Section 2 C H A P T E R 4 : KE E P I N G M Y B O DY F I T Breathing Techniques To avoid shortness of breath, you should regularly practice your breathing techniques. They will help regulate your breathing and are especially useful when you begin to feel a flare-up. Practicing these every day will also strengthen your lungs and prevent Flare-Ups from interrupting your day. • Pursed Lip Breathing • Expanded Standing Position • Relaxed Sitting Position • Abdominal Breathing • Expanded Sitting Position • Controlled Coughing • Standing Position Pursed Lip Breathing WAT CH VIDEO People with COPD sometimes have air trapped in their lungs. That air takes up space and stops the next breath from getting in. Pursed lip breathing creates a back pressure in your airways, allowing them to open up and get more air out in a timely manner. You can perform these steps for pursed lip breathing any time you need to. Sit in a comfortable position; try to stay as relaxed as you can. ST EP 1: Take a breath in through your nose as you count to two. ST EP 2: Purse your lips and exhale for four counts. Note: don’t force air out of your lungs; let it come out naturally. ST EP 3: Repeat a few times until you feel more comfortable. ST EP 4: I M P O RTA N T: BESIDES USING YOUR INHALER, PURSED LIP BREATHING IS THE NUMBER ONE RECOMMENDED WAY TO RELIEVE STRESS WHEN YOU BEGIN TO FEEL SHORT OF BREATH. Relaxed Sitting Position WAT CH VIDEO Your legs are your body’s biggest oxygen users. When you feel like you are losing control of your breathing, sit down in a relaxed position to take the weight off of your legs. Sit in a chair with your back rested against the chair. Relax your shoulders. ST EP 1: Position your feet flat on the floor. This will take the strain off them. ST EP 2: Rest your hands face-up on your thighs or on your stomach. ST EP 3: ST EP 4: Begin your breathing technique. I M P O RTA N T: FEEL FREE TO SWITCH BETWEEN POSITIONS IF YOU NEED TO. ASK YOUR HEALTHCARE PROVIDER WHICH POSITION THEY THINK WOULD BEST SUIT YOU. Expanded Sitting Position WAT CH VIDEO This sitting position takes the weight off of your legs and expands the rib cage, allowing your lungs to take in more oxygen. For this position you’ll need a chair, a pillow, and a table or desk. Sit in the chair with your feet flat on the floor. ST EP 1: Place the pillow on the table or desk in front of you. ST EP 2: Cross your arms over the pillow and rest your head on the pillow. ST EP 3: Begin your breathing exercises until you feel relaxed and in control. ST EP 4: I M P O RTA N T: IF ANYTHING AT ALL FEELS UNCOMFORTABLE WHILE TRYING THESE POSITIONS, TRY A DIFFERENT POSITION. THE MOST IMPORTANT THING IS THAT YOU CAN BREATHE COMFORTABLY. Standing Positions WAT CH VIDEO If you don’t feel comfortable in a seated position, or if you don’t have a chair available, you can use this standing position to help get your breath back. Find a wall that can hold you up and lean your back against it. ST EP 1: Stand with your feet about a foot apart so that your legs and the wall are sharing your weight. ST EP 2: ST EP 3: Relax with your hands at your side. Then begin your breathing techniques until you feel under control. ST EP 4: I M P O RTA N T: FEEL FREE TO SWITCH BETWEEN POSITIONS IF YOU NEED TO. ASK YOUR HEALTHCARE PROVIDER WHICH POSITION THEY THINK WOULD BEST SUIT YOU. Expanded Standing Position WAT CH VIDEO You can also use this alternate standing position to help get your breath back. This position helps support your weight, allows your diaphragm to flatten, and, because your arms are up, expands your rib cage and helps your lungs take in more air. ST EP 1: For this standing position, face the wall. Raise your arms up and cross them in front of you against the wall. ST EP 2: ST EP 3: Rest your face against your arms. Begin your breathing techniques until you feel under control. ST EP 4: I M P O RTA N T: IF ANYTHING AT ALL FEELS UNCOMFORTABLE WHILE TRYING THESE POSITIONS, TRY A DIFFERENT POSITION. THE MOST IMPORTANT THING IS THAT YOU CAN BREATHE COMFORTABLY. Abdominal Breathing WAT CH VIDEO Abdominal breathing (diaphragmatic breathing) also helps relieve shortness of breath. During the normal breathing process, two main muscles are used: your diaphragm and rib muscles. You learned in Chapter 1 that COPD can weaken the diaphragm. This forces your accessory muscles (neck and shoulder muscles) to help you breathe. Practicing abdominal breathing will help strengthen your diaphragm and abdominal muscles so that you do not have to rely on your neck and shoulder muscles. This will help you get your breathing under control. Sit comfortably in a chair, or lay flat in bed with your head and your knees supported by a pillow. ST EP 1: Place your hand in your midstomach or belly button area. ST EP 2: Take a deep breath in through your nose, letting your diaphragm push outward against your hand. ST EP 3: Exhale through pursed lips as you feel your diaphragm relax back into place. ST EP 4: I M P O R TA N T: PRACTICE THIS TYPE OF BREATHING THREE TO FOUR TIMES PER DAY FOR JUST A COUPLE OF MINUTES. DO IT A FEW TIMES THEN TAKE A BREAK. Controlled Coughing WAT CH VIDEO People with COPD have more mucus in their lungs than usual, and sometimes the mucus is thick and sticky and clogs airways. This causes discomfort and shortness of breath. Controlled coughing helps you get mucus out of your lungs and prevents uncontrolled coughing, which is unexpected and can make you short of breath. To practice controlled coughing: Take a couple of deep breaths in through your nose and out through pursed lips. ST EP 1: Then take a big deep breath in, and cough twice without taking a breath in between coughs. ST EP 2: Do this as many times as needed. If you need to repeat the controlled cough, take a gentle breath in between the double coughs so that the mucus doesn’t go back down as you breathe in. ST EP 3: Spit the mucus into a tissue and throw it away. ST EP 4: HU F F C OU G H S : IF YOUR MUCUS STILL DOESN’T COME UP, DO A FEW HUFF COUGHS BEFORE OR AFTER YOUR CONTROLLED COUGHING. HUFF COUGHS PUSH AIR OUT FROM YOUR LUNGS THROUGH THE USE OF “HUFF” SOUNDS. BREAK UP STUBBORN MUCUS BY DRINKING A WARM BEVERAGE TO SOOTHE THE AIRWAYS BEFOREHAND.