• If that amount of time off of oxygen frightens you, one of the things that might ease your distress is to ask to be on an oximeter while you are waiting to be put back on oxygen. You might ask your oxygen supplier or doctor's office to try that now rather than waiting until the next time you are retested. It might reassure you about your ability to survive a power outage. Would it surprise you to see that your oxygen level probably will remain in an acceptable range, above 88%, while you are quietly sitting? In fact, many people may find that their oxygen levels remain much higher than that.
  • If you are distressed, or start to panic when off of oxygen for such a short time, look at your breathing pattern. Is your breathing slow and relaxed? By slow, we mean that it probably should not be more than 16 breaths a minute if you are sitting in a chair. Slower is better. If your breathing is up to 30 or 40 breaths a minute you will most likely feel short of breath. You are beginning to panic.
  • Yes, you DO have some control over your breathing! Your respiratory system is unique in many ways. It is the only system of the body that is automatic (that is, your body will breathe for you if you are unconscious, or sleeping, or not thinking about it) yet you can easily choose to control your own breathing pattern. You CAN choose to breathe quickly. Try it now. You CAN choose to breathe very slowly. Try that now. You can also even hold your breath for a short time. You DO have a great deal of control over your breathing, and you can use that control, that power, to help yourself!
  • As you sit there with slow, relaxed breathing, notice your shoulders. Are they tense, and up near your ears? Relax them! Let your shoulder drop and relax as your breathing becomes slow and relaxed.
  • You also need to be sure that you are breathing out two or three times longer than you breathe in. This is very important! Why? Let me explain. Lungs damaged by COPD loose much of their elasticity. It is difficult to get all the air out of your lungs and you now have to work at it. If you think you work harder at breathing than some of your friends and relatives, you are absolutely right. There may be a 17 fold increase in the work of breathing because of this loss of elasticity and the work of getting air out of the lungs. Your lungs used to be like a balloon. You worked to get air into it, but when you allowed air to escape, like a balloon, it flowed out without effort. Now your lungs, if you have severe COPD, can be more likened to a paper bag. If you blow into a paper bag, the air stays in there. You have to squeeze the bag flat to get the air out of it.
  • How do we know if this is your problem? Do you remember taking a pulmonary function test, or having spirometry done? Do you remember the technician telling you to breathe out, out, out, out, out? This is how we measure your FEV1 , the forced expiratory volume of air that you can breathe out in one second. It is one way of telling how much damage, you have. A normal FEV1 is between 80 to 100% of the level predicted for someone of your height, age and sex. An FEV1 below 80% is abnormal. Many of our readers may have an FEV1 of only 30%, or 20%, or even lower. That means you can only force out 30%, or 20%, of the air in one second that someone with healthy lungs can. If you don't get that air out, there isn't room for fresh, oxygenated air to get in, is there? Can you now see why it is so very important for you to concentrate on breathing air out three times longer than you breathe in? But, in order to do so you must breathe much slower if you have COPD. Can you understand why gulping air in, breathing air as fast as you can, does nothing to help your shortness of breath?. It actually makes your shortness of breath worse, doesn't it? You must get that trapped air out!
  • Another problem that develops with COPD is that the residual volume of air in the lungs (the volume of air left in the lungs after you breathe out maximally) increases by 50%, 100%, or even 200% of normal. This can also be measured in your pulmonary function laboratory. Some residual air in your lungs is normal. Look at the balloon again for a simplified explanation. The "empty" balloon still has some air in it to keep it from totally collapsing and having the sides stick together. However, if you have 2 or 3 times as much residual air left in your lungs it leaves less room for freshly oxygenated air.
  • If you can breathe with your diaphragm, instead of lifting your chest up and down, that also will help. Would you like to give it a try? Start by lying down. Put one hand on your upper chest, and the other hand on your stomach. When you breathe in, your stomach area will pooch out. As you exhale, your stomach area will tighten to squeeze the air out of your lungs. Your chest should not move at all. You can see why this is often called "belly breathing". Do this for just a few minutes at a time to start with. Don't worry if you can't get it right away. Learning diaphragmatic breathing can take weeks of practice for some people, and may be especially difficult for those with very severe emphysema.
  • Now, where are we? You are sitting relaxed in your chair watching the oximeter show that your oxygen level is quite satisfactory. Your breathing is slow and relaxed. You are concentrating on breathing out, rather than in, and are breathing out three times longer that you are breathing in. Your shoulders are dropped and relaxed. You may even be able to do diaphragmatic breathing. Is there anything else that you can do to help yourself? Yes. You can do pursed lips breathing.
  • Done properly, pursed lips breathing (PLB) can sometimes raise your oxygen level just as high as it can be raised with the 2 lpm (liters per minute) of oxygen that you may be on. That's a pretty neat trick, isn't it? Learn correct pursed lips breathing and avoid panic.