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18 Breathing

Our respiratory muscles are working every minute of our lives. Without breath there is no life. We take approximately 20,000 breaths daily. Proper breathing technique is crucial for good health yet most of us give little thought as to how we breath and learning to breath correctly. At times I am startled to discover the times I am limiting my breath without being aware of it.

It is important to breath as deeply as possible. Deep breaths are more efficient because they allow your body to fully exchange incoming oxygen with out going carbon dioxide. Exhaling fully is as important as inhaling deeply otherwise there is insufficient room for incoming oxygen. A key to healthy respiration is slow exhalation in close connection with full and relaxed inhalation. The breath of life ebbs and flows naturally because of an amazing intelligence without which there would be no life.

Although the timing varies, all of us with ALS will have breathing problems. As our muscles involved with breathing weaken our breaths become shorter and shallower. This is a problem because less oxygen enters the blood and less carbon dioxide is released.

Weakened respiratory muscles can also make it difficult to cough with sufficient force to clear airways, allowing infections, such as bronchitis and pneumonia to set in. I have a history of bronchitis, sinus infections and air borne allergies so this is an important issue for me.

Some of the benefits of regular improved breathing practice:

  • strengthens your lungs

  • strengthens your critical diaphragm muscle

  • helps invigorate exhausted muscles

  • helps relieve anxiety, stress and tension in the body

  • helps you stay calm even when having a panic attack

  • helps you deal with pain

  • helps integrate your mind and body

  • leads to greater inner peace

I have discovered that directed breathing has a wonderful capacity to ease pain, soften stiffness and enliven exhausted muscles. For example, if I pause and breath into my fingers when my fingers give out while trying to button my shirt or computer keyboard, often I can resume with some degree of dexterity and complete the task. My worsening neck drop causes me a lot of pain. When I take the time to direct my breathing to my neck, it often reduces the tension and discomfort.

I have also found that my day goes much better when I take time to pause, slow way down and follow my natural breath. This simple practice that can be done in a minute or two has a remarkable calming and centering effect on me.

Since my ALS diagnosis, the Mayo Clinic has closely monitored my pulmonary function and started me on a nighttime BIPAP machine and a cough assist device as soon as they could get my insurance to cover this expensive equipment. The BIPAP facilitates deeper breathing and takes a load off my diaphragm and other respiratory muscles. It is referred to as non invasive ventilation and supplemental oxygen is not involved.

A cough assist is an airway clearance device that assists your breathing by clearing phlegm and other secretions from your lungs when your respiratory muscles are too weak to do so. I also have a suction machine to clear everything out if I can’t do it naturally.

Although I had no issues with phlegm, Dr. Ross, my neurologist, had me begin using a cough assist in connection with my BIPAP early on to keep my lungs healthy and to help strengthen my diaphragm. The approach was to prevent problems before they arise by using the device once or twice daily and to learn to use unfamiliar equipment when I am stronger and not sick. It is very difficult to add something additional to your routine when you are discouraged and not feeling well.

Because of the importance of keeping my respiratory system as strong as possible, I have also incorporated the following into my regular routine:

  • stack breathing exercises

  • anti-inflammatory diet, including no phlegm inducing dairy

  • numerous vitamins and supplements to support my immunity system

  • comprehensive protocol at first sign of respiratory infection

  • protocol for when flying commercial airlines

  • inhale peppermint essential oil when near someone who is sneezing or coughing

  • nasal pump flush

  • inhale steam

  • deep breath essential oils

  • essential oil defuser

  • nebulizer with food grade hydrogen peroxide with saline solution

  • breathing is integrated with my physical therapy and Feldenkrais lessons

  • meditation focused on breathing


Beloved Vietnamese Buddhist monk Thich Nhat Hanh points out that mindful breathing is a wonderful way to calm your body and feelings and to bring about stillness and peace of mind. Just allowing your breath to take place naturally helps harmonize your whole body and mind. As he teaches, becoming aware of your breathing is an important step in taking care of yourself.


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