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Access: The Blue Inhaler

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  • Hilary Stace,

    Buteyko was popular in New Zealand a few years ago. I did a course which was quite intensive with hours of daily exercises over a couple of weeks. It was an interesting experience. The theories of overbreathing and consequent lack of sufficient carbon dioxide in the breath seemed plausible. The exercises aimed at extending the breath and breath holding were helpful in the short term and it did help with that psychological need for a handy inhaler described by some of the posters above, as it taught techniques to deal with an imminent attack by breath holding. You were encouraged to nose breathe at night by taping up your mouth which was scary but probably helped some with poor sleep (which is common with asthmatics). But I think the promise of getting rid of your inhaler and curing your asthma with Buteyko was overselling it. You had to commit to daily exercises for ever which was a bit unrealistic. But I would probably consider trying it again if offered locally as I would consider anything new which might help with breathing security.

    Wgtn • Since Jun 2008 • 3229 posts Report Reply

  • Rosemary McDonald, in reply to Gray Kirkbride,

    Oh, yes.

    One technique we used some thirty years ago with panicky and very young asthmatics was to get them to blow. A long slow blow up a balloon blow. Blow this piece of paper out of my hand blow. Then breathe in slowly.

    In two three four five, hold two three, out two three four five....great to relax you off to sleep. And deal with childbirth.

    And, when tetraplegic partner had a serious on the back of chemo chest infection...panic stations as he couldn't breathe...was literally gasping. Nurses gave him O2 via various methods and somewhere, somehow in his gasping his last state, he pulled away the oxygen mask and said 'too much'.

    Nurse and I got him to really think about the breathing...out, in, out, in ...

    Turns out that sometimes breathing in oxygen at too higher rate can affect your breathing...your body kinda says...too much oxygen...don't need to breathe.

    Very frightening. For three whole days and nights...every breath he took required thought. I get him to do the same breathing thing in his sleep when he snores.

    Waikato, or on the road • Since Apr 2014 • 1346 posts Report Reply

  • linger, in reply to Hilary Stace,

    The theories of overbreathing and consequent lack of sufficient carbon dioxide in the breath seemed plausible […though] the promise of getting rid of your inhaler and curing your asthma with Buteyko was overselling it.

    It appears the former statement is dubious, and the latter more on the mark.
    Money quotes from the meta-analysis cited by Thrash Cardiom above:

    The three studies designed to test Buteyko’s proposed mechanisms of action […] do not support Buteyko’s theories…
    The five studies comparing BBT to a control for treatment of asthma […] show a variable though reasonably consistent reduction in […] drug use. Even more consistent however is the utter lack of any change in the participant’s pulmonary function tests.

    Hence, at best,

    these studies imply that BBT can alter a patient’s perception of their symptoms, and perhaps prevent overuse of asthma medications

    but

    BBT does very little to alter the underlying pathophysiology of asthma, and [there is] absolutely no evidence […] that BBT can cure asthma.

    Tokyo • Since Apr 2007 • 1944 posts Report Reply

  • Hilary Stace, in reply to linger,

    I think there was a fair bit of placebo effect, but anything that gives a sense of control and lowers the panic that comes with an imminent attack is surely worthwhile. Buteyko was similar to numerous breathing theories I have read or been exposed to over the years and even the use of a peak flow meter. Increased knowledge about the mechanisms of breathing and asthma, and knowing and measuring your own symptoms.

    Wgtn • Since Jun 2008 • 3229 posts Report Reply

  • Gray Kirkbride,

    Thank you for all the responses to my post about Buteyko. I would like to make the point that I persevered with the breathing exercises for two years before I felt that I had properly "retrained" my breathing, and so I was then able to stop the exercises. In both the links and the content of the responses, there was a common theme of people expecting permanent changes after a few weeks or months. I guess it comes down to how "angry" you are with your asthma - I remember I was pretty ropeable at the time! So my experience is a personal one, but as a long-time Public Address reader, I felt it was about time I contribute to something I feel passionate about. I would like to encourage anyone considering trying the technique to give it a go, and to stick with it. I've been asthma-drug-free and asthma-symptom-free for the last 19 years, and it has changed my life in many more ways than I've described in my posts here. All the best to asthma sufferers out there, and thanks Hilary Stace for raising the asthma issue.

    Freemans Bay • Since Jan 2016 • 3 posts Report Reply

  • Hilary Stace,

    Thank you, Gray, that is very interesting.

    Wgtn • Since Jun 2008 • 3229 posts Report Reply

  • Thomas Lumley,

    There’s also a story about medicinal chemistry in the improvement of preventive treatments. Corticosteroids will suppress the immune system as much as you want, but in addition to suppressing the whole body’s immune response (not just the airways) they also mess with a huge range of other things from glucose:insulin balance to stomach acid to bone density.

    The chemical success was in designing steroids that could be inhaled to suppress immune responses in the airways, but where neither the inhaled portion nor the (inevitable) swallowed portion of the dose would end up in the bloodstream.

    The safety improvement was so dramatic that inhaled corticosteroids are not just prescribed for asthma, fluticasone is now available over the counter for hayfever!

    Auckland • Since Feb 2013 • 50 posts Report Reply

  • Chris Waugh,

    Well, breathing exercises certainly do help. I find leaning forward and concentrating on deep, slow, regular breaths helps immensely with the natural panic response brought on by an asthma attack. And aerobic exercise generally, even though it is one of the triggers for many (myself included). Cycling worked wonders for my father, and since I've been back in NZ I've been cycling to work when that magic combination of weather and schedule allows and I've been getting back into swimming. But as Thrash Cardiom and linger have shown, it doesn't matter how fancy the name you give your technique, nor how much time you devote to it, there is no miracle cure.

    And what dave stewart said about climate and housing gels with my experience, too.

    Wellington • Since Jan 2007 • 2401 posts Report Reply

  • Lucy Telfar Barnard, in reply to Gray Kirkbride,

    So after a while I started to wonder why this Buteyko breathing method isn’t officially and vigorously promoted as a viable therapy by the NZ Asthma Foundation. It was then that I realised why – when I was on asthma medication I worked out it was costing the taxpayer $3000 a year for just me (just look at the subsidy amount on your medication label) – and that was 20 years ago. Worldwide, the asthma industry is worth billions to pharmaceutical companies. So why would they ever want to promote a therapy that fixes the condition once and for all, when you can keep making money out of just treating the symptoms instead of the cause. And in case you didn’t know, the NZ Asthma Foundation gets a lot of its money from those same pharmaceutical companies.

    Gray, you can be passionate about the Buteyko method without being rude about the Asthma Foundation. I have worked with, and for (for transparency, yes, paid, but it's not like I'm short of other work) the Asthma Foundation, and they are good people who are at least as passionate about trying to prevent asthma as you might be about the method that you've found that worked for you. I recall conversations with Foundation employees where they were clearly still feeling grief over the death of more than one young person they'd work closely with. I feel affronted by your insinuation that they would risk further lives rather than jeopardise one of their sources of funding.
    The Asthma Foundation base their official advice for asthma control on advice given to them by research scientists. The advice they give on Buteyko reads to me as a fair and balanced summary of the current state of research in the area, with appropriate cautions for people planning to try it (talk to your doctor, keep taking your medication). Given the current state of the evidence, to advise otherwise would be reprehensible.

    So, as I say, be as passionate as you like about Buteyko. Advocate for others to try it in case it helps them in the same way that it helped you. But don't assign impure motives to people who must, ethically, prefer research study evidence to your personal, non-controlled, non-blinded, sample of one.

    Wellington • Since Nov 2006 • 585 posts Report Reply

  • Rosemary McDonald, in reply to dave stewart,

    and my daily asthma drug cocktail now consists of Symbicort, Flixonase & Lorafix. It’s best not to wonder too much about any long term negative consequences of this intake of pharmaceuticals!

    ....and a search for published research into long term effects of beta agonists and corticosteroids is proving difficult because my measure for 'research integrity' is 'no funding from drug companies'.

    Waikato, or on the road • Since Apr 2014 • 1346 posts Report Reply

  • Rosemary McDonald, in reply to Lucy Telfar Barnard,

    But don’t assign impure motives to people who must, ethically, prefer research study evidence to your personal, non-controlled, non-blinded, sample of one.

    I didn't see Gray as being rude....more pointing out the facts.

    There is no doubt that drugs are keeping some asthmatics alive, and enabling many more to function on a daily basis.

    But it is a pity that the Asthma Foundation booklet Controlling Asthma offers no 'drug free' advice.

    Surely they could have had a "if you find yourself with no meds and help is far away" section that could give a Buteyko type breathing primer?

    Or suggest a strong caffeine drink if meds are unavailable?

    In fact, the message in the booklet (which might be the only resource to hand for some) is entirely drug based.

    It offers no alternative.

    Why is that?

    Waikato, or on the road • Since Apr 2014 • 1346 posts Report Reply

  • Hilary Stace, in reply to Rosemary McDonald,

    Good reason to drink more coffee

    Wgtn • Since Jun 2008 • 3229 posts Report Reply

  • Lucy Telfar Barnard, in reply to Rosemary McDonald,

    Why is that?

    I'm not the Asthma Foundation, and I'm a public health epidemiologist rather than a medically trained respiratory specialist, so I don't know sorry. But if you ask them, they may tell you. I would guess the answer is something like "we don't want people to underestimate the necessity of medication". Or alternatively "yes, good point, we'll look into it for the next iteration."

    I've certainly seen coffee suggested as an emergency treatment for asthma when other options aren't available (I remember it from an episode of Quantum Leap), but as ever with asthma there are two issues: preventing attacks, and treating them when they happen. According to this, taking caffeine can result in modest improvements in lung function for about four hours. "Modest improvements" probably means if someone's having a life-threatening asthma attack some caffeine might buy them enough time to get better treatment, but won't stop the attack altogether.

    On the prevention front, "It is not known if taking caffeine leads to improvements in symptoms. It may be that in order to improve the symptoms of asthma, caffeine is needed in such large amounts that the drug's adverse effects would become a problem, so more research is needed."*

    *As far as I can tell, the phrase "more research is needed" is compulsory in every public health paper. That doesn't mean it's not true, it just means it's longhand for "um, we don't know yet".

    Wellington • Since Nov 2006 • 585 posts Report Reply

  • Harry Musgrave,

    As I relatively mild asthma sufferer I did find myself in my teens and twenties getting into what the buteyko people called the drug trap. Every winter I'd get sick several times and it woulkd require more doses of ventolin to recover and bigger and bigger doses of the steroid drugs to keep stable. And all the steroids are not great for the immune system.
    A number of things have co-incided for me to be drug free most of the time now
    - a move away from the straight inhalers to the turbo inhalers. I found the drugs were impacting on the back of my throat and that this would be where I would get infections.
    - lowering my base allergy sensitivity by removing a thing from my diet I didn't know I was allergic to.
    - living in a relatively clean dust free home now (asthma was always much better when I was camping)
    - increased aerobic capacity gained by exercise (walking/yoga) - I thought as a kid that exercise had to be 'strenuous' and that always had me out of breath
    - and I did a buteyko course. I struggled a bit with the exercises but I did have one big takeaway from the course. Breathe through your nose - all the time. I had been breathing through my mouth pretty much all the time including while sleeping. Taping the mouth at night and concentrating on breathing with the mouth shut for a while turned it a habit suprisingly quickly.

    As the study says - my asthma isn't 'cured' - I still have crap peak flow - but my breath doesn't feel short so I'm happy with that.

    Since Jul 2009 • 28 posts Report Reply

  • FletcherB,

    As I’ve already posted about the drugs I take and how long I’ve been on them (since mid/late 1970’s)…

    I also have done a Buteyko breathing course here in NZ…. after being encouraged to investigate it locally after family members saw a 60-minutes (or similar?) 20-minute segment on it on Australian TV some-time in the 1990’s. And while I’m unsure if the “theory or reasons” they provide are accurate, or “psuedo-science”, I am convinced that the course provided plausible explanations about what I already knew about my condition, the actions they suggested seemed to help my condition, and while my drug use has not been eliminated, it has been reduced significantly, and I suspect it could have been reduced further had I been bothered to follow through and continue the breathing exercises (some of which are difficult) for longer…

    I paid several hundred dollars for the course($300-$500? I forget?) about 18 or 20 years ago… While it seemed expensive at the time, I think I’ve reaped enough benefit that I don’t begrudge it… but I’m not sure I would “recommend” it… (I believe the price has gone up considerably since I partook?)… but if you can buy a book, or find some info with Google.. I’d definitely say asthmatics who are not aware of these teachings should investigate it… The “theory” may or may-not be correct, but the “practise” seems to work for many….

    West Auckland • Since Nov 2006 • 893 posts Report Reply

  • FletcherB,

    Also, just going back to the original post… I think it’s pretty awesome that a medicine introduced so long ago (ie, Ventolin aerosol inhaler) is still the go-to product as a symptom reliever… when the “preventers” have been 1) ever-changing, and 2) not working as well as expected… is pretty cool.

    Thanks, are indeed, owed to it’s invention/inventors.

    West Auckland • Since Nov 2006 • 893 posts Report Reply

  • Gray Kirkbride, in reply to Lucy Telfar Barnard,

    I'm sorry you thought I was being rude Lucy. I do appreciate that the people who work and volunteer for the foundation are very dedicated and passionate about helping asthmatics. As my own experience proves, Buteyko is a viable cure for some asthmatics. Yet if you search for Buteyko on the NZ Asthma Foundation website, you get zero results. Why would they ignore it? Surely there's room there to give information for people who want to try a drug-free approach.

    Freemans Bay • Since Jan 2016 • 3 posts Report Reply

  • Ian Dalziel, in reply to Gray Kirkbride,

    Surely there’s room there to give information...

    ...in a sane universe perhaps, all information would be available for people to make choices - but where there are organisations,there are committees - which for good or bad means a diversity of opinion, usually resulting in people covering their asses as well as whatever bases they can, by whatever degree of consensus can be reached...

    I'd imagine that Buteyko, is similar to aspects of the Alexander technique and yogic pranayama - we are nothing without breath.

    Christchurch • Since Dec 2006 • 7953 posts Report Reply

  • Joe Wylie, in reply to FletcherB,

    I paid several hundred dollars for the course($300-$500? I forget?) about 18 or 20 years ago… While it seemed expensive at the time, I think I’ve reaped enough benefit that I don’t begrudge it… but I’m not sure I would “recommend” it…

    Thanks FletcherB. When This is What Big Pharma Doesn't Want You to Know comes with a substantial price tag, it seems a bit pot/kettle.

    flat earth • Since Jan 2007 • 4593 posts Report Reply

  • Ian Dalziel, in reply to Joe Wylie,

    a bit pot/kettle

    isn't there an angle along the lines of:

    Give a person an inhaler and they'll
    manage symptoms for as long supplies
    - and suppliers - and cash last.

    Teach a person to manage or tune their breathing
    and they've a tool always on hand to use...
    perhaps not in all situations or for all people, but...

    Christchurch • Since Dec 2006 • 7953 posts Report Reply

  • Rosemary McDonald, in reply to Ian Dalziel,

    Teach a person to manage or tune their breathing
    and they’ve a tool always on hand to use…
    perhaps not in all situations or for all people, but…

    I'm trying not to but in but....this makes me think about "natural childbirth", which led to thinking about the Lamaze program that was popular for a while.

    I would love to go into the politics of childbirth through the ages...and it is largely about control...but this is not the place.

    Relevant is the backlash from 'conventional medicine' at the dreadful proposition that with correct training in breathing and posture and, I suppose today they'd call it 'mindfulness', most women can give birth safely without medical intervention.

    Waikato, or on the road • Since Apr 2014 • 1346 posts Report Reply

  • Joe Wylie, in reply to Ian Dalziel,

    Teach a person to manage or tune their breathing
    and they've a tool always on hand to use...
    perhaps not in all situations or for all people, but...

    Perhaps there's something inherent in the Buteyko technique that prevents it being made widely available at minimal cost, much as the Hollows foundation has done with eye surgery. As long as there's a significant financial barrier, the teach a man to fish analogy seems a bit of a stretch.

    flat earth • Since Jan 2007 • 4593 posts Report Reply

  • Ian Dalziel, in reply to Joe Wylie,

    the teach a man to fish analogy seems a bit of a stretch.

    self taut?

    Christchurch • Since Dec 2006 • 7953 posts Report Reply

  • Hilary Stace, in reply to Joe Wylie,

    To be fair that price covered a lot of sessions and phone support for life

    Wgtn • Since Jun 2008 • 3229 posts Report Reply

  • Joe Wylie, in reply to Hilary Stace,

    To be fair that price covered a lot of sessions and phone support for life

    Which makes me wonder about the method's limitations. For example, it might be overly complex for someone with a cognitive disability. Having done the parental mercy dash to school camp with forgotten medication more than once in the past, the idea of a replacement technique sounds great in theory.

    flat earth • Since Jan 2007 • 4593 posts Report Reply

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