sitting – Inlife Blog.

Scouts Motto : Be Prepared

I have such wonderful conversations with my patients that often have lessons for both patient and therapist. The best patient centred relationship is one where we learn off each other.

We were discussing relievers and spacers and how research has proven the improved dispersal of the reliever when a spacer is used. My patient then went on to say that she has taken to travelling with her reliever and the hand held fan as a kind of mini pulmonary toolkit that gives her the confidence of knowing she is prepared for every circumstance.

It reminded me of a situation I was in last week whilst travelling in Tasmania.

Cradle Mountain, world heritage area of majestic beauty but also a place of extreme weather and unpredictability. I was climbing to the Mt Marion Lookout and found that half way up in the cold and floating rain I had trouble catching my breath.

Exercise induced asthma has little warning I find. As every good explorer should do I had a snack in my pocket and my bottle of water and was rugged up in beanie and coat against the cold.

However just shy of the top things got a little uncomfortable. That need to fill the lungs but not getting as much as I’d like coupled with the knowledge that I was literally in the middle of nowhere and my nearest reliever was , you guessed it, in the car park an hour and a half away.

There was no way I was going to turn around and miss getting to the top so I used what I had to get relief. I stopped and leaned forward, blowing out through pursed lips and took a rest break to get my breathing under control. After a few minutes rest and hydrating with my drinking water I started up again pacing myself this time, keeping up the pursed lips as I went.

I made it and with a little sprint to compete with my 13 yr old daughter I got there ahead of the family and promptly claimed the seat to lean forward and recover my breathing once more.

To say the least, my patient was wise in her preparation and a puffer in my pocket next time will be part of my good explorer ensemble.

Factors Affecting Breathlessness: Relaxed Posture

Factors affecting breathlessness of course has to include posture.

Tension in the upper body is one thing that you can start with.

So stand in front of a mirror and take a look after you’ve just done something that has left you puffy. As you catch your breath what can you see – how are you standing, supporting your arms/shoulders, sitting down, chest heaving, shoulders going up and down???

Now that you know what you are doing normally, try this as an alternative;

Lean forward, support your upper body by leaning on the bench/ back chair or sit and lean on your thighs with your forearms, drop your shoulders and relax as you gradually slow the pace of your breathing.

This will do two things:

it will relieve the tension between your shoulder girdle and chest to allow for chest expansion
it will release the accessory muscles in your upper body for the action you have been engaged in so they are not being overused.

Factors Affecting Breathlessness: Keep it close

A third way to reduce breathlessness in activity is to keep it close. So bring the work space up in front to waist level so there is no reaching and bending. This lessens the load on your heart and lungs thereby reducing the energy need and your level of breathlessness.

This can be done by putting the task on the table in front and sitting or by doing it on a table in standing or at a bench. The other way we have talked about previously is to have important daily used items on shelves between hip and shoulder height thereby bringing the activity closer to waist level.

This is the same for if you are lifting or moving items. Keeping it close reduces the strain on your arms and reduces your level of breathlessness. Remember never to hold your breath whilst you are lifting but continue to blow out through pursed lips in a gentle manner, always looking for ways to slide the load , break it up or use a trolley.

Factors Affecting Breathlessness – Take a Load Off

A fourth way to make activity easier is to lighten the load by sitting to do the task or by reducing lift and carry. Sitting uses less energy by taking the load off your body just in the same way that using trolleys can take the load off when you are moving.

Examples of this sitting to do the ironing, sitting to pot plants, leaning on the trolley in the supermarket, using a wheel barrow in the garden, a tray mobile in your living area, or a laundry trolley in the yard.

If you are struggling in getting about then try a wheelie walker that includes a seat and basket and this will assist you in staying mobile and connected with your community.