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ASTHma answers

This exercise establishes a calm state before doing the other exercises. Begin by lying down with a firm pillow or a folded blanket under your head. Bend your knees and rest your feet flat on the floor. If that is not comfortable, place a bolster or rolled blanket under the knees. Feel free to shift your position and stretch if you become uncomfortable. Some people like to play calming music as well.

Place your hands on the belly, close your eyes, and turn your attention inward. How do you feel? Are you uneasy, uncomfortable, buzzing, or distracted? Is it difficult to lie still? Is your mind racing? These are common experiences for an asthmatic. The goal is to let go of all that, which is not always easy. It may take several minutes (or several sessions) to relax deeply. Give yourself time.

With each exhalation, let your belly sink away from your hands and into the back body. After a gentle pause, can you feel the belly rise effortlessly when you inhale? This relaxed action cannot be rushed, so don't suck in the abdomen or force the movement in any way; an easy rhythm will settle in as your state of relaxation deepens.

As the body grows quiet, you will feel and hear the breath more clearly. The sound and movement have a rhythm that soothes and focuses the body even more. As a feeling of peace comes to the belly, allow your whole body to share in the experience. Pay attention to the sensations; this is an opportunity to compare how the body behaves when tense and when relaxed. The goal is to consciously relax until the body is in a state of non-action, i.e., alert passivity. When you feel truly relaxed and calm, exhale and bring your knees toward your chest.

I call this exercise The Wave because of the wonderful movement that ripples up and down the spine when the body settles into the natural breath. This movement helps unlock the diaphragm and massages the abdomen, chest, and spine, releasing tension that can interfere with healthy breathing. It produces a breathing pattern similar to that of a baby, and it is very soothing.

After Deep Relaxation, relax your arms out to your sides. Close your eyes and turn your attention to the belly and the way it melts into the pelvis each time you exhale.

Begin The Wave by gently relaxing the lower back into the floor as you exhale, and then lifting it a couple of inches as you inhale. The hips stay on the floor as the lower back rises and falls. This need not be a big movement, and the pace of breathing should be slow and easy. Allow yourself to settle into and slightly amplify this rhythmic wave, and notice if you can feel movement all the way up and down the spine. Do you notice the massage of the abdomen when you inhale and the chest when you exhale? Repeat this exercise 10 or 15 times before continuing to the next technique.

Poor breathing habits may confuse you and cause you to reverse the coordination of movement and breath, so pay close attention. If you find yourself feeling tense, take a few normal relaxing breaths between cycles. When finished, bring the knees into the chest on an exhalation.

This is the first of the active exercises in this program and one I suggest you practice it and the one to follow until they become reasonably comfortable before you go further. Always keep them in mind as you progress with the program.

Asthmatics are often chronic mouth breathers but it is important to breathe through your nose during all the exercises. In fact, it is important to breathe through your nose most of the time. Air breathed in through the nose is filtered, warmed, and moistened, making it just right for sensitive airways. Nose breathing also promotes correct diaphragmatic action since it makes hyperventilation more difficult. You may protest that you have to breathe through your mouth because your nose is always blocked. But did you know that a chronically blocked nose can be a result of poor breathing, instead of the other way around?

Here are a few tips to help unblock that schnozz and keep you breathing through it.

After an exhalation, try holding your nose and shaking your head up and down for a few seconds, stopping when you need to inhale. This can be very effective, especially if you repeat it a few times. If you do Headstand in your asana practice, you may find that it helps, too. Using a mild saline solution to wash out your sinuses is also a great habit to develop. (Neti pots are designed for this purpose.)

When you're trying to breathe through your nose, don't pull the air into the nostrils; instead, open the throat. I do this by imagining my mouth is located at the hollow of my throat. My last suggestion is an unorthodox but highly effective way to break the mouth breathing habit. Tape your mouth closed with surgical tape! It's a bit weird, but it really works&endash;especially at night, when you can't use other strategies. Be patient with your chronically stuffy nose; you will gradually feel improvement.

It is common for an asthmatic to over breath, i.e., the breath in is usually easier and longer than the breath out. As I've already explained, over-inhaling may actually lead to under oxygenation of the body. With this exercise you will try to soften the effort of your inhalation until it is shorter than the exhalation by as much as half. Chances are it will take some work to accomplish this because, as an asthmatic, you may have a skewed perception that if you don't inhale more strongly you aren't getting enough air. Expect to feel an urgency to breath in and even a little uncomfortable but remember that over breathing is a habit that has gotten you into trouble.

Begin by counting the length of the exhalation, the pause afterward, and the following breath in for several minutes to establish a relaxed breathing rate. Then, use the baseline length of your exhalation as the gauge for any modifications you make in your breath rhythm. In other words, don't struggle to lengthen your exhalation; instead, shorten your inhalation. With practice, this will become easier. In the meantime, please take several "normal" breaths between cycles if your fell anxious or strained.

An inability to exhale fully is a defining symptom of asthma. I do this exercise to help slow my breathing down and restore the diaphragmatic movement that allows a good exhalation, which in turn sets up a smooth inhalation. I practice this exercise frequently whenever I feel short of breath. It is also a good exercise to do when you need to calm down in general.

Lie on your back with your eyes closed and arms relaxed out to the sides. Remember the breathing guidelines. Then, beginning with an exhalation, purse your lips and blow the breath out in a steady stream. You will feel a strong action in the belly as the abdominal muscles assist the exhalation. Your exhalation should be longer than usual, but it is important not to push this too far. If you do, it will be very difficult to pause after exhaling and your subsequent inhalation will be strained.

Pause for a few seconds after your exhalation, relaxing the abdomen. Then, keeping your throat open, allow the inhalation to flow in through the nose. Because of the stronger exhalation, you should be able to feel the inhalation being drawn effortlessly into the lower chest.

Count the length of the exhalation, the pause, and the inhalation. At first, try to make the exhalation at least as long as the inhalation; do this by shortening your inhalation as in the previous exercise. Unlike the previous exercise, where breathing is at a resting rate, the overall rate of breathing here will be stronger and longer. Eventually, aim to make your exhalation more than twice as long as the inhalation and to make the pause after the exhalation comfortable rather than hurried. delete - (It may take you a while to accomplish these goals.)

Since asthmatics find exhalation difficult, it may help to imagine and eventually feel the sensation of the exhalation "flowing" upward, like a breeze, inside the ribs as it leaves the body.

Repeat 5 to 10 cycles of this exercise. As with all the exercises, I recommend you take several normal breaths between cycles. When finished, hug your knees toward your chest.

In combination with the previous exercise, this one provides excellent first aid for asthma symptoms. It doesn't give the same quick fix as an inhaler, but it can turn an asthma attack around if you start it early enough. I do this exercise frequently throughout the day when my breathing is compromised, and I find it easier if I have first practiced Complete Diaphragmatic Exhalations (Exercise 3).

This exercise is designed to help regulate the CO2 levels in the body. By pausing before you inhale, you give the body a chance to slow down and build up the level of carbon dioxide. (As I discussed before, asthmatics have chronically low levels of CO2.) An over-breather may find this to be the hardest exercise of all. At the outset it may be difficult to pause for even a few seconds, but if you keep trying you will notice improvement, perhaps even during a single practice session. Eventually, the pause can extend up to 45 seconds or even longer.

Position yourself as before: on your back, knees bent, with feet flat on the floor. With this exercise I recommend that you consciously shorten your inhalations and exhalation though the extended pause will, in effect, keep the overall breath rate slow. I suggest you inhale for one or two seconds, exhale for two to four seconds, and then pause. During the pause you may feel an urge to exhale a bit more, which is O.K.; in fact, the overall feeling of the pause should be like the natural relaxation that occurs as you exhale. You can extend the pause by consciously relaxing wherever you feel specific tensions.

As with all these exercises, patience yields better results than force. Repeat the exercise 5 to 10 times, and feel free to take normal breaths between cycles.

Going Further
When you are proficient at the exercises in a reclining position, begin to do them sitting up. Sit at the edge of a chair or on a floor cushion. Keep your back straight and your head upright. It can be surprisingly more difficult to do these exercises sitting up, so if you feel any stress lie down again. I always go through the exercises lying down first and often don't sit up at all. Remember that these exercises are remedial and therapeutic. They're not a contest!

Signs of success with this program include a decrease in symptoms, reduction in the use of rescue inhalers, and a general ease in breathing. When you reach this point it is important to begin to rebuild the strength that many asthmatics lose while ill. Since exercise can induce asthma in over breathers, many asthmatics avoid exercise and become weak.

But once you feel confident in your ability to breathe well, you should begin to exercise more. Start with brisk walks or some similar mild effort. From there take up a more aerobic activity you enjoy preferably one with repetitive motion such as jogging or hiking which allows you to more easily follow your breath. Over time, you'll feel strength returning to your body.

Here's an additional challenge: Keep your mouth closed while you exercise! At first you'll find this difficult. You may only be able to take two or three nose breaths before having to revert to mouth breathing. Don't push, but keep trying. Remember the tips about opening the throat and keeping your exhalation at least as long as your inhalation. Eventually, you'll be able to exercise as hard as you want while maintaining nose breathing.

Freedom Regained
There are, of course, many other breathing techniques that can be beneficial in the management of asthma, but I can personally vouch for the transformative power of the exercises in this program. I am still an asthmatic, but for weeks and even months I have no symptoms and rarely give my disorder a thought. I haven't been hospitalized or on Prednisone for a very long time.

The results of my efforts have been nothing short of exhilarating. Though I continued to practice yoga throughout my worst asthma years, my practice has become stronger as a result of the breathing exercises, and they helped me develop a greater sensitivity to the role of breath in asana practice. Also, I've been able to return to cycling, a favorite pastime I'd given up for more than a decade. Less than one year after adopting this program, I was able to cycle over Colorado's Loveland Pass (11,990 ft.) and to ride from Boston to New York City in a weekend without taking a single breath through an open mouth!

As an asthmatic, I accept that there are certain strategies I must implement to maintain a symptom-free lifestyle. I practice my breathing exercises daily and, if I find myself in a situation that in the past triggered an asthma attack, I use the exercises more frequently as preventive medicine. For me this regime is far preferable to a daily regimen of pills and sprays, and to the gradual deterioration of health that seemed to be my fate only five years ago.

Although each asthmatic has his or her unique set of circumstances, I hope my story and my eventual success at managing my own asthma will inspire others to have hope, take active steps to change their respiration, and prevail in finding their own way to breathe free.



© 2001 Barbara Benagh