Gay Baldwin,
Melbourne, Australia

This is an account of the progress made by my daughter, Laura, since attending a Buteyko workshop conducted in Melbourne in early 1993. I wish she would tell it herself but she is a 16 year old enjoying her life very much and preoccupied with other matters. She also says she doesn't remember a lot of the details. I will show it to her before sending it and get her O.K.

Laura developed asthma when she was about one. She started on low doses of medication but as the condition worsened the medication increased and became a regular part of life. The puzzle of asthma started very early. The doctors refused to put that label on it for a while (and weren't supposed to use the word with parents - why?). When Ventolin was first prescribed for her, we were concerned because my husband had suffered a mild attack of asthma several years before this and had been told by a different doctor that he must not on any account take more than two puffs of this stuff because it was very powerful and could `carry him off'. (It had just been released.) By the time we took the family to the United States in 1983, when Laura was three, we had to carry a nebulizer (`pump') with us. Ventolin had not been released in the States then. When we consulted an American doctor and told him about treatment in Australia, he told us that Laura had bronchitis, not asthma, and that we should be very wary of Ventolin because it was a strong, dangerous drug. When we returned home, our doctor said that the American `didn't know what he was talking about'.

Laura's asthma continued to get worse and we were using the pump more and more. The initial instructions (we must never use it more than 4-hourly) gradually changed to a suggestion that we use our judgment. One of the good things about our GP was that he admitted uncertainty and puzzlement very readily, told us that we probably knew more about our daughter's condition than anyone and that he saw us as equal partners in its management. But the uncertainty and conflicting messages were disconcerting and worrying.

Despite all our efforts, Laura ended up in the Children's Hospital about six times. There we talked to many different doctors about asthma - all concerned and helpful, all trying to inform us as fully as possible, but some admitting how little was understood. At that time, they were emphatic in their dismissal of any theory which posited a psychological or emotional element in asthma attacks. This fitted our sense of our daughter who, of our four children, seemed the happiest and most easygoing, despite her affliction..

As Laura's asthma got worse, so did her eczema, hayfever and rhinitis. Her sheets would be covered with blood from eczema lesions; her eyes and face would sometimes puff up so much she couldn't see; her nose was constantly blocked and often running like a tap. She used large quantities of hydrocortisone creams which only stopped the eczema from getting worse; she had far more doses of oral steroids than we were happy with (which made her puff up alarmingly); anti-histamines and nasal sprays did nothing for the hayfever. Her father and I would lie awake sometimes listening to her cough for hours on end, night after night. She was amazingly patient and good-tempered through all of this, following instructions and taking a vast array of medication without complaint. (It used to amaze me that Laura would cheerfully swallow foul substances when she was two and three - I still gag on aspirin and take almost no medication from one year to the next.)

The only time it all became too much for her was when we flirted with an `alternative' treatment of eczema - suggested, however, by the head of the Skin Diseases section of the Children's Hospital. It was all to do with cold compresses, smooth clothing, ointments based on Sorbolene-type substances and `thinking cool'. Her skin reacted violently and Laura became very distressed. We kept ringing the specialist who told us that she was not allergic to the various ointments but that we could try another if we insisted. After two weeks we took her back to our regular skin specialist who told us that it was a medical emergency because Laura's skin was so bad it had lost the capacity to regulate temperature. He put her back on to large doses of steroids. So much for alternative medicine, we thought.

We were going along like this, getting more and more depressed about her condition and her future when she had a massive asthma attack. It was terrifying because it progressed so quickly. Our local doctor immediately called an ambulance and said he had never seen such a swift deterioration. When I mentioned this to the specialist in the Children's Hospital, he informed me that he knew of cases where the time from first onset to respiratory arrest was 30 seconds, which terrified us further. Laura was in the hospital for almost two weeks. The whole thing was a nightmare. She was on 10 minute pumps, then on alternating pumps and oxygen. She was put into intensive care for a while, on neat, continuous Ventolin. Her heart beat started raising and fluctuating wildly (tachycardia) and she suffered from pronounced shaking of the body. She was, of course, on a steroid drip, swelling up before our eyes. Every time doctors or nurses listened to her lungs, there would be a concerned flapping around, because the passages were so blocked. One specialist came in on his day off just to check on her. The concern and attention she received from the staff were wonderful, but she didn't get better. They couldn't understand why she wasn't improving.

Finally, one of the doctors decided, on intuition, to cut back on the Ventolin. She simply told us that the Ventolin obviously wasn't helping Laura as it should, so they were going to try cutting back to 4-hourly pumps and monitor what happened. Laura started to get better. In the next few days, they did a lot of tests and were puzzled. Her lung function tests were considerably better than they had expected. After a lot of conferring, they suggested that they would like Laura to talk to one of their psychiatrists. We were astounded: after all these years of being told that asthma was a purely physical reaction of the air passages and all that she - and we - had been through during this attack, we were now hearing that all this might be `in the head'? `No, of course not', they said, `but our psychiatric unit is becoming more convinced that there is some psychological element with a number of these adolescents we are seeing whose symptoms are getting a lot worse'. The talk with the psychiatrist was quite inconclusive, though she did circle a bit around the notion of panic. At least it wasn't questions about whether everything was OK at home.

We had to rush Laura back to the hospital after a few days because she was wheezing louder than we had every heard and was very distressed. She was re-admitted, but given very little attention. When we asked for some, we were told she wasn't very bad. What about the sound of her lungs? I asked. The reply was `That doesn't mean very much. You can't really tell anything from listening to the lungs'. This after days of having many different people listening to her lungs and making alarmed faces which scared us terribly. The next day, they set up another `talk' with Laura and asked us not to be present. The diagnosis was plain - over-protective parents, convincing this child she was worse than she was (despite the fact that the whole sense of crisis and emergency had all come from doctors and nurses while we watched helplessly). I went to see our doctor, told him the story and collapsed into tears. He was furious - what the hell do they think they're doing? he said. He rang immediately and gave someone a blast. The result was a civilized conference, with apologies and air-clearing, but still pretty complete confusion about what we were dealing with.

Several weeks later, we had a very good talk with Laura's paediatrician, who had supervised the whole episode, but, given the way hospitals work, had not been present for a lot of it. He was wonderful - he's always been one of the most open and honest doctors I have met. He talked with real anguish about asthma in the community - its frightening growth, the uncertainty about causes, different ideas about treatment, etc. At one stage, he said `Sometimes I fear that everything we are doing is just making it worse.' He admitted that some experts were re-considering the possibility of a psychological element and mused reflectively, `who knows, perhaps there's some hyperventilation involved and this can be brought on by fear and panic'. He also said he wanted to try Laura on some breathing exercises and recommended a physiotherapist. Of course we tried this - we have always tried everything they have suggested to us. The physio gave Laura a couple of sessions on diaphragmatic breathing which seemed to have no effect.

I have gone into this in detail because I want to convey my strong sense of the confusions and contradictions in the medical response to asthma, and the effect all of this can have on parents trying to find their way through the maze, watching their child getting worse as the range and doses of medication increase.

Laura emerged from hospital very pale, overweight and dispirited. I took time off work to look after her and recover myself. After a few weeks I took her to Queensland to get some sun. Everywhere we went - into the rainforest, out on the Barrier Reef - we took the pump, after checking that an electricity supply would be available at all times. I couldn't bear to think of what her future life might be like.

Then someone told me about Buteyko. At first I thought, `Oh no, not another crack-pot theory'. Kind people were always suggesting to us that we should cut out milk, move to the country, etc. Our experience with `thinking cool' to cure eczema hadn't helped. But we were desperate - what did we have to lose, except a bit of money, which we would have paid many, many times over for something that worked?

The first workshop was off-putting in some ways. The style of the Russian practitioners was very different from typical Australian approaches - they were very emphatic and rather stern. They could not understand why Australian parents had any qualms about taping their children's mouths, for instance. And it made me very nervous that they claimed that over-breathing was the cause of so many different diseases - what kind of `universal panacea' were they offering? However, as they explained the theory in relation to asthma, it struck all sorts of chords with me. It offered an explanation for a lot of the puzzles I have outlined above. Hyper-ventilation, yes! Exacerbated at times by fear and panic, not necessarily any underlying emotional trauma, yes! Ventolin making things worse, yes! The allergies acting as triggers and themselves symptoms, not primary causes, yes! A tendency to become allergic to more and more things, yes! It was very exciting, despite my reservations. The other exciting thing is that they told participants to expect a better sleep even after the first night - and Laura did! She coughed very little and had the quietest sleep she had had for months. That continued all week (we went for a two-hour session on seven consecutive evenings).

Laura was 12 when she did the Buteyko workshop. She seemed to be the worse case in the group, starting with a control pause of 4 seconds and a maximum pause of 6. By the end of the week, she had worked them up to about 13 and 18 (though she found it very difficult to define exactly when she started to feel discomfort, being very inclined to do so after a few seconds - one of the reasons she has never found the control pause very useful). She found the exercises very hard and her caring father was, I know, inclined to discontinue the whole thing because he hated to see her upset. Her mother was already into `tough love' because of the glimpsed possibility of a seemingly miraculous way out of the nightmare. On the last night, one of the leaders (I think Sasha) concentrated on her and asked about her control pause. When she said `13', he frowned fiercely and said `That's terrible'. Laura thought she was being reprimanded and almost cried, but as he went on she and I both realized that he was concerned for her and thought she had started in a very bad state. Her breathing had become so bad that she was going to have to work very hard to re-condition it.

She did work hard - for years (with a lot of monitoring, nagging and unashamed bribing from her parents). I can't pretend she has been consistently focused on the technique, but she has been sufficiently motivated to transform her breathing patterns (she brought her maximum pause up to 170 seconds) and to use breathing exercises to control shortness of breath when it occurs. Her motivation was given a significant boost when we took her to an allergist just after we started the Buteyko workshop - an appointment arranged months before. He wanted her to go on to 8 puffs of Becloforte twice a day (a dose our local doctor considered likely to produce major, harmful side effects) and 4-hourly Ventolin pumps as routine treatment, while she cut out of her diet about 95% of all the foods she liked. She didn't have to think long before deciding that she would prefer to do the breathing exercises.

Laura has had almost no serious asthma since starting Buteyko and little shortness of breath. She has used the pump only twice in the last three and a half years - in doctors' surgeries, at their insistence. She does carry a puffer and uses it occasionally - I think it is a security need more than anything. I would like her to stop that, but feel I must leave it up to her. She takes one puff of Becloforte morning and night and will try cutting that out soon. I had started to say that she was cured of asthma, but two months ago she did have a worrying attack while her father and I were away, triggered by a bad bout of flu. The doctor told her to go to the hospital if it got any worse, but she and her older brother decided that she would try dealing with it at home, with Prednisone and breathing. Laura judged that she was not nearly as bad as she had been in the past and that it was safe to wait. The attack passed within 24 hours, much faster than previously and she was pretty much back to normal. It was disappointing, but also encouraging that she dealt with it so well.

Laura's hayfever and rhinitis are greatly improved and so is her eczema - although that has taken longer. The eczema remains a mystery. One of the Buteyko people told me that her eczema would get worse before it got better, without explaining why. He was right. Then a strange thing happened - it moved out of her body, retreating to her limbs. The skin on her trunk, neck and face gradually changed in character, becoming smooth, moist and olive-brown - skin like her father's which she had when she was a little girl but which disappeared for years. The skin on her arms and legs is still mottled red, dry, scaly and scarred with lesions, most of them old ones but some still new. It is a most peculiar thing to see - almost as if a poison is gradually leaving her system; but the process seems to have stalled recently. I keep feeling that there is still a final breakthrough to make with her breathing, to get rid of these last remnants of the diseases. I suspect the problem is with the night-time breathing, when she sometimes reverts to mouth breathing. I am still not prepared to try to make her tape her mouth. She fears that her nose will get blocked, she won't be able to breathe and will expire quietly in her sleep!

However, the transformation in her health and life is quite remarkable. She has a beautiful singing voice, very powerful, with wonderfully controlled breathing, and she plans to make a career of singing if she can. She has had this passion since she was a little girl and Peter and I used to feel very sad at the thought that she couldn't possibly realize this ambition with her asthma. Now she has a chance.

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