SOME THOUGHTS ON ASTHMA –
PART 2
In the first article I suggested a major factor leading to a higher rate of incidence of asthma in Western developed countries: indoor air pollution. Many people respond to polluted air by hyperventilating (breathing in excess air, mainly through their mouth). But here is what the book World of Chemistry (©2005-2006 Thomson Gale, a part of the Thomson Corporation) says is the human body’s response to hyperventilation: “…hyperventilation, or too-rapid breathing, can deplete the blood of carbon dioxide, leading to respiratory alkalosis…” (http://www.bookrags.com/research/blood-chemistry-woc/ ). The website http://www.btinternet.com/~andrew.murphy/asthma_buteyko_shallow_breathing.html observes: “During an asthma attack, people panic and breath too quickly. They actually overbreathe because they are breathing so rapidly, i.e. they are breathing in a far greater volume of air than normal. This causes the amount of CO2 in the blood to fall too low. The body reacts by causing the airways in the lungs to narrow and reduce the amount of air inhaled in each breath... which panics the patient into trying to breath even harder...” As this quote suggests, the body tends to react in various ways, like narrowing of lungs to try to reduce the amount of air inhaled in each breath. Other ways the body has to reduce the amount of air inhaled is narrowing of sinus cavities and secretion of mucus. As http://www.buteyko.ca/buteykomethod.html points out, “Physician Claude Lum noted that hyperventilation ‘presents a collection of bizarre and often apparently unrelated symptoms, which may affect any part of the body, any organ and any system’. Some of the symptoms of hyperventilation affect: The respiratory system in the form of wheezing, breathlessness, coughing, chest tightness, frequent yawning, sneezing, runny nose, congested nose, postnasal drip and snoring. The nervous system in the form of a light-headed feeling, poor concentration, numbness, sweating, dizziness, vertigo, tingling of hands and feet, faintness, trembling and headache, The heart, typically a racing heartbeat, pain in the chest region, and a skipping or irregular heartbeat. The mind, including some degrees of anxiety, tension, depression, apprehension and stress.” But some of these symptoms, like narrowing of lungs, narrowing of sinus cavities, and mucus secretion, can in turn lead one to hyperventilate (breathing through the mouth) all the more, in a vicious cycle.
That asthmatics have lower CO2 (carbon dioxide) levels than the healthy population is confirmed by the scientific evidence. For instance, the website http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7CVK-4CYNN92-1&_user=10&_coverDate=09%2F30%2F2004&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b25f502c14fbdc99f1490e703e1700d1 documents one scientific test confirming these conclusions:
“Results Mixed venous carbon dioxide levels in the students with asthma ranged from 5.08 to 5.71 kPa (mean 5.35 kPa), and in the healthy students they ranged from 5.62 to 6.45 kPa (mean 6.01 kPa). The mean difference in mixed venous carbon dioxide levels between the two groups was 0.66 kPa (95% confidence interval 0.28–1.03).
Conclusion This pilot study has demonstrated that a protocol using non-invasive mixed venous carbon dioxide measures is acceptable to people with asthma. It has also added to the evidence suggesting that asthmatic individuals have lower levels of carbon dioxide than the healthy population, even when they are stable and asymptomatic.”
Such lower carbon dioxide levels suggest that asthmatics have a hyperventilation problem that is leading to the asthmatic condition. Therefore, in order properly to address the asthmatic condition, one needs to address the hyperventilation problem, as well as the indoor air pollution problem that can often induce hyperventilation.
In 1952, Russian respiratory Professor Konstantin Buteyko discovered that the volume of our breathing has notable affects to our health. He came to realize the problems associated with hyperventilation, and he developed a technique for helping patients break their unhealthy hyperventilation habit. This is called the Buteyko "Shallow Breathing" method for controlling asthma, and it is very simply presented at http://www.btinternet.com/~andrew.murphy/asthma_buteyko_shallow_breathing.html . Here are excerpts from that website:
“"Buteyko" is a set of simple breathing exercises to help control asthma and other breathing disorders. Anyone can do it, and it only takes a week or so to master, and more than 50% of people with asthma will benefit from it.
Take 2 normal breaths, then breath out, and then see how long you can hold your breath for. Your goal is to be able to hold it for at least 60 secs.
Breathe, only using your nose, for 5 minutes. Take shallow breaths, using only your nose to breath through. Keep your mouth shut. Then take the "control pause" test again to see if your count has improved. Its that simple.
Hint: if your nose is blocked up, try pinching your nostrils together for a few seconds. This helps clear your nasal passage.
Repeat the "test - breath - test" routine 4 or so times in a row. It will take about 25 mins.
Repeat this training session 3 or 4 times a day, every day, for a week.
Don't worry if you miss a session or 2, but do carry on. Its increasing your 'control pause' test result that's the goal.
That's it. Its that simple. After a week, you should be able to breath out and hold your breath for a count of over 60 secs., and hopefully, your asthma will be much better.”
The website http://www.buteyko.ca/scientificresearch.html lists just some of the scientific evidence showing the Buteyko method works.
The website https://www.mja.com.au/public/issues/xmas98/bowler/bowler.html presents example scientific testing results showing the method works:
“In this largely self-selected cohort of asthma sufferers
with high medication use, those randomised to BBT
lowered their minute volume, reduced beta2-agonist use, and
demonstrated a trend towards lower inhaled steroid doses and greater
improvement in quality of life than did those randomised
to a control breathing program. No change in lung function was noted. To minimise the
effect of environmental influences and to maintain blinding, BBT and control
group classes ran simultaneously. This posed logistic problems not often
encountered in asthma intervention studies, where subjects are usually enrolled
sequentially over a substantial period of time, giving an opportunity to adjust
treatment. The need to complete randomisation for all
subjects before the interventions precluded comprehensive pre-study medication optimisation. Conventional teaching argues that
hyperventilation and hypocapnia are the result rather
than the cause of airway narrowing in asthma. Thus, increases in ventilation
are seen in normal subjects with methacholine-induced
bronchoconstriction.11
On the other hand, hyperventilation may cause bronchoconstriction.12,13
We could not show any change in ET CO2 in either BBT or control subjects; for both groups, ET CO2 remained significantly below that of normal individuals. MV was high (accepting a mean predicted resting MV of 5 L/min) in both BBT and control groups, and to a lesser (although statistically similar) extent in the normal subjects. Perhaps this may be explained in part by the use of a water-sealed spirometer, mouthpiece and noseclip, which have been shown to elevate tidal volume and respiratory rate.15 MV declined in the BBT group. Because MV and ET CO2 were measured at different times and on different devices, no direct correlation of MV and ET CO2 is possible.
What alternative explanations are there for the observed improvements with BBT? Both groups were contacted fortnightly by the research team. In addition, some of the BBT subjects who were experiencing difficulties with the technique were contacted frequently by the Buteyko therapist. We did not anticipate this contact, which leaves the study open to the criticism that the BBT group were influenced in ways the control group were not. The study clearly would have been stronger with matched, controlled phone contact between both BBT and control practitioners and subjects.
BBT might also have altered subjects' perceptions of asthma severity without affecting the underlying disease. This could account for the reduction in medication use and trends toward improvements in quality of life, and is consistent with the absence of any change in objective measures of airway calibre. On the other hand, the reduction in medication use in the BBT group did not lead to a decline in lung function, and rates of oral steroid use and hospital admission were similar in each group.
Reduction in beta2-agonist use itself might have led to an improvement in asthma control. There are suggestions that excess beta2-agonist use may adversely affect asthma control.16 To our knowledge, no study has suggested the converse, that reduction in beta2-agonist use may improve asthma control.
In conclusion, we found that those practising BBT reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without changes in objective measures of airway calibre.”
It really should come as no surprise to Christians that people should breath through their nose (and talk with their mouth). Here are a sample of verses from the Bible that testify to God’s design for each:
“And the LORD God formed man [of] the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.”- Genesis 2:7
“All in whose nostrils [was] the breath of life, of all that [was] in the dry [land], died.”- Genesis 7:22
“And thou shalt speak unto him, and put words in his mouth: and I will be with thy mouth, and with his mouth, and will teach you what ye shall do.”- Exodus 4:15
Besides trying the Buteyko method, there are some other things you might want to consider. One is a regular daily (except the Lord’s Day) exercise program providing aerobic exercise of at least 30 minutes. http://www.buteyko.ca/buteykoproducts.html points out: “Exercise enables the body to accumulate large amounts of carbon dioxide produced by metabolic activity; lack of physical motion means less activity and less carbon dioxide.” As noted at http://news.bbc.co.uk/2/hi/talking_point/4508365.stm , “Asthma suffers should keep fit and active according to advice released to mark World Asthma Day. Four out of ten people with asthma say their condition can stop them exercising, yet research shows that active people can control their asthma symptoms more effectively and enjoy a healthier lifestyle.”
Another was suggested in the first article in this series: taking measures to make sure your house is sufficiently porous to the outside air, so that there is sufficient air exchange.
Another is to avoid over-eating. As http://www.buteyko.ca/buteykoproducts.html observes: “Over-eating increases breathing because the body requires more energy to digest and process food. Instead of listening to the body and eating when hungry, as we have done for thousands of years, society now dictates at what time we should eat. In addition, we condition ourselves to eat more food than is necessary. How many times have you continued to eat all the food on your plate, or all the courses on offer, even though you didn’t feel hungry?”
Another is to re-consider whether bronchodilators as an asthma treatment are wise. To quote from http://www.buteyko.ca/buteykoproducts.html: “Professor Buteyko’s belief is that using bronchodilator drugs to relieve asthma symptoms causes hyperventilation. Bronchodilators relax smooth muscle and force open the airways, increasing the volume of air that can be inhaled with each breath. Steroids are preferable as a treatment because Professor Buteyko discovered that they reduce breathing. It is worth noting that increasing use of bronchodilating drugs during the 1980s corresponded with a significant increase in the asthma death rate.” The best scientific studies seem to corroborate Professor Buteyko’s opinion. For instance, the article “Meta-Analysis: Effect of Long-Acting ß-Agonists on Severe Asthma Exacerbations and Asthma-Related Deaths” at http://www.annals.org/cgi/content/full/144/12/904?linkType=FULL&journalCode=annintmed&resid=144/12/904 from the June 5, 2006 Annals of Internal Medicine notes these conclusions: “Pooled results from 19 trials with 33 826 participants followed for 16 848 patient-years showed that long-acting ß-agonists increased the risk for hospitalization for an asthma exacerbation, life-threatening asthma attacks, and asthma-related deaths compared with placebo. Hospitalizations increased among adults and children and with salmeterol and formoterol. The results of SMART were similar to the pooled results from smaller studies. In SMART, which followed 26 000 participants for 6 months, salmeterol compared with placebo was associated with a 2-fold increase in life-threatening asthma exacerbations and a 4-fold increase in asthma-related deaths (23)… Regular use of ß-agonists has been shown to increase bronchial hyperreactivity despite maintenance of some degree of bronchodilation (15, 65, 73, 81). These effects, along with a reduction in response to subsequent rescue ß-agonist use, may worsen asthma control without giving any warning of increased symptoms (15, 51, 73, 82)… In summary, long-acting ß-agonist use increases the risk for hospitalizations due to asthma, life-threatening asthma exacerbations, and asthma-related deaths. Similar risks are found with salmeterol and formoterol and in children and adults. Concomitant inhaled corticosteroids do not adequately protect against the adverse effects. The use of long-acting ß-agonists could be associated with a clinically significant number of unnecessary hospitalizations, intensive care unit admissions, and deaths each year. Black box warnings on the labeling for these agents clearly outline the increased risk for asthma-related deaths associated with their use, but these warnings have not changed prescribing practices of physicians (25). This information could be used to reassess whether these agents should be withdrawn from the market.” So in my opinion at least long-acting bronchodilators should be avoided, and short-acting bronchodilators should only be used when necessary. Better to go ahead and use steroids when bronchodilators can be avoided.”
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Another is to examine one’s tongue position. http://www.nosebreathe.com/mouthbreathing.html states the following: “Tongue thrust is natural in infants [infantile swallowing]. When the infant first starts to eat solid food, food spills out of the mouth. All mothers are aware of this because one must scoop the food off the lips with a spoon and place it back into the infant's mouth. Tongue thrust serves a useful purpose in infants because it keeps the tongue from falling back into the throat and help with swallowing because the oropharyngeal [throat] regions are growing at a rapid rate. At about six months, the infants start to outgrow the tongue thrust and start to place the tongue at the roof of the mouth [as found in normal swallowing] to help shape and develop the cranio-facial [head and neck] structures. This is done automatically as determined by genetic codes. [The early cranial development is vital for the normal development of the hypothalamus and pituitary gland. This is the "Master Switch" that controls and regulates the basic functions of the body. For protection, nature positions it deep at the base of the cranium] The rampant uses of pacifiers and sippy cups place the tongue low toward the lower jaw and prolong tongue thrust and encourage mouth breathing. Soon it becomes ingrained, and the habit is set for a lifetime… In normal swallowing [tongue placed at the roof of mouth], peristaltic waves are created that sends the bolus of food straight down the esophagus and into the stomach. Tongue thrust [infantile swallowing] does not generate normal peristaltic activity causing trapped air to be taken into the stomach and particles (mists) could be taken into the trachea and lungs from the partial closure of the epiglottis. Man swallows 2000 times a day. This is a lot of air that is being swallowed by mouth breathers. Eventually [long-term], pressure [excessive pressure] inside of the stomach [bloating] pushing against the esophageal sphincter [from the inside] will cause it to weaken and a leakage will occur [acid reflux results], mild at first. The continuous assault of stomach fluid on the pharyngeal lining [walls of the throat] will cause the throat to lose its elasticity and the resulting stiffness to the walls will cause it to collapse as found in moderate and severe OSA.” Some at http://www.nosebreathe.com/comments.html commented as follows: “I made a discovery last night about this "tongue suction" principle. I work at night in a casino and last night was my first night back at work since reading your web site a couple of weeks ago. I had been on vacation. Standing there working, and trying to apply my new knowledge about tongue suction and nose breathing, I found out just how much of a mouth breather I am. The new way of breathing was very uncomfortable for a while in the working environment. Then about half way through the night, I discovered the meaning of the terms "lip seal" and "tongue placement". As long as my tongue is touching the roof of my mouth, I can't breathe through my mouth. If I hold my nose and open my mouth as wide as I can while still keeping the tongue touching, I can't breathe. This was a profound discovery, because it made the whole principle much easier to apply. I think I will be able to retrain myself pretty quickly to breathe in this new way. Even so, I am thinking I probably should have ordered the two mouthpiece combo you offered. I have videotaped myself sleeping for two nights using the NB/HMB and the results are stunning. I sound like a little baby sleeping; compared to the scary loud sleeper I was before.” |
We are wisely to use means, while prayerfully walking with God in faith.