A Breathing Technique Offers Help for People With Asthma
Buteyko was ridiculed for many years in the West -- in a typical rejection of anything outside familiar parameters. The anecdotal evidence in favour of the technique was so strong, however, that a few trials have now been done -- with striking results. Buteyko techniques also seem to have been quietly adopted as an option in many mainstream asthma clinics
I don’t often write about alternative remedies for serious medical conditions. Most have little more than anecdotal support, and few have been found effective in well-designed clinical trials. Such trials randomly assign patients to one of two or more treatments and, wherever possible, assess the results without telling either the patients or evaluators who received which treatment.
Now, however, in describing an alternative treatment for asthma that does not yet have top clinical ratings in this country (although it is taught in Russian medical schools and covered by insurance in Australia), I am going beyond my usually stringent research criteria for three reasons * The treatment, a breathing technique discovered half a century ago, is harmless if practiced as directed with a well-trained therapist.
* It has the potential to improve the health and quality of life of many people with asthma, while saving health care dollars.
* I’ve seen it work miraculously well for a friend who had little choice but to stop using the steroid medications that were keeping him alive.
My friend, David Wiebe, 58, of Woodstock, N.Y., is a well-known maker of violins and cellos, with a 48-year history of severe asthma that was treated with bronchodilators and steroids for two decades. Ten years ago, Mr. Wiebe noticed gradually worsening vision problems, eventually diagnosed as a form of macular degeneration caused by the steroids. Two leading retina specialists told him to stop using the drugs if he wanted to preserve his sight.
He did, and endured several terrifying trips to the emergency room when asthma attacks raged out of control and forced him to resume steroids temporarily to stay alive.
Nothing else he tried seemed to work. “After having a really poor couple of years with significantly reduced quality of life and performance at work,” he told me, “I was ready to give up my eyesight and go back on steroids just so I could breathe better.”
Treatment From the ’50s
Then, last spring, someone told him about the Buteyko method, a shallow-breathing technique developed in 1952 by a Russian doctor, Konstantin Buteyko. Mr. Wiebe watched a video demonstration on YouTube and mimicked the instructions shown.
“I could actually feel my airways relax and open,” he recalled. “This was impressive. Two of the participants on the video were basically incapacitated by their asthma and on disability leave from their jobs. They each admitted that keeping up with the exercises was difficult but said they had been able to cut back on their medications by about 75 percent and their quality of life was gradually returning.”
A further search uncovered the Buteyko Center USA in his hometown, newly established as the official North American representative of the Buteyko Clinic in Moscow.
“When I came to the center, I was without hope,” Mr. Wiebe said. “I was using my rescue inhaler 20 or more times in a 24-hour period. If I was exposed to any kind of irritant or allergen, I could easily get a reaction that jeopardized my existence and forced me to go back on steroids to save my life. I was a mess.”
But three months later, after a series of lessons and refresher sessions in shallow breathing, he said, “I am using less than one puff of the inhaler each day — no drugs, just breathing exercises.”
Mr. Wiebe doesn’t claim to be cured, though he believes this could eventually happen if he remains diligent about the exercises. But he said: “My quality of life has improved beyond my expectations. It’s very exciting and amazing. More people should know about this.”
Ordinarily, during an asthma attack, people panic and breathe quickly and as deeply as they can, blowing off more and more carbon dioxide. Breathing rate is controlled not by the amount of oxygen in the blood but by the amount of carbon dioxide, the gas that regulates the acid-base level of the blood.
Dr. Buteyko concluded that hyperventilation — breathing too fast and too deeply — could be the underlying cause of asthma, making it worse by lowering the level of carbon dioxide in the blood so much that the airways constrict to conserve it.
This technique may seem counterintuitive: when short of breath or overly stressed, instead of taking a deep breath, the Buteyko method instructs people to breathe shallowly and slowly through the nose, breaking the vicious cycle of rapid, gasping breaths, airway constriction and increased wheezing.
The shallow breathing aspect intrigued me because I had discovered its benefits during my daily lap swims. I noticed that swimmers who had to stop to catch their breath after a few lengths of the pool were taking deep breaths every other stroke, whereas I take in small puffs of air after several strokes and can go indefinitely without becoming winded.
The Buteyko practitioners in Woodstock, Sasha and Thomas Yakovlev-Fredricksen, were trained in Moscow by Dr. Andrey Novozhilov, a Buteyko disciple. Their treatment involves two courses of five sessions each: one in breathing technique and the other in lifestyle management. The breathing exercises gradually enable clients to lengthen the time between breaths. Mr. Wiebe, for example, can now take a breath after more than 10 seconds instead of just 2 while at rest.
Responses May Vary
His board-certified pulmonologist, Dr. Marie C. Lingat, told me: “Based on objective data, his breathing has improved since April even without steroids. The goal now is to make sure he maintains the improvement. The Buteyko method works for him, but that doesn’t mean everyone who has asthma would respond in the same way.”
In an interview, Mrs. Yakovlev-Fredricksen said: “People don’t realize that too much air can be harmful to health. Almost every asthmatic breathes through his mouth and takes deep, forceful inhalations that trigger a bronchospasm,” the hallmark of asthma.
“We teach them to inhale through the nose, even when they speak and when they sleep, so they don’t lose too much carbon dioxide,” she added.
At the Woodstock center, clients are also taught how to deal with stress and how to exercise without hyperventilating and to avoid foods that in some people can provoke an asthma attack.
The practitioners emphasize that Buteyko clients are never told to stop their medications, though in controlled clinical trials in Australia and elsewhere, most have been able to reduce their dependence on drugs significantly. The various trials, including a British study of 384 patients, have found that, on average, those who are diligent about practicing Buteyko breathing can expect a 90 percent reduction in the use of rescue inhalers and a 50 percent reduction in the need for steroids within three to six months.
The British Thoracic Society has given the technique a “B” rating, meaning that positive results of the trials are likely to have come from the Buteyko method and not some other factor. Now, perhaps, it is time for the pharmaceutically supported American medical community to explore this nondrug technique as well.
TO look and listen to Daniel Roper you would never think that a month ago he was at death's door. Melanoma had spread through his body and the Melbourne man, 25, was given two days to live, the Herald Sun reported.
But at the 11th hour a US drug company, hospital ethical boards and brave doctors gave Mr Roper a long shot at life - an experimental course of drugs. Overnight on February 28 he recovered and, just four days later, he walked out of the Austin Hospital.
"I felt like I was going to burst," he said. "It was literally overnight that the fluid started draining and all the signs started moving in the right direction. The speed of it was just amazing."
He had learned only in December that melanoma had spread through his body and by January his spine, liver, lungs and ribs were riddled with tumours.
His only hope was a transfer to the Austin Hospital, where an experimental drug combination, which switches off the cancer gene, BRAF, and disables its driver, MEK, was scheduled for trials in a few weeks. Only 60 people in the world, and five in Victoria, are being selected for the world-first trial.
But Daniel suddenly deteriorated and he blew up with a massive infection in his abdomen.
He had 19 litres of fluid drained from his body in two days, and as he slipped away calls were made across the globe to bring the Victorian part of the trial forward. His situation was so dire that his mother Helen's hope wasn't that he would survive, but that he would hang on for a few more days until his sister arrived from the US. "I could see him going in front of my eyes. I have been nursing for 30 years and I knew he wasn't going to last," Mrs Roper said.
The long-term success of the drug - and Mr Roper's prognosis - is unknown.
The Austin's head of cancer medicine, Prof Jonathan Cebon, said the effort required just to get Daniel the chance of taking the drug was as remarkable as its effects. GlaxoSmithKline fast-tracked approval in the US and the Austin's ethics committee paved the way for the experiment to begin. Specialists fast-tracked weeks of tests so he could be ready in just 24 hours.
In a twist of fate, the randomised trial allocated Daniel to the control group, meaning he received only the BRAF drug, but it was enough to save his life. "It was a race between us and the disease," Prof Cebon said.
Mr Roper's hope now is that the Austin regains its $45 million in state government financing.