EVERY BREATH YOU TAKE
Sunday Tribune, 14 July 2002
Most of us know somebody with asthma writes Kate O Flaherty,
It affects some 300,000 adults and children in Ireland, and we have the forth highest prevalence in the world.
The causes of asthma are unclear, with various theories suggesting environmental pollution, allergens and the hygiene hypothesis, which claims that the rise of asthma is linked to our more sterile environments, where children are exposed to less infectious disease and so their immune system do not mature properly. However, the medical consensus is that asthma is a disorder of the inflammatory or immune system.
There is however, an alternative explanation for the symptoms of asthma, based on the observations of Russian physician Professor Konstantin Buteyko, which claims that asthma is caused by over breathing.
Breathing is something we all take for granted, so it may come as a surprise to learn that many of us are probably not doing it properly. We all know the basics- we breathe in oxygen which is transferred from the lungs to the blood stream and around the body, and we breathe out carbon dioxide. However, the lungs need to retain a certain concentration of carbon dioxide in order for the oxygen transfer system to operate efficiently.
The normal volume of air we should breathe is about six litres a minute, but if people breathe greater volumes than this, they exhale too much carbon dioxide from their lungs. The body then switches on its defence mechanism to avoid losing carbon dioxide (as this is turn affects our oxygen supply), which is to constrict the airways, which gives rise to symptoms such as wheezing, breathlessness, coughing and chest tightness.
Buteyko tested thousands of asthmatics and found that all of them were breathing twice or three times the normal amount of air. He developed a breathing therapy, based on training people to use a lesser volume of air. By correcting their chronic over breathing, the carbon dioxide levels in the lungs remain normal, and the airways remain open. The results for asthmatics is that they no longer require medication to control their symptoms.
The Buteyko therapy was brought to the Western world in the 1990’s first to Australia and then to Europe, and has generated much debate and controversy, as it was initially greeted with scepticism by the medical establishment, which advised patients of the dangers of substituting breathing techniques for medication. However, the basic principles behind the method are accepted, and while much of the evidence is anecdotal, the task for Buteyko practitioners now is to prove its benefits in clinical trials.
It’s a task that one Scottish woman has taken on with a passion. Jill McGowan had asthma and worked as a practice nurse in Glasgow. Initially sceptical, as she was very involved in helping people manage their asthma through medication , she attended a Buteyko seminar in Glasgow. “Within 24 hours, my breathing had improved – it was unbelievable” she says. “I was using a nebuliser and ventolin inhaler, and I haven’t been using either since first the weekend. After about twelve weeks of being symptom-free, and when I had mastered the breathing exercises, I started to slowly reduce my steroids, which I eventually came off as well. I haven’t taken steroids or antibiotics since.
“Since it had such a dramatic effect on my own health, I became quite committed to using and teaching the Buteyko method, but it took a full year for me to believe, because it was challenging my own beliefs. I thought about patients who had died from asthma, wondering if we were doing the right things for them, and that was very difficult to come to terms with. So I resolved to try and get the therapy into wider practice”.
Jill’s commitment was so great that when she found it difficult to get funding for a clinical trial. She sold her own house to fund the research project. The trial, involving 600 patients, is the largest to date in the world. The preliminary results after the first year are impressive. Patients using the Buteyko method show a 98% reduction in asthma symptoms, a 92% reduction in the use of preventer or steroid inhalers and a 100% reduction in the use of inhalers. They also report huge increases in vitality, emotional health and quality of life. These results are preliminary and the completed study must undergo scientific scrutiny if it is to be accepted and change the long held beliefs of respiratory experts.
Jill’s goal is to have the Buteyko method made available on the NHS, and she hopes that her research will provide the scientific evidence for such a decision. Her study was discussed in the British Parliament in June, and senior politicians have responded favourably to her efforts to make the therapy more widely available.
Here in Ireland, Patrick McKeown was also a severe asthmatic who became medication free after trying the Buteyko method. He trained as a practitioner in Moscow and set up a practice called Asthma care in March of this year. He holds workshops around the country where he trains people in the breathing techniques and offers lifestyle advise to minimise symptoms. “The Buteyko method is not a cure,” he says. “Its a way of better understanding and controlling your asthma. Patients who come to us sign a contract stating that they will remain on prescribed medication and will only change it after consultation with their family doctor, when their symptoms improve substantially. Anyone over five can learn the therapy, but it does require discipline to practice it in the initial stages”. Patrick too would like to see further research into the therapy to enable the benefits he has experienced to be more widely available.