Exhaling & Relaxing With COPD©Philip J. Cable 2006 - Permission granted to re-produce For non-profit distribution.

        Exhaling – A tremendously neglected part of therapy by our medical community! Our problem as COPD’ers is not getting good air (O2) in, it’s getting bad air (CO2) out. Extending our exhale time helps us on two fronts. First of all, it gives our lungs a much better chance of ridding our bodies of CO2. Secondly, I believe extended exhaling is the main reason that I have been exacerbation free for the last 1 ½ years. I realize the immune system helps, but I was getting pneumonia, probably every three months before I learned to breathe and exhale properly.

The more stale air you exhale, the more fresh air you can inhale, which gets deeper into the lungs and does not give all the little creepy crawlies a moist, damp environment in which to multiply. Extending our breathing time is not easy because it goes against what our mind is telling us. Our body is telling us to get rid of CO2, but our mind is telling us we need more O2. It’s listening to our mind that causes us to hyperventilate as we gulp for air. The nature of PLB causes us to slow down our exhale as well as opening our airways, but it also restricts the amount of air we can exhale. After 4 or 5 PLB’s we can actually exhale normally. So we should exhale for 4 seconds and then let our lungs refill naturally. That is, do not consciously inhale. I find if I consciously inhale I invariably want to top off my lungs, which increases my O2 input and that is counter-productive. When I was learning to PLB, they all said to breathe in through your nose, although nobody had a definitive answer as to why. Everybody said for added moisture or infection control. I finally found an acceptable answer for myself a few months back. I noticed that when we inhale through our nose, it is very hard to top off the air in our lungs. If we breathe in through our mouth, the tendency is to "top off" our lungs and that is not what we want when we are SOB. So if you mouth breathe, be conscious of “topping off”.

         Relaxing – If you exhibit any muscle soreness after a bout of SOB, it is probably because you are either over-breathing or not breathing correctly. With a combination of PLB, diaphragm breathing and exhaling for 4 seconds, you should be able to talk yourself into relaxing all those muscles used to breathe. Something I have used sometimes for the last year or so is to start humming a tune. Myself, I hum to “Amazing Grace”. Humming it right it forces me to extend my exhale, take small inhales and gets my mind off of my SOB and allows me to relax. Relaxation is very important. Pick your own song!

        Exertion causes us to be SOB and as COPD’ers we have to learn how to pace ourselves to try and cut down on the episodes of SOB. We also have to exercise regularly to keep our muscles as well toned as possible as well-toned muscles use a lot less O2. Pulmonary rehab is highly recommended for all who have not been there.

 As a final note, most of us know how important it is for us to address our breathing problems properly. Unfortunately, the medical community has not seen that need, as yet. We have medicinal therapy, physical therapy, nutritional therapy, but no breathing therapy as such. Somehow we have to reach out to the medical community to see how this can be changed. I presently go to three different COPD forums on a regular basis, and it is through these forums that I have developed most of my breathing techniques. Anyone who has COPD should join a forums and learn how to cope with the various aspects of COPD. Many will be surprised how manageable it is.

COPD in Canada ( a NEW forum/message board but created by the patient who wrote this article)

Anxiety

Diaphragmatic Breathing

Breathing Overview