Coping with breathlessness and relaxation

Adopt a cooperative work sharing attitude  Interchange easy with difficult activities and take within your family.

• rest periods in between to prevent over fatigue
• Work to your own speed, do not rush                                             
• When possible sit down to work
• Organise your activities, do the tasks requiring Learn relaxation techniques the most exertion when you have the most energy
• Use breathing control

Bending

• Try to avoid bending over from the waist as this makes breathing difficult
• Crouch keeping your back straight and bend from the knees. This allows you to keep your chest upright and your shoulders back, a position from which you can continue to breathe as comfortably as possible
• As you crouch try to ensure that you have something secure to hold on to such as a table or sofa to provide you with extra support. This will also give you something to push against as you stand.
• When working at a level below your waist, e.g. emptying the washing machine or gardening, use a low stool and sit rather than bend.

Arranging things around the house

•  Put items that you use most frequently in an easily accessible place
•  Unclutter your storage areas so that you can easily find and reach what you need.

Showering and bathing

• Avoid water being too hot and do not fill the bath too full
• Keep shampoo and soap within easy reach
• Use a bath board or shower stool if necessary
• Install grab rails and use nonslip bath mats to help you keep your balance
• Use a long handled scrub brush to wash your back
• Sit to undress, bathe, dry and dress
• Help, to dry yourself by wrapping yourself in a towelling robe Avoid over exertion by taking rests.

Planning your activities

• Try a daily and/or weekly schedule
• Make a decision as to which jobs are absolutely necessary to make your home comfortable and attractive
• Distribute tedious tasks throughout the week. Alternate heavy tasks with light ones.

Pacing your activities

• Frequent short rests are more beneficial than fewer long rests
• Can you break tasks into steps, can any of these steps be delegated?

Food preparation

• Prepare food for two or more meals at one cooking session and refrigerate or freeze.
• Always have a store cupboard or items for when you may be too tired to prepare a meal e.g. thick nourishing soups.

Shopping

• Use home delivery or delegate tasks or shop with a friend or family member  Take a list
• Make full use of customer services available.

Talking on the telephone

• Make sure that family and friends know that it can take you some time to answer the telephone. Do not rush.
• Sit down before you pick up the phone
• Take a moment to catch your breath before you start the conversation If you become breathless talk in short sentences.

Feeling tired

Rest throughout the day, but balance periods of rest with some gentle exercise as prolonged rest can result in a rapid drain of energy that can lead to feelings over overwhelming tiredness.

Try the quick relaxation technique or listen to the relaxation tape.

Treat yourself now and again

Share your problems, don’t be afraid to ask for help.

Try not to worry too much about things that are out of your control

Try to develop an optimistic attitude to life.

Minimising worry, what to do

Breathing control

This can be used to ease your breathlessness i.e. following some exertion.

However if your breathlessness is increasing and your symptoms continue to worsen despite your relievers then contact your GP/hospital

Breathing in COPD

People with COPD tend to breathe more using the upper part of their chest, with shoulders hunched forward often fixing their arms on their knees.

This is inefficient and uses more energy than it gains.

While adopting this position, the oxygen you breathe in is not being used effectively.

What is breathing control?

This is a more efficient way of breathing and can help you to relax and have a feeling of control.

When practicing breathing control make sure you are in a comfortable position. Closing your eyes may help you to relax. Think about relaxing your shoulders and breathing in and out through your nose. Do not try to take deep breaths, just gentle breaths in and out. Think about slowing your breathing rate down.

Positions of ease

Position one	Postion two	Position three
Find a wall or window ledge to lean on. Rest your arms and let your head fall forwards.	Sitting leaning forwards, arms resting on your lap, or on a table will help.	Lean against a wall. Let your head fall forwards and your arms hang loosely at your sides.

Posture

Posture can affect breathing. Sitting slumped in a chair or lying slumped in a bed hinders the working of the main muscle of breathing i.e. the diaphragm.

The diaphragm is attached at the base of the ribs and a slumped posture stops it working correctly.

Sitting with a small cushion in the hollow of the back and with the chest supported to the back, lifts the ribs up and out of the stomach. This allows a longer, lower breath to be taken.

 In standing or moving, stretching up a little taller allows the ribs to lift up.

Pulling the shoulders blades together pushes the breast bone forward a little and also increases the capacity of the chest.

Warning signs

If you have COPD you are more likely to get chest infections and exacerbations. Exacerbations of COPD are when your usual symptoms become much worse. It is important that you call your doctor as soon as possible and receive the appropriate treatment. The sooner you receive treatment the easier it will be for you to recover.

You should call your doctor if you experience any of these warning signs

Relaxation is good for you but this doesn’t just mean sitting slumped in front of the television.  It has been proven that practiced regularly, relaxation lowers the blood pressure, heart rate and breathing rate as well as releasing endorphins, the body’s own pain relieving chemicals.

You should try to set aside 20 to 30 minutes per day to practice relaxation.

• Settle yourself comfortably propped on the bed with a pillow under your knees, to take the strain from your lower back, or sit comfortably supported in an armchair.
• Place your relaxed hands on your lap with your palms facing uppermost. Shut your eyes and take a few slow, long breaths.
• In turn relax all big muscle groups starting with your face, moving on to your arms and hands, then to your shoulders, chest and abdomen, buttocks, legs and feet.
• In turn tense all these areas, let go and feel the difference. Then enjoy the feeling of being relaxed.
• When you feel ready gently move and stretch your joints to waken up slowly.

You may feel you are able to relax more thoroughly to music. Relaxation tapes and CD’s are widely available and can be extremely effective.

Relaxation can be used both when you are acutely unwell and when your disease is stable.

Quick relaxation technique

When faced with a difficult situation, and you can feel your tension level rising, the following quick relaxation technique can help.

1. Stop
2. Sigh
3. Drop your shoulders
4. Take two or three controlled, relaxed breaths

Carry on more calmly and, if possible, a little more slowly. Speak to your physiotherapist if you are unsure of your technique.