Yoga and COPD – The Case of P and Q

This week I had the privilege of doing a yoga group with patients "P" and "Q", both with exacerbation of COPD going on.  What I have noticed about persons with COPD (and many others as well) is that they have trouble getting all their old air out; therefore, it is tough to get enough new oxygenated air in!  This was the case with P and Q.  In addition, those with COPD breathe high in the chest, often pumping their shoulders up and down as they breathe.  Because this way of breathing does not access the deeper muscles of breathing, it is an inefficient way of breathing.  This leads to fast shallow breathing, anxiety, and extreme muscular tension around the shoulders and neck.  Coincidentally, both patients also had pain issues going on.  P had rib pain of 9/10  and Q had low back pain of 7/10.

First, I wanted to assist P and Q to exhale more completely, so I led them in a three part exhale.  This entails breathing out as completely as possible through the nose (if the nose is clear), inhaling as completely as possible through the nose (again, if the nose is clear), then releasing a bit of air, pausing, releasing a bit of air, pausing, releasing the remainder, pausing, inhaling again and continuing with the three part exhale.  We continued the three part exhale for 10-20 breath cycles.

Next, I wanted to help P and Q increase their breath capacity on the inhale, so I led them in a three part inhale.  First, I had them breathe out through the nose completely, then take in a small sip of air, pause, take in another sip, pause, breathe in as deeply as possible, pause, then release all the old air out.  We continued this for 10-20 breath cycles.   It should be noted that I informed the patients to return to normal spontaneous breath anytime they felt stress in the breath before trying the three part breathing again.

After practicing both the three part inhale and the three part exhale, both patients reported being able to breathe easier and deeper.  As a bonus, P reported that her pain had decreased from 9/10 to 7/10 and Q reported that her pain had decreased from 7/10 to 4-5/10.

Next I led the patients in simple joint-freeing exercises, starting with exercises for the eyes and moving downward.  For the most part,  this involved flexing and extending the joints and doing other simple movements paired with the inhale or exhale.  For example, I asked them to roll the shoulders forward and up toward the ears on the inhale and back and down on the exhale.  After the joint-freeing series, I led the patients in a three part meditation.  The first part involved a body scan exercise in which I had them simply become aware of each body part as I mentioned it and imagine that part being filled with joy.  After the body scan I asked them to imagine each of their trillions of cells containing a yellow smiley face.  Finally, I asked the patients to recall the most joyful experience they could remember and to bring the sensations of joy into their bodies now. 

At the end of the session, not only were the patients breathing better, but P reported her pain had decreased further from 7/10 to 4/10 and Q reported her pain further decreasing from 4-5-10 to 2-3/10. 

These are the kind of results that I always look for in my work.  This was indeed a good day and one I will call upon when accessing my own joyful memories.