Improve your breathing without medications

Breathing is a basic life function and for most of us it goes on without thinking except when we have a chest infection or are tired after strenuous exercises like running or jogging.

If there is no underlying pathology most of us can breathe normally and it is ideal to have lungs which are functioning optimally to cope with stressful times. This article assumes that there is no underlying pathology and is for individuals who want to improve their breathing without medications. A follow up article, Improving breathing with medications, is already being produced and will be published in about one week.

Normal and Accessory muscles of Respiration.

Air from the exterior enters the lungs when the pressure in the lungs is less than the pressure outside. This happens when the intercostal muscles contract and raise increase the ribs upward. This increases the intrathoracic volume, consequently decreasing the intrathoracic pressure. So air will enter from the exterior to the interior, of the lungs, until the pressures balance out. This process is called inspiration.

Expiration occurs by recoil. When the intercostals muscles relax the recoil of the muscles compresses the thoracic cavity. The internal pressure rises and has to equalize. As long as all the airways are expiration will occur until the pressures balance.

When we have chronic obstructive airway disease our body tries to keep maximum oxygen saturation. Since there is obstruction (usually inflammation) the body has to put in extra effort to get air into the lungs. The body does this by using the accessory muscles of respiration include the neck muscles and the muscles of the nose. Hypertrophy of the neck muscles will make a client’s neck look short. When a patient is using his nose’s muscles, nasal flaring may be seen. Finally, sometimes patients use their lips to help them breathe – this is called pursing. Pursing creates a slightly higher PEEP inside the patient’s lungs. One other accessory breathing muscle is the abdominal muscle / diaphragm. Abdominal breathing is common in the elderly and patients who are acutely ill.

When we are standing up, our abdominal organs fall into the pelvic cavity. Therefore, it is easy for air to enter and exit the lungs. When we lie down, in a horizontal position, our intestines move by gravity to occupy a slightly higher position in the abdominal cavity. This movement actually hinders the movement of air, in and out of the lungs. In a healthy individual this may not mean much. However, in a patient who is barely meeting his oxygen need, this may be sufficient to tilt his health status. For this reason patients who become short of breath when lying down must be nursed sitting up in bed. Sometimes, patients who have problems breathing lying down, are best nursed in a Geriatric Chair. You will need to pay particular attention to their pressure areas. This is a short term solution until the underlying cause of the difficulty in breathing is found and treated.

Patients who have minor difficulties with breathing tend to elevate their arms naturally. This arm movement has the effect of increasing the intrathoracic volume, thus slightly more air than usual will enter the lungs.

Picture 1. Normal Healthy Lungs are better then the Best Lungs money can buy!

In hot weather the demand for oxygen increases because the metabolic rate goes up. Consequently, the individual’s respiratory rate goes up. So, if you are stressed out in hot weather, it may a good idea to cool yourself with a fan or in the cool breeze. You must be wondering, why I am not advocating drinking plenty of water. Read the next paragraph for the answer to this question.

Drinking clean water, is a good thing most of the time. I am cautious against this because if you are on fluid restriction or are in some degree of heart failure, then drinking water may make your situation worse. Excessive water, in patients with heart failure, will fill up the alveoli (small lung tissue bubbles) and make it difficult for gas exchange to take place.

Smoking? The choice is yours. Cigarette smoke contains tar, carbon monoxide, irritants, carcinogens and other poisons. Smoking increases the heart rate and increases the need for oxygen. It also increases the metabolic rate. Additionally, it irritates the epithelium of the lungs and paralyses the cilia (hair like structures which propel waste to the exterior). The not effect of smoking is that it increases the demand for oxygen but obstructs it from getting to the lungs and the tissues where it is needed. So from a breathing perspective, if you want to improve your breathing, you will need to give up smoking. Yes, I know of your grandfather, he smoked all his life, never had a cough or chest infection.

Exhaust smoke? Exhaust smoke contains irritants and carcinogens, just a little worse than cigarettes because it contains sulphur, lead etc. So avoid exhaust smoke as much as you can. It will also be helpful to avoid smoke produced by local vegetation burns. This smoke is just as bad for your lungs.

If you are allergic to pollen, dander, house hold dust, conifers or the dust mite it is best to avoid these. These allergens can enter your lungs, cause inflammation and cause broncho spasm or an asthma attack.

Doing exercises have many benefits. These increase the capacity of the lungs to exchange gas and also make the body more robust. Light jogging of about 6 to 10 minutes is very helpful.

If you are allergic to certain foods you need to avoid them. I have seen patients who unknowingly consumed peanuts (they were allergic to them) end up on a respirator. I am not in a position to know how many did not reach Emergency Department or the ICU.

If you are heavier than you should be than consider loosing weight. More weight means that your heart and lungs need to work harder to supply oxygen and nutrients and also work hard at removing waste material. The body has to transport the oxygen and nutrients through longer blood vessels. All this extra work means that your body needs more oxygen, therefore you will have to breathe harder. Loose weight and you will breathe easier too.

It is easier to breathe in humidified air because gas exchange can take place more easily. In extremely cold weather, it may be a good idea to humidify the internal home environment. Extremely dry air dries up the mucosa of the mouth and nose predisposing the patient to mouth and chest infections.

The consumption of alcohol paralyses the cilia temporarily. It is also a poison which is in part excreted by the lungs. It is for this reason that you are able to smell the alcohol on the breath of someone who has been drinking. So, as far as breathing is concerned, it is not a good idea to drink alcohol.

For years people in the UK have drinking cuppa after cuppa of tea. Until recently the reasons behind this habit were not clearly understood. Now it is known that tea contains a weal bronchodilator and hence the cuppa seems to help the breathing.

If you or your patient has a tracheostomy the air and oxygen should always be humidified because it is going straight into the lungs. If the patient is breathing spontaneously and is on room air then a humidification device known as a “Swedish Nose” must be used.

Breathing is more difficult in thin air. So if you are an asthmatic or have some other breathing problem you may want to live at sea level. You will definitely find it easier to breathe at sea level. If your breathing is really bad, and you have the money you can go down in hyperbaric chamber and relieve your breathing problems, temporarily.

A patient can measure his/her lung function using a peak flow meter. This is usually available in the GPs clinic or in the Emergency Department of your local Hospital.

A good pair of lungs is better than the best ventilator money can buy. So look after them. The next article will deal with medications which help to improve breathing. Breathing medications are usually prescribed by treating medical doctors and are patients specific.