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optimistic, for once in my life (!) - helen-louise
baratron
baratron
optimistic, for once in my life (!)
Hmm. I have had half a day of trying to breathe at 1/4 my usual rate, and I am in substantially less pain. There might be something in this.

To answer everyone's questions at once: the reason I feel as though I'm suffocating is that I've been breathing quickly and shallowly my entire life. This is why it's hyperventilation occulta - the hyperventilating isn't obvious even to me. It's not like the kind of hyperventilating when you panic, so breathing into a paper bag isn't going to help - it's hyperventilating over months and years, not minutes. I have to completely retrain my muscles and/or lungs to do something different.

The reason for my physical fatigue and muscle weakness is that for months and months now my muscles have been not getting enough oxygen, thus respiring anaerobically, and thus building up an excess of lactic acid. Most people are familiar with lactic acid buildup from exercising - well, this is like that on a grand scale. You get into a pattern whereby you breathe incorrectly and start to feel pain because of it, and the pain stresses your body and makes you continue to hyperventilate, and this spirals and spirals until it's completely out of control. I was rather unconvinced by the diagnosis because it seemed to be trivialising the problem, but the resources I've found about chronic hyperventilation syndrome suggest that yes, it's a very real problem, and if it goes on for long enough it can be as disabling as the problems I've had.

My doctor was quite pleased to make the diagnosis because he's been puzzled for years (since I've been seeing him) as to the cause of my joint pain and stiffness, when various physical tests have come back negative. When you are chronically ill, you go to see the doctor every month or so for them to try tests and see how different drugs have worked, and each time you only talk about the symptoms which are most troubling at that time. Over a many-year illness, all the symptoms are there in your medical notes, but in a 15 minute appointment, the doctor doesn't have time to go back through it - 8 or 10 or 13 years of illness, seeing the doctor every month - that's a hell of a lot of notes! So it wasn't until I typed all the symptoms out together that it was obvious. Apparently.

He said it explained 90% of my symptoms - basically everything except me always having a cold and the allergy stuff. Well, poking about online, I discover that when you are in this pattern of crappy respiration, the histamine level in your blood rises. Now, most allergy medicines are anti-histamines - I'm not amazingly sure what a histamine is, but I know it's implicated in allergies. So that could be connected too. Also, me always having a cold - if I'm breathing through my mouth too much, I'll be taking in a lot more germs, because the mouth is much less good at filtering air than the nose. Hrm. The other thing that's interesting is that I have become more and more ill since I've been working for the market research place. Now, if all my problems, or 90% of them, are linked to my breathing, being on the phone all day could explain how they've got worse and worse - because when you're talking constantly, you do a lot more shallow mouth breathing. I know a couple of times when I've been at work, especially recently, I've found myself having to take a toilet break just to go somewhere and breathe slowly for a couple of minutes because I've felt dizzy from lack of oxygen, and I get through Olbas inhalers at a ridiculous rate because talking too much with a blocked-up nose makes me nauseous.

The other other thing is that in some of the articles I've read about chronic fatigue syndrome which have talked about it actually being a catch-all term for a huge variety of problems, chronic hyperventilation has been suggested as causing some small percentage of CFS cases. I completely ignored that when I was reading them before because I thought I knew what hyperventilating was and didn't think it had anything to do with me. Hrm.

I haven't been referred to anyone - Kingston has fuck all money and a huge waiting list for anything, it seems. I did specifically ask my doctor about physiotherapy, but he just gave me a printout about "yogic breathing". That probably sounds quite callous on the part of my doctor, but it didn't come across that way to me - I was just in shock at what I'd just been told (you mean, I've been disabled to this extent by my breathing??), and not at all convinced by the diagnosis. If I had've realised that this isn't a new problem, I've always breathed this way, then I might have pushed a bit harder. As it is, I'm not sure that seeing an ordinary physiotherapist would be any good. There are asthma clinics around, but when I inquired about them in my teens, was told they were just to teach you how to use your inhaler properly. Well, that's not very difficult, is it? The instructions even have photographs! Teaching breathing techniques was probably a bit new age for the NHS in the early 90s. I don't know quite what would be encompassed by them now.

I have ordered this book - if it doesn't go into enough detail or I still have problems, I'll ring up the Butenko people and find out how much their specialist "teaching asthmatics not to hyperventilate" courses actually cost. Going to see how this goes, and take the rest of my month off work, because going back to a job where I don't breathe properly for 4 hours at a time would be a very bad idea just now, and I'm chronically behind on my degree again because I've been ill for a large number of weeks.

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Comments
elisem From: elisem Date: 13th March 2003 18:07 (UTC) (Link)
It would be so cool if this turns out to be the key to getting your health back. Fingers crossed for ya!
quiet000001 From: quiet000001 Date: 13th March 2003 18:39 (UTC) (Link)
I'd be interested if you could share anything you find out about retraining yourself to breathe properly, as I'm fairly well convinced that fucked breathing patterns are responsible for at least some of my problems. (I never get dizzy or anything, but the entire muscle pain thing is spot on, as are a couple of other things- including that Neph has observed me breathing about twice what he does, and his rate is fixed at 13bpm. Which is, you know, too fast. And that's resting.) (I also have the medical history to support developing chronic hyperventilation- chronic respiratory infections as a child, some of which lasted *months* and definitely fucked up my breathing habits, and also the whole depression/high stress thing.)

So I suspect that improving the situation at the very least isn't going to *hurt* me. :) Even if I do need to be checked out for other things at a later date- I mean, some of my problems I know are related to psoriasis and the associated arthritis. (Although, fixing my breathing should improve that- fucked up blood chemistry will certainly be contributing to my psoriasis being as bad as it is.)

Yeah, anyway. Enough babbling. Very interested to hear how it goes, both because I hope you feel better, and because I hope it'll help me feel better too. :)
rivka From: rivka Date: 13th March 2003 18:40 (UTC) (Link)
I'm delighted that changing your breathing seems to be helping already. When you're traveling down a path that's as unexpected as this, it's good to have an early sign that you're on the right track.

Two additional kinds of professionals who would probably be able to help you retrain your breathing habits: vocal coaches/singing instructors, and psychotherapists who specialize in treating anxiety disorders.

Keep us posted! This is fascinating.
polyfrog From: polyfrog Date: 13th March 2003 19:01 (UTC) (Link)
vocal coaches/singing instructors
Wow, Rivka! That's an amazingly insightful idea!

(and as an added bonus, I think Baratron's voice might make a very interesting singing voice...)
_nicolai_ From: _nicolai_ Date: 13th March 2003 18:54 (UTC) (Link)
There are asthma clinics around, but when I inquired about them in my teens, was told they were just to teach you how to use your inhaler properly. Well, that's not very difficult, is it? The instructions even have photographs! Teaching breathing techniques was probably a bit new age for the NHS in the early 90s. I don't know quite what would be encompassed by them now.


Probably a bit new age, but then, if the NHS jumped on every new idea that came along immediately, how many cockups would there be?

My personal hobby horses aside, my actual comment is:

A number of "Eastern" (Chinese/Japanese/Thai/etc) philosophies and/or martial arts have a breathing-exercises component. Maybe you would find them useful to you? Certainly, they have a lot of practicing how to breathe in a manner you decide, not what is instinctive. You could tune what you decide, to be what you need.

Nicolai
baratron From: baratron Date: 14th March 2003 16:42 (UTC) (Link)

I did quite a bit of yoga when I had a gym membership. I could never do the breathing exercises part of it, because breathing at the rate they said made me feel as though I was suffocating (for reasons which are now obvious). I also have dire trouble with yoga due to having "swayback" knees: my knees bend in the wrong direction slightly, and I can't stand upright without my knees being slightly bent back, which apparently is very very bad for you in yoga because the muscles are supposed to be relaxed but mine are always in tension. Also, I have virtually no sense of balance - even when my legs and back are behaving themselves, I can't stand on one leg for more than about 10 seconds without falling over. If I do anything like this in the future, I'll have to find a teacher who can handle having to provide a billion and one adaptations of exercises for me. It'd have to be one-to-one, or a very small group.
johnckirk From: johnckirk Date: 14th March 2003 01:15 (UTC) (Link)
This wouldn't have occurred to me as the root of your problems, but it does make sense now that you mention it, so I hope it al turns out well. You mentioned nose vs mouth in your last post - despite "mouth breather" being a derogatory term, I don't see a problem with that. I find that breathing through my mouth is generally quieter than breathing through my nose. I think the key issue is how deeply you breathe, rather than how fast - once you've got that sorted out, the speed will follow on by itself. There was an occasion at school when I thought I might be developing asthma, since it felt like I wasn't getting as much air into my lungs as I used to. So I went along to the infirmary, and they gave me a tube to blow into, which would measure lung capacity, and they said I was fine. Would that be an option for you, or would your asthma prevent that?
baratron From: baratron Date: 14th March 2003 16:53 (UTC) (Link)

I'm pretty sure it is supposed to be much better for you to breathe through your nose than through your mouth, although I'm not sure why - one reason is the vastly superior filtration (of germs and pollution) system in the nose that I mentioned; there are other reasons too. Breathing through the mouth is generally quieter than breathing through the nose, but generally speaking it's only in a very quiet room (such as a bedroom in the middle of the night) or when sitting right next to someone else that anyone apart from you can hear your breathing to any extent. And the reason breathing through the nose is noisier is because of all the hairs (cilia) in the nose that are cleaning the air for you.

The tube to blow into you're referring to is probably a peak flow meter - I own one of those. However, that is no use for measuring how you breathe normally. It specifically measures forced expiry volume, which is a much greater amount of air than the way you (anyone) normally breathe - it's not exactly maximum lung capacity, because some air is always in the lung, but (if you do the forced breath correctly) it's the maximum capacity that your lung can contain apart from the residual volume which has to stay there. The only devices I'm aware of that measure normal breathing are on the scale of lab equipment, several feet in each dimension, which obviously wouldn't be very practical for home use in most cases.
nmg From: nmg Date: 14th March 2003 02:00 (UTC) (Link)

I'm glad your efforts seem to be having some immediate results.

Well, poking about online, I discover that when you are in this pattern of crappy respiration, the histamine level in your blood rises. Now, most allergy medicines are anti-histamines - I'm not amazingly sure what a histamine is, but I know it's implicated in allergies.

Histamine is a protein which is produced by mast cells in response to an antigen. The effects of histamine on the body are twofold: firstly, an increase in the permeability of vascular tissue (so blood fluids seep through vessel walls causing local swelling and puffiness - and in the worst case anaphylactic shock as blood pressure falls - or the familiar runny nose and watering eyes), and secondly a contraction of smooth muscle (the cause of airway restriction in asthmatics).

Anti-histamines block an allergic response by inhibiting the action of histamine, rather than by addressing an antigen-specific response.

(understanding why you have hayfever does not stop you from suffering from it, alas)

adjectivemarcus From: adjectivemarcus Date: 14th March 2003 02:07 (UTC) (Link)

Wow, I'm really pleased to hear it's having a positive effect!
I'm very happy for you. :o)
ailbhe From: ailbhe Date: 14th March 2003 04:56 (UTC) (Link)
Wow, the idea of your illnesses being caused by something that is actually within your power to control is so unbelievably wonderful! I expect it'll be really difficult, but you're good at difficult.

I think the singing lessons thing sounds great - I know that the reason I breathe so well is from learning to breathe all the way from my diaphragm in order to sing (I smoke and am still better at breathing exercises than most people I know - wish I could sing too).

You could try the lying on your back with a book on your tummy thing, too - if you're breathing to the bottom of your lungs, the book rises.

A.
(Amateurs'R'Us)
gerwinium From: gerwinium Date: 14th March 2003 07:29 (UTC) (Link)
Why not ask your doctor to refer you to a hospital specialist to teach you how to breathe? I'm sure they should know what the options are. It'll be on the NHS then as well rather than you having to pay for breathing classes. Good that you know what it is though! (And did you get my email regarding car being repaired next week?)
hobbitbabe From: hobbitbabe Date: 14th March 2003 08:53 (UTC) (Link)
Wow! That sounds like good news, that (a) a potential single cause of a lot of your troubles has been identified, and (b) that it's something you might be able to change by yourself!

Good for you for writing out that detailed list of symptoms. Good for your doctor for reading it all and paying attention.

I wonder if it would be useful for you to borrow or rent some videotapes (DVDs?) intended to help people to practice yoga or meditation at home. I've never tried them myself, but the yoga classes I attend involve long spells where everyone is lying on the floor breathing and the teacher is reminding us about paying attention to our breathing*, and other parts where most of the people are doing some exercise, some of the people are lying on the floor breathing, and the teacher is still reminding us about paying attention to our breathing. So if you could get a tape like that, it might give you some help and encouragement about the breathing even without doing any of the movements.

*Usually my teacher says things like "Don't try to change your breath yet - just notice how it feels, notice if you're breathing more in your mouth or your nose today, notice which nostril you're breathing with more easily .... now don't force a change in speed but try to inhale down to your belly and just let the exhalation happen by itself ... now see what happens when you breathe in for longer than you breathe out ... now the other way around ... now open your mouth all the way and yawn, now relax your jaw and put your tongue on the roof of your mouth" with each of these instructions about 3 minutes apart.

It might also be useful to notice whether it's easier for you to breathe deeply/slowly standing up, sitting down, or lying down. If sitting makes it harder, you could experiment with different chairs and positions.

I'm glad you're going to still take your month off work. I hope you aren't so bored that you'll rush out and do too much too soon.
nitoda From: nitoda Date: 14th March 2003 09:19 (UTC) (Link)

Happiness!

Good to hear you sounding so much more positive - hope you find the breathing slowing down thing helpful. I've often noticed that I breathe many less times per minute than my partners do - and wondered why. Probably due to having sung in a choir and had to learn breath control for singing, i guess. I really hope it helps you to regain your health and happiness.
*HUGE HUGS*
alexmc From: alexmc Date: 14th March 2003 09:52 (UTC) (Link)

best wishes

Unlike the last two generations of McLintock's I am not a doctor, but I would not be surprised if this shallow breathing is a major cuase of your ill health. I really hope that you can improve it.

Best wishes.

Alexmc (32 tomorrow)


trinker From: trinker Date: 14th March 2003 10:19 (UTC) (Link)
In addition to the other suggestions (yoga/meditiation, singing lessons, etc.), I'm going to suggest that Pilates might help.

Feel free to e-mail for more details, or ask here and I'll respond as I can.

And...I'm so thrilled on your behalf that this diagnosis and the subsequent efforts are helping!
memevector From: memevector Date: 14th March 2003 12:17 (UTC) (Link)
Wow!

this is so interesting!

It's not like the kind of hyperventilating when you panic, so breathing into a paper bag isn't going to help - it's hyperventilating over months and years, not minutes. I have to completely retrain my muscles and/or lungs to do something different.

I'm not an expert but... I think it's possible that the paper bag thing could nevertheless be useful to you as part of the "retraining" bit.

Some years ago, I was seeing an Alexander technique teacher. They don't deal specially with breathing, but they look holistically at muscle use and how you balance yourself, and part of the reason I went there was I thought it might help my singing.

My teacher recommended me the paper bag thing as something to try. What ze said was something like: As the additional CO2 kicks in, your current breathing habits are overridden and an automatic deep breathing takes over. It's evolved to keep human beings alive through situations where there really isn't enough oxygen, so the process which manages the deep breathing is going to have its way pretty much regardless of what's happening in consciousness. That's not word for word what ze said, but the interesting point was that the body's "emergency systems" know how to do effective deep breathing even for people who don't know how to do it consciously. And the paper bag CO2 trick is a way of invoking that hardwiring.

In my case, the conversation wasn't to do with the speed of my breathing - I breathe pretty slowly - what ze wanted me to get the feel of was that I wasn't using the full capacity of my lungs. So, ze was telling me this as something to try in order to learn what real deep breathing felt like and give myself a chance to get more into the habit of it. So in a way it was as part of retraining my muscles to breathe differently.

Anyway, regardless of the details... wishing you good results along this promising-sounding path :-)
barty From: barty Date: 16th March 2003 11:02 (UTC) (Link)

Wow. I'm glad it's working. It sounds like you are firmly on the path to wellness. Yay. Wow again.
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