WHERE THERE'S A WHEEZE,
THERE'S A WAY

Health: Clear view of the way ahead - Where there's a wheeze, there's a way: Sally Magnusson examines fresh thinking on asthma

By SALLY MAGNUSSON, The Herald, Scotland 10th October 1996


Dressing like a pop star, fumbling your slides, losing the thread of your patently unplanned lecture, and getting grumpy with your audience is not the approach best calculated to win the allegiance of thrawn and sceptical Scots.

Indeed, it was not until the third Buteyko seminar that Christopher Drake, the man claiming to bring a revolution in asthma treatment to the country, began to realise there might be an art to explaining complex and controversial ideas to the hundreds of doctors, nurses and physiotherapists, and asthma sufferers, who turned up to hear him. On the other hand, as someone remarked wryly after the particularly shambolic second seminar in Glasgow, if he really were a quack he would have dressed like a consultant, prepared a slick presentation, and been nice to everyone.

Christopher Drake, a laid-back Australian, gives the impression of being too convinced he's right to bother much about the arts of persuasion. Maybe messiahs never arrive in the guise you expect. 'Just come to one of my courses and see whether it works,' he kept saying. Dozens of people did, and I went along to watch.

What he does in these five evening workshops is to teach a gruelling series of breathing exercises, designed to help asthmatics take in less air and so boost their carbon dioxide levels. The theory, developed by a Russian physician called Buteyko, is that asthmatics, and others with different physiological weaknesses, are chronically over-breathing. Asthma, so the theory goes, is one of the several defence mechanisms against over-breathing; when the breathing is shallow, the various triggers like pets and colds and dust mites will no longer produce this excessive defence. Physiotherapists, who spend their lives teaching people to breathe deeply, and doctors, who tend to associate over-breathing with acute hyperventilation, which is something quite different, are still pretty sceptical about the whole thing. But some GPs, recognising their limitations with this spiralling disease, have started to refer patients.

The people attending Scotland's first workshop in Glasgow had widely varying ages, backgrounds, and types of asthma. What most of them had in common was daily dependency on a mind-boggling array of drugs - not just the steroid inhalers which are supposed to prevent attacks, but symptomatic medications like Ventolin, Bricanyl, and the massively powerful Serevent, all of which Christopher Drake claims are making the over-breathing worse, leading the patient on to stronger steroids in a debilitating vicious circle.

On the last evening I spoke to all but three of the 22 people who had paid Pounds 290 for the course. All - to a man, woman, and even child - spoke of initial scepticism giving way to surprised delight as the symptomatic medication was jettisoned (steroids were to be reduced later, but only in consultation with a doctor) and the wheezing became controlled by breathing alone. They felt better, looked great, and were facing the future with something app-roaching optimism for what in some cases was the first time they could remember. Many of them, at my request, kept a diary of the week. Lily Weir (39), from Glasgow, who despite taking all the prescribed medication has been close to death from asthma, was typical:

Day 1: I didn't know what to expect tonight. I'm not sure I understand all the theories behind it and I find the shallow breathing very difficult. The tutor asked me to stop taking Serevent. Mercy! But I will. Taped my mouth up during the night to stop me breathing through it.
Day 2: Dropped the Serevent today. Can't really say I missed it. Came home very excited from the class tonight. At one point my chest felt totally and utterly clear and without a wheeze, a way it hasn't felt for years. It took me totally by surprise and I thought I was imagining it, until I heard the lady next to me in class say to the lady next to her. 'I feel really clear here', and point to the lower part of her chest. The feeling lasted for about 15 minutes. Incredible.
Day 3: Still struggling with the shallow breathing exercises, although I caught myself doing it today at work, without trying to. Still OK without Serevent. Took Bricanyl a couple of times, but even that's a huge improvement. Still taking Becloforte, Volumax, and Unyphyllin. The 'clear chest' feeling at class tonight lasted a wee bit longer.
Day 4: Didn't use Bricanyl at all today. Tried to do shallow breathing as much as possible, even if it's only in short bursts. I think I'm getting better at it. My breathing is definitely easier with fewer drugs. I'm amazed. I was a wee bit cynical at the start, but I can't deny I've made progress.
Day 5: I still find the exercises very difficult, but I feel so much better. I now experience a clear chest in one-and-a-half-hour bursts through the day and can successfully use the breathing method to stop wheezing.'

Elaine Gillespie, a 17-year-old from Greenock, was on a frighteningly high dosage of drugs. When she started the course she couldn't walk up a flight of stairs without resting and had to travel to school, one block away, by car. She wrote:
Day 1: Today was the first workshop and we were told about the 'maximum pause' breathing exercise. I was a bit sceptical about this, because it was the complete opposite of what I had been told to do in the past and it was very uncomfortable. Instead of taking big, deep breaths, we were told not to breathe at all!
Day 2: I didn't use any Serevent today and only needed six puffs of Ventolin, which is great because I usually need about 45 puffs plus two nebulisers.
Day 3: I am completely off Serevent, Ventolin, and have halved my Uniphyllin dose. My appetite has diminished and I also have more energy.
Day 4: Still no Serevent or Ventolin. I had an attack today when I woke up and I did a maximum pause and shallow breathing. My breathing returned to normal and I did not need any medication.
Day 5: No medication apart from the steroids Prednisolone and Flixotide. I didn't have any symptoms and I catch myself shallow breathing without thinking about it. I am really pleased with the way things have gone this week. It is strange not to be constantly shaking from the effects of Ventolin. I cannot see why this method seems to be in for so much scepticism. It works, and no-one in the class has not made an improvement.' Afterwards she told me excitedly: 'I've been asthmatic since I was 18 months old. Now I'm a healthier colour, I sleep very well, and I'm looking forward to watching You've Been Framed without having to go on the nebuliser every time I laugh.'

Nothing brought home to me the life-destroying misery of chronic asthma as sharply as this picture of a teenager who couldn't watch Jeremy Beadle without a nebuliser. It seems to me that if Christopher Drake had succeeded merely in giving that one youngster the promise of even a semi-normal life, he would have done enough to wipe the floor with his critics. But I was getting similar stories from every corner of the room. David Iles (53), from Galston, so severely asthmatic that he had to give up work, approached the course grudgingly, and only on his wife's insistence. He found the exercises difficult, but surprisingly effective. By the end of the week he had reduced his 'cocktail of eight drugs', was sleeping well, feeling better, and reporting: 'If the improvement continues, I will be more than delighted.'

A 40-year-old English woman who flew to Glasgow from Abu Dhabi for the course, wrote of her fury at the National Asthma Campaign. 'Really I feel I've won the battle. It hasn't been easy, but it worked. The NAC says it can't recommend this course as clinical trials have not been conducted. I say, get your finger out and do the clinical trials then, because this course certainly works better than any poisonous drug being currently prescribed.'

Guy Nelson, from Rhu, said he felt 'fitter and healthier and more in control of my body'. Meredith Cooper, also from Rhu, said: 'This is the start of the rest of my life. I have been so amazed at what this course has done for me and for everyone.' Karen Lynas (12), from Glasgow, said: 'It's been good for me and I hope I stay this way.'

Morna Dallas (25), from Glasgow, was amazed to find how easily she could do without Serevent and Ventolin. She concluded: 'Feel that I've come a good distance, but am confident I can go much further.' Pam Duncan, from Arran, reported: 'It was terrible to be on all that medication (Flixotide, Serevent, Uniphyllin, Zaditers, and Bricanyl) and still it wasn't working. I will definitely persevere with this method.'

Joanne Webster (16), from Angus, said: 'This week has been tough, but definitely worth it.' Fiona Lyon, from Glasgow, who did the course with her sons Alasdair (18) and Fearghas (8), reported benefits to all three, although nasal problems had dogged Alasdair's progress.

Gillian Muir (23), from Stevenston, said: 'It has been absolutely brilliant, amazing. I can't believe how much better I am.'

Diane Aitken, mother of Sarah Aitken (7), said she was very pleased. An anonymous lady from Largs said it was worth any amount of money. Mairi Stewart (23), from Glasgow, said: 'I hate doing these exercises - I dread them. My progress hasn't been that dramatic, but I'm confident it's getting better.'

Paul Birchard, father of Amy Birchard (9), said: 'We can't put a price on the change in Amy. I think we now have the tools to deal with asthma.' For all these people, the test over the next months will be maintaining a difficult discipline without peer support and in the teeth of colds and bad days at work. I hope to follow their progress. But for many of them, those five days in eptember have already meant the difference between an existence and a life.

Further workshops and seminars are continuing in Scotland. Inquiries not to The Herald but to the Hale Clinic on 0171 631 0156.


Another article by the same author..

26 Aug 96 Family (Home File): In despair we can turn to the care of our community

By SALLY MAGNUSSON

FIRST some news for the many people who have signed up for the asthma seminar I wrote about last time. The organiser, Jane Martens, phoned in a panic to say that so many people have signed up to hear about the Buteyko breathing method that the modest conference hall she had booked in Glasgow's Holiday Inn is now much too small. The seminar will be held instead down the road in the Stakis Ingram Hotel in Ingram Street, Glasgow, just behind George Square. It's at the same time - 7pm on September 4 - and Jane says she'd be grateful if anyone else who plans to attend could let her know on 0171 631 0156 so that she can do a final count.

The response to that report about a breathing technique that is helping some of the most devastatingly afflicted asthmatics to enjoy a normal life again has been overwhelming. It has not just been sufferers who've been ringing up to find out more, but doctors, physiotherapists, pharmacists, all sorts of professionals involved in the treatment of respiratory disease. One hospital specialist, who says he's simply fed up with not being able to do more for them, has already arranged to sponsor four of his patients on the course. It's just the sort of open-minded attitude that the Buteyko practitioner Christopher Drake has been pleading for, and I'm proud that he's finding it in Scotland. His seminar is a chance not just to find out about the method, but to challenge him with difficult questions. Scepticism is fine; it's apathy that is unforgivable when we're dealing with a seemingly unstoppable disease that is launching more and more children on a lifetime of drugs. If this is the major breakthrough he claims it is, it needs to be questioned and tested and coolly assessed. Perhaps the process is starting at last...

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