Some notes From papapoo

Ever since the doctor whapped me on the butt almost 65 years ago, I have been addicted to oxygen.  When I first started out and for the first 63 years of my life, the oxygen content in air, which I understand is in the neighborhood of 21%, was perfectly fine.  Even though 40 years of smoking caused a deterioration of my lungs, the Maker gave me enough flexibility in my physical makeup to continue to feed my oxygen  addiction at a satisfactory rate with that 21%.  However, a little over a year ago, my body said, "Enough is enough, if you want me to continue to get out of the bed and off your back, you are going to have to supplement the 21% with a little extra."  Now my body continued, "Also, Bill, since you have been so abusive to me, I am going to make it even harder for you -- I am also going to make you a 'retainer' so that you are going to have to be careful with that oxygen level so that your CO2 will not build up too high."

Now, you may not believe this, but when I next visited my doctor, he said essentially the same thing.  (Fortunately I had picked out a great doctor and had a good rapport with him because I had read Bill Horden's Survival Guide.  The doctor of pulmonary medicine did say that I should use the oxygen as prescribed and treat it like I would any other prescription or therapy because that is what it is.  He also gave me the amounts that I should use when at rest, during activity, and at night when I wear a BiPap to control my breathing and keep the CO2 levels down.  He also advised me that I should:

First, stay within the guidelines that he had established for me because, particularly for retainers, too much oxygen is not good for me.

Don't try to reduce the level of oxygen without consultation with him.  As he explained, "Everyone is different and we must proceed with a structured plan that will work for you.  It is a lot like smoking.  Trying to cut down just does not work for most folks.  So if I am going to continue to get these big bucks for treating you, why not listen to what I have to say?"

So now I am fat, dumb and happy with my hose in my nose 24/7 and reasonably healthy -- but definitely still addicted to oxygen!
 
 

Speaking of oxygen, every Lunger needs to understand that proper breathing is also the key to keeping the oxygen and carbon dioxide at reasonable levels.  I am not going to go in to the specifics of the proper numbers that must be maintained, but it sufficient to say that Lungers need to understand how to breathe properly and particularly how to force themselves to breathe properly when  Shortness of Breath (SOB) comes calling.  If you don't, you take a good chance of doing exactly what I did during my big crash - that is become more and more concerned that you can't breathe and the more you concern yourself, the more difficulty you have breathing.  Now some call this panic.  It may not meet the medical definition of panic but it is a form of panic nonetheless.

About a year ago I stole the following from a document I had and have been using it as the basis of discussions with others who are interested.  Hope I do not bore you with the basics of pursed-lip breathing and diaphragmatic breathing.  Year before last before I joined the COPD Online Support Group  and met a couple of the more militant champions of managing your own care,  I managed to pitch myself to the crash level and ended up in the hospital five times in about 60 days.  I already had a primary physician and a doctor of pulmonary medicine but it was not until the fifth trip when a nurse (who reminded me of a Marine Corps Drill Instructor) in ICU came over to me and in her gruff voice told me I should purse-lip breathe.  Since I was almost as big as she was and a whole lot better looking, I retorted, "What is pursed lip breathing?"  She was flabbergasted and wanted to know what planet I was from. Anyway, she taught me the basics and damned if it did not work for me.  Later on in pulmonary rehab, I learned more about diaphragmatic breathing, effective coughing, postural drainage and percussion/vibration methods for clearing the lungs.
 
 

Pursed-lip breathing (Sniff the roses, blow out the candles)
Slowly breathe in through your nose, keeping your mouth closed.  It's not necessary to take a deep breath; a normal breath will do. Pucker your lips in a whistling position and breathe out slowly, gently tightening your stomach muscles to help push the air out through your lips. Be sure to use enough pressure to make a sound but do not force exhalation. EXHALE AT LEAST TWICE AS LONG AS YOU INHALE. You will find that this will become second nature for your breathing when you exercise or do any other kind of physical activity.

Diaphragmatic Breathing (Belly breathing or use your belly for something other than a coffee cup rest)
We lungers often have weak and flattened diaphragms for reasons that I will not discuss here (aren't you glad?) but what happens is as your diaphragm is better able to work, the effort of breathing eases.
Place one hand on your belly just below the ribs and the other hand on the upper part of your chest.  Breathe in through your nose so that your belly moves out against your hand as far as it will go.  Keep your other hand on your chest which should be as still as possible. As you breathe out slowly and fully through pursed lips, press your belly gently upward and inward with your hand. EXHALE AT LEAST TWICE AS LONG AS YOU INHALE.  Concentrate on keeping your chest still so that it is your diaphragm and not your chest and neck muscles that do the work of breathing.

Now if you do the two methods together, you have mastered "Lunger Breathing