Profile:

Rickie Bishop MCSP SRP
Rickie qualified in 1970 from Bath School of Physiotherapy. After hospital work, she moved to work in a special school in Bexhill-on-Sea where her interest in breathing exercises and rehabilitation for asthma started in 1979 with children. [more]

Take control of COPD

1 Quit smoking

NHS Stop Smoking Services Helpline: 0800 169 0 169

http://www.givingupsmoking.co.uk/nhs_sss

2 Use your inhalers correctly - check with your nurse

3 Keep fit and active - see below

4 Eat a healthy diet

Breathing advice for breathless people

HOW TO BREATHE WELL

Breathing is essential for life and yet many people do not breathe correctly and can suffer great distress as a result. The main purpose of breathing is to absorb oxygen into the bloodstream. We also expel carbon dioxide with every out breath.

To check your own breathing, sit in a comfortable chair and relax with your shoulders down. Place one hand on your tummy just above your waist and take a normal sized breath in and out again. If you feel your tummy swell gently as you breathe in, you are breathing correctly and should continue to breathe in this way for another 2 minutes to make sure of it.

Normal breathing should make your tummy swell and flatten about one inch for each breath. Most people take between 12 and 16 breaths in a minute, so it takes 4 or 5 seconds to complete each cycle of breathing in and out again. Try breathing in for 2 seconds through your nose then out for 2 or 3 seconds each time.

HOW TO CONTROL YOUR BREATHING

If you found your breathing was not correct then spend 2 minutes in each hour practising with one hand on your tummy, to train your body to remember how it works. After a day or two, you should find it is getting easier. Then you can start to practise good breathing with activities such as walking.

WALKING WITH GOOD BREATHING

Start by standing still and breathing well then start to walk slowly on a flat area and check that you are still breathing well. Once you have found a comfortable pace that keeps your breathing well controlled, you can try the same thing on slopes or stairs, but you may need to halve the pace you can walk on the flat.

If you become breathless, stop walking and rest leaning forward on your forearms to support your body, and focus on breathing with tummy movements until the control comes back. You can breathe correctly at any speed your body needs to.

If you find daily tasks like washing and dressing cause breathlessness, modify the speed of all activities so that you can do them more comfortably, and use your good breathing control throughout everything you do. It is not necessary to rub yourself dry after a bath or shower, you can just wrap yourself up in a couple of towels and sit down until you have 'blotted dry'. Sit down to get dressed and keep breathing whatever you are doing. Often people get breathless because they have forgotten to breathe!

KEEPING FIT FOR AN ACTIVE LIFESTYLE

It is important to realise that being breathless is a normal part of everyday life. As we grow older we tend to be less active and find ourselves getting unfit. You will notice this because you will feel breathless when doing things you have not done for a while such as dancing or digging. It is tempting to avoid these activities thinking it may be harmful. In fact the opposite is true. By avoiding exercise you will become less and less fit and find you cannot do anything without becoming breathless. By exercising regularly at a pace that makes you moderately breathless, you will keep fit, active and happier!

CLEARING YOUR LUNGS OF SPUTUM (Active Cycle of Breathing)

It is important to keep your lungs clear of excess secretions as this allows good exchange of oxygen and carbon dioxide and keeps you free of infection. If you need to cough up sputum use the following technique:

  • Sit or lie in a comfortable position.
  • Use your good breathing control for about 4 breaths.
  • Take 2 or 3 extra big breaths feeling your lower ribs expand above the waist.
  • Return to breathing control.
  • Take a medium sized breath in and blow, firmly squeezing the air out of your lungs. This may make you cough, if not, repeat the 'huff' once more and spit if necessary. This will avoid painful coughing.

Return to breathing control, and if needed repeat the process above until you have cleared excess secretions. If you do not manage to cough anything up, leave it for a while and try again later. Over enthusiasm does not help to clear secretions, but rather blocks them in.

In certain cases it is necessary to use special positions to use gravity to aid clearing of sputum. As a general rule, if the sputum is in one side of the chest, that side needs to be placed uppermost so that the airway from that lung is pointing downhill. Therefore lying on the Left side will clear the Right lung and vice versa. If you are not sure where the sputum is, you may be able to tell by placing your hands on your ribs when you 'huff'. You can sometimes feel a rattle where the sputum is vibrating as you blow; wherever that is, sit or lie with that area of your chest uppermost and it should help to clear it.