the trial. The results for the Buteyko group show average reductions of over 90% for reliever medications, preventer medications and asthma symptoms after 6 months, which were maintained at 12 months. BIBH member Jill McGowan, who ran the trial, also presented these results at the British Thoracic Society Winter Conference in London on 4 Dec 2003.

Full link here: http://www.buteyko.info/sr-ct-thorax.html

Located in the appendix below are a number of further references that suggest it can be an effective technique.

So inappropriately I want to ask – Why no cigar?  But fundamentally we seem to have a good set of examples suggesting how effective this can be as a technique.

The latest Wikipedia comment is: The Buteyko method or Buteyko Breathing Technique is a form of complementary physical therapy that proposes “breathing retraining” as a treatment for asthma, amongst other conditions. The method takes its name from the late Ukrainian doctor Konstantin Pavlovich Buteyko (Ukrainian: Бутейко), who first formulated its principles during the 1950s. This method is based on the assumption that all forms of asthma, and numerous other medical conditions, are caused by chronic hyperventilation; however, this theory is not widely supported in the medical community due to the lack of research supporting it. This method purportedly retrains the breathing pattern to correct for the hyperventilation, which, according to the method’s proponents, will therefore cure asthma as well as any other conditions caused by hyperventilation. At the core of the Buteyko method is a series of reduced-breathing exercises that focus on nasal-breathing, breath-holding and relaxation.

“” For example, cardiologist Claude Lum talks about chronic hyperventilation becoming a habit. Kazarinov talks about the habituation process, the same concept. “”

UK .. the British Guidelines on the management of asthma is sponsored by NHS, British Thoracic Society, Scottish Intercollegiate Guidelines Network, Asthma UK, College of Emergency Medicine and the Royal College of Physicians. It states explicitly- “Buteyko breathing technique may be considered to help patients to control the symptoms of asthma.”

2.) Requires too much 1:1 counselling investment..

Asthma uk comment: Very little has been published in medical journals about the Buteyko technique… Two [Australian] studies … found both positive and negative effects of the technique.

Asthma UK funded research … of the Buteyko breathing method …

It showed that for some people with asthma the Butekyo breathing technique helped to reduce their symptoms and use of reliever inhaler, but it did not improve their underlying condition. Buteyko breathing may help people adapt to their asthma and feel more in control of their treatment and may be worth trying for those … willing to commit the time required.

More research is needed to identify if certain people with asthma benefit more than others.

There are a number of different standard approaches to teaching the Buteyko method. There is a common one that aims for 5 1 hour sessions with the expectation that you’ll see substantial differences by the end of a week.  Sometimes they are arranged as two full days a week apart. The key thing is always to present the approach, teach a few relatively simple exercises, and then reviewing back with the experienced practitioner to ensure that the individual is making progress, and is staying safe.  IE lead with the exercises rather than the medication reduction.  In general if the breathing rate check says that you have 30 seconds of air in your lungs then you’re in good shape.

Profits and being risk averse leads us to create crutches not solutions

Examples of born to run, brain training for runners…

Permanent struggle being human..our brains can always override our instincts

100 years of medication:

http://ajrccm.atsjournals.org/cgi/content/full/171/11/1202

Non PC fitness and how great deep breathing is!?

http://www.mattfurey.com/deep_breathing_011905.html

Samurai breathing, gentle zen like breathing:

http://1stholistic.com/meditation/hol_meditation_tao-of-breathing.htm

..ends think of holding a baby, hold it gently but firmly.

http://www.discoveringyourinnersamurai.com/2010/05/mindful-breathing-lessons.html

Mindful breathing – a few interesting breathing techniques..

Michael Cichorski – Australian former Glaxo salesman for Respiratory drugs

New Zealand Medical Journal (12 Dec 2003, Vol 116 No 1187) “Buteyko Breathing technique for asthma: an effective intervention”

A blinded randomized controlled trial comparing Buteyko with control was conducted on 38 people with asthma aged 18 to 70 over 6 months.The Buteyko group exhibited reductions of 85% in beta 2 agonists (reliever medications) and 50% in inhaled steroids (preventer medications).The conclusion was that Buteyko is a safe and efficacious asthma management technique and has the clinical and potential pharmaco-economic benefits that merit further study. The researcher on this trial was Dr Patrick McHugh from Gisborne, NZ.

Thorax Journal 2006 000:1-7doi 101136/thx2005 054767

CA Slader, HK Reddel, LM Spencer, EG Belousova, CL Armour, SZ Basnic-Anticevich, FCK Thien, CR Jenkins.

Results after applying Buteyko techniques for 12 weeks

• Reliever usage – median reduction of 86% • Preventer usage – median reduction of 50%

New Zealand Medical Journal Vol 119 No 1234 ISSN 1175 8716 May 2006

Patrick McHugh, Bruce Duncan and Frank Houghton, Gisborne, New Zealand

Results after applying Buteyko techniques to children with asthma for 12 weeks

• Reliever usage – median reduction of 66%

• Preventer usage – median reduction of 41%

• 11 courses of prednisone given 3 months before the trial. • 1 course of prednisone given three months after the trial.

Proceedings of the American Thoracic Society, 2006;3: A530

Foothills Hospital Medical trial, Calgary, Alberta. May 2006. Robert Cowie

Results after applying Buteyko techniques for 6 months

• Asthma control improved from 41% to 75%, an increase of 34% • Decrease of ICS was 39% • Elimination of ICS was 21%

Thorax Journal Dec 2003, Vol. 58, p 674-679, City Hospital, Nottingham, UK

Cooper,Osborne,Newton,Harrison,Thompson Coon, Lewis, Tattersfield

Studied Buteyko Breathing Technique & the Pink City Lung exerciser devise effect Asthma

Results after 6 months to 90 subjects with Asthma

• Buteyko reduces symptoms & bronchodilator use • No change in FEV1 measurement • No benefit was shown for the Pink City Lung Exerciser

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