This is part 3 of our Breathless Series. In Part 1, we looked at some of the reasons for breathlessness in cancer patients. I also shared my husband’s experience with shortness of breath to the point he nearly died. In Part 2, we looked at medical approaches to breathlessness. This post will be about non-medical approaches to breathlessness, including breathing technique and ways of controlling your environment to alleviate symptoms of breathlessness.
Non-medical approaches, including specific breathing technique, can be very effective ways to breathe easier.
On January 25, 2017, the Lung Cancer Alliance, kicked off their Coping Series with a webinar called “Breathing Easier.” The Coping Series is designed to educate and provide practical ways to manage the most common symptoms and side effects experienced by lung cancer patients and survivors. If you would like to see the full webinar, click here.
I would like to thank the Lung Cancer Alliance and the webinar presenters. They’ve kindly allowed me to share (originally on Heather Erickson Author/Writer/Speaker) the information they taught, along with some slides from the webinar. I especially thank Dr. Lynn Reinke, a nurse practitioner, recognized nationally and internationally as a dyspnea crisis management expert (1). She spoke about breathing technique and other non-medical interventions to improve breathing.
Breathing Technique: Pursed-Lip Breathing
There are many advantages to the pursed lip breathing technique. It is simple to do. In fact, many people intuitively use this method of breathing when they are breathless. It can be used when you are at rest, as well as when you are active. This breathing technique is perfect for when you are climbing stair since it increases your blood oxygen levels.
Here’s how you do it:
- With your mouth closed, inhale through your nose. Count 2-4 seconds as you breathe in.
- Now, purse your lips (as if you’re going to drink from a straw).
- Exhale slowly through your pursed lips. Count 6-8 seconds as you breathe out.
- Repeat as often as you need.
Breathing Technique: Diaphragmatic Breathing
Most people breathe wrong. When they take in a breath, their stomach contracts as they fill their lungs. That’s not the way we were created to breathe. The next time you get to see a baby lying on its back, watch him or her breathe. What do you notice? Their tummy rises as they inhale and sinks as they exhale. That’s because their diaphragm is doing its job the way it was meant to. Check out the diagram below to see what I mean.
By using the diagrammatic breathing technique, you will strengthen your diaphragm and reduce breathlessness, long term.
Bonus: This not only helps with breathing but also with pain control. Because of chronic pain, I go to a pain clinic. In physical therapy, this was the first thing they taught me. Pain perception and pain threshold are both affected by relaxation and the use of the diaphragmatic breathing technique.
Positioning: Leaning Over
Leaning over helps you to relax your shoulders and upper chest so that your diaphragm can expand opening up your lungs. There are several ways you can do this.
- Leaning over a grocery cart while shopping
- Lean over the back of a stable chair.
- Rest your head on a pillow while seated at a table.
Don’t bend over too far, or you will make it harder for your diaphragm to do its job.
Tricking Your Brain:
One interesting intervention involves using a hand-held battery-operated fan.
- Aim the fan at your nose/face.
- Hold the fan 6 inches away.
- Continue to have the fan blowing on your face for 5 minutes.
It’s believed that the effect of the air stimulates your facial nerves, changes the perception of breathlessness in their brain.
Here is a highly recommended fan on Amazon:
VersionTech Multipurpose Collapsible Portable Fan Outdoor Fan Clip Fan Desktop Fan(3 Speed, Black)
Relaxation technique: Progressive Muscle Relaxation
This can be used in conjunction with the diaphragmatic breathing technique.
Progressive muscle relaxation is just that—you progress through your body, relaxing your muscles one at a time until you are completely relaxed. This reduces anxiety, helping you to breathe better. This has the same pain relieving bonus as the diaphragmatic breathing technique.
Often this is done by listening to a recording which prompts you to imagine… After you’ve done this a few times, you will be familiar with it and will be able to do it at any time you need to even if you don’t have a recording to listen to.
Here are the basics of PMR:
- Either lie down or sit in a comfortable chair and relax.
- Take a few deep breaths by using the diaphragmatic breathing technique.
- Focus on your toes. Scrunch them up, and then release.
- Next, tense your ankles and release.
- As you move through the body, you will repeat this. After releasing, you will keep that part of the body relaxed as you progress through the rest of your muscles. Take a deep breath between each muscle group.
- Tighten and then release your calf muscles, thigh muscles, your buttocks, and pelvic area.
- Now, breathe deeply in, and as you breathe out, slowly relax and release any tension you may have in your back.
- Lift your shoulders and then release completely.
- Now relax your neck. Gently move your head from side to side.
- Tighten and release your jaw muscles.
- Finally, the top of your head. Imagine all the tension in your body has floated out of the top of your head, leaving you relaxed and refreshed.
- Finish with some more deep breaths. If you are able, stay in this position for a few more minutes of calm and relaxation.
One of my favorite PMR scripts is called “Anesthesia.” It uses the same concept as the one above, except instead of tensing the muscles, you imagine each part of the body is dipped into a bowl of anesthesia, causing it to fall asleep. It’s so relaxing you just might fall asleep afterward. I once relaxed this way while getting a tooth pulled!
Other techniques include meditation, guided imagery, and acupressure/acupuncture etc.
Planning: Energy Conservation
One thing cancer patients learn quickly is the importance of conserving their energy. This involves scrutinizing your schedule to ensure it isn’t too full.
- Plan your week so that you don’t have more obligations than you can handle each day.
- Plan your day according to your priorities. What:
- do you need to accomplish?
- would you like to accomplish?
- can wait until another time if you can’t get to everything?
- Pace yourself.
- Think about the big picture.
- How will a morning appointment affect the rest of your day?
- Plan Your Position.
- Consider where and when you will be able to sit throughout the day.
- Getting a shower seat can be helpful when just taking a shower wears you out.
- Some people get a walker, to always have a seat when they need one. Standing in line can be particularly difficult because there is nowhere to sit.
- For things like vacations and state fairs, nothing beats a scooter. There are scooter rentals available everywhere. They will even deliver and pick up at hotels.
Avoid environmental triggers which lead to shortness of breath.
- Air pollutants
- extreme temperatures (Humidity, Cold)
A scarf or face mask can be helpful for reducing the impact of these triggers. In Minnesota, the cold winter air was very hard on my husband’s breathing. It sent him into terrible coughing fits. He began to use a face mask like doctors use. This made a big difference.
Many Tools for Many Factors
Learn multiple approaches to managing breathlessness and what learns best for you. You will have a variety of ways for dealing with the various things that contribute to shortness of breath.
We will look at exercises that can reduce the impact of breathlessness on your life.
WHAT ARE YOUR THOUGHTS?
I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!
In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.
My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com
I also blog at Heather Erickson Author/Writer/Speaker
Dr. Lynn Reinke, Ph.D., ARNP, FAAN (University of Washington) is a nurse practitioner, recognized nationally and internationally as a dyspnea crisis management expert.