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This manual and the associated audio tape are general information
products only.
This information should be used only under consultation with a registered physician. Do not alter any medication or treatment without proper
medical advice.
Any liability to the author, publisher or agents for any impact on the
purchaser or other reader of the use or non-use of this information is expressly disclaimed.
There is no guarantee or promise that effects and relief, as proven with
personal training using this information in the past, will offer any future
benefit to users of this training.
The purchaser or other user of this information uses or does
not use it at their own risk.
Warnings
Changing your breathing can result in certain responses from your body.
Chapter 10 has a summary of what symptoms could possibly arise as the result of a
breathing change. Liability for any such effect lies with the user.
CONTENTS
Contents
FOREWARD
CHAPTER ONE
The Cause of Asthma
Evolution of the Atmosphere
Quick Review
Asthma Is Your Defense
CO2 is a Powerful Bronchodilator
How to Stop Coughing
Summary
CHAPTER TWO
How To Estimate Your Breathing Level
The Measurement Pause
Your Lungs Are Like the Carburetor On A Car
16
CHAPTER THREE
Your Nose Is For Breathing, Your Mouth Is For Eating
Dry Lungs
The Best Reason to Keep Your Mouth Closed
23
CHAPTER FOUR
Stopping Asthma The Simple Answer
The Drugs of Asthma
1. Relief Drugs
What Relief Drugs Are Actually Doing To You
Buteyko Strategy
2. Preventative Drugs
Strategy for Preventative Drugs
How To Use Buteyko To Stop An Asthma Attack
27
CHAPTER FIVE
Shallow Breathing To Tune Your Body
Definition of Shallow Breathing
Am I Doing It Properly?
The Everyday Training
Measure Your Progress
Record Your Progress
39
CONTENTS
CHAPTER 6
Exercise Induced Asthma
46
CHAPTER 7
The Secret of Night Asthma
49
CHAPTER 8
The Effect of Diet On Your Breathing Health
The Need For Supplements
57
CHAPTER 9
The Link Between Asthma/Allergy
Attacks and Trigger Factors
62
CHAPTER 10
Clearing Reactions Coming Back To Normal
65
CHAPTER 11
What is depth of breathing
Childrens Asthma
67
CHAPTER 12
Asthma In Infants
89
CHAPTER 13
Emphysema
98
APPENDIX 1
Summary of Results of the Buteyko Clinical Trial
109
APPENDIX 2
The Importance of Carbon Dioxide
in Buteykos Theory
113
APPENDIX 3
Steroid Deficit in Asthma
118
APPENDIX 4
How To Wipe Your Nose
and Control Sneezing
122
AUTHORS NOTES
127
Foreword
Thank you and congratulations on taking the step of allowing yourself
to view a model of asthma that is different to that currently supported by the
vast majority of health professionals. The support is only lacking at this
time simply because doctors and health practitioners in general are unaware
of it.
This manual and tape provides an understanding of asthma that is
simple, easy to follow and implement. The basic material included can be
found in any good medical text. Nothing is suggested that is not completely logical. The only criticism that can be leveled against it is that it is
too simple. It is this simplicity which has caused hesitation in the minds of
the medical establishment, despite the clearly proven effectiveness of the
method. [See Appendix 1 for Clinical Trial Results.]
This manual is written for the person in the street, who for decades has
been patronized by the so-called medical experts. By the time you finish
reading this book, you will have a different understanding of asthma than
your specialist doctors. You will understand the simple cause of asthma,
and therefore will be looking for the drug-free relief that over 15,000 Australians have found.
This book is dedicated to Professor Konstantin Pavlovich Buteyko who
has the genius to look at confusion, and draw out the simple truth.
CHAPTER 1
espite the vast array of reasons that people believe cause asthma,
there is only one. If this one cause is removed the list which
includes dust mites, dust mite droppings, dust, smoke, stress,
exercise, atmospheric changes, food, odours, and many more becomes
irrelevant.
Lets look logically at what happens when we get asthma. Asthma
appears to have many variations. Some people get tight, others wheezy,
or develop a cough, or perhaps just the sensation of restriction. The
actual symptoms can vary or even disappear and reappear later in life.
Many children start of with a cough [called bronchitis in the past], then later
develop tightness, and later get the cough back again.
Others will not develop any symptoms until later in life. People who
are otherwise in perfect health. The severity can vary from day to day, or
year to year.
Many people of all ages even appear to grow out of it, which is called
by the doctors a spontaneous remission. There has been no explanation
of how this can happen, until now. You are about to find out exactly how
people do grow out of asthma, even though these lucky ones do not know
how they did it themselves.
Buteyko is simply learning how to do this.
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CHAPTER 1
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CHAPTER 1
Millions of years
During this very long interval with changes in the air occurring,
mankind had to develop a system which gave a constant internal chemical
balance. The human body cannot tolerate much change in its chemical
composition. The change in the air composition caused the body to evolve
a special organ to ensure the levels of these two gases stayed within a safe
range. This organ has allowed humans to thrive even as the atmosphere had
massive changes. This organ is obviously the lungs.
The logic of this role of the lungs is proven by the fact that despite the
level of CO2 in the air being almost zero, there is on average 6.5% CO2 in
the lungs. This means that one of the major roles of your lungs is to act as a
carbon dioxide trap. It is no longer a bellows with the goal to fill and
empty as fully as possible, but rather a gas mixing chamber.
A key point is there is almost no CO2 in the air that surrounds us, so
therefore the CO2 that is in your lungs has been trapped in! Whenever
your body burns energy, it uses up oxygen and produces carbon dioxide.
Your lungs are there to ensure that you do not lose too much carbon
dioxide. If you lose too much carbon dioxide from your body you will die.
So as you are sitting there quietly, you will be using up a little oxygen,
and producing a little carbon dioxide. If you were running around, lifting
things, doing heavy work, you would be using more energy and therefore
use more oxygen and produce more carbon dioxide. The single thing that
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CHAPTER 1
controls how much of that gas is let out, and how much is trapped in, is
your breathing rate and depth.
When you produce more CO2, your breathing will increase so that the
level in your body stays about the same. [This also allows more oxygen in.]
When you produce less CO2 [by burning less energy], your breathing will
be less, so that the level in your body stays about the same.
In reality it is normally your carbon dioxide levels that control your
breathing, not your oxygen levels. Oxygen levels will over-ride the
controls only if the oxygen levels get too low. I.e. if you are being
strangled, your oxygen levels take over your breathing controls.
Quick Review
We have learned that our breathing is controlled by our carbon dioxide
levels, not our oxygen levels. If the level of carbon dioxide in our bodies
gets either too high or too low, then we will perish. The levels are
maintained for us by our lungs and levels of breathing. If we produce more
CO2, we breathe more to release it. If we produce less, we breathe less.
This is nice and simple, but where is the problem that causes asthma?
There is a section of our brain called the respiratory centre which is
the control panel for keeping the CO2 level safe. It measures the amount of
CO2 in the system, and then gives directions on how much to breathe.
It is a little like the thermostat on an airconditioner. If the temperature
of your room rises, it causes the cooler to work harder. If the temperature
of the room falls, it causes the cooler to stop or the heater to start. The
temperature in the room is controlled by the thermostat. You can change
the thermostat and your room will go to a new temperature and be maintained there.
Your respiratory centre is like a breathostat. If the CO2 gets above
the setting on the breathostat, it tells you to breathe more. If the CO2 gets
too low, it will tell you to breathe less.
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CHAPTER 1
Here is the vital point. You can also alter the setting on your
breathostat, just as with a thermostat. You can change the settings which
maintain the levels of CO2 in your body. [We will learn how later.]
The ideal level for your breathostat maintains the CO2 level in your
lungs at about 6.5%. [Note that is a different level to the CO2 level in your
blood.] A chronic asthmatic will have pushed their breathostat down much
lower, perhaps has low as 3.0%. This means that their body is in crises, as
the effect of this decrease affects every part of the body, and any further
loss of CO2 increases the problem.
With a low CO2 setting, the amount of breathing that occurs is always
much greater than with a normal setting. Remember this is because it is the
breathing level that the breathostat uses to keep the CO2 level where it
thinks it should be. The amount of air breathed by an asthmatic can be as
high as ten times as much as a non-asthmatic, and this will still feel like not
enough.
CHAPTER 1
more. This is exactly wrong, even though it feels right. Fighting to push
more air in and out will cause worsening of the condition, and will quickly
also result in a shortage of oxygen in the body as the pipes become more
and more closed. The shortage of oxygen will then over-ride the
breathostat, and will force the body to breathe even more deeply, making
the pipes close even further. This can result in respiratory arrest and death.
The only solution is to do whatever you must to survive the very severe
attack, and begin work to normalize your breathing as soon as you can to
avoid another one.
In a less severe attack, and where the asthmatic remains calm and
breathes less than they feel they want to, the attack will just subside. When
sufficient CO2 is trapped in for the person to be out danger, the swelling
will reduce and the airpipes open again.
What is Asthma?
The key point to remember is why your body is acting to restrict your
breathing? There is only one logical reason for your body to do this and
that is because the amount of air you were breathing was far more than
appropriate. This caused your CO2 levels to become life-threateningly low.
By reducing your breathing, you trap in more CO2 [that your body has
produced], and raise the level away from the danger zone.
In the past you may have been told that you had hyper-responsive
airways, but no one could tell you why you had this condition. Nor could it
be explained that if you had this condition, why did it sometimes go away,
and give you no symptoms.
Now you can easily explain it by looking at your breathing and CO2
levels.
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CHAPTER 1
Key Point:
The Level of Carbon Dioxide Determines
How Much Mucus Is Produced.
The additional secretion from the glands [or mucus factories] in the
wall of the airpipes, is switched on by the lowered levels of CO2. The
mucus blocks the pipe, this reduces the airflow, which means more CO2 is
trapped in. When enough CO2 is trapped in, the mucus factories are
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CHAPTER 1
switched off, and mucus production stops. [You may have noticed that as
your asthma attack subsides there is often a little relieving cough as the
mucus that blocked your pipes is no longer needed and is released.]
It is almost ironic that bodys natural response to this defense is as
wrong as its defense against constriction. The natural thing to do when
you have extra mucus production is to cough. The slight tickle in the throat,
the clogged feeling in the chest both make you feel you need to hack this
sticky itchy goo out.
However, now that we know the only reason for the extra mucus is the
shortage of CO2 caused by breathing too much, we will recognize that the
breathing that comes with coughing will actually cause the mucus to get
worse, or at least to maintain the mucus production. i.e. the more we
cough, the more CO2 we lose, the more mucus we produce, the more we
cough, and so on. By trying to clear the mucus that is there, we will always
produce more than we clear. This is why many have had bronchitis for
many decades, despite the best drugs and physiotherapy available.
Every person I have ever seen with a bronchitis cough has been able to
stop it within one day by not coughing [just let it tickle] plus reducing their
breathing as shown later in this program. Every single one of them also had
the concern, that if they did not clear the mucus they would clog up and
die. All of the specialists and therapists had told them this [or at least
implied it].
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CHAPTER 1
What they were not told is that your body has a very efficient garbage
removal system. There are very large numbers of cells called macrophages present in most part of your body, but particularly in your lungs. The
sole purpose of these cells is to devour any toxins, bacteria, or other
matter that should not be there. The only problem is that if you are
producing a massive amount of mucus because of your breathing, your
garbage system cannot keep up. When you reduce the mucus production, it
quickly catches up and most of the mucus will disappear without you
having to cough it up. [Of course, some will be released upwards.]
In practice what happens is that sometimes large gobs of mucus will
be released and come up by themselves to the back of your throat. A tiny
mouth closed cough will bring it to your mouth, where you can either spit
or swallow it. However, the vast majority will be broken down by special
garbage cells and released into the lymph system. It is common for some
mild diarrhoea to occur during this mucus-clearing time.
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CHAPTER 1
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CHAPTER 1
An extra bonus comes from the realization that your nose, throat and
sinus cavity are part of your airways. If you experience a blockage or
excess mucus production in these areas, think why. If it occurred to you
that the cause of blocked, runny, itchy noses or congested sinus is the same
as asthma, you would be correct.
In fact if we consider asthma to be any response from your body which
will help reduce an excess loss of CO2 from the body, then hay fever, sinus,
post nasal drip, polyps are all forms of asthma. Think about snoring as
well. Your body is simply trying to help you breathe less.
The next section is learning a simple technique that will help you
estimate your own CO2 levels.
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CHAPTER 2
n this section we are going to learn a simple technique which will allow
you to measure your breathing health any time you like for free. Before
we start with that, a brief story about breathing.
CHAPTER 2
hyperventilation [Breathing too much]. They will say that hyperventilation will cause an excess loss of CO2, which will cause constriction of
blood and air pipes, changes to the pH of the body, affect the nervous
system, and produce low oxygen levels. If continued it will lead to death,
just as in Buteykos first project.
This was confirmed by the work an English scientist called Henderson.
He designed an experiment that mechanically force dogs to hyperventilate
[over breathe]. The changes to the gases were as predicted, and the dogs
died awfully.
The lesson is as Buteyko succinctly puts it The more deeply you
breathe, the closer you are to death.
Lets now learn the simple measurement technique and what it means.
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CHAPTER 2
To get an idea of the sensation of where the starting point is, sit straight
in your chair, breathe in gently and push your belly out, then relax your
belly. When you relax your belly there is a slight exhalation, almost like
a sigh. You can use this procedure to start your pause.
If you have any difficulty getting started an alternative is to breathe in
gently for the count of 3, then out gently for the count of 2.
While you are holding your breath you must pinch your nostrils closed,
or the gases will diffuse, and the measurement will be affected.
So here is the procedure.
The first few times you do this measurement, it is likely you will hold a
few seconds too long, as you will not be certain when to stop. With a few
practices you will become more sensitive to the sensation of a slight
shortage of air, which is what your breathostat makes you feel when you
have reached your normal CO2 level.
It often helps to view this measurement graphically.
A gentle in breath can be represented by an upward line:
The little out breath that follows as a downward line :
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CHAPTER 2
When you feel a slight discomfort and want a breath, you allow the in
breath, and the breathing is not disrupted. ie it is about the same size, with
no stress.
If you hold on too long, you will need to gasp, and your breathing will
be greatly increased. If you find you have done this and your breathing is
increased, then control your breathing and do not allow it to waste your
CO2, or you may find yourself having asthma. The following diagram
represents the WRONG way:
Activity
You should stop reading now and do a measurement
pause if you have not already done so.
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CHAPTER 2
Measurement Pause
60 Seconds
30 Seconds
20 Seconds
15 Seconds
10 Seconds
Less than 10 Secs
Examples
If your measurement pause is 22 seconds, your CO2 will be just over 4.5%
If your measurement pause is 8 seconds, your CO2 will be less than 3.5%
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CHAPTER 2
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CHAPTER 2
Activity
Key Point:
- Page 22 -
CHAPTER 3
here are several reasons why it is obvious that your nose is designed
to be breathed through. Firstly, your nose is like an air conditioner
for your lungs. Air that passes through your nose on the way to your
lungs is filtered by the nose. Your nose will massively reduce the amount
of dust, pollens, bacteria, virus, or anything else that is floating in the air.
These things would cause major problems if there were allowed to
flow straight down into the lungs. The nose is designed to handle them. It
is your first line of defense. If you breathe through your mouth you do not
use these defenses.
Secondly, in this airconditioner, the air that is brought to your lungs
via your nose has been in your body slightly longer, and so is brought closer
to your body temperature. Your lungs do not like temperature extremes.
Nose breathing reduces the problem.
Your airconditioner also works to increase the humidity of the air
that reached your lungs. Your lungs like the air to be clean, not too hot or
cold, and very humid. Air that is taken in via the mouth is far drier on
reaching the lungs than air via the nose.
Dry Lungs
It is probably this information about the lungs needing moistened air
that led to earlier theories of asthma based on the lungs drying out, and
the development of vaporizers which are designed to put moisture in the
air in your house or room to stop this drying out. These machines do
appear to have a small impact, but only if you breathe through your mouth.
If you breathe through your nose, you have an automatic humidifier built in,
and do not need them.
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CHAPTER 3
It may whistle and carry on, but remember the more it is blocked, the
more CO2 is trapped in, which will tell it to open again.
If you are experiencing a blocked or partially blocked nose now,
experiment with your breathing to make it get more blocked [release CO2
by breathing more deeply at the same speed].
Then, make it get less blocked by breathing less deeply, or just hold
your breath for several seconds [pinch your nostrils closed] longer than is
comfortable and breathing as little as possible through your nose after you
breathe.
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CHAPTER 3
In brief, all you have to do is trap in more CO2 than you release, just
as you will do to stop asthma.
If your nose being blocked is preventing you from closing your
mouth and becoming a healthier nasal breather right now, then unblock it
with the following procedure. Then keep your mouth closed! When you
first convert from a mouth-breather, you may find that it feels like you are
not getting enough air. This is a good sign, and means will benefit almost
immediately. Simply put up with it, it will pass as you progress into your
shallow breathing exercises.
Be aware of yourself trying to sneak a mouth breath by chewing a
pencil or a finger, or yawning more than a couple of times. If you do start
to yawn madly and repeatedly, repress it a little and keep your mouth
closed. An occasional yawn is to be enjoyed stretch and make a good
yawning noise it is good for stress relief.
To unblock your nose right now. You need some extra CO2, so after
a small out breath, pinch your nostrils closed and hold your breath. [Your
mouth is obviously closed at this time.] Hold until about 5 seconds after
you have developed the feeling that you want to take a breath [not need a
breath], release your nostrils and allow only a little breathing to occur
through your nose. Keep the CO2 in! It will be at least a tiny bit clearer. If
it is still very blocked, repeat the process several times with about 5 seconds
between each hold. Really restrict your breathing. Be like a statue and
dont move. [Keep your mouth closed!]
It may block up again as your breathing tries to increase to its
previous level, but that is OK, just repeat the procedure. All you have to do
is trap in a little more of the CO2 you are producing inside you.
A different way to do this is to keep breathing at the same level but
increase your CO2 production. You can do this by standing, and without
increasing your breathing, march on the spot. In a very short time you will
feel your nose starting to clear, once it is clear, stop and restrict your
breathing to keep the CO2 in.
If you become breathless while marching, stop and reduce your
breathing it will mean you have unconsciously increased your breathing,
and have actually lost more CO2.
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CHAPTER 3
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CHAPTER 4
Stopping Asthma
Stopping Asthma
The Simple Answer
his section will give the instructions on the most effective way to
correct your breathing. It is quite a long chapter, and covers the
roles of relief and steroid medications first. It is important to
understand how the drugs work, and fit into a rational approach to stopping
your need for the defense of asthma.
The key point here is to recognize that the only way you can get
asthma is by first breathing too much, which causes you to lose too much
CO2, which in turn causes your body to defend itself by forcing you to
breath less.
Therefore there are two steps involved in being free of symptoms.
The first is to learn to stop an individual asthma attack by trapping in more
CO2. This involves following some general guidelines to follow which
combine breathing and your relief drugs which gives a very rapid decrease
in the need for relief drugs.
The second step is to reset your breathostat or respiratory centre to
a level which automatically gives you a healthy level of breathing, and the
right mix of gases in your body. This is the tuning of your carburetor.
Important warning over page.
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CHAPTER 4
Stopping Asthma
1. Relief drugs
The majority of this class are the bronchodilators. You will know
that bronchus means airpipe, and that dilate means to open up. So
in the simplest sense, these drugs work to open your airways. They are
chemicals which, when detected by special detector cells in your airpipe,
simply instruct the pipe to open. These drugs can be taken by inhalation,
which means spraying and breathing them into your airpipe, where they act
quickly and effectively.
They can also be taken orally as a tablet or syrup, which eventually
releases them into the blood stream, and finally to the lungs where they take
effect.
In emergencies, bronchodilators can also be injected.
The majority of asthmatics rely on a class of drugs called betaagonists. The most common of these inhaled drugs is salbutamol, known
as Ventolin [or variations of this]. Other drugs of this type include
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CHAPTER 4
Stopping Asthma
Drug Name
Speed and
Effectiveness of
Action
Length of
Action
Salbutamol
inhaled through puffer
or nebuliser
Short-acting,
about 4 hours
Terbutaline inhaled
Short-acting,
about 4 hours
Ipratropium bromide
inhaled
Medium
about 6 to 8 hours
Theophylline tablet
Varies
Salmeterol
Xinafoate
Due to the way that these chemicals are marketed in different parts of the
world, there are hundreds of different brand names for the same chemicals. Do
not be confused with the classification of drugs like Serevent [salmeterol]. If the
action is to hold the airpipes open, rather than to make them less likely to close [as
with steroids], then class them as a bronchodilator.
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CHAPTER 4
Stopping Asthma
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CHAPTER 4
Stopping Asthma
He had to take the preventative puffer every morning and night. Is this for
the rest of his life asked his mother? Very likely, but well see said the
doctor.
Despite the new puffer, he began to get more and more tight, more
and more often. The two puffs of relief puffer no longer worked well
enough, so they bought a machine that sprayed the chemical out of a mask
he wore on his face. This gave pretty good relief, but on some days he
needed it 3 or 4 times. He was a large teenager, so he received the full adult
dose, and made sure he used all of it. [Note: .1 puff of relief puffer is 1/
10,000th of a gram. A full nebule of relief puffer is 50/10,000th of a gram.
So one nebule is equal to 50 puffs, but a lot gets out of the sides so lets say
its equal to 25 puffs from the relief puffer.]
Mother is getting very worried now, has been back to the doctor, who
has doubled the dose of preventative puffer and referred them to a
pulmonologist. This doctor sees mostly asthma, and is considered the
best in the area. He immediately does more tests involving mostly huffing
and puffing, and puts our lad onto 50mg of oral steroids per day, for 6 days,
then on a reducing amount. This reduces the asthma, and two weeks later,
only puffers are needed. A few weeks later, it all starts again.
The family learn to live with it, and have some periods of good
health. Their pulmonologist sees them every month, and gets hold of new
drugs earlier for them to try. Which work for a while, but then seem to fail.
A trip to the emergency ward is made about twice a year.
Then, after 8 years, the family moves to a different area near the
beach. The lad takes up surfing, and within 1 week the asthma has stopped.
A call to their pulmonologist gets the reply that this happens quite often,
they seem to just grow out of it.
This story illustrates how the amount of relief medication needed
usually increases with time in many people. Others never need much more
that a couple of puffs a day.
What is really happening? Your overbreathing pattern is causing you
to lose more and more CO2 from your lungs. When it gets low enough,
your body acts to trap more in. When you feel this restriction, it feels
unpleasant and you feel you are not getting enough air. The bronchodilator
you take tells the airpipes to open up.[Turns off your defense, and stops it
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CHAPTER 4
Stopping Asthma
for about 4 hours.] This means that you can return to the breathing that
caused your need for the defense in the first place. If your breathing has not
improved when the drug wears off, your defense will start again. You will
want more drugs, to improve your airflow again.
Over a period of time, this will cause you to need more and more of
the drug, as your body becomes more resistant to it. Where one puff per
day was enough before, you may start to need many more puffs, plus the
addition of other drugs. If this loop continues without an improvement
[decrease] in your breathing, your body will work harder and harder to stop
the CO2 loss, until the point where hospitalization is needed because your
airpipes no longer respond at all to your drugs.
Buteyko Strategy
The Buteyko strategy is to use your breathing to trap in more CO2 at
the first sign of asthma, and after a short time use your fast acting, short
acting drugs then only if needed. The activity here involves the use of an
exercise called shallow breathing, which is an easy way to trap in more
CO2. Shallow breathing is covered in the next chapter.
The Buteyko Method has found the best way to use relief drugs is to
use them only for the purpose they were first designed to relieve an
attack. If you are on a regime where you are taking bronchodilators as
routine rather than according to need, please see your doctor and discuss it.
If you are taking these drugs when you do not need them you are taking
more than you need, and you will never be able to be free of them.
We will later describe a strategy which has a 99% success rate for
asthma, which relies on using your relief drugs only when you need them,
and after you have tried to use your natural bronchodilator carbon
dioxide first.
If you are taking long acting drugs such as Serevent, remain on the
same dose until your need for supplementary short acting dilators is almost
nil. Ie you need no salbutamol for example. After this time ask your
doctor to reduce it slightly. If symptoms occur on the lowered dose, use
your breathing and short-acting drugs to relieve them. Do not reduce the
Serevent again until you are symptomless again. Then repeat the reduction.
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CHAPTER 4
Stopping Asthma
Use the same process for the newer drugs like Accolate. Allow little
symptoms to break through so you can use your breathing [plus short acting
bronchodilators, if needed ] to relieve them.
If your regime includes the drug Ipratropium [Atrovent], it is best to
ask your doctor to simply stop it. This may mean that you could require
slightly more of your short-acting reliever in the short term, but because of
your use of the breathing it is unlikely. [This drug is usually an add-on,
and given to patients only because there appears little else to try. It is weak,
has additional side effects, and will confuse your recovery program.]
The other group of drugs which need to be mentioned are the oral
bronchodilators. The most common of these is theophylline, although it is
used less and less these days because it is weak, has awful side effects, and
the dosage needed is only just less than a toxic dose. Again it is usually an
add-on, when no other options are seen. This drug is best reduced slowly,
no more than 25% per day. As with Serevent it should be reduced only as
the condition improves. Follow your doctors advice. You should not
continue on this drug if you have no symptoms. It is a bronchodilator, and
should only be used for relief not prevention.
2. Preventative Drugs
The second general category of drugs is preventatives. This
includes all steroids plus those with antihistamine type actions. They act
locally to reduce the ability of the airpipe to constrict, as well as systemically to produce a different effect.
The majority of people asked about steroids believe they are
dangerous, have terrible side effects, and you are better off without them.
The side effects include degeneration of skin and bone tissue, weight
variations, and blindness. This negative outlook is mainly the result of the
way that steroid doses are determined, plus the impact of the general press.
A more accurate reality is that our bodies are full to the brim with
steroids, when we are completely healthy. They are a vital part of our
body chemistry. Steroids include most of the hormones in your body. They
include the majority of the active chemicals in your body. If you have the
right amount of steroids, you will be healthy. If you have either too little or
too much of any steroid you will have problems.
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CHAPTER 4
Stopping Asthma
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CHAPTER 4
Stopping Asthma
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CHAPTER 4
Stopping Asthma
CHAPTER 4
Stopping Asthma
Other rules:
If the onset of your attack is so fast and severe that you usually go
straight to the nebuliser machine, use your discretion when doing your
breathing exercises. Ie try the steps above, but if you are out of control
simply try some breathing first, try the puffers, and then the machine.
Remember the goal is to try to use your natural bronchodilator CO2
instead of the chemical one. If you have to go the machine sooner,
remember to stop as soon as you have relief. Then do your shallow
breathing to supplement the drug with your CO2. As you spend time doing
your breathing practice, you will find that the attacks become less frequent
and severe. They will require less and less drug to relieve them.
There will be a great day when you overcome the attack without any
drugs. To get to this day, you must follow the steps. You must try the
breathing first, then the drugs only if needed. If you take the drug
immediately you feel the attack starting, you will never learn to stop it with
your breathing.
Remember it is best to try and stop it before it gets too hard. Do
your breathing at the first sign.
There are no points for not taking the drugs when you need them and
being miserable or taking unnecessary risks. Simply follow the steps. If
after the first two steps you are not greatly improved, go to the next step,
use the drug.
Your progress is assured without need for heroics or extra stress.
There is no rush. All you have to remember is to use the Buteyko breathing
first, then the drug. Soon you will need less drug, and then no drugs, then
no attacks, so you will need no moderate level shallow breathing. Just
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CHAPTER 4
Stopping Asthma
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CHAPTER 5
Shallow Breathing To
Tune Your Body
e are now at the position where we can discuss more exactly the
process that if followed will normalize your breathing. We have
seen in earlier chapters that our breathostat or respiratory centre
has somehow become set at the wrong level.
How did they become set at the wrong level? One major factor is the
false idea of the usefulness of deep breathing, which is often combined with
deep breathing exercises. A big long deep breath with a good stretch is
good to relax. If you do it repeatedly, it will turn your breathostat the
wrong way.
Another factor which increases breathing intensity is over eating,
especially high protein. Protein will increase your depth of breathing
considerably. Animal proteins in particular are capable of producing
powerful changes. If we use dairy products as an example, we can see the
effect of all foods.
It is commonly known that consumption of milk products tends to
promote the formation of mucus. This is almost correct. What happens is
that the milk causes an increase in the depth of breathing, which in turn
causes a loss of CO2. We now know that reduced CO2 will tell the mucus
factories [glands] in our airpipes and sinus cavity to produce more mucus.
So the problem is not with the poor cow, but simply that the high protein
levels cause an increase in breathing.
Since the industrial revolution the amount of protein consumed has
steadily increased, along with so called diseases like asthma and hypertension.
Other factors that increase the breathing include lack of physical work,
narcotics, and exposure to many chemical agents.
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CHAPTER 5
CHAPTER 5
There are several key points. The first is that we are reducing the depth
of breathing. When we do this the frequency or rate at which we breathe
increases by itself. This is correct, and the rate should not be interfered
with. That would be direct control of the breathing, which is far harder to
maintain, and usually leads to a huge shortage of air which is followed by
gasping. This is not the goal. So reduce the depth only.
The next point is that the way we do it is by relaxing the breathing
muscles, not holding them. The more relaxed they are the more still you
become. The more still you become the less deeply you can breathe. [If
you become still by holding or tensing you will develop sharp pains in your
ribs as the muscles complain.]
The other key point is that our goal is to develop a training that can be
done anywhere, is comfortable so it will not be avoided, and can be
combined with other tasks. The way to this goal is to allow only a tiny
shortage of air to develop. It is all that you need. If it feels awful and
suffocating you have created a large shortage, and should relax and start
again. If you feel no shortage at all, become more and more still until you
do.
As part of this process, recognize that there is no rule that says you have
to be breathing all the time. If you find yourself breathing away with no
real need or desire to stop.
An alternative way to start your shallow breathing is to do a measurement pause without holding your nose. This really means that you stop
breathing until you feel a tiny shortage of air. All you have to do then is
be relaxed and still enough to maintain that shortage.
Am I Doing It Properly?
This is the most common and natural question. You are shallow
breathing if you feel a tiny shortage of air, and you are comfortable. A
shortage of air is a sensation that you would like to take an extra breath, but
to maintain the shortage do not. If you are suffocating, you have too great a
shortage remember unless it feels comfortable, you will not do it enough
and will get poor results.
If you feel no shortage of air you are not doing it!
This is very important!
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CHAPTER 5
CHAPTER 5
Pulse
Measure
Measure
Measure
Measure
Pause 1
Pause 2
Pause 3
Pause 4
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Pulse
CHAPTER 5
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CHAPTER 5
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CHAPTER 6
The key point from this manual is that there is only one way to get
asthma. And we know that that is to release more CO2 than we produce.
This causes some of our airpipes to close to prevent further loss, and to
relieve the shortage.
There is no other reason for your pipes to close up.
The use of bronchodilators before exertion is therefore now logically
flawed. You do not need the drug if you can simply be more aware of the
balance of your breathing gases.
First Step
In all physical activities, the rules of breathing remain the same.
1. You should breathe only through your nose.
2. You should never allow yourself to lose control of your breathing, and
start puffing or panting. This will decrease your endurance, reduce your
recovery rate, and also bring on your symptoms. Read the Appendix 2,
about the Bohr Effect.
3. Do not consciously increase your breathing to get more air as you
begin any heavy exertion.
In many people the key time for exertion asthma is after the physical
exertion has stopped. At this time, the production of CO2 has almost
dropped to nothing, but the breathing is still going on as if the CO2 was still
being produced at a high level. This means that more CO2 will be released
than is being produced, and a defensive constriction will be needed soon.
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CHAPTER 6
The other time is a few minutes after starting the exercise. This is
usually because the person has increased their breathing in anticipation.
When you begin an exercise, take your time to get started. Do some
shallow breathing during your warm-up, and pay special attention to
keeping your breathing to only just what you need.
When you stop the exertion Stop the breathing
When you get to the top of the stairs, reduce your breathing for a while.
Go to moderate level shallow breathing. Suffocate for a little while. Trap
in some extra CO2. Do not puff.
If you tend to develop restriction during the actual exertion, be more
aware of your breathing, make it a little less.
During the exertion, keep your mouth closed
If you get to point where you want to breathe through your mouth
STOP, reduce your breathing, and continue only after your breathing is
controlled.
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CHAPTER 6
Within a few weeks your endurance will have greatly increased, and you
will able to train easily with your mouth closed, and not get out of breath.
It will only work if you stop just before your lose control of your
breathing.
If you are a serious or professional athlete, you will know that races or
games are won or lost at training. Combine your new knowledge with your
training sessions. It will mean reducing the intensity at first so that you will
be able to exert with your mouth closed. It takes a very short time [a couple
of weeks] to reach the point where you can apply your full physical force
without having to open your mouth for extra air. You will then notice a vast
improvement in your endurance and recovery.
But during training you must stop and reduce your breathing immediately you start to feel the urge to gasp. During your match or contest do
everything you must to win. When you get the chance to recover, reduce
your breathing rather than do deep breathing. Suffocating a little tiny bit
will release more oxygen to your muscle cell and allow you to recover
faster.
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CHAPTER 7
Nocturnal Asthma
The Secret of
Nocturnal Asthma
emember there is only one way you can get asthma. Asthma during
sleep is also as simple. When the human body becomes horizontal,
the resistance to deeper breathing is reduced. Ie it is a lot easier to
breathe more deeply when you are lying down. As soon as you become
unconscious, your breathing gets deeper and deeper, simply because of the
horizontal position.
Some people, particularly children, will develop asthma within 2 hours
of going to bed. The night cough often starts at this time, because the CO2
is low and mucus production has increased.
The other common time for problems is between 3:30 and 5:00 am,
when the body is at its deepest point of sleep, which also causes the
breathing to be greater at this time. You may notice that people start to
snore, or they wake with full bladders, or, if children, they may wet the
bed at this time. These are all associated with low CO2 that is caused by
overbreathing.
Snoring is simply your body attempting to reduce the airflow by
swelling the throat and reducing the size of the pipe. Obstructive sleep
apnea is a more severe defence of this type.
In terms of bladder problems, these are usually caused in sleep by
spasms of smooth muscle in response to low CO2. The same smooth
muscle which lines the airpipes and bloodpipes, also lines the bladder.
When CO2 is low, it will constrict making the bladder feel full. This will
wake an adult, but a child may simply urinate.
Sleeping is a danger time. The majority of heart attacks and strokes
occur at the time of deepest sleep and therefore the deepest breathing.
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CHAPTER 7
Nocturnal Asthma
Your Mouth
Possibly the greatest factor in nocturnal asthma is the fact that while
asleep you have no conscious control over whether or not you breathe
through your mouth or nose. Your mouth can just drop open.
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CHAPTER 7
Nocturnal Asthma
Old Wisdom
I have heard of a fascinating true story about the American artist George
Catlin. After a number of years watching and drawing the native Americans
he drew the conclusion that the cause of maladies in the so-called civilized
men was that they allowed breathing through the mouth. In all of the
thousands of Indians he saw, they enjoyed almost perfect health and
premature death was rare.
He ascribed this to the fact that the Native children were never allowed
to sleep with their mouths open. The mother would watch the sleeping
child, and if the mouth opened, would press the lips together. The child
developed the habit to keep its mouth closed, awake or asleep. A very
simple and effective way to assist good breathing.
CHAPTER 7
Nocturnal Asthma
you the easiest and safest way to do it. There is no danger of suffocation
providing you have your hands free, and are capable of removing the tape
yourself. This is enhanced by folding the ends of the tape to form tabs
so it is very easy to remove.
Definitely do not apply tape to infants or small children who cannot
easily remove it.
The following is an extract from my manual Maximum Sleep
Minimum Noise. There is reference to sleep apnea. Most asthmatics
suffer from at least a small amount of sleep apnea. There are two basic
form of this defense against excess loss of CO2. The first is called
obstructive sleep apnea, and is similar to snoring except that it manages in
some people to close the throat completely, causing them to stop breathing.
The other is called central sleep apnea, which is where the respiratory
centre itself tells the body to stop breathing. It is simply another way of the
body reducing the CO2 loss from overbreathing while you are asleep.
Most asthmatics have some degree of sleep apnea. It is not the defense
itself that causes the problem seen in sufferers, it is that the sleep is very
disturbed and of poor quality. Asthmatics often believe the general
tiredness they feel is normal, and are stunned when they feel so refreshed
after their first night with reduced apnea. If you do not feel refreshed in the
morning, it is likely you have some degree of apnea and will benefit from
intervention. The same applies to snoring.
CHAPTER 7
Nocturnal Asthma
ensure that your mouth is closed before you apply the tape horizontally
from cheek to cheek in direction. It is important because you can still
breathe [and snore loudly] through the tape if your mouth is only a little
open.
Note:
A. It is most usual to pull the tape off on the first few nights between
2.30 and 5am, when your breathing is at its deepest. It is imperative that
when you wake after this, which you will, that you recognize the tape is off
and reapply another piece. Have a spare torn, folded and ready, stuck to a
convenient place at your bedside.
You must be really disciplined the first few nights. Really avoid the
temptation to not reapply the tape because there is only a couple of hours
of sleep left. It is at this time that much damage can be done to your
system, and if you leave the tape off at this time you will snore and have
apnea.
Within a few days you will sleep right through the night, and wake more
rested. After a few months you may wish to experiment in sleeping without
the tape, but you will notice the difference in your rest levels very quickly if
you do. I have been using tape for a couple of years now, and continue to
use it because I wake feeling far more refreshed than if I do not. Even
though this sounds like a very strange thing to do, and your partner or
family may initially laugh a little at how silly it looks at first, it is possibly
the best thing you can do for your health. You may also find that people
who giggled will also want to give it a try when they see the change in you,
which is often very dramatic.
B. The other question usually raised is Will this suffocate me if my
nose blocks up?, which is a reasonable question. The answer is that your
nose will not block up completely unless your mouth is open. Even with
the worst flu or allergy, if you keep your mouth closed, nose may swell a
fair bit, but it will not completely close unless you open your mouth.
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CHAPTER 7
Nocturnal Asthma
CHAPTER 7
Nocturnal Asthma
ADDITIONAL REMARKS
This method of treating sleep problems is a subset of the approach
which I use to relieve the symptoms of several diseases at my clinic here in
Townsville. It is an integral part of that treatment, and overcoming the
initial surprise at the strangeness of suggestion of mouthtaping and giving it
a chance is vital.
The overall success in treating ailments such as asthma and emphysema
with this cause-based approach is very high. After 7 days the mean
decrease in need for relief medication [bronchodilators] is over 90% in
asthmatics. This success has just been replicated in a clinical trial
conducted by the Australian Asthma Foundation through the Mater Hospital
in Brisbane. It is only a matter of time before recognition of the real cause
of diseases like this is gained, and treatment altered accordingly. For
asthma I give a moneyback guarantee of a significant improvement within 7
days, so if you want to be free of asthma, come to Townsville.
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CHAPTER 7
Nocturnal Asthma
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CHAPTER 8
he key point to remember here is that everything you eat will make
you breathe more deeply. Some foods will make you breathe more
than other foods. Plus there is some individual variation in how
much people respond do different foods.
With this issue please realize that you will need to eat something to
stay alive. As all foods increase your breathing depth [because of the
digestive process], your breathing is going to be affected, there is no
avoiding it. The strategy is simply when your breathing is poor, and you
are having symptoms, eat as little as possible and eat the foods that have
least effect on your breathing.
Remember that the problem is to do with your breathing, that is
where the most important focus of your recovery should be. It is your
shallow breathing practice that is more important than anything else,
including diet.
The foods which tend to increase breathing the most are animal
proteins, animal fats and refined sugars. This includes chicken, beef and
other meats, and milk products. Plant proteins and fats are less harmful.
Nuts, beans, berries and other fruits can have strong impact on some
individuals breathing.
The rule is to reduce animal protein as much as possible, and observe
your breathing after eating. Always reduce your breathing after food to
reduce the impact of the food. Once your breathing has been conditioned to
maintain a higher CO2 level, you will be less affected by what you eat.
Until then, minimise or stop your meat intake, along with all dairy foods.
[Note: Soy milk is very high in protein, and only slightly less harmful than
animal milk in breathing terms.]
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CHAPTER 8
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CHAPTER 8
Osteoporosis
There is a great deal of mis-information about Calcium. Despite
what you may have been told, eating dairy food is not a positive source of
calcium. The problem is that when you eat a food which is high in protein
and calcium, you cannot absorb the calcium. For example, drinking
calcium fortified milk will cause you to lose more calcium than you absorb.
There is calcium in the milk, but because there is also a lot of protein, you
cannot absorb the calcium.
If we look at the diets in countries where osteoporosis is very
common we can see this. In Australia, NZ, Europe and North America the
amount of dairy consumption and calcium supplementation is very high. So
is the level of osteoporosis. In places where there is almost no calcium in
the diet, but also very low protein in the diet, there is also an absence of
osteoporosis. If you have a low protein diet, you do not need very much
calcium in your diet. The more protein you eat, the more calcium you
actually lose.
On the subject of osteoporosis, more and more research is showing
that weight-bearing exercise is at least as important for strong bones as any
other factor. Your diet is also important, and a normal breathing level is
vital. When you take any mineral supplement, especially calcium, ensure
that you have it with food. This is because calcium is absorbed in the
duodenum which is a very short section of your gut. If it is combined with
food, it will take longer to pass through the duodenum, and so you will
absorb more.
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CHAPTER 8
Antioxidants
The other important aspect relating to food supplements is tied to
how our body deals with toxins. Every day our body will normally produce
some toxins, mostly because of incomplete digestion. We will also absorb
toxins and poisons from our environment, from our food, from the air, even
by radiation from the sun. The name of the group of chemicals which are
formed by these toxins is free radicals. Research over the past 20 years
shows that these chemicals are associated with almost every degrading or
aging disease we have. It includes dementia, Parkinsons disease,
osteoporosis, arthritis, and comprises a major part of what we think of as
aging. These chemicals affect our genome and cause distortions which are
now linked to cancer.
Most of these chemicals are usually dealt with by another group of
chemicals called antioxidants. These neutralize the free radicals. The
most commonly known antioxidants are Vitamins A, C, E and B complex.
We have know for decades that sufficient doses of these vitamins reduce
the chance of disease. Now the theory is catching up. We know more
about free radicals and their effects than ever before, and it is the antioxidants which appear to be our answer.
There is another antioxidant which is now being shown to be even
more potent than Vitamin C. It is extracted from grape and pine seed
extract, and some studies have shown it to be up to fifty times more
powerful than vitamin C. The active component is called OPC, and is
available called Grapeseed Extract or Pineseed Extract. It has a slightly
different action, and complements the other antioxidants.
A good answer is to eat only the best food you can get. Free of
poisons, and a fresh as you can get. You will also need to supplement with
minerals and vitamins, particularly when under stress or unwell. You do
not need high doses of minerals, just a regular supply. It is usually simplest
to find a tablet which has a combination of minerals, particularly Calcium,
Magnesium and Zinc. [Zinc is important for proper sexual function in
men.] Minerals should be taken with food.
Your vitamins should include the antioxidants Vitamins A,C,E, B
complex, and Grapeseed Extract. Extra vitamin C in the form of calcium
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CHAPTER 8
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CHAPTER 9
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CHAPTER 9
CHAPTER 9
The question comes back What proof do you need? Simply ask
any of the 10,000 or so Australians who have made themselves have less
asthma and hay fever by changing their breathing. Ask any of the
previously severe asthmatic subjects of the Clinical Trial at the Mater
Hospital in Brisbane to tell you how they have little or asthma at all now
with no other change in their environment. Are the dust mites still there?
Yes. The pollution? Yes. The stress of daily life? Yes.
What about a huge double-blind study with thousands of subjects
conducted over at least 10 years that has been published in a credible
medical journal like The Lancet or the British Medical Journal? You mean
like the absolute gibberish about trigger factors and dust mites, or like the
studies that said high dose radiation was a good way to kill lice on
schoolchildren, [The latest at this time is that American EPA has decided
that a popular antihistamine drug [Seldane] which they have proclaimed
to be safe by them for years (lots of big studies) is now unsafe and will
probably be withdrawn from sale.], or the studies that said thalidomide was
a safe drug or any number of studies that were soon proven to be absolutely
wrong?
Yes do you have any studies like that? Sorry, we have only one
powerful, unchallengable little study that proves conclusively that it works,
and about 10,000 Australians and 400,000 Russians who all have a personal
success story to tell you.
The key point to this discussion is that the trigger factors are
irrelevant once the breathing is normalized. If you are breathing at a
physiologically normal level, dust mite droppings for example will not give
you asthma. You will still get a nice little red spot with an allergy skin test.
[or an antibody reaction in a blood test] but you will not get asthma. If
there was a blood test for stress if that was your trigger before, the stress
would still be there, but you will not get the asthma.
If you really need a theory, then maybe the answer is that your body
does indeed need a trigger to start the asthma or other symptom, and it
simply sensitizes to what ever is common in the environment. Dust mites
for example are perfect, because they are so common your body can start an
asthmatic defense almost any time it wants. When there is no need for the
defense, the trigger has no effect at all. If you dont like this theory, create
one of your own, it cannot be any more flawed than the allergen fiction.
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CHAPTER 10
Clearing Reactions
Clearing Reactions
Coming Back To Normal
CHAPTER 10
Clearing Reactions
The other problems are mentioned just to warn you that if something
more interesting does occur, not to panic. For example, the release of large
amounts of mucus, sometimes blood coloured, is not abnormal. In cases of
emphysema and other lower airways disease some really revolting looking
stuff can be released.
It is pretty scary to cough up foul smelling tissue, but now having
being warned it could happen, it will not be as awful if it does.
If you do experience any kind of clearing reaction, rest as much as
you can, eat only if you are hungry, and continue to do your shallow
breathing. Continuing the shallow breathing will assist in its more rapid
completion.
In the case of headache, if it is not helped by paracetamol, then often
drinking some slightly salty water may relieve it.
When it is over, never forget that it was caused by your earlier
pattern of overbreathing. If this breathing pattern is returned to, then the
same diseases you had before will return. After a clearing reaction, the
Measurement Pause will increase as a reflection of improved breathing.
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CHAPTER 11
will cover this briefly as it is the cause of some conflict in people who
have already learned abdominal breathing. When I refer to how
deeply you breathe, I am not referring to where in your body you
breathe. I am not referring to your lower belly moving when you breathe,
or your upper chest. I am referring to the length of time each breath
takes.
If it takes a long time, it is a deep breath. If it takes a shorter time, it
is less deep. Of course this is reflected in the anatomy of where you
breathe as well. A deep [long] breath usually means that have used the
lower part of your lungs, and a shallow breath [short] MAY mean that only
your upper chest moves.
The reality is that what part of your body moves when you breathe is
a result of the position of your spine rather than anything else. For
example, sit in a slumped position and breathe normally, noticing what part
of the area below your neck moves.
Usually, you will see your upper chest and rib-cage doing most of
the work. Now, sit up straight and fold your arms behind your back [the
reverse of folding your arms in front!], breathe normally without forcing
your breathing. Usually, you will see that more movement is lower down
in your belly so to speak.
Notice now that if you stay in this postition and take very small,
short breaths [mouse breathing which you will learn shortly], it will still
be your belly area that moves not your chest! So you will be abdominal breathing shallowly.
So do not worry about which part of your body moves when you
breath the movement is the result of something rather than what you
should try to do.
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CHAPTER 11
Straightening your spine and relaxing your chest will cause your
breathing to be in your belly. It will also cause you to breathe less
deeply! ie. each breath will be shorter! This is a surprise for most
people.
Lets now begin to work with your children. Please read through the
entire chapter carefully before starting with your children.
The Procedure
Read all of the following information carefully, then follow the
directions that follow.
The Basic Breathing Exercise STEPS
This is used as both a measurement and as part of the training. It is used for
measurement in children because they lack the sensitivity to accurately
complete a Measurement Pause.[Which is discussed in the comprehensive
Manual.]
1. Get ready. Child is standing.
The child takes a normal [not large, not
forced] breath in, then passively
releases a small out breath.
The goal of this is to ensure that
the lungs are not full or empty, but are
comfortable. Using the same
procedure also allows some degree of
consistancy for measuring progress.
ie. always start the same way. Note
that all breathing both in and out
are always through the nose.
2. The child now pinches his
nostrils shut with thumb and
forefinger. This is best done with the
hand above the nose so that the thumb
and forefinger resemble a clothes peg.
(GO OVER PAGE)
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CHAPTER 11
This allows the mouth to be clearly seen, and it can be noticed if any
air sneaks in through the mouth.
3. With the nose pinched and mouth closed, the child now marches
forward, and continues until he cannot hold his nose any longer and must
breathe. As the child takes the steps, count them! You will be asked to
record the number of steps taken, as this will be the measurement part of the
breathing training.
4. When the child cannot go any further, he must stop and stand
still. This is the most important part of the training, and you must pay close
attention. Upon stopping, the child will have trapped in a lot of extra
carbon dioxide much more than he is used to.
This will cause the child to have the desire to breathe very deeply to
expel all the carbon dioxide. This must be prevented. The goal of this
exercise is to cause extra carbon dioxide to be trapped in, and then retained.
If the breathing at this time is not closely monitored, then it has the
capability to reduce the CO2 level below the starting point and actually
cause an asthma attack. For children, the key to this vital step is the
analogy with the mouse and the elephant. [see later]
5. After a couple of minutes [recovery time will vary with progression of training], then the child may be allowed to move from the spot
where they stopped and get ready for the next set of steps.
You must monitor your childs breathing [watch it carefully] for a
few minutes after each set of steps to ensure that the impulse to breathe
very deeply is repressed. Signs that this has happened include touching of
nose or face, or movement of the childs shoulders in a vertical direction. If
this occurs remind the child to breathe like a mouse again.
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CHAPTER 11
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CHAPTER 11
CHAPTER 11
Sit down and relax for a moment. Now gently close your eyes and
pretend there is a really big elephant standing right in front of you. It is a
very friendly elephant, and will not hurt you.
Look at how tall he is. He is as tall as the roof. Wow, he is really,
really huge! Look at his big ears, and his trunk. He is a light gray colour
and has big brown eyes. Now look at how much he is breathing. He is
putting his trunk over just in front of you so you can feel how big his breath
is.
Keep your eyes closed and put your finger up high under his trunk so that
you can feel the breathing. [Parent place the childs index finger of the
right hand up parallel to the ground in front of them to feel the breath.
Blow on the finger or wave air onto the finger.]
Wow its huge it almost blows you over. You can even smell what
the elephant had for lunch!
WOOSH WOOSH it is pretty noisy too!
Now that is called elephant breathing. It is big, and noisy and you
can feel it on your finger.
Keep your eyes closed for a little bit longer, and we will look at the
next animal. The elephant has gone away....
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CHAPTER 11
CHAPTER 11
breathing like a mouse. If you ever feel a bit worried or annoyed or if you
start to get asthma then this is how you should breath to stop it. Breathe
just like a little .....[try to get child to say mouse] mouse. Not like a big
....... [try to get child to say elephant] elephant.
CHAPTER 11
At the same time reinforce again the mouse breathing. If you do not
allow yourself to cough, then the urge to cough will simply go away. If you
do allow the coughing cycle to start it will get worse and worse as the
deep breathing causes more and more CO2 to be lost which will cause
the production of more and more mucus.
To cough a lot you must breathe like a big..........Elephant.
On occasions with smaller children, they may say to you that they
cannot stop the cough. Here you must be firm if you want them to become
free of the cycle. They are simply not allowed to cough. [Yell if you must,
but it usually better to do more closed mouth coughing practice.] Obviously also explain that they can cough if they are choking on something.
If you notice a post nasal drip, which is fluid running down the back
of your throat, then the procedure is the same. Mouse breathing first, and if
that does not stop it, then do steps until it has stopped.
Same applies to itchy nose and eyes. If you see your child doing the
allergic salute, pushing on their nose because it is itchy, explain again that
they have been breathing like a big ......elephant! Itchy eyes might be gently
rinsed [eyes closed!] with cool clean water, followed by mouse breathing.
Nose Breathing
As explained more fully earlier in the Manual, we are designed to
breathe through our noses. Reasons include:
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1. Nose filters out things that would cause severe damage to our
lungs, including bacteria, pollens, dust, mites, other organic material,
fungus, etc. If these were to go via our mouth and reach our lungs we
would have greater chance of disease. If you really want to get sick, find
someone with the flu, and take big deep breaths through your mouth in front
of them. Just breathing through your nose will reduce your chance of
infections.
2. The nose humidifies and temperature-controls the air. Your lungs
are very wet, and also do not like temperature changes. Air that reaches
your lungs via your mouth is dryer and further from body temperature than
air through your nose. It is a built in humidifier and air conditioner. You
do not need a room humidifier if you close your mouth!
3. You will breathe less through your nose. There are two small
holes versus one big gob. The balance of gases in your body is upset if you
breathe more than is appropriate. 4. This the reason that most children
older than 6 years will use to keep their mouth closed. If you were to ask
your children to be actors, and play the part of someone who was really
dumb, stupid and uncool[?], would their mouths be open or closed? The
answer is that it you want to look dumb, then let your jaw hang. [A slackjawed yokel?] How do you look with your mouth hanging open?
DUMB!
Rule
Always breathe through your nose. There is only one reason that it
will block up and that is because you are breathing like an elephant. You
are not an elephant, and your body will try and make you breathe less it
will make your nose block up, and make your lungs get wheezy, and will
make you cough.
The System
The goal is to alter your childs breathing pattern by having them
breathe only through the nose, by having them do specific exercises called
steps, and by making them understand the relationship between the depth of
breathing and conditions like asthma and blocked/itchy/runny nose.
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The short-term goal is to get them free of symptoms. The next goal
is to be free of medication, which of course you will need to discuss with
your physician particularly in respect to preventative medication.
Their should be only a gradual increase in intensity of training.
Day One
The main aim on day one is to allow your child to breathe only
through the nose. When you first breathe only through your nose when you
have been used to breathing through your mouth it feels a bit suffocating! This is because you have become used to lower than healthy levels of
CO2, and when you close your mouth an increased [healthier] amount of
CO2 is trapped in.
This makes you feel the desire to take a deep breath, until you get
used to it. After that time it feels strange if you breathe through your
mouth. You adapt to the higher level very quickly but only if you stick
at it.
If you can keep your childs mouth closed [unless they are talking or
eating] for just one day, then the next day it will be much easier for them to
keep zipped.
So go through the Mouse and Elephant Story just read it out if
you wish or substitute animals. Do not under-estimate your childs
ability to understand what you are saying. Explain about the breathing
even if you think they will not understand!
Do all of the hand actions, of feeling the breaths, and holding the
mouse. It is better if you have a dry run by yourself first so you know how
you would hold a mouse or put a finger under an elephants nose.
Have do some practice at mouse breathing, and explain that it can be
done at any time, but especially if any symptoms occur.
Explain about why they should breathe through their noses only.
Then it is time to introduce steps as an exercise. On the first day the
focus should be on getting the form right.
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Steps Instructions:
Take a normal breath in through your nose, then let a little tiny
breath out through your nose, pinch your nose from above, and march
across the room. When you cannot go any further, stop!
When you stop, you must breathe only through your ..........NOSE,
just like a little .......MOUSE. It will feel a bit funny but that is OK, just
stay really still with your finger under your nose and you will soon feel
better.
Make sure that you keep your mouth zipped shut, or some air will try
to sneak in! If any air does sneak in, you have to stop, and just breathe like
a ..... mouse through your .......nose.
It is a good idea to arrange the setting so that you can see if their are
any sneaked mouth breaths especially with smaller children who will do it
to try and please you, or to compete with a sibling. If there is breath
blame the air that sneaked in, rather than the child to causing it to happen.
Count each step that is marched. Allow them to go at whatever pace
they want most prefer brisk as it is less boring and higher numbers are
reached. No running is to allowed, but fast walking is OK. Record the
number of steps there is a sample form at the end of this chapter; there is
a sample workout sheet at the end of this chapter.
Reinforce with them and yourself that the most important part is the
breathing like a mouse when they stop, and for several minures afterward.
When the child stops, stand next to him, making sure the finger is under the
nose. Say that they will feel a bit strange, but that is OK. It is normal for
children to raise their shoulders upward and to tense their body when they
stop. Ask them to lower their shoulders [downwards] and to relax. Then
remind them to mouse breathe.
On the first attempt, some children can only go for a few steps, while
others may do up to 30 or more.
It does not matter too much on the first day, and there is no need to
push them for more steps this can be increased gently over the next few
days. There is no rush.
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For many children, asthma does not recur after the first session, as
they simply breathe like a mouse as soon as they feel the start of the
symptoms. For many just ensuring that the mouth is closed will stop the
asthma.
If there is an attack [asthma, coughing, blocked nose or other] then
the tactic is to breathe like a mouse for a minute or two, [while smothering
any coughing] then do 2 or 3 sets of steps, and if there isnt much
improvement use the relief medication.
It is good to try to do some breathing to try to get relief before using
a relief drug if possible, but if the onset of your childs asthma is very rapid
then obviously skip it or do only a very brief attempt.
Your child will develop better control and attacks will be less severe
as breathing improves [as measured by the number of steps.] The attacks
will be avoided rather than having to be dealt with. Usually when your
child has built up to 100 steps there will be no asthma. For the majority of
children the number is much smaller.
The goal of training to get to the point where 100 [or more if the
child has athletic ambition] steps are easy, as this means that asthma does
not occur. If it does occur [number of steps will have dropped], then begin
again, building steps back up to 100, and the asthma will go again.
It is not unusual for a child to have a relapse a few months after
becoming free of asthma. It is usually less severe, and responds even faster
to the same training method that stopped it the first time. A second relapse
is unusual, as the first relapse will have allowed the child to further develop
his or her breathing skills. If it should occur do it again right from the
beginning!
So, on day one mouth closed, no coughing, and do some sets of steps
[3 or 4] perhaps twice in the day, including once before bedtime. Use the
system to ensure that nasal breathing is possible [ie use steps to unblock
nose if needed.]
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instructions. The goal is to have just enough sticking power on the tape to
for it to stay on, and keep the lips together.
The tape recommended is called surgical or paper tape about 1 inch
wide, available from a pharmacist. Tear off a strip about 2 inches [5 cms].
Fold a small tab on each end, so that it is easy to grip. Then repeatedly put
the tape onto your palm and tear it off. Do this until it is hardly sticky at
all.
It does not need much power to keep your lips together. Ensure your
mouth is closed, as you can breathe through this tape, and gently place in
lengthways along your lips. I suggest you do this on yourself first to show
your child that you are also doing it. [It will greatly improve your sleep
quality if you actually wear it in bed.]
Have a practice during the day with the tape so there is less if any
drama at bedtime. Check on the child around 3.30 am to check he has not
pulled it off. Re-apply it if necessary.
If it is off and you do not re-apply it, then your child will have no
protection during the deepest sleep/breathing period, and will start the next
day dealing with the results of huge elephant breathing. This may be
asthma, bedwetting or just plain tiredness. As with the breathing drills, this
is as important as brushing your teeth!
The most common concern with this is that your nose will block up
will your mouth is taped closed and you will suffocate. Fortunately, the
effect of CO2 on your nose makes this impossible. The more blocked your
nose becomes, the more CO2 you will trap in. The extra CO2 will cause
your nose to unblock. So your nose will not block completely unless you
open your mouth. It may whistle a bit, but cannot close up completely.
You may have noticed that there is a lot covered on Day One. This
is true. The following days are just a matter of reinforcement.
CHAPTER 11
Steps sessions should now be done three times per day, with 4 to 5
sets of steps each session. ie. this means that each session should consist of
4 - 5 sets of steps, the number of which is recorded on a form or eventually
in a notebook. It is valuable to also record the level of asthma and
medication next to the steps records on a daily basis. This clearly shows
the decrease in symptoms and relief medication needed as the number of
steps increases.
On this day it is useful to introduce the idea to the child that there is
significant benefit in breathing like a mouse after ANY physical activity.
This will stop any exercise induced asthma that may exist, as well and
decreasing the recovery time for sports or activity. ie. if you breathe like a
mouse after running around, you will be ready to run around again sooner
than if you breathe like an elephant.
A good illustration of children using exertion to start asthma is to
observe small children running around madly, having an excellent time,
getting very puffed [which of course is elephant breathing,] then shortly
after starting to cough a little, then more and more until a full blown asthma
attack is in progress. This is short-circuited by mouse breathing and not
coughing.
Another example is the child with the ability to throw a tantrum until
they begin to cough, then starts the asthma cycle. Parents learn to recognize
this cycle and may become conditioned to simply give in as it better than
a couple of weeks of having a very sick child possibly in hospital with
asthma.
The answer is to explain how the breathing during the tantrum
causes the asthma, and to forbid it. Alternative attention [positive]
hopefully may result in the replacement of the tantrum behaviour with a less
damaging one.
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puffed or winded.
I remember the first time it happened to me very clearly it was
great. Unfortunately I was no longer a child when I discovered this system.
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example if all symptoms disappeared when the steps were around 45 steps,
then if he or she can do 90 steps then you have a safety zone [of 45
steps].
Usually when a child can do 100 steps there is little problem.
However there are always exceptions so a better goal is 150 steps. Having
said that do not get too hung up on the numbers. It is more important to
recognize the point where the asthma or other condition disappeared and to
build in a safety zone above that.
This should be an absolute minimum of 50 steps. More is better. If
your child seems to lack the drive to go much past this point, do not be too
critical as it is most likely to do with development phase than with any
lack. Simply ensure that more time is spent on the other drills such as
star jumps.
A young man [10 years old called Nathan] in Townsville was able to
go from being able to do only 7 or 8 steps to over 300 steps in a six-month
period. He was extremely severe with asthma and other conditions, and in
now an excellent [champion] swimmer.
Until the disappearance of all symptoms, steps sessions should be
done 3 times per day [with one before bed]. This should be done until there
is a buffer of at least 50 steps over the number at which the asthma
disappeared. At this point this may be reduced to sessions of two sets of
steps twice per day.
As a safeguard this should be maintained for at least 6 months, after
which it may be dropped back to once per day. At this point it is more as a
measurement of breathing level rather than training. Should the number of
steps that you child is able to do begin to fall, then increase the intenstity
and frequency again. ie go back to 3 times per day.
Should your child get a cold or infection, the number of steps they
can do will drop. If your child simply remembers the mouse breathing and
non-coughing rules, there is not usually a problem, and when they feel
better start steps training at the beginning again.
If breathing becomes so poor that asthma recurs, start the training at
the beginnning immediately. During an infection like this it is difficult to
do many steps. To balance this do more sets of steps. ie. if he cannot do
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around 60 steps as usual but only 35 steps, then do more sets of steps. So
instead of 3 sets of 60, do 5 sets of 35 remembering that the training
effect is in the reduced breathing when the steps are complete.
Review
Training for children consists of:
1. Retraining to ensure nasal breathing only
2. Retraining to ensure breathing after physical exertion is mouselike
3. Introduction of Steps as a measurement, as a training aid, and as a
symptom relief aid
4. Ensuring that breathing depth during sleep is reduced by body positioning and tape
5. Ensuring that the association between elephant breathing and symptoms is understood
6. Ensuring that relief medication is available at all times, even after
apparent prolonged disappearance of symptoms
7. Involving your medical practitioner in the process
8. Encouragement to increase the number of steps up to a target level,
while maintaining breathing control afterward.
9. Restarting the program if there is a relapse of symptoms at a later
time.
10. Installing a routine of doing the steps on a daily basis, with similar
importance as brushing of teeth.
11. Being aware of the impact of different foods on breathing depth, and
being ready to alter the childs diet if needed.
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Day/Date
End
Pulse
Medication/Condition Diary
Record All Symptons and Medication
CHAPTER 12
Asthma In Infants
ou will have seen from your reading that applying the Buteyko
Method is an active process. The person who is learning the
method takes control of their breathing and by reduction of the use
of their deep breathing muscles reduces the depth of their breathing until a
desire for a deeper breath is felt. This indicates that a higher level of CO2
is being trapped in, so in a short time avoiding the conditions associated
with CO2 deficiency.
For you to apply the Buteyko Method in infants it is necessary to
recognize the ways in which your breathing can be affected indirectly. This
simply means that you must recognize what makes your breathing deeper,
and avoid it where possible. Once you have followed how this applies to
adults then you simply apply it to babies.
1. Keeping your mouth closed.
This is the first step for all people learning to apply the method. It is
active in the sense that you control the separation of your lips, but the way
that this alters your breathing is passive. You simply close your mouth and
the increase in CO2 levels happens to you. [Providing that you do not
become stressed and increase your breathing depth, still with your mouth
closed. This may be a factor if you suffer from panic attacks.] In most
cases people who have been used to breathing through the mouth will feel a
little suffocated or feel the desire for a deep breath within a minute or two
of having their mouth closed.
This feeling is an indication that you have trapped in a little more
CO2 than you are used to, and your normal response to this is for your body
to believe it should get rid of some of this extra CO2. This is the reason for
the desire for a deeper breath. After a time your body becomes used to the
higher level of CO2 that keeping your mouth closed causes. Once used to
this level the desire for a deeper breath [or feeling of slight suffocation]
disappears. At this point keeping your mouth closed feels absolutely
normal, and breathing through your mouth will feel a little odd.
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If you follow a powerful sneezer home and observe how his [more
pronounced in the male] toddler sneezes guess what you will find. The
child will have learned without being officially told that appropriate way to
deal with a nose tickle is loud, violent and irrigating method that dad does,
or whichever person the baby has learned from.
Another excellent example of this is how to blow your nose. Study
the nose blowing method of a child whose modelled parent is from the
enraged elephant school. I have even seen parents coaching toddlers in
power blowing something that almost guarantees continuing demand for
handkerchiefs and tissues. [If you have been captured in this international
practical joke please see a new Appendix I have added How to blow your
nose.]
So what is the message? Follow the simple rules that the Buteyko
systems teaches you. Keep your mouth closed, your posture reasonably
straight, and read the Appendix to see how you should blow your nose and
sneeze.
3. The next part of helping your asthmatic child is to look carefully
at what and how much you are feeding him or her
You will have heard of the impact of dairy food on people in general.
You may have heard that dairy food is mucus-forming. This implies that
the food itself causes the formation of mucus, but you now know that the
food simply causes a change in the depth of breathing which then causes the
production of mucus. [The increased depth of breathing causes you to lose
a little more CO2, which causes your mucus factories to increase
production!]
Different people have different levels of response to different foods.
Some people can eat a whole bucket of double chocolate icecream, and
have almost no change. Others can observe mucus after one teaspoon.
With others it might be strawberries, or oranges.
Your child is an individual, but has similar genes to you. Look at the
sensitivities of both parents and grandparents when looking at your child's
diet. Find all of the clues you can about how your entire family handles
their food. Quiz your parents ask what you were fed, and if you had any
problems. It is amazing what people remember about their own babies!
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This is traditionally done because the big meal makes them drowsy,
[the huge dose of insulin released does it], and therefore easier to put to
sleep. If your child is getting asthma then you have to forego this
shortcut.
Give the larger meal well before bedtime, and then a smaller snack
before bed. If you are using milk or formula, then use a small bottle at
bedtime or give water or [unsweetened] juice at that time.
In effect this usually means breaking the larger before bed feeding
into two smaller feedings. Just like when breastfeeding. This same rule
also applies to adults have either a very small meal before going to bed
or nothing at all.
What food is best for your baby? Breast milk is best. Sometimes
this is not possible or always available so mostly you will use or supplement with milk [cows] or some kind of formula. If you are having
problems or at least your baby is with coughing or wheezing, then
you need to experiment. Many children are lactose intolerant which
means that cows milk will not allow them to thrive, and will adversely
affect their breathing.
As a general rule if your child has problems go off cow's milk
and other dairy. Substitute non-dairy formula or soy or goats milk.
Experiment! Try different things for a week or so, making notes of
coughing, wheezing and runny noses.
SUMMARY
The most important thing to remember is that once your baby is old
enough you can teach them active steps to take to clear up their asthma.
Your main tasks are to ensure that they are kept alive until then, and to keep
their comfort level as high as possible. This may seem a brutal thought
but the fact is that you cannot retrain their breathing habits unless they are
alive. So you must remain calm in the face of symptoms, yet be ready to
seek emergency help and all the power of modern medicine to ensure their
survival. Take no risks.
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If you have the use of an older sibling, then you can use them as
models for teaching infants and toddlers how to do the exercises in the
childrens instruction chapter. A two year old will mimic the things done by
a 5 year old. These exercises have a massive impact even if not done
exactly right by a toddler. If you can get it pretty close [as the child is
not yet able to do it precisely], you will still get decreased symptoms.
Obviously is also a good idea to avoid trigger factors like dust, dust
mites, and pollens if you can. Regulary turning mattresses and washing
mattress covers with a touch of bleach helps, as does ensuring that pillows
are clean and fresh smelling. A weekly dose of sunshine on pillows helps
with this. If you able then having non-carpeted floors is good.
Care should be taken to keep the family cat dander free. This can be
done by a weekly bath. Dander is a very potent trigger, and even if it does
not affect breathing enough to cause asthma, it will still cause itchy eyes. If
your cat does not allow a weekly bath, say goodbye to it.
Remember that as an adult you can minimise the effect of trigger
factors by carefully monitoring your breathing and reducing it at first sign
of an effect from the trigger factor. Your baby cannot yet do that, so you
must simply minimise the exposure to it.
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CHAPTER 13
Emphysema
Emphysema
n the past emphysema has been seen as a death sentence. Your doctor
or specialist may have explained to you that this condition is
progressive, and will eventually stop you from breathing at all. You
may have been told that new drugs are becoming available all the time, and
new research is happening.
If you are youngish, then you may have been told there is a chance
for a lung transplant later. Some doctors will simply say to make the most
of the rest of your life while you still can.
While this is pretty good advice to follow anyway, there are some
really interesting other things to know about. There is a theory that
smoking causes emphysema. There are literally thousands of people who
have emphysema, but have never smoked ever. They have never been
exposed to even passive in any dose; they have the same condition as a
two-packs-a-day-for-thirty-years smoker.
Other people have what scientists describe as alpha antitrypsin
deficiency, which is a genetic code that produces less of an enzyme that is
needed in your lungs than normal people. The interesting thing is that in
the vast majority of these cases, the emphysemic condition is not seen until
later in life even though the genetic pattern that says there should be
emphysema has been there since birth. What is the missing factor that
explains what is going on?
CHAPTER 13
Emphysema
Smoking
Smoking is a double whammy for emphysema. The deep breathing
associated with smoking causes the loss of more CO2, which induces your
mucus factories [special glands that produce mucus or phlegm] to
increase their output. Added to this is the effect of bringing foreign
particles into your lungs. This also causes an increase in mucus production
[to clean up the bits of tar and debris]. The effect is a huge increase in
mucus and it is no wonder that alveoli [and bronchi] clog up.
An additional effect of bringing all of this cigarette muck into your
lungs is to increase the chance of your lung cells mutating and giving you
cancer. The other effect of smoking [while we are bashing this silly habit!]
is that it introduces hot, dry air to your lungs. Your lungs are wet and
sloppy and they function best this way. When they dry out or are heat
affected they are easily damaged, and more likely to become cancerous or
infected.
To conclude my tirade on smoking if you are addicted to nicotine,
then find another way to get it into your body. If you must do this via your
lungs then use a similar device to what marijuana or opium smokers use
a pipe or bong. This drags the smoke filled air through water which
washes it a little, and cools it a lot. The amount of gunk that gets into
your lungs is decreased and you can actually see it in the foul smelling
water that is left. Of course to use these devices you have to breathe very
deeply, so you will still lose CO2, and still probably get emphysema but
you may have a lower chance of getting cancer of the lungs, lips, mouth or
throat.
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Emphysema
If you must continue to smoke, then at least bear in mind the lessons
contained in this book. You will be able to reduce the symptoms of
emphysema if you follow this breathing model because you will be
stopping one of the factors that produce the symptoms. The other will still
exist, and you will continue to do damage until you stop.
Antytrypsin Deficiency
The curse of the genetic ability to produce less antitrypsin than
you need can also be reduced in effect. I now have two clear cases where
people with severe symptoms and this genetic deficiency have had major
reductions in emphysema symptoms after using the Buteyko System. One
lady in England used only this Instructional Manual. The first I learned of
it was when a British Doctor who was now working in Australia contacted
me to ask how it could have happened. This GP said that it was hard to
believe, but she could not argue with the results. So if you have been
tested, and shown to have this particular gene do not give up hope!
The reason for hope is that for a major portion of your life you
produced enought antitrypsin to live normally. At some point something
changed which resulted in you beginning to experience the symptoms of
emphysema. I am saying that one thing that changed is the depth of your
breathing. It changed in exactly the same way that the breathing of
someone who gets asthma late in life also changed.
Often people can trace the beginning of their symptoms back to a
particular illness or event. It may have been a serious infection, a shock
such as a death, an operation, or even childbirth. It may be even be a less
awful event like retiring or moving to a nicer climate. Because you were
unaware of your breathing the only change you would have noticed is that
you seemed to be getting breathless more easily, or that you had a cough.
Asthma, Emphysema or Both!?
You will now be noticing that there is not a lot of difference between
asthma and emphysema. The cause as stated above is the same, the
symptoms are similar in effect, and even the medications used are the same.
The major difference is that emphysema causes more lung damage.
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Emphysema
You may have been told that you only have a certain percentage of
your lungs still working as the mucus blockages in the alveoli have
damaged the alveoli so that they are no good for exchanging gases.
Before I go further into the practical way to determine whether you have
asthma or emphysema I want to give you some good news.
You do not need to have 100% of your lungs working to have a
decent quality of life. Obviously, the more the better but there a
thousands of cases where people have had large sections of their lungs
removed [usually because of cancer], and afterwards can function on one
lung or less.
So regardless of how much good lung you have been told you have
left be positive! Your goal will be tune your breathing so you can take
best advantage of what you have, plus try to prevent any further damage.
Another point is that lung tissue that appears to quite destroyed on X-ray
will still be able to do the job to some degree so the percentages that are
calculated from x-rays are always more pessimistic.
OK. Is it asthma or emphysema? The difference is in the location of
your defense to stop losing too much CO2. Whichever defense you have is
determined by your genes. One person will get a defense in the airpipes,
another in the alveoli, another in both places.
As a general rule, the more your symptoms are caused by asthma, the
better. This is because there is generally less damage to lung tissue in
pure asthmatics, and much more in pure emphysemics. [Note that if
you have severe asthma for long enough you will also have some emphysema and lung (alveoli) damage.]
The easy way to tell how much emphysema or asthma you have is
examine how well you respond to your relief medication. For example,
when you take your Ventolin [salbutamol] or other fast acting bronchodilator, how long does it take to work? If it works within a few minutes that
means you have a good component of asthma because this medication
works mostly on the airpipes. It does not mean you have no emphysema
only that you have some asthma. If it does not work for 10 minutes or so,
then you have more emphysema, and less if any asthma. If it does not work
at all, which is common, and makes no difference at all, then you probably
have straight-out emphysema.
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Emphysema
CHAPTER 13
Emphysema
recovery which is the most important part. You must do the opposite of
what you really want to do which is to put your hands on your knees and
suck in the big ones. It will feel as if you are not getting enough air and
I am telling you to suffocate even more!! I will go over some of the
chemistry to do with oxygen and CO2 below but the simple fact is that
you have nothing to lose by trying it. No one else is telling you that you
can reverse your condition.
Another point about working on your emphysema is that usually you
will not realize you are puffed or out of breath or knocked-up until
you are REALLY out of breath. By this I mean that you will not realize that
you have gone from being OK to being breathless until it is too late. Once
it is too late, it will take you a lot longer to recover. If you can stop your
exertion when you are only just a tiny bit breathless, the you can recover
faster with much less misery and your progress will be much faster.
It does you no good to lose control of your breathing, and will
actually contribute to your condition worsening. For example, if you are
walking, then stop BEFORE you get so puffed you have to stop! This may
seem a little frustrating and may slow you down in the short term but in
the long term you will get better faster, and not worse. You get no points
for getting to the point where you begin to gasp.
If your condition right now is that you are gasping [even before you
have done anything] then just sitting or lying there is sufficient exertion
to begin with. Your first step is to be not needing to gasp; the only way
you can do this is again doing the opposite of what it feels right to do. That
is, you have to suffocate yourself a little, even though what you really want
to do is breathe deeply like a horse.
Remember that the reason you are gasping is because your body is
trying to stop you breathing like an elephant instead of a human.
Oxygen and Carbon Dioxide
Much confusion arises with these two gases when you first try to
figure out what is going on. This book is telling you that it is carbon
dioxide [CO2] which is the controller of your breathing, but you know from
your own experience that oxygen is also needed.
When your breathing is normal, and you are not suffocating, it is the
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CHAPTER 13
Emphysema
level of CO2 which controls your breathing. However, when the level of
oxygen in your blood drops too low, then this takes over the control of how
deeply you breathe. Now some interesting points rise to make things more
confusing.
When I speak of CO2 levels dropping and causing constriction of the
airpipes, I am referring to the levels in the lungs. When the level in your
lungs drops too low this effect is magnified throughout the entire body
because a special chemical measure called the pH depends greatly on the
level of a form of CO2 in lungs. This special kind of carbon dioxide [called
carbonic acid] can cause rapid changes in pH, and if pH changes too much
then most of the chemical reactions in your body simply will not work.
So if the level of CO2 in your lungs is wrong, then it can affect every
single reaction in your body. [To confuse things a little further the
increased level of CO2 in your blood will alter pH as well but in a
different direction to the change caused by a lack of CO2 in your lungs. In
a way they balance almost themselves out.]
Now the CO2 level in your blood is different to the level in your
lungs. If you have emphysema and have been to hospital you will know
that as well as measuring your blood oxygen, they also measure your blood
CO2 and when you difficulty breathing it is usually very high!
This is because the CO2 that your body produces [a little when you
are still, and more when you use up more energy] cannot pass through the
alveoli to get into your lungs [and therefore out into the air], and so keeps
going around and around in your bloodstream. When your lungs are
working normally the CO2 can get out of the blood by crossing the alveoli
into the lungs, but when the mucus has blocked the alveoli it cannot.
So this means that you can have too high a level of CO2 in your
blood, but too low a level in your lungs. The fact that it is too low in your
lungs means that the mucus still keeps being formed in your alveoli, and
keeps it blocked.
Now follow closely here because this explains why you feel so
suffocated. When the alveoli is blocked, it means that the oxygen in your
lungs cannot get into your blood. Remember that to stay alive your body
uses up oxygen, and turns it into CO2 which gives it energy.
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CHAPTER 13
Emphysema
So your body uses the oxygen in your blood and turns it into CO2
but if your alveoli is blocked off by mucus then the CO2 cannot get out
of the blood, and more oxygen cannot get INTO the blood. You have plenty
of oxygen in your lungs and no matter how much you breathe you
cannot get it past the blocked alveoli into the blood where the level is
getting lower and lower.
I mentioned above that oxygen takes over from CO2 in controlling
your breathing depth when the oxygen level in your blood gets too low.
And this happens! The oxygen level in your blood drops, and this causes an
automatic increase in your breathing depth. [It is trying to force more
oxygen into the blood.]
However, the deeper breathing caused by this automatic reflex
causes even more CO2 to be sucked out of the lungs this stimulates the
mucus factories to increase their production even more which blocks off
the flow of oxygen in and CO2 out of the blood even more!
So even though you are getting lower and lower levels of oxygen in
the blood, the more deeply you breathe to try and get more in the more
you block off the passages. So you are stuck in a loop!
The only way to break out of the loop is fight against your automatic
reflex to breathe more deeply when your oxygen levels are low. This means
that even though the low levels of oxygen are making you feel suffocated
you must do the opposite of what feels right and suffocate yourself even
more than you already feel! This sounds scary doesn't it?
It is scary at first, but once you do it a couple of times and feel it
work you relax and it is not so bad. You simple must remember that even
when you feel suffocated you must do the opposite and breathe as if
the air is going just into your nose and just out again. This will allow the
level of CO2 in your alveoli (lungs) to build up which will reduce the
mucus production which will allow the oxygen to get into your blood
from your lungs, and the CO2 to get out of your blood into your lungs.
When enough oxygen has got into your blood, the oxygen control of
your breathing [which makes you want to breathe deeper and deeper] will
stop, and CO2 will start controlling it again. But you will not change your
strategy your answer is ALWAYS to breathe less deeply than you want
to.
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CHAPTER 13
Emphysema
Over a period of time if you keep trapping in more CO2 than your are used
to you will get used to higher and higher levels [in your lungs!]. The
more you are used to, the less mucus you will produce in your alveoli
and the less your emphysema symptoms will be.
Your goal is to remember that you want more CO2 in your lungs, and
the way to do that is to breathe so gently that you cannot hear your
breathing or feel it if your place your index finger under your nose.
If you have severe emphysema then you will have to be tough on
yourself at first. This means that you will have to breathe a lot more
shallowly and feel much more suffocated than those woossy asthmatics.
This is because you will feel suffocated before you even start and you
have make the suffocation worse! If you do not make it worse, then this
method will not work.
You can do it and it is only slightly worse than what you are
going through already, and if you do it then you can look forward to
improving rather than getting steadily worse. You can do it from this book
but it is a lot easier if you can get to a class or find an instructor who will
guide and support you.
About Oxygen
The level of oxygen in your blood when you are able to breathe
normally is very high. You cannot significantly increase the level of oxygen
in your blood by breathing more! Your blood is usually 99% saturated
with oxygen you cannot squeeze more in by deep breathing.
A study was done in 1963 and written up in the New England
Journal of Medicine [a very prestigious medical journal], where people
were forced to breathe as deeply as they could for 15 minutes. Before they
started the doctors measured the oxygen and CO2 levels in their blood.
After 15 minutes of deep breathing the level of oxygen had
DROPPED greatly in the blood, and the CO2 level had increased. Did this
breathing make them feel good? Nope. They were dizzy, nauseous, and
many were coughing and wheezing.
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CHAPTER 13
Emphysema
- Page 107 -
CHAPTER 13
Emphysema
- Page 108 -
APPENDIX 1
Summary of Results
of the Buteyko Clinical Trial
Introduction
In December, 1994 a clinical trial began which compared the
efficacy of the Buteyko Method with conventional asthma treatment. It was
conducted by Respiratory Physicians Prof. C Mitchell and Dr S. Bowler.
The Trial was held at the Mater Hospital in South Brisbane, and was
funded primarily by the Australian Association of Asthma Foundations.
It was initiated in response to a huge volume of anecdotal evidence
claiming its effectiveness. It was a controlled, randomized study which
compared the Buteyko Breathing Technique with a placebo breathing
technique plus conventional asthma management. Measured were
symptoms, quality of life, lung function and medication.
Methodology
Thirty-nine subjects were recruited and randomly divided into two
statistically equal groups, based on history of asthma and current medication levels. Each group was trained at the same time in different room of
the same building, with sessions over 7 days each lasting 60 to 90 minutes
each. Blinding was maintained over the groups until 12 weeks, so that
neither group was aware of which group they were in.
Throughout the trial, including the 1 month run-in period, bronchodilator medication was to be used on an as required basis, with both
groups attempting to minimise usage. Diary cards were kept which
recorded medication usage, symptoms level and peak expiratory flow.
Subjects were instructed not to alter inhaled steroid dose during the
initial six weeks, after which a clinical review would take place. After that
review, subjects using short acting B-agonists at one dose or less than one
- Page 109 -
APPENDIX 1
dose per day were instructed to reduce their inhaled steroids according the
protocol.
The control group was trained by a qualified physiotherapist in
standard asthma education including relaxation, coughing and abdominal
breathing techniques, and the Buteyko group by an experienced Buteyko
Instructor.
Respiratory testing FEV, Minute Volume, and End Tidal CO2 were
conducted after run-in, at 6 weeks, and at 12 weeks. Diary card data was
gathered at this time and Quality of Life Questionnaires were administered
at these times plus at 8 months. Also at 8 months a further medication-use
questionnaire was given.
Results
Results at 6 Weeks
Beta Agonist Use:
Buteyko Group decreased average agonist use by 90.1%.
[From 1235ug to 134ug]
Placebo Group decreased average agonist use by 5%.
[From 1029ug to 978ug]
Inhaled Steroid Use:
Buteyko Group average inhaled steroid use fell 12.5% from 1893ug to
1656ug
Placebo Group average inhaled steroid use remained statistically the same
at 1450ug to 1551
Diary Card Symptom Scores
Buteyko Group decreased symptoms score by 50%
Placebo Group decreased symptoms score by 15%
- Page 110 -
APPENDIX 1
Results At 3 Months
Beta-agonist Use
Buteyko group had maintained decreased average use by 90%
Placebo group had increased average use by 9%
Inhaled Steroid Use
Buteyko group had decreased average use by 49%
Placebo group was statistically the same as before the trial
Diary Card Symptom Scores
Buteyko group 71% improvement
Placebo group 14% improvement
Quality of Life Scores
Buteyko group had significant improvement that was still maintained at 8
months
Follow-up At 8 Months
At 8 months the decrease in beta-agonist use in the Buteyko Group had been
maintained.
- Page 111 -
APPENDIX 1
Discussion
This study showed that a group of severe asthmatics [averaging over
12 puffs of relief medication] were able to reduce their medication to an
average of just over 1 puff per day, simply by learning a different model for
breathing. As well as reduced relief medication, the need for steroids was
also significantly reduced. This is combined with massively reduced
symptoms and greatly improved quality of life.
In this trial it was also attempted to changes in CO2 levels, changes
in peak expiratory flow levels, and minute volume levels. Because of the
relatively small sample size, the only statistically significant change among
these measures of lung function was minute volume. Minute volume is an
objective measure of the volume of air breathed at rest in one minute while
stable. It is a consistent measure of the degree of hyperventilation in the
patient.
The Buteyko group average minute volume dropped from 14.0+6.5
litres, to 9.6+3.1 litres [p=0.9] which is a significant drop when compared
to the placebo group [which went from 14.2+4.9 to 13.3+4.0 litres per
minute.]
This change is exactly as predicted by Buteyko Theory which states
that a reduction in hyperventilation will result in reduction in symptoms of
asthma and hayfever.
[Correlation was found between the relative reduction in beta-agonist use in
the Buteyko group and the relative reduction in Minute volume,
r=0.51,p=0.04]
Addendum
The control group of the above Clinical Trial was offered the
opportunity to receive instruction in Buteyko Breathing after blinding was
removed from the groups.
In an uncontrolled trial equally dramatic improvement was shown in
the 10 subjects. Average decrease in B-agonists at 4 weeks was 75%, and at
8 months was 90%. [From 1733+1231ug/day to 228+467ug/day]
APPENDIX 2
The Importance
of Carbon Dioxide
APPENDIX 2
called the Red Blood Cell [or RBC] which is like a ferry for gases inside
the body.
On this RBC ferry, their are special seats for oxygen. These are
called hemoglobin, and there is a limited number of seats, so they are
often almost completely filled with oxygen as the blood leaves the lungs.
[97% saturated with oxygen.]
The RBC ferry travels through the body on the arterial freeway
which becomes narrower and narrower until there is only one lane for
RBCs. This single lane puts the RBC very close to the cells, which may
be for example muscle cells.
At this time, because there are more oxygens on the ferry than
around the cells, many oxygens gets off the ferry. If there are heaps of
CO2s in the area, it changes the chemistry of the bus, and many more
Oxygens get off. These oxygens are then available for use by the cells.
[that is, they can be reacted with sugar inside the cells to make more energy
and CO2.]
At this time lots of CO2s get onto the RBC ferry. There are special
seats on the ferry for CO2 as well. A very small amount [7%] will just
stand in the aisles [as CO2 dissolved in water] A slightly larger group
[23%] will take some old oxygen seats [hemoglobin]. The biggest group
[70%] is turned into bicarbonate by a special enzyme on the bus. [It is
this reaction that makes more oxygens get off the ferry. There more CO2
there is to turn in bicarbonate, the more oxygen gets off.]
After having gone through the single lanes of the arterial highway,
the RBC ferry now is on the Vein highway. At this time there is usually
still a lot of oxygens on the ferry, with about 75% saturation. So most of
the oxygens get a round trip.
The vein highway takes the RBC ferry back towards the lungs.
Because of some very important mechanisms your body uses to keep
the balance of charges at the same level at all times, the special form of
CO2 called bicarbonate is very important. To keep things in balance,
most of the bicarbonate will jump out of the RBC ferry and be washed
along beside it in the fliud called venous plasma.
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APPENDIX 2
When the RBC ferries and bicarbonates along side them reach the
lungs, the sheer pressure from the masses of oxygens just inside the alveolar
sacs pushes in and takes over all of the hemoglobin seats. The reaction
involved in taking these seats releases a chemical which causes the
bicarbonate to be turned into carbonic acid. This can be turned back into
CO2 and water. This CO2 and the water that is formed are released into
the alveolar spaces [where the oxygens have just come from.]
This is a little complex, but the ratio of carbonate and carbonic acid
is very important, because these chemicals act as a buffer for the body.
[This is just a way to keep all of the charges, plusses and minuses balanced.
Your body cannot handle big changes in the charges.] The ratio of
bicarbonate to carbonic acid present determines the pH of the extracellular
fluid, which surrounds all of the cells in your body.
There is no problem with the levels of bicarbonate as it is fixed and
closely controlled by your body. On the other hand, the carbonic acid level
is determined by the amount of CO2 that is kept in the alveoli. [The sacs at
the end of the airpipes.] The pressure of this CO2 gas in the lungs will
stop too much carbonic acid being turned into CO2 in the lungs, and
escaping the body. If too much or too little carbonic acid is released, the pH
of the fluids that surround all the cells will change. This will affect the
ability of the RBC ferries to provide free oxygen where it is needed and to
remove excess CO2 from the cells. It will also interfere with the internal
workings of the cells. So having the right ratio of bicarbonate to carbonic
acid is vital.
The pressure of the CO2 in the lungs, which keeps the carbonic acid
levels set, is dependent on the rate at which CO2 passing out of the blood in
the lungs is diluted with atmospheric air. So the level depends on the depth
and frequency of breathing.
The character of our breathing pattern is determined by our
respiratory centre or breathostat, [in the brain] which is sensitive to both
CO2 levels and pH of the extracellular fluid [which depends on bicarbonate
and carbonic acid ratio].
When the pH [the balance of charges] in the fluid around our cells
because of a decrease in bicarbonate [it got onto the RBC ferry], the
breathostat tells the breathing to increase which lowers the CO2 dissolved
in the lungs, which allows the carbonic acid to drop, which brings the ratio
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APPENDIX 2
of bicarbonate and carbonic acid [and thus the pH] back to normal.
Just to complicate thing a little further, your kidneys help to regulate
the pH of the extracellular fluid as well. They do this by regulating the
bicarbonate levels. [So here is the link between kidney disease and your
breathing.]
Buteykos Theory
Due to deep respiration an excessive amount of CO2 is removed
from the body, resulting in a change in chemical balance which is only
partially neutralized by compensatory mechanisms. Over a period of time
the loss of CO2 becomes increasingly disruptive to the functioning of the
body. All physical and chemical processes are affected.
The loss of CO2, because of release from the lungs at a rate faster
than its creation in the tissues leads to an increase in pH. Generally a state
of oxygen deficiency also occurs due to reduction of the Bohr effect.[Less
oxygen is taken from the RBC ferry.]
This oxygen shortage will cause an increase in the amount of
incompletely oxidized products of metabolism which act chemically to
lower the pH. [Metabolic acidosis] This effect will not quite cancel out the
increased pH from the CO2 loss, and the efficiency of all normal systems
will be reduced.
- Page 116 -
APPENDIX 2
- Page 117 -
APPENDIX 3
his section is only for those who are currently requiring oral steroids
to remain stable, or those who have a need to take oral steroids
periodically to control severe attacks.
APPENDIX 3
APPENDIX 3
APPENDIX 3
- Page 121 -
APPENDIX 4
APPENDIX 4
Step 2. Using the fingers of your left hand, use the handkerchief to
block your left nostril, and blow gently ONCE ONLY. This will clear your
right nostril.
Step 3. Then block your right nostril with the handkerchief, and
blow gently ONCE ONLY. This will clear your left nostril. Fold your
handkerchief and put it away.
From this point, if your nose is blocked then you will be able to
unblock it with reduced depth breathing as described in this book. You will
not be able to unblock it further by blowing harder and harder.
Rules
1. There should be almost no sound. There should definitely be no
trumpeting like an elephant. A person a few feet away should hear
nothing. If there is noise, it means that you are blowing harder than your
need to, and you are losing more CO2 so causing the production of more
mucus than you clear. The more you blow, the more mucus you will create,
or the more blocked your nose will become
2. After you have finished, then you need to breathe like a mouse
for a minute or two, to trap in some extra CO2, which will decrease the
swelling of the lining of your nostrils.
3. Remember, you want to remove only the mucus that is within an
inch of the end of your nose, leave any other mucus for your body to clear
using its normal mechanisms.
- Page 123 -
APPENDIX 4
APPENDIX 4
it out. Each time you do this you lose more CO2, which in turn makes your
nose more sensitive, and then another trigger another sneeze is produced.
The more you sneeze, the more likely it is that you will sneeze again!
The best approach is to avoid the first sneeze, or failing that the
second sneeze. If you hardly ever sneeze, or sneeze only when something
like a fly blows up your nose, then this approach is not relevant. However,
if the tiniest little smell or atom of pollen or dust affects you, then you can
benefit from this.
The sneeze is a useful tool for expelling foreign substances from
your breathing system. However, when you have caused your sneeze reflex
to become too sensitive [by losing too much CO2], then you will sneeze
when it is not needed to remove a foreign substance from your breathing
system. The sneeze trigger becomes too sensitive!
The main rule is that you should not try to smother or contain a full
blown sneeze. If the sneeze gets to the point where you cannot stop it, let it
out, and try to prevent the next one. If you try to contain a sneeze you have
the potential to damage your hearing.
Before each sneeze there is always a warning that it is coming. This
is the tickle or itch sensation in your nose. If you act quickly as soon as
you feel the itch, you can prevent the sneeze.
Your actions consist of recognizing that your have been breathing too
deeply, and you have lost too much CO2, so you must trap some more in
quickly. The simplest way to do this is to stop breathing. You can hold
your breath, just as you do in a Measurement Pause, or you can do what
they used to do in the movies!
If you are a fan of cowboy movies you will be able to picture a scene
where our hero and his partner are being pursued by a bunch of nasty
bandits. At a very tense point where our heros are hiding close to the bad
guys, the not-so-bright partner of our hero will begin to pre-sneeze. He will
go ah ah ah, but before the loud choo arrives our hero will place
his forefinger under his partners nose, his breathing will reduce, and the
sneeze will be avoided [saving them from detection by the bandits and
certain death!] You do not need the banditos to stop your sneezes.
You need only the realization that greatly reducing the depth of your
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APPENDIX 4
breathing will trap in more CO2, and will relieve the itch which start is
the sneeze.
Everyone knows that the simple act of putting your finger under your
nose can stop a sneeze it has surely been known at least as long as
movies have been around. Now you know how and why it works, and you
can make it work better for yourself. The same applies for most itches that
occur in the triangle that can be drawn from the centre of your upper lip to
your right temple to your left temple. This includes itchy eyes and itchy
noses. If you find yourself touching your face to scratch your nose, or
rub your eyes check your breathing. See if you can make the itch go
away just by breathing like a mouse. It is very likely that it will just
disappear.
You can reduce the impact of things like pollens and dust mites [and
droppings] if your reduce your breathing depth as soon as you sense these
triggers. For example, if smelling smoke has made your nose itch and eyes
scratchy in the past, then you can reduce this if your reduce your breathing
depth. [Obviously better to avoid them if you can, but at least now you can
cope when you have to.] Another example might be vacuuming or mowing
lawns this stirs up lots of dust and muck you can reduce the effect if
you suffocate a little while you are exposed. [Mouth closed of course!]
So, to summarize about sneezing
At the first sign of the warning itch in your nose that a sneeze may
be building stop your breathing, trap in some extra CO2, and try to make
the itch reduce. If you are too late to stop the first sneeze, try to stop the
next one. Do this by doing a Measurement Pause straight after the first
sneeze, and then breathing only just enough to stay alive. [Pretend there is
a really bad smell!!]
Do not try to hold a sneeze in if you cannot stop you may
implode [just kidding]. Just work on stopping the next one.
There is another benefit is stopping the sneeze cycle as soon as
possible. Each sneeze causes the release of more histamines which make
the whole area more sensitive. These chemicals stay in your face for quite a
while making even a slight breeze enough to make you itch. Once they
break down, the whole area in the triangle described above becomes less
- Page 126 -
APPENDIX 5
rom the moment I could read and understand, I have been fascinated by
science. It seemed to me that science would eventually solve all of the
problems of the world. The problems of the world included by own personal
battle with illness in the form of asthma, allergy, and hay fever. I have been studying these science problems first-hand since I was about 10 years old. There is
plenty of time to analyze when you lie in the darkness before dawn struggling for a
good breath.
For the first thirty years of my life I battled with asthma, as did most of my
family. Science would give us the answer soon. A new drug, an operation, or
perhaps even gene therapy would stop our disease. I studied biochemistry and
physiology at University to find all the clues. I then worked for multinational
pharmaceutical company to learn more about the drugs and the research.
Science appeared to be failing me. It could give me no simple theory or
cause for this disease. Everyone was looking into smaller and smaller detail,
looking at the very molecules and atoms that may be involved. Yet the problem
occurred in more and more people. There had to be an obvious, simple link
between our lifestyles and asthma because people often grew out of asthma.
It just went away.
There also had to be a link because some people did not develop the
problem until they were much older this implied that something other than
genetics was involved. Something we did caused the asthma gene to switch on
or off. I did not know what it was. I experimented with diet, which seemed to
help. I experimented with exercise, which seemed to help a little. Meditation and
martial arts also helped a little.
A little over 6 years ago, I found out about a Russian Professor called
Buteyko. His supporters claimed amazing relief from asthma and many other
diseases they even offered a guarantee. From the training I had received in
Science the impulse was to believe it was a fraud, which would soon disappear.
However, I was looking for a common link so I asked for and was given the
Biochemical Analysis of Buteyko Theory.
Hidden among the deep biochemistry was a very simple story. Every
person with asthma breathed a certain way, if their breathing was changed, their
symptoms would change. The breathing could make asthma symptoms appear or
reduce.
- Page 127 -
APPENDIX 5
APPENDIX 5
E-mail:
instep@beyond.net.au
- Page 129 -
APPENDIX 5
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