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Disclaimers
This manual and the associated audio tape are general
information
products only.
This information should be used only under consultation with a
regis-
tered 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 ex-
pressly disclaimed.
There is no guarantee or promise that effects and relief, as
proven withpersonal 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.
A Special Warning for Diabetics
Please be aware that this breathing training will cause a
decrease in blood
sugar. This may cause any medication that is also taken [insulin
or oral
hypoglycaemics] to reduce blood sugar levels to lower than
recommended levels.
Should a diabetic undertake this training, it should be preceded
byconsultations with your doctor/endocrinologist.
The frequency of blood tests should be increased and the
symptoms of
hypoglycaemia [very low blood sugar which could cause coma]
should be
reviewed. It is not recommended that diabetics follow this
training without
supervision from an experienced Buteyko Instructor.
This Book is Copyright. Any unauthorised
use, copying, lending, or other transmission is forbidden.
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CONTENTS The Buteyko Method
Contents
FOREWARD 4
CHAPTER ONE 5
The Cause of Asthma
Evolution of the Atmosphere
Quick Review
Asthma Is Your Defense
CO2 is a Powerful BronchodilatorHow to Stop Coughing
Summary
CHAPTER TWO 16
How To Estimate Your Breathing Level
The Measurement Pause
Your Lungs Are Like the Carburetor On A Car
CHAPTER THREE 23
Your Nose Is For Breathing, Your Mouth Is For EatingDry
Lungs
The Best Reason to Keep Your Mouth Closed
CHAPTER FOUR 27
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
CHAPTER FIVE 39
Shallow Breathing To Tune Your Body
Definition of Shallow Breathing
Am I Doing It Properly?
The Everyday Training
Measure Your Progress
Record Your Progress
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CONTENTS The Buteyko Method
CHAPTER 6 46
Exercise Induced Asthma
CHAPTER 7 49
The Secret of Night Asthma
CHAPTER 8 57
The Effect of Diet On Your Breathing Health
The Need For Supplements
CHAPTER 9 62
The Link Between Asthma/Allergy
Attacks and Trigger Factors
CHAPTER 10 65
Clearing Reactions Coming Back To Normal
CHAPTER 11
What is depth of breathing 67
Childrens Asthma
CHAPTER 12 89
Asthma In Infants
CHAPTER 13 98
Emphysema
APPENDIX 1
Summary of Results of the Buteyko Clinical Trial 109
APPENDIX 2 113
The Importance of Carbon Dioxide
in Buteykos Theory
APPENDIX 3 118
Steroid Deficit in Asthma
APPENDIX 4 122
How To Wipe Your Nose
and Control Sneezing
AUTHORS NOTES 127
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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
issimple, easy to follow and implement. The basic material included
can be
found in any good medical text. Nothing is suggested that is not
com-
pletely 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 finishreading 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 Aus-
tralians 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.
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CHAPTER 1 The Cause Of Asthma
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The Cause Of Asthma
Despite 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, oryear 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.
Asthma occurs because you have developed a breathing depth
level
which is far in excess of the ideal, and your body uses
defensive
measures to force you to breathe less. These defenses include
causing
your airways to be restricted, and also clogging them up with
sticky
mucus.
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CHAPTER 1 The Cause Of Asthma
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The cause of asthma actually comes to us from prehistoric
times.
Follow through this story with me, as it will help understand
why the
problem arises. This section seems outrageous to some, but just
follow with
the simple explanation that it offers.
When we go far back into the past we find that the atmosphere
has
changed greatly in the past millions of years. There used to be
a very
different mix of gases in the air. The two gases we think about
in terms of
breathing are oxygen [O2], and carbon dioxide [CO2].
Over many thousands of years the amount of CO2 in the
atmosphere
has dropped from perhaps well over 40% to currently almost none.
[It is
actually now close to 0.03%] At the same time the amount of
oxygen [O2]
has increased from almost zero to around 21%.
Another Russian [with a similar name to Buteyko, called M.I.
Budyko],
in 1977 showed from rock samples that the level of CO2 in the
atmosphere
around 360 million years ago was 4.0%. I.e. over 10 times higher
than it is
now. The greatly higher CO2 levels in the past were due to
massive
volcanic action. Man was apparently not for several hundred
million years
after this time.
The drop in CO2 has occurred because there has been an
increasingamount of plant life on earth. Remember that plants
convert CO2 to O2, so
that the more plants there are, the more conversion of CO2 to O2
there is.
As the amount of plants on the earth doubled again and again,
this
caused a slow but steady decrease in the percentage of CO2 in
the air, and a
steady increase in the O2 percentage in the air. Remember that
this story is
spread over hundreds of millions of years.
Despite what recent history may have suggested to you, there is
no
doubt now that there are vastly more plants alive today on earth
than therewas millions of years ago. This explains the percentage
increase in O2 and
the decrease in CO2 over this time.
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CHAPTER 1 The Cause Of Asthma
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Graph of The Changes In
Carbon Dioxide and Oxygen LevelsVersus Evolution of the
Atmosphere
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 hadmassive 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, sotherefore 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
Millions of years
Atmospheric
CO2
Atmospheric
Oxygen
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CHAPTER 1 The Cause Of Asthma
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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
thelevel 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
main-
tained 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 The Cause Of Asthma
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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 itthinks 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.
Asthma Is Your Defense
As the amount of air breathed gets greater and greater, the CO2
levelgets lower and lower. If it gets too low, death will follow.
Some people
have the genetic ability to mount a defense against the loss of
too much
CO2. The bodies of these people can recognize that CO2 is
getting
dangerously low, and take actions to trap more in.
The best defense is to be able to simply restrict the airflow by
causing
the airpipes to swell. As less air is able to pass through the
pipe, more CO2
is trapped in. This is felt as the restriction or tightness of
asthma.
Because it forces you to trap in more CO2 than your breathostat
wants,
you will feel as if you are not breathing enough. This is why
the usual
response to asthma is to try and get MORE air in. The problem is
that the
more air you try to force in, the worse your defensive closure
of the airpipes
is going to get.
During an asthma attack you are already breathing vastly more
than you
need, but because your breathostat is maladjusted, it still
feels like not
enough. This means that the natural response is to try and
breathe even
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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
thebreathostat, 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 swellingwill 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 thanappropriate. 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 The Cause Of Asthma
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Carbon Dioxide Itself Is
A Powerful Bronchodilator
Another way to think about asthma is that if I reached into my
chest,
pulled out a decent length of airpipe, and put it into air that
had low CO2, it
would constrict. The smooth muscle in the walls of the pipe
would swell
and twist.
If I then put it into air with sufficiently high CO2 it would
open fully.
The smooth muscle in the airpipe walls would stop swelling and
twisting.
[I used to get severe asthma, now I dont. If I was to change my
breathingand lose all my CO2 again, I would see the return of my
breathing
restriction [asthma]. If I then altered my breathing to trap in
sufficient
CO2 again, the asthma would disappear again.] In the absence of
CO2,
smooth muscle goes into spasm.
The other symptoms of asthma are similar in action to the
broncho-
constriction [closed airpipes] discussed above. The other
defensive action
of asthma is to cause an increased production of mucus. This
increased
mucus secretion comes from the walls of the airpipes. [There are
glandsthere whose job is to produce mucus in class I call them
mucus
factories.] As every good plumber knows, what happens to the
airflow
when you pump sticky stuff into a pipe?
The pipe is clogged up, and the flow is reduced.
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 The Cause Of Asthma
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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 wecough, 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.
The More You Cough Deeply
To Clear Mucus,The More Mucus You Create
Resist the urge to cough, trap in more CO2 to reduce the
mucus
production, and your body will have no further need of the
mucus
and will clear it for you.
Every person I have ever seen with a bronchitis cough has been
able tostop 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 The Cause Of Asthma
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What they were not told is that your body has a very efficient
garbage
removal system. There are very large numbers of cells called
macroph-
ages 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 othermatter 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 spitor 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.
How To Stop Coughing
The key point here is that when you start to do this you may
feel a littleuncomfortable. In the past when there was a slight
tickle in your throat or a
feeling of lumpiness in your chest, you coughed and had short
term relief.
Now you must use your willpower to not cough at all if possible.
If you
absolutely must cough, you do one with your mouth closed. It is
a bit like
throat clearing before speaking. The air is released only
through your nose.
If there is some mucus right there, obviously do not allow
yourself to
choke. The goal is to not allow any more CO2 to escape than
necessary.
[Remember the more you cough, the more CO2 you release, the
more
mucus you produce, the more you cough.]
Within a short time of not coughing, and practicing shallow
breathing
[which we will learn later it simply traps more CO2 in.], you
will notice
the tickle has gone.
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CHAPTER 1 The Cause Of Asthma
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A little story about this relates to my partners father. He at
one time
was the caretaker of quarters for temporary accommodation for
children.
He had a simple rule that said that No-one is allowed to be ill.
He is a
caring old marshmallow, but could give the impression of a stern
militaryman. In their efforts to please him, the children would
suppress their
asthmatic [at that time called bronchitis] cough. Within a short
time even
the urge to cough would be gone, and the child would have
seemingly
grown out of it.
Coughing is often a very simple and effective way to get
affection and
attention for children. The mechanism is unconscious, but all
they have to
do is increase their breathing or run around madly with
uncontrolled
breathing, and the coughing or wheezing will start.
You may have seen children who become upset, carry on for a
while,
and then develop a really excellent asthmatic attack. This is
real asthma,
not psychosomatic, it can be dangerous and is often fatal.
There is a childrens instructional chapter that has been added
to this
manual. The rules are simple. They are not allowed to cough [the
dry
asthmatic cough], and must be very still and reduce their
breathing just as
the adults learn to do. A very effective asthma stopper in
children is be
very still, place their forefinger under their nose, and breathe
in and out insuch small breaths that they can hardly feel the air
from their nose on their
finger. [Breathe like a tiny little mouse] In a short time the
attack will
abate.
Obviously, you must use common sense in an emergency, and
follow
any medical regime outlined for the child. This technique should
be learned
by the child in a non-emergency, and be used at the first sign
of any
problems, to totally avoid the emergency situation.
In a large number of my personal cases, all that was required is
anexplanation to the child of the cause of the problem, a short
practice on
what to do if their throat gets tickley, and the general strict
instructions to
Keep your mouth closed and Dont Cough. [Unless they are
choking.]
This one session is often sufficient to stop all symptoms of
asthma. How to
clear a blocked nose to allow nasal breathing is covered
later.
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CHAPTER 1 The Cause Of Asthma
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Point Summary of theCause of Asthma
Our bodies use oxygen and produce carbon dioxide when we
consume energy. For our bodies to function we must have certain
levels of
both oxygen and carbon dioxide. Just as with oxygen, if carbon
dioxide
levels get too low we will die.
If the mechanism that controls our breathing level gets
unbalanced, it
will cause us to breathe more than the amount that would keep
our carbondioxide levels safe. Remember we breathe out carbon
dioxide rich air, and
breathe in air that is poor in carbon dioxide. So the more we
breathe, the
more carbon dioxide we release. If we release more than we
produce
our level in the body drops. If it drops too far we will
die.
To help stop this potentially fatal loss of CO2, some of us have
the
ability to automatically restrict our breathing by having our
airpipes either
constrict or be filled with mucus. Both of these will reduce the
amount of
air we breathe, and therefore trap in more CO2. Your asthma is
not a
disease, it is a defence against losing too much CO2 from
breathing toodeeply.
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 Estimating Your Breathing Level
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How To Estimate Your
Own Breathing Level
I
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.
The information in this manual is from the research of
Professor
Konstantin Pavlovich Buteyko, an eminent scientist and doctor
still working
in Moscow.
His early study as a medical student meant a project which
involved
measuring the breathing of fatally ill patients. His project was
to measure
their breathing as they approached death. This task, which seems
like a
ghoulish thing to ask a young man to do, gave Buteyko the
direction for his
lifes work.
His measurements showed that the closer the people got to death,
the
deeper their breathing became. It got to the point where Buteyko
could
predict with great accuracy the time of death, from days before
simply
by measuring their breathing. It seemed odd to him at the time
that the deep
breathing he was seeing on deathbeds was identical to that being
promoted
at the time [and still today by some misguided experts] to
developGOOD
health.
His later research asked perfectly healthy subjects to breathe
deeply for
a period of time. All of them became dizzy, nauseous, and
developed
symptoms such as wheeziness and coughing, and eventually passed
out.
The accepted theory at that time was that it was caused by
oxygen
saturation of the brain.
It was Buteykos research over the next decade, along with Bohr,
that
has changed the accepted theory. If you now ask any good
medical
student why these subjects responded in this way, they will say
it is
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hyperventilation [Breathing too much]. They will say that
hyperventila-
tion 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.
The Buteyko Measurement Pause
This is a simple way to determine the setting on your
breathostat.
By holding your breath you immediately begin to trap in all of
the CO2
you produce. When you have trapped in more CO2 than your
breathostat is
used to, it will make you have a desire to take a breath and
release some
CO2.
The key is to measure how long it takes for you to feel youwant
to take
a breath. This is not a measurement of how long you can hold on
for. If
you hold too long, the measurement will be inaccurate. You will
know
when you have held too long because your breathing after you
release your
nostrils, will be labored and you will gasp a bit. A simple way
to check is
to watch yourself in a mirror. If you look stressed when you
release youhave held too long.
The other important key to this technique is that you should
always start
with your breathing in the same place. You should be
comfortable, your
lungs not full or empty. A simple routine to get to this point
is to take a
normal [dont overfill] breath in, then a gentle breath out.
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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 breathyou must pinch your nostrils
closed,
or the gases will diffuse, and the measurement will be
affected.
So here is the procedure.
The Measurement Pause
1. Breathe in gently, not overfilling.
2. Release a small gentle breath,
3. Pinch your nostrils closed, and hold your breath. Note the
second hand
on your clock.
4. Hold only until you feel slight desire to take a breath.5.
Release your nostrils, and allow your breathing to begin. Note the
time.
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 outbreath that follows as a downward line :
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The time of breath-holding can be represented by a horizontal
line, ie no
breathing:
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.
The time in seconds from A to B is the Measurement Pause.
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 yourCO2, or you may find yourself having asthma. The
following diagram
represents the WRONG way:
Holding on too long causes disruption to the breathing which
isincreased. With a little practice the breathing after is the same
as before.
Activity
You should stop reading now and do a measurement
pause if you have not already done so.
A CB
A B
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The Meaning of the Measurement PauseThe measurement pause
measures the time in seconds it takes to trap in the
amount of CO2 which just exceeds your normal setting.
The length of the pause has been correlated with laboratory
testing and is
consistent.
The following table gives the measurements. Remember 6.5% CO2 in
your
lungs to close to the ideal.
Measurement Pause CO2 in Lungs [Alveoli]
60 Seconds 6.5%
30 Seconds 5.0%
20 Seconds 4.5%
15 Seconds 4.0%
10 Seconds 3.5%
Less than 10 Secs Less than 3.5%
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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How To Calculate How Much Too
Deeply You Are BreathingIt is a simple calculation to work out
by what factor you are
overbreathing. Divide 60 by your pause and multiply by 100%.
For
example a pause of 30 gives 200%. This means you breathing
enough for
two people. If your pause is 60, your factor is 100%, which is
just right. If
your pause is 5 seconds, your factor is 60/5 x 100% equals 1200%
or
deeply enough for 12 people. [Note that as the time gets really
smaller
this estimation gets less accurate. Just be aware that whether
it is 5 or 10
times too much it is far too much!]
[If your pause is that low then you are very unwell, and if you
are not
suffering symptoms of asthma, then review the Appendix Other
Effects
Of Chronic Low CO2.]
As a general comparison, if you were to eat two or four or
twelve
times as much as you physically need, what would happen to you?
Would
you be healthy?
Your Lungs Are Like The
Carburetor On A Car
Another analogy is to compare your breathing to a carburetor on
a
motor. A carburetor is the device which controls the mixture of
gases for a
motor. You will know that when the mixture is wrong, the motor
will run
poorly or not at all. If it does run with a non-ideal mixture,
the power will
be reduced, the economy reduced, backfiring will occur, and the
life of the
engine will be reduced. The only thing that can improve this is
to correct
the mixtures by adjusting the carburetor.
It is the same with your lungs. If you have the wrong mixture
of
gases in your lungs, your body will have low power, use too much
fuel, will
backfire, and will wear out much sooner. All you have to do is
tune your
carburetor. That is what Buteyko is going to teach you to do.
Your
respiratory centre or breathostat is the carburetor for your
lungs.
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CHAPTER 3 Using Your Nose & Mouth
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Your Nose Is For Breathing
Your Mouth Is For Eating
T
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 closerto 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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This moisture factor was also believed for a while to be why
asthmatics who took up swimming often benefited, whereas running
or
jogging less frequently seemed to help. This has been debunked
now by
further research.
Of course, you and I now understand why swimming is more
likely
to reduce asthma it alters your breathing pattern. You have to
stop
breathing for a while when your face is underwater, plus because
you are
burning
energy, you are producing more CO2, so you can train your
breathostat to
accept a slightly higher level. Swimming does not appear to help
some
asthmatics probably because they overbreathe even more as they
swim.
The other reason that your nose is for breathing is that because
thenasal passages are far smaller than your mouth, you are forced
to breathe
less. You have to work a lot harder to overbreathe with your
mouth closed.
You can still do it, it is just a little harder. In addition,
nasal breathing
allows the extra defense of the swelling of your nasal passages
to reduce the
airflow. The only reason you nose blocks up is because the
shortage of
CO2 causes the smooth vessels to swell, just the same as in
asthma.
If you keep your mouth closed, your nose will help reduce
your
airflow for you.
Note:
Your nose will not block completely
unless your mouth is open.
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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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
yourmouth 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 startto 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. Ifit 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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Goodbye To Nasal Sprays and Pills
You now have the ability to unblock your nose at any time
without drugs or surgery. If you follow why it blocks up, you
can
reverse the process. The same procedure will also dry it up.
The Best Reason To Keep
Your Mouth Closed
The final reason that you should breathe through your nose is
most
important reason to many. I find that the most compelling reason
for
teenagers and children is how you look when you wander around
with your
mouth hanging open.
Take a moment now to think about the movies. In a good young
peoples movie there will be a good guy, a main bad guy, and
usually a
herd of not-too-bright assistant bad guys. The main goodie and
baddieare smarter, and the actors who play them will keep their
mouths shut.
However, the actors who play the dumb ones will automatically
begin to
mouth-breathe. We will automatically subconsciously associate a
lower
intellect with an mouth hanging open.
Try it yourself. Pretend you are really stupid. Is your mouth
open or
closed? Now be cool [or whatever the current word is Rad? Kewl?
],
and close your mouth........or look dumb.
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Stopping Asthma
The Simple Answer
This section will give the instructions on the most effective
way tocorrect 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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The Drugs of Asthma
Warning and Disclaimer: Any and all advice, explicit orimplied
in this book or tape, is general information only. No
alteration
to any drug, or other treatment regime, should be undertaken
without
first obtaining medical advice. This information is designed to
be used
under medical supervision only. Do not alter your own drug
program
without checking with your doctor.
It is up to each reader to comply with any federal, state or
local
laws. The authors, publishers, and distributors of this
package
expressly disclaim any liability for the use or non-use of the
information
contained herein.
Before we go over the strategy to stop your asthma attacks, we
need
to first review the role of drugs. There are two basic classes
of drugs. The
general categories are Relief and Preventative.
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
eventuallyreleases 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
beta-
agonists. 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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terbutaline, fenoterol, and dozens of slight variations. Some of
this class of
drugs have been engineered to produce a longer lasting effect.
These
include ipratropium bromide (Atrovent), and salmeterol
xinafoate
(Serevent).
As doctors meet with failure to control symptoms, it is usual to
add
more and more of these drugs to your regime. It is simplest to
break the
drugs into length and effectiveness of action categories. If you
are on a
drug that is not listed, ask your medical advisor to guide
you.
Due to the way that these chemicals are marketed in different
parts of theworld, 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.
Salbutamol
inhaled through puffer
or nebuliser
Strong effect, works very
quickly
Drug Name
Speed and
Effectiveness of
Action
Length of
Action
Short-acting,
about 4 hours
Ipratropium bromide
inhaled
Theophylline tablet
Salmeterol
Xinafoate
Strong effect, works very
quicklyShort-acting,
about 4 hours
Weak effect, works
medium quickly
Medium
about 6 to 8 hours
Very weak effect,
slow to act
Varies
Medium to strong effect,
very slow to act
Long acting. Lasts up
to 12 hours.
Terbutaline inhaled
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What Relief Drugs Are
Actually Doing To You
You now recognize that the closing of your airpipes is basically
your
bodys defense against the lowering CO2 levels caused by you
breathing
more than is appropriate for the amount of physical work you are
doing. It
is your defense against your releasing more CO2 than you
produce.
So when you suck these chemicals into your airpipes, their
powerful
effect over-rides your defense, and allows you to breathe as
deeply as your
breathostat wants you to. It is a great feeling of relief when
the airpipes are
pushed open again, and you are able to go back to breathing many
timesmore air than you need. Aaaahhhhhhhh.
If you use a drug with a long action, you can breathe as much as
you
want all day. Almost no restriction at all. The only problem is
that after a
while, it may be days, weeks or years, your defenses will start
to get a bit
more serious about stopping the CO2 loss [which it knows is
fatal].
An Example of the Development of Severe Asthma
Lets follow the development of a typical asthmatic. Lets say he
had
a cough [bronchitis] during childhood, and probably some hay
fever. As a
teenager, the cough reduced, but was replaced by a restriction
in his
breathing, usually very early in the morning, or when he
exercised.
A worried parent took him to the doctor, who did various
measure-
ments, and said Asthma!. The shame of this was hidden, and
the
teenager instructed on the use of a puffer [lets say
relief-puffer]. At
the start, all it took was two puffs, every now and then, say
twice a week,and the wheeze disappeared like magic. Not too
bad.
Later in the same year, the winter was quite nasty. He found
he
needed to use the puffer more and more. His mother, having read
about the
increased death rate associated with high use of puffers
returned him to the
doctor. Ahh. said the doctor wisely, we will need to introduce
a
preventative puffer, as this has been shown to reduce the death
rate that
had apparently risen because of the increased use of the
relief-type puffer.
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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
goodhealth. 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
neededusually 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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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 youhave 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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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, andthe 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 systemi-
cally 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,
weightvariations, 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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The appropriate way to think about the use of steroids in asthma
is to
view them as a supplement to your own production. In very
simplified
terms, one of the effects of low CO2 on your body chemistry is
to change
the pH. With this slight change, the organs responsible for your
usualproduction [such as your adrenals], produce less than you
need. Two
effects of this are the extra sensitivity of your airpipes in
responding to
allergens, plus the allergic skin problems that often occur
alongside
asthma. You will know that the application of steroid cream to
an allergic
rash reduces the swelling quickly, but continued use [or
overdose] causes
changes in the skin texture.
Similarly, the use of inhaled steroids is useful as a
preventative for
asthma attacks. The placing of the steroid on the inside of your
airpipe
makes it less sensitive, and therefore less likely to react, and
therefore youwill need less bronchodilator. [This is good because
of the apparent
increase in risk as you use more and more bronchodilators. The
use of
inhaled steroids allows you to need less bronchodilator
medication.] There
is no suggestion here that inhaled steroids alter the internal
texture of your
airpipes.
In terms of the overall steroid production shortage, the use of
inhaled
steroids is not usually enough because of the low doses
involved. The dose
is so low that there is almost no effect on steroid levels
except in theimmediate area [the airpipes].
As the CO2 levels get lower and lower with increasingly
severe
asthma, the production of steroids gets lower and lower. The
shortfall in
the amount needed for health gets larger and larger. This is
seen as
increased asthma, despite the use of the inhaled steroids. There
is simply
not enough.
In these cases, the use of oral steroids in far greater doses,
makes up
for the shortfall in production. The main steroid that is in
deficit iscortisone. Usually your adrenal glands produce all you
need. If you
supplement your production with man-made cortisone [or variants
of it with
longer life in the body than human cortisone], the
hypersensitivity of your
body decreases, and you are able to reduce your breathing level.
This in
turn allows your blood chemistry to change, and your own adrenal
cortisone
factories to increase production again.
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CHAPTER 4 Stopping Asthma
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The problem of side effects occurs because people are
prescribed
more steroids than they are short of. So they end up with too
much in their
body. This helps to reduce the asthma quickly, but also quickly
begins to
affect other processes in the body such as bone formation. If
the overdosecourse of steroids is continued for a period of time,
this becomes a serious
problem.
For example, assume you are a severe asthmatic, and upon
seeing
your doctor it is decided that oral steroids are needed. Chances
are that
your doctor will start you on quite a high dose, and then reduce
over time.
Lets say you were the equivalent of 14 milligrams of cortisone
short. You
are given a starting dose of 50 milligrams. This means that you
are
overdosing by 36 milligrams. This will make you swell up, feel
awful, and
if continued serious problems like osteoporosis may occur. [It
even has theability to apparently cause schizophrenia.]
Lets review that. Your body normally produces heaps and heaps
of
steroids. This is good and necessary. When your chemistry is
altered by
continued overbreathing and the lowered CO2, there are changes
in the
body fluids which affect your glands. Less steroid is produced
than you
need, and your body becomes hypersensitive, and reducing
your
breathing becomes almost impossible. You will continue to
deteriorate until
the shortfall in your steroid level is made up. If you take more
steroids thanyou need, the extra amount will cause the side effects
that have made
people believe in the past that steroids are bad for you.
The ideal would be to take only the exact amount of steroids you
are
short of. It is very difficult to recover unless you have at
least this amount.
The goal is to have this amount and no more. There is a
suggested process
to this, but as it is not relevant to the majority of asthma
sufferers it is
covered in Appendix 3 Steroid Supplementation.
Note: Just because you have asthma does not
mean you have a steroid deficit.
It is a problem in only severe patients and not all of them.
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Strategy for Preventative Drugs
The simple strategy for preventative drugs is that if you are
stable on
your inhaled drugs, stay on them until you have had no symptoms
of asthma
for at least a month. At that time see your doctor, and follow
their advice
on gradual reduction. Because the actual doses in inhaled
steroids are so
low, there is no downside to their use, and their presence will
make
reducing your breathing a little easier.
If you are on oral steroids, please study Appendix 3 carefully,
and
ask your doctor to assist you to follow the strategy suggested
there. Do not
alter your dosages of any steroid medication without medical
advice. Until
your own steroid factories are back in full production it is
better to have a
little extra than be a little short.
How To Use Buteyko
To Stop An Asthma Attack
Do these steps at the first sign of yourattack if possible it is
easier to avoid an attack
than to conquer a full blown one.
Step 1. Think WHY your breathing is being restricted or
extra
mucus being produced. There is only one answer. Your body wants
you to
breathe less.
Step 2. Do shallow breathing at Moderate Shallowness as
shown
in the next chapter for 5 minutes. Resist the urge to cough, or
if you
absolutely must cough keep your mouth closed to minimize the CO2
loss.
Step 3. Do a Measurement Pause, followed by another 5 minutes
of
Moderate Shallow Breathing.
Step 4. Take one puff only of your short fast acting
bronchodilator
[eg salbutamol] if you need it. [If you do not need it, dont
take it. ]
Followed by 5 more minutes of moderate shallow breathing. The
shallow
breathing will improve the effectiveness of the drug.(GO OVER
PAGE)
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CHAPTER 4 Stopping Asthma
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Step 5. Only if needed, take another single puff of your
reliever.
Followed by another 5 minutes of shallow breathing.
Step 6. If you are still unimproved, proceed to use your
nebuliser[atomizer] loaded with your short acting reliever [e.g.
salbutamol] only.
Use the machine only until you have relief. As soon as you have
relief,
remove the mask from your face as you need no more of the drug.
Do not
finish it if you do not need it.
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 controlsimply 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
andbeing 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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follow the steps.
Do not take any unnecessary risks. If you know you are really
in
trouble, do whatever is necessary to save your life, go the
hospital orwhatever you do in an emergency. You can work your way
clear of asthma
a little later, but only if you are alive. The hospital is a
good place to
practice your shallow breathing if that is where you should
be.
Note that the instructions say to take one single puff, not two
puffs of
your reliever medication. You may only need one puff, if you
automatically
take two, you will never know. You can take the extra puff a few
minutes
later if you do need it.
Check with your doctor before altering any drug regime. He orshe
may not be very happy with this approach, but if they are worth
keeping
as your doctor, they will be extremely interested and will
support your
decision and give you extra observation or care to ensure you do
not get
into into difficulties.
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CHAPTER 5 Shallow Breathing To Tune Your Body
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Shallow Breathing To
Tune Your Body
W
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
breathingconsiderably. 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 hyperten-
sion.
Other factors that increase the breathing include lack of
physical work,
narcotics, and exposure to many chemical agents.
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CHAPTER 5 Shallow Breathing To Tune Your Body
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As your breathostat is exposed to greater levels of breathing
and lower
CO2 levels, it becomes conditioned to a lower level. Then
further deep
breathing, perhaps as part of a fitness or health training, can
turn it even
lower. This training effect continues until such a low
breathostat level isreached that your body takes defensive action
to avoid a catastrophe. In
asthmatics it restricts the breathing.
It is a relatively simple strategy to reset your breathostat by
exposing it
to higher levels of CO2 than it is used to. This is the opposite
of the
approach which lowered the breathostat CO2 level, which was to
expose it
to lower levels of CO2.
We want an approach that will:
a. Be easy and comfortable to do,b. Be able to be done anywhere
by anyone,
c. Be combined with other tasks so we do not need to take time
from
your busy day.
The most effective way to do this is to use an indirect
approach. This
means not trying to control the size or length of holding of
each breath, as
that requires huge concentration and very careful training. It
does mean
using simple muscle relaxation which will make the depth of
breathing less,
and requires no control of the rate of breathing which is
difficult.
The key instruction is simple and short.
Shallow Breathing is:
A gradual reduction in the depth of breathing,
by relaxing the diaphragm and breathing muscles,
until a tiny shortage of air is felt
and then maintained.
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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 tomaintain, 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
morestill 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 bedone 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
atiny
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 noreal need or desire to stop.
An alternative way to start your shallow breathing is to do a
measure-
ment 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 Shallow Breathing To Tune Your Body
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A Slightly Greater Shortage
of Air To Relieve Symptoms
One way to get the feeling of a small shortage of air is to
develop a
moderate shortage so you can recognize it. To get a moderate
shortage,
pinch your nostrils, stop breathing until a few seconds after
you definitely
want a breath. Ie hold for a few seconds longer than is
comfortable, and
keep your breathing as small as possible when you do breathe.
Maintain
this feeling of being a bit more suffocated.
You can actually feel the extra CO2 making you want to breathe
more,
but dont.
Use this the level of moderate shortage shallow breathing
when
trapping in extra CO2 to relieve symptoms.
The Everyday Training.
The goal is to recondition your respiratory centre to maintain
higher
levels of CO2 in your lungs. You do that by exposing this
breathostat toslightly higher levels of CO2 for as much of the day
as possible. So right
from the start, combine this breathing where you have only a
tiny shortage
of air, with other tasks. Whenever you read, drive a car, work
at a desk, talk
to your friends, go for a walk, have a shower, or do anything at
all, reduce
your breathing while you do it.
Make it habit whenever you get into your car, reduce your
breathing.
Open a magazine, reduce. Put the kettle on, reduce. After a time
it is
automatic.
As you read through this manual, develop a tiny shortage of air.
[Just
stop breathing and wait, when you feel the little shortage,
allow your
breathing to continue but less deeply by keeping your chest and
gut
muscles still and relaxed. Check at the end of each page that
the shortage is
still there. If it has gone, simply re-create it. No
problem.
If you go up a flight of stairs, reduce your breathing as you go
up, when
you reach the top, reduce a little further for a moment
[moderate shortage,
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just as for relieving a symptom.]
As well as this, always do some shallow breathing before sleep
and on
waking. At least 20 minutes until you are free of asthma.
Measure Your Progress!
As your breathostat gets used to higher and higher levels of
CO2, this
will be reflected in your measurement pause. Your pause will
also indicate
your asthma status. When your pause gets above 25 seconds,
asthma does
not usually occur. This figure can be as low as 15 for some
peoples asthma
to stop. [Mine stopped at 16]
Should I allow my pause to drop that low again, I would
develop
symptoms. Your goal with your training is to get your pause to
at least 45
seconds. Remember that 60 is the ideal. The higher your pause,
the greater
the buffer between you and asthma or other illnesses. The higher
your
pause the better your overall health and energy. 60 seconds may
seem like a
very long time at the moment, but once you start it will draw
closer and
closer.
You will notice that sometimes your pause will jump all over the
place.This is normal. It is the trend which is important in the
early days. If you
get an unusually high or low pause, just record it and see what
the next one
is.
Record Your Progress!
If you are experiencing regular symptoms it is very worthwhile
to
conduct formal practice sessions at least until the symptoms
have gone.
This is best done morning, afternoon, and night. The formal part
is thatyou record your scores. On a blank sheet or in a notebook
write the
following columns.
Date/time Pulse Measure Measure Measure Measure Pulse
Pause 1 Pause 2 Pause 3 Pause 4
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The Breathing Workout Workbook is also available. It gives more
detail
on how to structure your breathing sessions, plus more breathing
tips.
Fill in the date and time, take your pulse, do a measurement
pauseand write it in the M.pause1 column. Then shallow breathe for
10 minutes,
then take another measurement pause and write your score in the
next box.
Shallow breathe for 10 more minutes, another pause, and so on.
If you have
the time do 40 minutes [4 pauses], and finish with another
pulse.
If you only have 30 minutes, do only three pauses. Do as much
as
you can often as you can until your symptoms are gone. When you
are free
of symptoms you can just use your informal training to keep the
improve-
ment going, or you can keep doing the formal practice to
maintain your
momentum.
Formal practice means your record your scores, and follow
the
pattern above. Informal practice is done anytime, anywhere, with
no
recording. It is best combined with other activities that you do
every day.
eg driving, watching TV, reading, doing the washing. Combine it
with
everything!
This is the most important part in the long term. Once you are
free
of symptoms your habit of reducing your breathing while doing
other thingsis all you will need.
A simplified form of the formal exercise is the following:
Step 1. Take your pulse. [Count the number of beats in 15
seconds,
multiply X 4 ] . Write it down.
Step 2. Do a Measurement Pause. [Normal breath in, the small
unforced breath out, pinch nose, and hold until you want a
breath. Time
how long this takes in seconds. And write it down.
Step 3. Shallow breathe [means you want to take a slightly
deeper
breath, but continue to take less deep breaths.]
Step 4. Take a Measurement Pause, and write it down.
(TURN TO NEXT PAGE)
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CHAPTER 5 Shallow Breathing To Tune Your Body
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Step 5. Shallow breathe for 10 minutes.
Step 6. Take a Measurement Pause, and write it down.
Step 7. Shallow breathe for 10 minutes.
Step 8. Take a Measurement Pause, and write it down.
Step 9. Take your pulse again, and write it down.
NOTE: If your condition is severe, then it will be easier for
you to do
shallow breathing for 5 minute intervals instead of 10 minute
intervals.
Ensure you do not decrease the total time you spend with your
formal
practice because of this. Simply have more intervals and
MeasurementPauses. As you condition improves, increase the length
of interval to at
least 10 minutes.
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CHAPTER 6 Exercise Induced Asthma
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Exercise Induced Asthma
Alarge number of people only get symptoms of asthma during
or
after physical exertion. They go up a flight of stairs, or go
for a jog
and become breathless.
The key point from this manual is that there is only one way to
getasthma. 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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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
tokeeping 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.
Training Your Breathing For Exercise
It is simple to develop the situation where you never get puffed
or out of
breath.
The rules are clear.
Start off slowly at low intensity, such as a walk or march.
Your mouth must be closed, and you should develop a very tiny
shortage
of air by shallow breathing. [This is very easy when you are
walking]
If you start to feel you need to gasp through your mouth, you
must stop
immediately, reduce and control your breathing, and only then
continue.
Over a few sessions you will find that you can go further and
further
without getting puffed. When you can proceed at that intensity
for over 15
minutes, you can raise the intensity slightly, but follow the
same rules.
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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
yourbreathing.
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
immedi-
ately 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.
Close your mouth and neverallow yourself to puff and pant
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CHAPTER 7 Nocturnal Asthma
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The Secret of
Nocturnal Asthma
R
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