Video: A 3 Minute Diaphragmatic Breathing Bodyhack to Relax and Recharge

An example of a 3 minute diaphragmatic breathing rhythm session to show how you can switch your nervous system from constant low level fight or flight into complete relaxation in a very short amount of time. It feels fantastic and is the only automatic bodily function that we can consciously control quite easily, so it is a way of regulating the same nervous system that regulates our response to stress – the autonomic nervous system (ANS). And all other automatic functions – digestion, metabolism, elimination, detox, immune, all endocrine glands, mood, sleep cycles etc. etc. As such, it allows you to give your body a profound, internal rest and recharge as often as you want 🙂

 

Asthma is a Breathing Issue. And Breathing Retraining is BY FAR the Best Solution for Asthma

Breathing Dynamics for Prevention & Treatment of Asthma

Asthma is defined by the Global Initiative for Asthma as “a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing particularly at night or in the early morning. These episodes are usually associated with widespread, but variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment”.

Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in 1 second (FEV1), and peak expiratory flow rate. Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic).
Asthma is caused by environmental and genetic factors. These factors influence how severe asthma is and how well it responds to medication. The interaction is complex and not fully understood.

Studying the prevalence of asthma and related diseases such as eczema and hay fever have yielded important clues about some key risk factors. The strongest risk factor for developing asthma is a history of atopic disease (hypersensitivity or allergic diseases – eczema or atopic dermatitis, hay fever or allergic rhinitis; atopic conjunctivitis). This increases one’s risk of hay fever by up to 5× and the risk of asthma by 3-4×. In children between the ages of 3-14, a positive skin test for allergies and an increase in immunoglobulin E increases the chance of having asthma. In adults, the more allergens one reacts positively to in a skin test, the higher the odds of having asthma.

Research is also beginning to show a strong correlation between the development of asthma and obesity.

Asthma is probably one of the world’s most over-diagnosed and over-medicated ailments.

According to Associate Professor Colin Robertson, Respiratory Physician at the Royal Children’s Hospital, 80 percent of children diagnosed with asthma may have symptoms induced by exercise; therefore the community at large perceives asthma in a certain way. This can be positive in the sense that the problem can be easily recognised, however sometimes other respiratory conditions can mimic asthma.

Professor Robertson suggests, “Doctors, relatives and enthusiastic physical education teachers can mistake a child who exercises and gets out of breath as having asthma when they are actually just unfit”.

“This gets interpreted as Exercise Induced Asthma (EIA) but it doesn’t respond to anti-asthma therapy. What they need is breathing exercises to learn how to control it. It is a simple effective intervention and it is important for people to know that it exists”

Medications for Asthma

Medications used to treat asthma are divided into two general classes: relievers or quick-relief medications used to treat acute symptoms; and preventers or long-term control medications used to prevent further exacerbation.

Relievers which include Ventolin, Bricanyl and Spiriva are recommend to be used only for relief or tightness or breathlessness. They are adrenaline based so they increase heart rate and over use can be dangerous, or even fatal. Those who use relievers more than 3 times per week are considered being at risk and are recommended to cut back dosage.

As a result of these dangers, long acting steroid preventers were produced to suppress the immune reaction or inflammation and hypersensitivity in the body, and therefore reduce reliever usage. These medications are usually inhaled gluco-corticoid steroids and include Flixotide, Pulmicort and Alvesco.

A third group of asthma medications have now been developed that combine the reliever and preventer medications. These include Seretide (the most widely prescribed asthma drug in the world) and Symbicort. These combination drugs were produced as a result of dangers caused by the development of high-potency, long acting reliever medication which, as people were getting longer lasting relief, they often discontinued use of their preventer. After several hundred deaths (due to over-exposure to adrenalin), a solution was devised to combine preventer medication with reliever to prevent patients.

The problem with the combination drugs is that each puff of Seretide or Symbicort contains around 4-6 puffs of Ventolin. Given steroid preventers were developed in the first place to prevent patients using more than 3 puffs of reliever weekly (remember that more than 3 puffs per week were considered risky), these combination drugs actually increase the dosage of Ventolin to up to 24 puffs per day!!!

The irony of the medical approach to asthma and breathing difficulties is that, whilst these medications relieve symptoms in the short term, they can exacerbate or cause asthma and breathing difficulties in the long term.

For example, adrenaline based reliever medication opens the airways and relaxes smooth muscle which eases symptoms in the short term. But, adrenaline causes the breathing rate to rise which, over time leads to over-breathing.

And, steroid based preventer medication reduces inflammation in the lungs, reduces breathing rate on a short term basis and suppresses the immune system response, which results in less asthma symptoms in the short term. But, the suppressed immune system response leads to more colds and flus, and chest and lung infections – which, ultimately, result in over-breathing.

As we will see now, over-breathing plays a major role in creation of asthma and breathing difficulty symptoms, and correction of over-breathing is fundamental to reduction in symptoms and reliance of pharmaceutical drugs.

The Breathing Dynamics Approach

Note it is recommended you read many of the blogs on ‘Breathing Dynamics’ or ‘Respiratory Therapy’ on this website prior to reading this section, as the following is a simplified summary based on a knowledge of this theory.
The Breathing Dynamics approach to dealing with asthma is to look for the ‘root cause’ of asthma. It is not a disease as such – more a condition that can be managed.

Based on “The Bohr Effect” we know that low arterial blood levels of carbon dioxide (CO2) will lead to haemoglobin having a higher affinity for oxygen, and therefore O2 is not released into tissues for energy production. As a result of lower CO2 levels, the body will cause restriction in smooth muscle to prevent CO2 loss (and as a result reduced release of O2 into cells).

In asthma, this constriction of smooth muscle occurs in the airways and alveoli in the lungs resulting in inflammation and spasm in the respiratory system, and ultimately, breathing difficulties such as wheezing and shortness of breath.

We know also that over-breathing results in reduced arterial blood levels of CO2. So, it can be logically deduced, that over-breathing plays a significant role in the pathology seen in asthma.

Also, generally those who over-breathe tend to be sympathetic nervous system dominant (see general breathing notes), which produces the ‘fight or flight’ reaction in the body. This reaction causes a surge of adrenaline in the system and leads to a cascade of other reactions in the body including elevated heart rate, breathing rate and, amongst other things, elevated histamine levels.

Elevated histamine levels will promote or increase immune system hypersensitivity associated with asthma.

Therefore, in dealing with asthma via breathing retraining, we aim to correct over-breathing in order to:

  1. Elevate arterial CO2 levels – reducing smooth muscle constriction and spasm in the airways and alveoli.
  2. Balance the autonomic nervous system – (between sympathetic and parasympathetic enervation) to reduce adrenaline and histamine levels.

This is achieved by a number of techniques aimed at:

  1. Breathing through the nose at all times – including at night and during low level exercise (and even higher levels over time with training).
  2. Increasing brain tolerance to elevated plasma CO2 levels (via breath hold and breathing rhythm techniques) to allow the body to be comfortable with lowered breathing rates and volumes.
  3. Developing breathing rhythms using CapnoTrainer biofeedback technology aimed at maintaining elevated plasma CO2 levels and keeping the airways nice and open – therefore preventing the likelihood of constriction and inflammation in the airways and reducing elevated histamine and adrenaline.

Once developed, all of these techniques can be replicated long term, turned into one’s habitual breathing pattern, and offer not only prevention of breathing difficulties and asthma, but also allow optimal respiratory function. And once trained, the practice is free!!

There is now an overwhelming amount of evidence supporting the use of breathing retraining in the management of respiratory disorders such as asthma.

One study published in 2006 in ‘Thorax’ a highly respected International Journal of Respiratory Medicine, found that in a 30 month, double blind randomized trial of two different breathing techniques in the management of asthma, confirmed that both groups achieved an 86% reduction in bronchodilator reliever medication and a 50% reduction in the dosage of inhaled cortisone medication.

My clinical experiences in treating asthma using Breathing Dynamics or breathing retraining have certainly echoed these results.

To book in for a consultation to see Tim regarding the use of Breathing Dynamics to prevent or treat asthma, email Tim or call 0425 739 918.

 

Let Your Body Teach You How to Breathe Optimally Using Biofeedback

CapnoTrainer® Biofeedback Technology

Capnometry is the science of measuring partial pressure of carbon dioxide, CO2 (PCO2), during respiration. This is not new technology. It has been used extensively in hospital operating theatres and ICU’s. Because of the vital role of CO2 in respiration (see The Bohr Effect) and in blood chemistry (especially maintenance of correct blood pH), it is a medical necessity to monitor CO2 to ensure that they remain are in the correct ranges for maintenance of  ideal functioning of the body. The CapnoTrainer® is a small and highly portable capnometer that, via software provides real time information on breathing efficiency.

The CapnoTrainer® provides for a continuous measurement of PCO2 while breathing. As there is only 0.03% CO2 in atmospheric air we breathe it reads effectively “zero” on inhalation. During the exhalation it rises sharply to the average level of PCO2 in the alveoli of the lungs, rising very slowly during the transition from exhale to inhale (alveolar plateau), and eventually reaching a peak immediately prior to the next inhale. This peak is known as the End Tidal carbon dioxide (ETCO2). The waveform is represented via a live graph on a computer screen is known as a Capnogram. See below.

Better_breathing_applications_chart

ETCO2 in people with healthy lungs and a healthy cardiovascular system is highly correlated with the arterial partial pressure CO2 (PaCO2).

As previously mentioned The Bohr Effect states: “the lower the partial pressure of CO in arterial blood, the tighter the bond (or the greater the affinity) between haemoglobin and oxygen”.  So PaCO2 is the limiting factor in breathing efficiency. It will determine how efficiently the oxygen we breathe is released from our blood to our cells for energy production. The minimal PaCO2 required for optimal respiration and release of O2 into cellular tissue for energy production is 40mmHg.

ETCO2 measurements on the CapnoTrainer will give an immediate look at the efficiency of an individual’s breathing based on the principles of The Bohr Effect. Less than optimal efficiency of breathing can lead to a multitude of symptoms as a result of the body’s need to compensate for this reduced functioning. These compensations include hypoxia (reduced oxygen supply) in cellular tissue, constriction or spasm in smooth muscle and excessive mucous production. And apnoea.

Respiratory rate is also obtained through measurement of the time between the end tidal peaks (diagnostic norms for breathing rate at rest are 8-10 breaths per minute). The averages of both respiratory rate and ETCO2 are plotted on a history graph for real time review.

The CapnoTrainer® provides immediate and first hand biofeedback information to the observer about air flow and breathing efficiency. Gasping and other breathing irregularities can immediately be seen.

Not only does the CapnoTrainer® measure breathing efficiency potentially in a variety of situations or circumstances (due to its great portability), it is also a fantastic tool to train an individual to improve their breathing efficiency. The CapnoTrainer® software offers a number of training tools to improve breathing efficiency. It can also be used as a measurement to verify the effectiveness of training interventions being performed by an experienced breathing practitioner or trainer.

CapnoTraining® can be used to improve breathing efficiency to treat a number of ailments, as a preventative measure to prevent anxiety, asthma, snoring etc. or as a means of enhancing performance with athletes, artists and business professionals.

I have used Capnometry to assess and retrain breathing for many years and find it an essential and fantastic means of retraining client’s breathing to alleviate symptoms and ailments, and to perform at greater levels.

It simple, quick and mobile. Contact me if you like to investigate further.

Nose Breathing Improves Health and Performance by Increasing Nitric Oxide Levels

Use Your Nose to Relax, Be Healthier and Perform Better

In a recent blog, I discussed how diaphragmatic breathing helps to regulate the autonomic nervous system (ANS) that regulates all of our automatic functions, and our response to stress. In fact, emphasising certain phases of the breathing cycle (via the diaphragm) can dramatically increase the relaxation response.

Well, the story of the role of breathing in regulating or influencing the ANS goes even further, and the nose plays a major role as well as the diaphragm. This truly is a ‘wait, there’s more’ moment…

Relatively recently, a third subsystem of neurons that have been named ‘non-adrenergic and non-cholinergic’ neurons (because they use nitric oxide as a neurotransmitter) have been described and found to be integral in autonomic function, particularly in the gut and the lungs.
Nitric oxide has been found to act as a neurotransmitter, immune-regulator and vasodilator.
Some of the actions of nitric oxide include:

  • Regulation of blood pressure.
  • Boosting the immune system.
  • Fighting microorganisms such as bacteria and viruses.
  • Fighting cancer.
  • Increasing blood supply to cells.
  • Improving sleep quality.
  • Increasing gut motility.
  • Aiding in muscular control, balance and coordination.
  • It has also been suggested to protect against cardiovascular disease, impotence, diabetic retinopathy, Alzheimer’s Disease and Parkinson’s Disease.
  • Many athletes now use nitric oxide supplements to increase performance, as it increases endurance and strength.

Nitric Oxide Benefits

A recent study comparing nitric oxide production in nose breathing and mouth breathing found that the nasal passages produced a significantly higher amount of nitric oxide than mouth breathing did. In fact, 50% of exhaled nitric oxide is produced  in the nose. A further study found that nitric oxide is absorbed in the nose as well as being produced there.

Also, as exercise intensity increased, the levels of nitric oxide increased in nose breathing but not in mouth breathing.  So, it can be implied that, when under high levels of stress, nose breathing will offer stress mediating effects via nitric oxide that can protect against the deleterious effects produced by long term stress, whereas mouth breathing will not.

To learn how to regulate your autonomic nervous system by nose and diaphragm breathing, for greater health, performance or relaxation, contact me by email or phone. I offer breathing dynamics taining one on one, via video Skype or in group courses.

Breathing Away to a Dream Career.

Testimonial: A Fantastic Breathing Dynamics Success Story.

A great success story for a client who came to me after having been accepted into the RAAF, but failed a peak flow test, so he couldn’t be admitted. He had an opportunity again a few weeks later, so he came to me for breathing training.

The peak expiratory flow rate (PEFR) is a test that measures how fast a person can exhale (breathe out). This test checks lung functioning, and is often used by patients who have asthma.

Measurement of peak expiratory flow gives an idea of how narrow or obstructed a person’s airways are by measuring the maximum (or peak) rate at which they can blow air into a peak flow meter after a deep breath.

Peak flow monitoring helps measure how much, and when, the airways are changing. Due to the wide range of ‘normal’ values and high degree of variability, peak flow is not the recommended test to identify asthma. However, it can be useful in some circumstances.

“Breathing training went great. I managed to pass the test earlier today. Can’t thank you enough for your help. I’m certainly going to continue the techniques taught by you”.   Josh, Torquay

Similar to the BMI test for obesity, the peak flow test is a very crude measurement for breathing performance in that the test itself forces the recipient to over breathe, and therefore making them susceptible to symptoms of over breathing. Including constriction and spasm in the airways, as displayed in asthma.

Nevertheless, within a 2 week period, we retrain Josh’s breathing so that his body would accept a lower breathing rate and volume, and he was able to extend both the duration and volume of hos exhalation. The result being that he aced the test on the second occasion.

As such, Josh was able to be admitted to the RAAF and begin training for a career that had been a dream of his.

A great outcome, and a pleasure to assist a person chasing their dreams.

Not only can breathing retraining assist with many aspects of health or illness, it can also be fantasting in enhancing many aspects of performance.

Feel free to contact me via email or phone if you’d like to explore how improving your breathing can help your life.

 

 

 

 

Your Breathing Will Determine Whether You Are Relaxed or Anxious – It’s All Under Your Control!!

Diaphragmatic Breathing Helps You to Regulate Your Nervous System

Functional (or optimal) breathing using the nose and diaphragm plays a very major role in regulating the two aspects of the autonomic nervous system – the sympathetic and parasympathetic aspects. It serves to balance them. Something which, as observed from previous discussion, is not achieved by mouth or over-breathing which serves to maintain us in sympathetic nervous system dominance (or ‘fight or flight’ responsiveness) for most of our lives. As most of us have developed into over-breathers over our lives, this pertains to us all.

The diaphragm in particular, plays a major role in sympathetic/parasympathetic nervous system balance in two ways:

  1. Balance between the contraction and subsequent recoil of the diaphragm helps balance SNS & PSNS activity.
  2. The predominance or abundance of SNS and PSNS in different parts of the lung. 

Firstly, the contraction of the diaphragm on inhalation requires sympathetic nervous system input to fire the contraction and resultant flattening of the diaphragm which draws the lungs down and allows air to fill the lungs – particularly the lower lobes. The exhalation however involves switching off the SNS driven contraction of the diaphragm allowing it to return or recoil back to its original position. This is driven by PSNS activation which acts as a complementary opposition (in this case) to the SNS. As stated, it relaxes the diaphragm or switches off the contraction leading to the recoil or return of the diaphragm to its resting state.

Breathing Man Inhalation

 

 

Breathing Man Exhalation

 

Most over breathers use the accessory muscles of breathing as the dominant muscles of respiration, to the detriment of optimal diaphragmatic breathing. As such the diaphragm becomes weak or atonic and loses its flexibility. We have found via CapnoTrainerTM biofeedback equipment and general clinical observation that, over-breathers have most difficulty controlling their exhalation. It ends up being shorter in duration than the inhalation. Diagnostic norms suggest, however, that the inhalation:exhalation ratio is ideally 2:3, and therefore the exhalation is ideally 50% longer than inhalation.

As a result of this imbalance in the inhalation:exhalation ratio, the ANS becomes SNS dominant.

At Breathing Dynamics we focus on creating a balance between inhalation and exhalation, and therefore balance in the autonomic nervous system. The result of this nervous system balance can positively affect many other functions of the body that are under the influence of, or are regulated by, the ANS. For example, we regularly see positive effects from diaphragmatic breathing on:

  • The brain and neurotransmitter levels – Increased PSNS enervation naturally elevates serotonin and melatonin and, as such, we regularly see great results with anxiety & depression and sleep quality via diaphragmatic breathing retraining.
  • The digestive system – diaphragmatic breathing often yields great results with digestive complaints such as IBS, constipation and reflux. After all, a system that is sympathetic dominant will inhibit the digestive system, whereas, one that is parasympathetic dominant (via diaphragm breathing) will encourage it.
  • The circulatory system – allowing greater blood flow to the brain and peripheral areas, resulting in great benefits for headaches and migraines, cold extremities, skin quality etc.
  • The lymphatic system – as the diaphragm helps to act as a constant pump for lymphatic system – which is reliant on muscular contraction for flow.
  • The urinary system.
  • And more.

Secondly, as previously stated, mouth breathing originally (or from an evolutionary perspective) served as an emergency function in response to an acute stressor. Generally, the chest muscles are mostly used when mouth breathing (instead of the diaphragm – unless you have received previous training) which predominantly fills the upper and middle lobes of the lungs, and less so the lower lobes. The upper lobes of the lungs are rich in SNS receptors which, when activated, serve to accentuate the requirement of the body to respond in emergency fashion – or via a ‘fight or flight’ mechanism. This serves a specific function. An example of this would be when we gasp in response to being frightened or surprised.

But it was not designed to be our predominant mode of functioning.

On the other hand, when breathing uses predominantly the diaphragm (as in optimal breathing), the larger, lower lobes of the lungs are comfortably filled allowing for more gas exchange. And respiration is far more efficient. In addition, the lower lobes are rich in PSNS receptors which allows for a balance between the PSNS and SNS and a correction of our predominant ‘fight or flight’ functioning.

When breathing ‘diaphragmatically’ and through the nose it is common to experience relaxation and a calming of the mind. It also gives athletes greater access to ‘zone like’ or ‘alpha’ states during exercise or competition, which generally involve higher levels of PSNS activation than in normal waking states.

The table below shows a comparison in terms of effects between breathing with the diaphragm as the driver of respiration as opposed to predominantly using the chest muscles or other accessory breathing muscles. Whilst, not all of the points listed in the table are covered in the general information, they are covered when we introduce the ‘Breathing Dynamics’ optimal breathing rhythm in courses or via online training modules.

Diaphragmatic Breathing Breathing Using Accessory Muscles
Fills blood rich lower lobes of the lung first. Fills predominantly upper & middle lobes of the lungs.
Allows use of full lung capacity for gas exchange and removal of wastes.Creates a more rhythmic, reduces breathing rate via control of the recoil on exhalation.

Activates PSNS receptors in lower lobes. PSNS and SNS are balanced.

Full use of lungs compromised.
Breathing rate is elevated and rhythm is more random.Activates SNS stress receptors in upper/mid lobes and SNS dominates.
Stimulates ‘rest and digest or rejuvenate’ response. Activates ‘fight or flight’ response.
Diaphragm is strong and elastic. Diaphragm becomes weak and atonic.
Allows for relaxed, rhythmic and efficient respiration. Requires more work and higher breathing & heart rate to achieve efficient respiration.
Sinuses remain clear due to constant air flow through them. Sinuses become congested from discontinued use.
Facilitates lymphatic drainage and circulation to heart, lungs, ribs and chest via the ‘pump’ like action of the diaphragm. Lymphatic drainage and circulation to heart, lungs, chest and rib cage compromised.
The ‘Pump’ like action also facilitates efficient functioning of digestive organs (i.e. peristalsis), urinary organs and sexual organs all located in the abdominal cavity. Function of organs in the abdominal cavity compromised.
Ribs and chest allowed to move in their full range of activity and remain flexible. Ribs and chest become inflexible.
Thoracic spine remains flexible. Thoracic spine at insertion of ribs becomes stiff and rigid.
Neck and shoulders not overworked. Neck and shoulders become tight.

 

 

The World We Created Causes Us to Over Breathe

What is the Cause of Over Breathing?

I’ve already written about the importance of breathing to our health, the biochemistry and mechanics of breathing, what optimal breathing looks like and what it doesn’t look like, so it is now time to discuss the cause of dysfunctional breathing or over breathing.

In short, STRESS CAUSES OVER-BREATHING. More specifically, we become conditioned to respond to stress by over-breathing or mouth breathing as an emergency response.

Our innate response to stress is the ‘fight or flight’ state which is an evolutionary response to a perceived threat, and served to effect changes in our bodies that prioritise or make us more capable of ‘fighting’ or ‘fleeing’. For example, if a wild animal poses a threat to our safety, we choose to either fight or flee the source of this extreme stress. In this evolutionary example, the stressor either goes away either by us successfully fighting or fleeing the animal. Or we die. There was indeed an “emergency” that asked for a body/mind response that called upon all of our resources. With the removal of the stress, our physiology returns back to a basal level and we return to the tasks of living.

The modern stressors we deal with are, more often than not, far less threatening to our safety. Whilst the the sources of stress are often far less severe, due to the culture we have created being far different to the environment our bodies evolved or adapted to, they are far more chronic or long lasting. Unfortunately we do not often return to this basal low level (or zero level) of stress we predominantly existed in (outside of emergencies) in times past. As a result we reduce our body’s ability to deal with more acute stressors and we often regularly respond in ‘emergency’ fashion to stressors that do not require this response.

Nevertheless, the process of evolution has led to us responding to any stress in a way that has long been our mode of functioning, because that its what we evolved to do. That the severity and types of stress we now deal with are vastly different to those we evolved dealing with is not of consequence to the body. Our safety is far more assured than in previous times, yet our body still responds with this ‘fight or flight’ mechanism.

Our body’s innate stress response is driven by the ‘autonomic nervous system’ (ANS) – a part of our nervous system that controls the functions of our organs and many of our body’s functions (including respiration!!) which functions regardless of whether we are conscious of it or not; i.e. the functions it controls still operate whether we are awake or asleep. It comprises the sympathetic nervous system (SNS), which excites or arouses the body to prepare for the ‘fight or flight’ stress response, and the parasympathetic nervous system (PSNS), which calms the mind and rejuvenates the body. The sympathetic and parasympathetic divisions typically function in complementary opposition to each other.

A common analogy used to compare these two facets of the autonomic nervous system describes the SNS as the ‘accelerator’ and the PSNS as the ‘brake’. The sympathetic division typically functions in actions requiring quick responses. The parasympathetic division functions with actions that do not require immediate reaction.

The ‘fight or flight’ response to stress causes the sympathetic nervous system to dominate. Sympathetic nervous system dominance leads to the following changes characteristic of the ‘fight or flight’ response:

  • Adrenaline levels in the blood rise.
  • Over time, blood levels of cortisol increase.
  • Heart rate increases
  • Blood pressure increases
  • Blood is redirected from the digestive system to skeletal muscles
  • Breathing rate and volume increases
  • Triggers the burning of sugar and storage of fat.
  • Elevation of plasma levels of clotting factors and histamine.

When breathing rate and volume rise we over breathe. When we over breathe we lose too much CO2 and the blood becomes too alkaline. As a result, haemoglobin holds on to inhaled oxygen in the blood stream, cells become deprived of oxygen and we experience different symptoms.

Once this response occurs regularly enough it becomes a conditioned response or a habit. Over time, this adaptive response, originally designed as an emergency response to an acute stress, becomes our normal mode of functioning.

But, as humans we are born ‘obligate nose breathers’ meaning that we do not possess the voluntary ability to breathe through our mouths. Mouth-breathing, the most common example of over-breathing is a learned response triggered by our emergency response to stress.

For example, you will notice that newborn infants breathe quietly through their nose all of the time. However, if their nose becomes blocked they will struggle to get air into their lungs. As they have not learned the response to mouth breathe, they will begin to suffocate. As a response, they begin to cry which allows large volumes of air to enter the lungs rectifying the emergency. The infant then returns to its normal nose breathing.

When subsequent stressors arise they repeat this emergency response, until they become conditioned from a very early age to respond to any sign of stress with this emergency mouth breathing response.

In our modern world of chronic low level stress, mouth-breathing, originally an emergency response, becomes a conditioned response and a habit. And, eventually our normal way of functioning.

The parasympathetic nervous system, on the other hand, promotes a “rest and digest” response, thus a calming of the nerves return to regular function, and enhance digestion. Some of the functions of the PSNS are:

  • Increase in digestive system function.
  • Breathing rate and volume decrease
  • Lowering of the heart rate (or returning it back to normal or resting rates)
  • Lowered blood pressure
  • Reduced blood cortisol
  • Constriction of the pupil and contraction of the ciliary muscle to the lens, allowing for closer vision.
  • Stimulation salivary gland of secretion, and accelerates peristalsis, so, in keeping with the rest and digest functions, appropriate PNS activity mediates digestion of food and indirectly, the absorption of nutrients
  • Increase in blood flow to the brain
  • Increase in ‘happy’ neurotransmitters, serotonin and dopamine – low levels of these are seen in depression
  • Is also involved in erection of genitals
  • Stimulates sexual arousal
  • Increase in night time melatonin – promoting a more restful sleep.

If you observe the cascade of changes that are evident when we over breathe and are in ‘fight or flight’ responsiveness, you will see that this cascade of changes accounts for many of the pathologies that occur in a great number of the chronic ailments we suffer from in the modern world.  Which, in turn, points out that over breathing is not something that we should ignore or take for granted.

The Breathing Dynamics training program will teach you to beak the cycle of over breathing, and help to get out of habitual ‘fight or flight’ responsiveness.

 

How Would Optimal Breathing Feel to Your Body?

What Does Functional, or Optimal Breathing Look Like?

Normal breathing is defined as:

  • A silent, gentle wave pattern
  • 8-10 breaths per minute
  • Through the nose
  • Tongue resting at the roof of the mouth.
  • Driven via the diaphragm with minimal or no upper chest or shoulder movement
  • Yielding a tidal volume (volume of air in and out) of 4-5 litres per minute.

These diagnostic norms combined with the optimal concentration of CO2 in arterial blood of 40mmHg partial pressure (based on the previous discussion about the Bohr Effect), will ensure that the pH of the blood is maintained at its ideal levels (7.35-7.45), and result in optimal energy production in cells.

The respiratory centre(s) in the brain control breathing rate and depth and primarily use the concentration of CO2 in arterial blood (pACO2). pAO2 is also used in part (via receptors in the carotid arteries), but, as oxygen availability in cells is directly related to pACO2 (The Bohr Effect), CO2 concentrations remain the primary determinant.

A functional or normal breathing rate of 8-10 breaths combined with pACO2 of 40mmHg will allow for maintenance of pH in the ideal range of 7.35 to 7.45.

Therefore if pACO2 drops below 40mmHg, it follows that the breathing rate will have to increase to maintain this ideal pH range.

If the pACO2 remains below ideal for an extended period of time (as is the case with over-breathers or those with chronic breathing disorders such as asthma, snoring, hyperventilation etc), the brain will accept this as normal functioning and will adapt by establishing this elevated breathing rate as normal. So the respiratory centre(s) in the brain will now have a lower pACO2 as a ‘trigger point’ to re-instigate breathing via the diaphragm.

As mentioned earlier, the diagnostic norm of 8-10 breaths per minute translates to 12,000-14,000 breaths per day. Yet the average person breathes up to 30,000 times per day. This suggests that the average person breathes roughly twice as often as we are ‘designed’ to and, more seriously, that the average person does not meet diagnostic norms for breathing. And therefore, is not capable of breathing functionally or optimally due to habitual over-breathing patterns.

Indeed, our clinical experience has confirmed this. Using CapnoTrainer biofeedback technology, we have not found a single person, without previous training, capable of breathing at a level that is considered functional according to diagnostic norms. So we are all over breathers – both in rate and volume until we are trained to breathe functionally again.

Common sense, reinforced by research, suggests that performing a bodily function at a level that is considerably inferior to that which is found to be optimal (from an evolutionary perspective) will ultimately lead to a compromise in function, including pathology, elsewhere in the body.

For example, we all know that living with blood pressure that is significantly above or below what is the diagnostic norm for blood pressure (and, as such, the blood pressure our system was designed to function optimally at) will lead to serious side effects or pathology. Indeed, high blood pressure and low blood pressure are both medical conditions that are taken very seriously by the medical community.

Similarly, if insulin levels are constantly elevated compared to diagnostic norms (via elevated blood sugar levels), then diabetes can eventually be the result. Obviously, diabetes or hyper-insulinaemia are both treated as serious or chronic life threatening medical conditions that are in epidemic proportions in the Western world.

Yet, whilst it is common knowledge that most or all of us over-breathe compared to diagnostic norms, why is it that over breathing is not treated as a serious medical condition?

Perhaps because breathing is so central to our functioning at all levels of the body and in all systems of the body, the side effects of over breathing are not as obvious as they are with the above abnormalities in our physiology or biochemistry.

Understanding the problem requires an understanding of the current medical model and its origins.  The medical system which evolved to deal with the historically predominant threats of infection and trauma became a system which focuses its energy on acute treatment of distinct, specific diseases, seeking to eliminate a single causative agent, with the patient as a passive recipient of the ‘cure’.  We can see how this approach is out of alignment with the new wave of chronic disease.  Instead, these patients require long term management, of multiple, overlapping states of dysfunction, driven by numerous causative factors, with the patient being required to take the primary role in their own risk reduction.

The Breathing Dynamics program will retrain you to breathe at functional, or optimal levels. Your energy levels, sleep, performance, circulation, digestion, nervous system, and many other systems in the body will see the benefits of this….

Nose Breathe Your Way to Energy and Health

We Are Designed As Nose Breathers!!

In using the word ‘designed’, I am not talking about a grand design in a religious or spiritual sense. I am using this term to describe the outcome of factors that have contributed to how our bodies are both constructed and function, optimally. These factors are the evolutionary influences (environment etc.) that, over a million years and more, have led to us being what we are now.

As such, the respiratory system is designed for us to breathe through or nose (see diagram) via the following mechanisms:

Human_respiratory_system

  • The inside of the nose contains turbine like ridges, known as turbinates, which swirl the air into a refined stream most suitable for oxygen exchange.
  • The hairs in the nose filter inhaled air removing it of larger debris.
  • The mucous membranes in the nasal passages produce mucous that help disinfect (via lysosomes) other pollutants in the air we breathe.
  • Our sinuses produce up to 2 litres of mucous per day which serve to disinfect (as per the nose), humidify (as moist air is required in the lungs for optimal gas exchange) and heat or cool inspired air.

If we breathe regularly through our mouth, we by-pass the above processes leading to:

  • Poor gas exchange in the lungs as the air that enters them is not humidified.
  • As a result we also dry out and irritate sensitive lung tissue which produces mucous as a protective mechanism. This mucous takes up space in the lungs that would otherwise be used for gas exchange, and wheezing can be a common consequence.
  • As the air that we breathe is not filtered or disinfected of bacterial, viral and foreign particles, excessive immune system activation occurs in our tonsils, adenoids and sensitive lung tissue leaving us more susceptible colds, flu’s and respiratory tract infections.
  • The support that the tongue provides the upper jaw (to counteract the pressure exerted by the cheeks on the upper jaw) is removed as the tongue position shifts to the bottom of the mouth. This can lead to narrowing of the jaw and crowding of the teeth, especially during development.
  • Drying of the saliva in our mouths which disrupts the pH of the saliva, removing some of its antibacterial effect which can predispose to dental carries and upset digestion.

Moreover, we breathe up to 6 times the volume of air in, and subsequently out, when we breathe through our mouths. The deleterious effect of this is that it washes out the reservoir of 6.5% end-tidal (after exhalation) CO2, therefore disrupting our ability to achieve the optimal pH in arterial blood (7.35 via 40mmHg of CO2) required for optimal oxygen release into tissues (based on the mechanics of the Bohr Effect discussed in my last blog). 

This means that mouth breathing if far, far less efficient than nose breathing, resulting in reduced energy production, and it can contribute to many common ailments.

Most people mouth breathe far more than they are aware of – especially at night when they are sleeping, which significantly reduces the quality of their sleep and energy levels the next morning.

Mouth breathing is a very obvious example of over breathing. Other examples include sighing, yawning, coughing, snoring, talking too quickly, laughing and yelling.

 

Oxygen is Not The Limiting Factor in Breathing – It is Actually Carbon Dioxide!!

The Mechanics of Breathing and Your Breathing Potential

The entire premise of the training we do at Breathing Dynamics is based on the Bohr Effect. Christian Bohr, a Danish biochemist, won the Nobel Prize in 1903 for his discovery that “the lower the partial pressure of carbon dioxide (CO2) in arterial blood (pACO2), the greater the affinity of haemoglobin for the oxygen it carries” (in other words, the lower the partial pressure of CO2 in arterial blood, the lower the amount of oxygen released by haemoglobin to cells for production of energy). This discovery was named ‘The Bohr Effect’.

Restated – it is CO2 that determines how freely oxygen (O2) is released into the cells for energy production.

This means that, rather than oxygen, it is actually CO2 that is the limiting factor in respiration potential.

Indeed, whilst we have access to 21% oxygen in the atmosphere at sea level, we only use 5% (or less than ¼) of this 21%. So we have more than enough oxygen in inspired air for our requirements. It is how we use this oxygen that is important.

Interestingly, there is only 0.03% of CO2 in the atmosphere at ground level as it is used as fuel for respiration by plants. We actually make the CO2 we use as a by-product of metabolic processes (production of energy). This is either exhaled as waste or stored in the lungs.

The role of CO2 in the Bohr Effect occurs via its role in altering blood pH. The optimal pH for uptake of oxygen from inspired air by haemoglobin in the lungs is 7.45, whilst the optimal pH for release of O2 by haemoglobin into cells in arterial blood is 7.35. Therefore a drop in pH, or increase in acidity, is required between O2 being taken up into the blood in the lungs and being released into tissue or cells.

The presence of CO2 in our lungs, and subsequently our arterial blood, allows for this change in blood pH by being converted into carbonic acid in the blood. The minimal partial pressure of CO2 required in arterial blood to allow optimal release of O2 by haemoglobin into cells (at pH 7.35) is 40mmHg. In order to achieve this minimal partial pressure of 40mmHg we need to have a residual store of 6.5% CO2 in our lungs after exhalation. This residual storage of CO2 in the lungs then permeates back into the arterial blood to affect the drop in acidity to 7.35 for optimal release of O2 into our cells.

So how do we ensure we maintain this storage reservoir of 6.5% CO2 in our lungs that enables the pH shift in arterial blood, and therefore optimal release of oxygen into cells?

By nose breathing – at all times. 

In Breathing Dynamics courses you will learn to nose breathe and optimise the potential of The Boh Effect, meaning that you will also produce energy more efficiently..

BREATHING FOR LIFE – OR DEATH!!

Introduction to Breathing Dynamics – Why is Proper Breathing So Important

Breathing is the most central process of our functioning that we have direct conscious control over and the area where we can have the most influence regarding whole health.

Breathing is central to all life – we cannot live without it for more than a few minutes.

It is the one thing we do more than anything else – the average person breathes up to 30,000 times per day on average.

BUT did you know that:

  • The quality of your breathing affects the quality of your life?
  • And that most of us OVER-BREATHE – both in rate and depth? For example, diagnostic norms suggest that we should breathe 12-14,000 times per day rather than 30,000 times.
  • Do you know what it means to breathe OPTIMALLY?
  • The limiting factor in OPTIMAL RESPIRATION, and therefore OPTIMAL ENERGY FOR OUR CELLS, is not a lack of oxygen that we inhale? It is a lack of oxygen released into cells (due to low levels of carbon dioxide) caused by OVER-BREATHING OR DYSFUNCTIONAL BREATHING!!!!

So why do most of us take our breathing for granted?

Why do we accept less than optimal breathing function?

Perhaps, until now, we have not been aware of the link between dysfunctional breathing and symptoms of ill-health or disease. Some of these symptoms include:

 

Fatigue & Lethargy Digestive upsets – IBS, constipation, diarrhoea. Irritability Waking un-refreshed
Anxiety Allergies Shortness of breath Headaches/migraines
Depression & emotional disturbances Skin irritations – eczema etc. Breathing difficulties – asthma, wheezing. Sinusitis & excessive mucus production
High blood pressure Poor  concentration Night-time toilet trips Frequent colds & flus
Dental problems &/or deformities Memory loss Poor sleep or leep disturbances Muscular or nerve chest & pains

Also, very few of us are aware that we could make significant changes to our health, stability, posture, attention, composure and sleep quality by learning how to breathe functionally. In addition to reversing the symptoms of ill-health or disease mentioned above, some more of these changes include:

 

Enhanced energy levels Greater endurance & stamina Improved focus & concentration
Improved immune system function Improved blood flow to extremities Improved responsiveness to stressors
Better posture & stability Delayed lactic acid onset during exercise Greater access to “Zone” states during exercise/performance
More relaxed muscles/joints Better focus & concentration Enhanced happiness/self image
Improved flexibility Improved mood stability Lower heart rates

 

Breathing Dynamics aims to restore optimal or functional breathing and therefore maximise delivery of oxygen to cells (for energy) by offering a variety of understandings and techniques that encourage:

 

  1. Breathing through the nose at all times.
  2. Using the diaphragm as the principal or primary muscle for breathing.
  3. Regulating breathing rate and volume.

 

We offer breathing retraining courses for individuals and groups, which usually run for 8-10 hours (broken up into a few sessions) plus ongoing evaluation. These courses have a strong practical focus. To facilitate learning, we use CapnoTrainer® biofeedback technology, which gives an individual information on their own functioning from their own body’s perspective rather than just relying on coaching or feedback from a another person. By the end of the course we give clients the knowledge and understanding, both theoretically and practically, for them to be able to breathe functionally or optimally in many of life’s varying circumstances.

We also offer online modules (purchased via the online shop) on breathing retraining to optimize function and facilitate healing for a number of ailments and purposes. These include:

  1. Asthma
  2. High blood pressure/hypertension
  3. Fatigue
  4. Anxiety/depression
  5. Snoring/sleep apnoea
  6. Eczema/skin conditions
  7. Stress management
  8. Allergies
  9. To facilitate dental corrections
  10. Enhanced sporting performance
  11. Enhanced work performance – artistic and business.
  12. Ability to hold the breath underwater (specific to surfers etc)
  13. Breathing for yogis.

Book Release: ‘The Breathing Dynamics Solution to Snoring and Sleep Apnoea’

I am proud to say that I’ve written and published my first book. It is a full information guide and four stage course or training program on the use of breathing retraining as a solution to snoring and sleep apnoea.

Whilst the standard medical treatment for apnoea is a C-PAP machine, it is both expensive and annoying. As such compliance is very low – as low as 15% or less.

But there are more natural, and less expensive alternatives, and breathing being one of them.

As both snoring and sleep apnoea are both fundamentally a breathing issue at their core (or original cause – in most cases due to the mouth being open whilst one sleeps), breathing retaining provides a brilliant solution that is inexpensive and can be learned quite simply, even at home. And it doesn’t take long to see results.

Or, in cases that also involve rectifying an existing obstruction, it is an excellent adjunct to treatment options that look at this.

I decided to create a book/course on breathing retaining as I have found from several years of clinical experience as a respiratory therapist that, whilst most people take their breathing completely for granted, the vast majority of us fail to breathe according to medical diagnostic norms. And I have found time and time again, breathing retaining is an extremely potent method of creating solutions for many health problems and is excellent for both relaxation and performance outcomes.

I started with the subject of snoring and apnoea as it is so widespread and breathing retraining works so well in providing solutions. And the snorers or apnoea sufferers are not the only victims. Their partners, and even family, are often more affected that the actual snorers. And the snorers are often very averse to admitting their problem and seeking help.

I will write other books on a number of clinical and performance issues, including:

  • Asthma and breathing difficulties.
  • Headaches and migraines.
  • IBS and GIT disturbances.
  • Anxiety and depression.
  • Relaxation and stress management.
  • Sports and athletic performance.
  • Surfing performance (including breath holds).

I will also make these available as online, video courses soon.

For receiver of this newsletter, I will make the book/course available for $50.   The course provides the equivalent to 5 consultations with a professional as it is a comprehensive 4 step program designed to simulate how I would work with a client clinically.

Some clients still choose to work one on one with me, using the book as a background, for more personal guidance along the way. Especially given I train them using biofeedback control via Capnometry.

If you would like a copy of the course, please email me at tim@timaltman.com.au

Article: Asthma. “The End of the Beginning”

Asthma. “The End of the Beginning”. How to prevent the onset of an attack rather that treating it after the event?

Below is a fantastic article by respiratory physiologist, Roger Price, who taught and inspired me to be a respiratory therapist, on the natural, drug free prevention and treatment of asthma that gets to the ‘root cause’ of the condition rather than the medical approach of putting out fires. The breathing based solution is easy to learn and implement and does not take long to see results. The long term results, most of the time, see clients free of reliance on pharmaceutical medications to manage their asthma, and free of symptoms.

If it sounds too good to be true then read the article and read further on respiratory therapy on this website and you’ll see it’s the simplest and most logical solution to the prevention and treatment of asthma. And that’s exactly why it woks so well.

Roger is now based in the USA kicking goals as a health educator spreading the incredible value of respiratory therapy and breathing retraining as a fantastic solution (or co-solution) to many ailments, chronic health conditions and as a potent performance enhancement tool.

The article is published in the Journal of Lung, Pulmonary & Respiratory Research – Volume 3 Issue 2 2016.

Instead of linking it, I’ve copied the whole journal here – including references. It’s definitely worth a read for anyone interested in furthering their understanding of asthma and/or breathing retraining. I think it sums up the whole situation or mess associated with asthma, and outlines the solution beautifully.

I also included Roger’s Facebook summary at the beginning.

 

“For over 50 years I have been involved with people who have been diagnosed with “asthma” and have seen the industry grow from one or two simple ephedrine and theophylline based medications to a multi-billion dollar enterprise where Asthma – COPD medications now occupy 40% of the top 10 selling drugs on the market – creating an annual wholesale revenue of around $12 billion.  The reality is that nobody ever gets better – they just have their symptoms chemically controlled.  Attached is an article just published June 2016, in the Journal of Lung, Pulmonary and Respiratory Research JLPRR.  

 

Journal of ISSN: 2376-0060JLPRR 

Lung, Pulmonary & Respiratory Research

Review Article

Volume 3 Issue 2 – 2016

Asthma. “The End of the Beginning”. How to prevent the onset of an attack rather than treating it after the event?

Roger L Price*

Respiratory Physiologist and Integrative Health Educator, USA

Received: May 15, 2016 | Published: May 19, 2016

*Corresponding author: Roger L Price, Respiratory Physiologist and Integrative Health Educator, Breathing Well LLC, 1425 Broad St Suite B, Clifton NJ 07013, USA, Tel: (973) 778-9225; (505)331-1051; Email: 

Citation: Price RL (2016) Asthma.“The End of the Beginning”. How to Prevent the Onset of an Attack Rather than Treating it After the Event?. J Lung Pulm Respir Res 3(2): 00080. DOI:10.15406/jlprr.2015.03.00080

  Download PDF

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NOTE: The complex physiological and biochemical processes have been deliberately simplified in order to allow lay people to grasp the concepts without being confused by the pure science. What is essential is for people to understand ‘why’ and not necessarily to have to know ‘how’.

Author’s Note:

I fully accept that asthma is a potentially life threatening condition and strongly support the use of appropriate medication when required. What I do not support however, is the reckless abandon with which ‘puffers’ are prescribed and used, for everything from a niggling cough to fundamentally dysfunctional breathing – which has nothing to do with asthma.

How does an ‘asthma attack’ begin?

The first signs are usually tightness in the chest and difficulty in breathing.

WHY does this happen?

No matter which definition you use, nor which set of data are used as a reference, the message is always the same.

“Asthma is a chronic inflammatory disease of the airway causing the breathing tubes to narrow”

Again – one must ask the question WHY? What is the cause of the inflammation, how does it happen, and what can be done to prevent this?

But firstly, let’s look at some facts about ‘asthma’.

The following statement has been taken directly from the Website of the American Asthma and Allergy Foundation.

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WHAT CAUSES ASTHMA

“Since asthma has a genetic origin and is a disease you are born with, passed down from generation to generation, the question isn’t really “what causes asthma,” but rather “what causes asthma symptoms to appear?” People with asthma have inflamed airways which are super-sensitive to things which do not bother other people. These things are called “triggers.”

If this is true – where does the notion of “late onset asthma”, “hidden asthma” and “exercise induced asthma” come from?

And furthermore, why is it that in the vast majority of cases that I have come across in the 50 years plus, that I have been working in this field, very little – if any – family history is taken, relative to the incidence of asthma in parents, grandparents, siblings and children? The diagnosis usually relies on either spirometry, peak flow or provocation tests – and the outcome is predictable.

My understanding of the nature of heredity in asthma is confined to three specific areas:

  1. The bands of smooth muscle surrounding the bronchioles, are thicker, stronger and tighter than in people with no genetic tendency – and when these bands tighten – it is very difficult to get them to relax.
  2. The mucus producing cells in those with genetic asthma are larger and more productive, so on stimulation, will produce copious amounts of mucus – causing the wheezing.
  3. People with ‘heredity asthma’ usually have a far wider range of allergic triggers, creating an enhanced environment for problems to occur.

BUT this does not adequately answer the question as to what causes the onset of an attack.

If one looks at the structure of a bronchiole it is easy to see what happens when the smooth muscle bands go into spasm.

The airway narrows and makes breathing difficult.

What is it that triggers the spasm in the smooth muscle bands?

Surprisingly enough the main trigger is the sudden drop in Alveolar or End Tidal CO2. The moment the brain detects that the PaCO2 pressure is dropping and the pH of the respiratory system is heading towards alkalosis, it immediately acts to restrict further loss, by narrowing the bronchioles.

If the person persists in gasping, overbreathing and any other activity which continues to drop the ETCO2, then the mucus cells respond by producing copious amounts of mucus minimizing loss by further occluding the airway.

This is NOT a disease. It is a protective mechanism initiated by the body to prevent cell death from respiratory alkalosis brought about through hyperventilation/overbreathing.

The simple answer to a complex question is that it is primarily mouth breathing, or overbreathing/hyperventilation, that causes low CO2 levels, or hypocapnia.

Could you imagine a person sitting quietly in a chair, breathing gently through their nose, suddenly having an ‘asthma attack’? Unlikely. Most ‘attacks’ come through a sudden change in breathing patterns – usually accompanied by a rapid drop in ETCO2. Exercising with open mouth, crying, laughing, coughing – all lower ETCO2 – provoking bronchospasm – ultimately leading to a full blown attack.

According to a study in the UK published in January 2015, more than one million people in the UK have been misdiagnosed as having asthma. 1

In my own practice, in which I have certainly handled more than 10,000 ‘asthmatics’ over the years, less than 10% have required ongoing management with bronchodilators and corticosteroids. The vast majority have been able to lead perfectly normal lives just by learning how to breathe functionally.

This has been borne out in numerous trials, papers and reports – published in the cream of respiratory journals such as Thorax, Chest, and the main medical journals such as the BMJ, AMJ, MJA and others. See the list of published articles and trials at the end of this article.

So this calls into question the accuracy and validity of the current method of diagnosing asthma

The first fundamental law of scientific measurement states that the measuring methodology should not alter the parameters of the function being measured.

Considering the rapid effect that a sudden drop in ETCO2 has on bronchioles, causing almost an instant response, does spirometry and peak flow not provoke bronchospasm?

If that bronchospasm is provoked, and the patient is then nebulized in order to break the spasm, and the next reading taken when the airway is artificially ‘propped open’, where is the validity in the ‘diagnosis’ that the person has ‘asthma’?

The Gold Standard for Asthma Management

I remember only too well the sacrosanct command that if a reliever was used more than 4 times a week, asthma was out of control, there was a danger of heart problems developing from the over-stimulation brought about by the adrenalin-type action of the salbutamol, and that it was then ‘mandatory’ to use a steroid preventer to reduce the amount of reliever.

The main purpose of the inhaled steroid – and of course the systemic prednisone, was to suppress the immune response and reduce the inflammation to such a degree that it was no longer necessary for the regular use of bronchodilators, avoiding the associated side effects.

Contradiction One

If the use of a short-acting bronchodilator more than 4 times a week is deemed dangerous,where is the justification in giving someone 24 hour long-acting bronchodilator, which is the equivalent of 6-8 puffs of short acting beta 2 agonist, every day of their lives?

What has been suggested is that by altering the chain length of the beta-2 agonists, there is less of a “jolt stimulation” to the heart and a lower risk of an adverse effect. This is borne out by the warning that the long-acting beta-agonist (LABA) should not be used as a ‘rescue’ to address an immediate attack, as it can take up to 40 minutes before the effect is felt. The reasoning further goes on to explain that by using the long-chain drug there is a smoother and more sustained bronchodilating effect which has a lower risk.

But what about the effect of a 24 hour bronchodilator? There are numerous papers and articles written about the remodeling of the airway as a result of long-term (lifetime) asthma medication – and it is no secret that in many segments of modern medicine ‘iatrogenesis’ or as it is more subtly put, ‘unintended consequences’, have the potential to cause additional comorbid diseases.

Propping the airway open, in direct conflict with nature’s response to shut it down, has the potential to cause inflammation of the mucous lining. Is this perhaps the reasoning behind adding the inhaled steroid to the combination drug, to address the inflammation that was caused by propping it open in the first place? A little like the boy who shot both parents and then asked the judge for clemency on the grounds that he was an orphan.

Contradiction Two

Everyone knows that cortisone is given to suppress the immune system so that it will not react to, or reject foreign objects. This has been the standby of the organ transplantation industry for decades. Remember however, that in the case of cortisone saturation to prevent rejection, the patient was so at risk of bacterial or viral infection, that people had to be ‘hazmat suited’ before being allowed to visit.

If cortisone suppresses the immune system how in the name of any sensibility can it ‘protect the lungs’ during the cough and cold virus winter season, and even more bizarre, at a higher dosage?

Cortisone certainly helps to reduce the inflammation – but renders the user more susceptible to catching common infections – especially in the winter months.

Using the same general principle, in the same way that the ‘orthodontist’ accepts that the teeth are crooked and have to be straightened, that the ENT accepts that the tonsils are infected and have to be removed, the pulmonologist just accepts the fact that the airway becomes inflamed and has to be treated with steroids.

Just look at the definition of ‘asthma’ and it would appear that the inflammation is of an unknown etiology – usually an immune response to allergic triggers. That is VERY vague – just like saying that the ‘teeth are crooked’ or ‘the tonsils are enlarged’.

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What Is Asthma?

“Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.”

AND – how does this definition then correlate with that of the Asthma and Allergy Foundation of America statement that “Asthma is a disease you are born with?” The contradictions are bizarre and, quite frankly, embarrassing to say the least. What we have here is a concept that appears to be fundamentally flawed. Well… If the concept is fundamentally flawed, and you specialize in it, all you become is a specialist in a flawed concept. It does not make that concept any more valid.

Nowhere does it explain HOW and WHY the inflammation occurs – it just accepts that it is there and medicates it.

Why does the airway become inflamed?

The answer is so simple it is embarrassing. The airway becomes inflamed largely because it is subjected to a large volume flow of inhospitable air, and is simply not designed to be able to cope with this onslaught.

The air entering the lungs needs to be:

  • The correct volume
  • Filtered
  • Sterilized
  • Warmed/cooled to body temperature
  • Humidified so that the lungs are able to allow the gases to permeate (Henry’s and Fick’s Laws)

The NOSE is the perfect 4 stage filtration system, and in addition to the filtering process, nasal breathing stimulates the paranasal sinuses to produce and release Nitric Oxide, which is a potent antimicrobial as well as a vasodilator.

The adenoids and tonsils are the final stage of micro-filtration to ensure the quality of the air entering the lungs.

Surely it does not take a great leap of imagination to see that bypassing this sophisticated system, and breathing large volumes of untreated outside air, straight into the delicate lung tissue, could be the major cause of inflammation and infection?

The bypassing of the Nitric Oxide production/release removes a very powerful vaso/bronchodilator from the system, and the rapid loss of CO2 from the large volume of mouth breathing, is the main trigger for the protection provided by bronchospasm.

Does it make sense?

That if the bronchioles are shutting down in self defense, in order to protect the body, that propping them open twenty-four hours a day is self-defeating, and can only aggravate the condition further?

It is not possible that it is this very action that perpetuates the inflammation, and that is why ICS is added to the LABA to counteract the inflammation caused?

If the Gold Standard calls for the use of steroids to offset the overuse of bronchodilators, does it not make sense that reducing the need for bronchodilators will reduce the need for steroids?

In the face of all this ‘sense’ how can it be justified to increase bronchodilator use and thereby consign the patient to a lifetime of steroid medication – with zero chance of the ‘disease’ being ‘cured’?

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REWRITING THE RULES

It is no secret that ‘standards’ change under the observation and reporting of data which is collected on a routine basis. The SRG is a group of clinical pathologists who constantly review collected data and adjust the “norms” to reflect what is being noticed in pathology reports coming in from participating countries. 
(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769782/)

These corrected “norms” then become accepted as fact – and using the orthodontic profession as a prime example – end up drawing the conclusion that 3rd molars are no longer necessary in modern day life – and 28 teeth are now the “norm”. The fact that 3rd molars simply cannot erupt because the Western diet has largely removed the requirement of ‘chewing’ and resulted in under-developed jaws – is conveniently ignored, and wisdom teeth are ‘expected’ to be impacted and therefore require surgical removal.

COMMONPLACE BUT NOT NATURAL/NORMAL

Under the deluge of propaganda, advertising, TV promotion and pressure from representatives of drug and medical equipment companies, society has accepted that commonplace equals normal, and is unavoidable. In other words, crooked teeth are commonplace and have to be straightened. Inflamed tonsils are commonplace and have to be removed. High blood pressure is commonplace and has to be medicated.

The reality is that these things are commonplace, but are NOT normal or natural, and CAN largely be avoided by early detection and remediation.

As will be seen from the accompanying chart – Minute Volume – the amount of air inhaled and exhaled per minute – has always been accepted as approximately 6 liters per minute. Simple mathematical calculation, based on lung volume and respiratory rate, then shows that functional breathing at rest should be approximately 8-10 breaths per minute – breathing between 4-6 liters of air per minute.

Just remember, in 1930, before the start of WW2, the average minute volume was 4.5 liters/minute and at an average breath rate of 6-8 per minute.

With the advent of fast foods in the 1950s and onwards, minute volume and breathing rate steadily escalated to the present ‘accepted norm’ of 12 liters/minute and 18 – 20 breaths per minute.

That is Hyperventilation, and is not normal. Just because it is commonplace it means nothing other than there are a lot of dysfunctionally breathing people out there – contributing in no small measure to the epidemic of the awful Western disease called Average Health.

The physical structure of the nose, the airway and the lungs can happily accommodate this rate and volume, and functional breathing is silent – with no irritation to, or vibration of the tissues of the nose, mouth and airway.

This can ONLY be achieved through nasal breathing, driven by the diaphragm, and this is the way the body was designed to function.

Mouth breathing, with its accompanying hyperventilation, drags more than double the volume of air, unfiltered and non-sterilized, at more than twice the rate that the airway structure is designed to handle – causing localized and systemic inflammation – as well as severely disrupted biochemistry. This in turn leads to compromised and compensatory physical and postural behavior which in turn aggravates other functions of the body.

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WHY NOT PREVENT THE ATTACK FROM HAPPENING?

Why not teach people how to avoid an attack by not creating the conditions that cause one?

Numerous double-blinded, randomized, placebo controlled trials have proved – conclusively – that by changing breathing from high-volume, chest/mouth, to low volume nose/diaphragm, bronchodilator usage can be reduced by 86% and ICS usage by 50% – with absolutely zero side effects.

These trials have always been criticized on the grounds that they have not shown any improvement in FEV1. That is a total red herring and maintains the resistance to clinically trialed and proven facts.

The Tiffeneau-Pinelli Index – better known as the FEV1/FVC index was designed for restrictive and obstructive lung disease – where there is a degradation in lung tissue – such as related to pathological and degenerative diseases.

This is yet another example where a metric – designed to be used as a comparator, or indication of progress or regression, has become perverted and is used as an empirical diagnostic tool in a totally different environment. The FEV1 has no correlation with the triggers that cause overbreathing. All it attempts to do is measure the consequences of congestion/dysfunction brought about by provocation – and is therefore of dubious value in the context in which it is used, namely to discredit the numerous trials. I become very frustrated when I hear ‘holier-than-thou’ specialists dismiss these valid, clinically based, published and peer reviewed trials on the grounds that “it did not improve FEV1 – therefore it is of no value.”

ASTHMA IS NOT A DISEASE. It is a condition which only manifests itself when provoked. Remove the provocation and the condition is controlled.

THERE IS NO DOUBT THAT ASTHMA CAN BE LIFE THREATENING – but this is in a very small number of cases across the spectrum. Brittle Asthma is a reality – and people need hospitalization and extreme care when this happens.

What I am talking about is the extremely high percentage of misdiagnosed cases – due to a flawed diagnostic process – where the diagnostics provoke the condition. It is this very significant percentage – estimated at approaching 90% of those diagnosed, who are being over medicated, spending billions of unnecessary dollars on medication which they do not need, and potentially causing iatrogenic issues later on in life.

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THE SOLUTION

In the same way that a person can be coached in a sport so that they do not hurt or harm themselves, it is possible to coach people in how to breathe functionally.

Our diet and lifestyle are working against us – and the vast majority of people are in a state of constant stress.

This sympathetic dominance has them in a state of alertness all the time, and as a result of this Fight/Flight response, they are hyperventilating or overbreathing.

There are simple and effective ways of addressing this situation and teaching people how to return to normal breathing.

Massive Costs In Terms of Medication

Given that the diagnosis of asthma is so often incorrect, but the patients are still placed on ‘puffer therapy’, it is no wonder that the costs to individuals, as well as the system, are as high as they are.

In a recently published survey, by IMS Health: FDA, the top 10 most frequently prescribed drugs were listed by wholesale prices.  This means what was earned by the manufacturers, not what the consumer pays, which could be between 50% and 100% more.

Of the $38.2 billion dollars generated by these drugs, just on 40% – $11.7 billion – were for asthma and COPD drugs.

How much of this could be saved by reducing, or even eliminating the unnecessary usage – due to misdiagnosis?

There is no shortage of people available to teach, train and guide ‘asthmatics’ in how to prevent the onset of an ‘attack’. The ideal people are Occupational and Physical Therapists, and other trained, licensed and registered Respiratory and Manual therapists, as they have the correct training, understand the human body as a whole, and will readily learn the specialized skills required to teach people how to normalize their breathing.

‘Idiopathic-Iatrogenic’ – The final indignity.

There is no doubt that stress is one of the major drivers of breathing disorders. The Fight/Flight response instantly changes breathing rate, depth, dynamics and mechanics, as well as major physiological and biochemical responses, resulting in a multitude of changes throughout the body. Being in a state of constant stress, as a large percentage of “asthmatics” are, maintains a level of sympathetic, or cortisol dominance, and a reduction in the time spent in parasympathetic recovery.

Inhalation drives the sympathetic and exhalation drives parasympathetic responses, and the ratio should be roughly 40% to 60%, thereby allowing the person more time in recovery mode than in excitation mode.

Most people’s breathing patterns are reversed – with longer inhalations and shorter exhalations – due to the brainstem response initiating the next inhalation before the full exhalation has been completed. This is as a result of many years of dysfunctional breathing causing the medullary trigger to ‘kick in’ earlier than it should.

To take someone who is in a constant state of adrenalin/cortisol dominance, and place them on permanent long-term, 24 hour medication, with a combination drug whose components are long-term beta-2 agonists and inhaled corticosteroids, can only aggravate this condition and consign the sufferer to a lifetime of the iatrogenic ‘stress-symptom-stress-symptom’ cycle. This then completes the idiopathic-iatrogenic loop of “I don’t know what is causing it”, and, “what I am doing is actually making it worse”

There is a better way to manage this ‘pandemic’.

Go to…

 

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Breathing Dynamics Course for Surfers and Sports People

Breathing Dynamics Course for Surfers and Sporting Performance at One Lifestyle, RACV, Torquay. Starting Wednesday 14th October

I am excited to be offering an 8 week Breathing Dynamics course for surfers and sporting performance on a Wednesday evening at RACV Torquay resort.

Breathing has been described as the ‘last frontier’ of exploration of sporting performance.

Most people do not realise that they breathe at only 50-75% of their physiological and biological potential at best.

More and more research has started to come out suggesting that if we unlock this unused potential we can experience many benefits for sporting performance, including:

  1. Great use of full lung volume for gas exchange.
  2. Ability to operate at lower breathing and heart rates at higher levels of exercise.
  3. Greater efficiency of oxygen to cells for energy production.
  4. Ability to hold the breath for extended periods of time.
  5. Delayed lactic acid onset and greater buffering of lactic acid.
  6. More relaxation during exercise.
  7. Greater access to ‘zone’ states during sporting performance.
  8. Increased core stabilisation via diaphragm control.

The course will suit both water based (surfers, swimmers, paddlers etc.) and land based (cyclists, runners, football players, yogis etc.) as we will mix up activities.

Both members and non-members of One Lifestyle at RACV Torquay are welcome to participate.