COPD: Innovative Breathing Techniques: a natural, stress-free approach to coping with chronic obstructive pulmonary disease using the Brice Method

By Paul Brice

The Brice Method aims to show people with COPD how to recognise and overcome some of the most the common issues that can make breathing so challenging. The Method teaches you: how to listen to your body, and how your posture plays a pivotal role in how you breathe; new breathing techniques that show you how to avoid severe breathlessness, so you can take more natural, relaxed breaths; a series of simple exercises that will help you to open your lungs and mobilise your body; how to coordinate your breathing with movement, and allow your body to remember what should come naturally; how gradually to improve your lung and body fitness and incorporate physical activity back into your life. This book is a 'must read' if you have COPD or care for someone who does.

• Language: English
• Publisher: Hammersmith Health Books
• Release date: Sep 27, 2018
• ISBN: 9781781611234

Paul Brice

Paul Brice is a Sports Scientist and Clinical Exercise Specialist, and has been working in the field of Exercise Rehabilitation for more than 20 years. A former international athlete, with a Joint Honours BSc in Sports Science and Biology, Paul has worked in the health and the fitness sectors since 1987. He worked as a physical activity lead for the Great Yarmouth and Waveney PCT for 7 years, promoting physical activity to improve health. Since 2009 Paul has been working alongside the award-winning Respiratory Nursing Team, at the James Paget University Hospital, Great Yarmouth. (They won the Association of Respiratory Nurses, Nursing Team of the year 2016.) Paul is one of the innovators of the BEET (Breathing, Exercise, Education, Training) programme. BEET is a community gym-based Pulmonary Rehabilitation Programme that has had over two and a half thousand patients referred to it over the last 9 years.

Book preview

COPD

innovative breathing techniques

A natural, stress-free approach to coping with chronic obstructive pulmonary disease using the Brice Method

Paul Brice

This book is dedicated to the memory of Morag Minton

Contents

Title Page

Dedication

Important safety advice for the reader

Foreword

About the author

Acknowledgements

Introduction What is COPD?

Landmark 1 Self-test 1

Chapter 1 Knowing your body

Chapter 2 When breathing goes wrong

Chapter 3 Postural self-awareness

Chapter 4 Learning to de-slump yourself

Landmark 2 Self-test 2

Chapter 5 Relaxed breathing techniques

Chapter 6 Upper body mobilisation and breathing

Chapter 7 Synchronising lower body movements and breathing

Landmark 3 Self-test 3

Chapter 8 Breathing on the move

Chapter 9 Increasing effort and developing strength

Chapter 10 Skills for everyday life

Addendum 1 Results and patient feedback

Addendum 2 Equipment and further advice

Addendum 3 List of figures

Index

Copyright

Important safety advice for the reader

Before following any of the advice contained in this book, it is recommended that you consult with your doctor if you are in doubt as to the suitability of the exercises.

If, like many people who suffer from COPD, you are very inactive, read the section on ‘Monitoring any pain’ in the Introduction (page 9). This specifically advises you on what you should be able to do and what you should avoid.

Foreword

Presumably the reason you are reading this book is because you or a loved one is experiencing problems with breathing. Getting out of breath is not always pleasant; however, it is normal. It is a natural response when your body needs more oxygen and energy when you do something that requires physical effort. Getting out of breath when we exert ourselves is a positive reaction and is usually viewed as a normal response to increased activity.

However, some people get out of breath every day when they’re not physically exerting themselves. They unexpectedly find it difficult or uncomfortable to breathe, and may feel they can’t control their breathing. This long-term breathlessness is known as ‘chronic breathlessness’. It often develops gradually and lasts for weeks, months or years. Sometimes people also cough, bring up phlegm or feel wheezy (British Lung Foundation 2018).

Breathlessness is not only a physical symptom. It can also affect how we feel about things. An episode of breathlessness which has made us feel frightened or anxious will affect how we cope with the same situation when we next encounter it. This can lead to avoiding certain situations and allowing the fear of breathlessness to stop us living our lives as completely as we would wish.

Over the past 30 years working with people with breathing problems, I have been exposed to many methods of trying to counteract the symptoms of lung diseases, particularly chronic obstructive lung (or ‘pulmonary’) disease (COPD). General practitioners and specialists can refer suitable people with breathing problems to local services providing pulmonary rehabilitation programmes.

Over the past 15 years I have managed the local pulmonary rehabilitation service and have firsthand experience of how these programmes can enhance the lives of people with lung diseases. These invaluable programmes are particularly beneficial for people with COPD. Anyone with this condition should ask for a referral as they can dramatically improve how they cope with their breathlessness.

The Brice Method has developed from Paul Brice working with colleagues in the NHS over many years. Paul is an inspirational leader in the area of breathlessness management. His insight into the individual’s fears regarding their challenging breathing is instinctive and within one session he can reduce fear and reinstate hope in the lives of people who have been severely affected both physically and mentally by their breathlessness.

I have worked closely with Paul over the past nine years and have always been impressed by his results. I have confidence in his abilities to look at innovative ways of helping individuals cope better with a condition which cannot be cured. Just because a condition cannot be cured does not mean that it cannot be helped.

I would encourage anyone with lung disease to read this book and to lend it to their Respiratory Health Care Professional to inspire others to adopt the safe and effective Brice Method for helping to manage breathlessness.

Heather Matthews

RN RM BSC

(

HON

)

MSC

Independent Respiratory Nurse Specialist

UK

About the author

Paul Brice is a Sports Scientist and Clinical Exercise Specialist and has been working in the field of Exercise Rehabilitation for more than 20 years. A former international athlete, with a Joint Honours BSc in Sports Science and Biology, Paul has worked in the health and fitness sectors since 1987. Paul worked as a physical activity lead for the Great Yarmouth and Waveney PCT for seven years, working on promoting physical activity to improve health.

With business partner Spencer McCormack, Paul helped set up the first commercial health club to be based within an NHS Hospital in the UK and has worked for the NHS on a number of pilot schemes using physical activity in conjunction with conventional NHS treatment to help improve health outcomes.

Since 2009 Paul has been working alongside the award-winning Respiratory Nursing Team, at the James Paget University Hospital, Great Yarmouth. (They won the Association of Respiratory Nurses, Nursing Team of the Year 2016.) Paul is one of the innovators of the BEET (Breathing, Exercise, Education, Training) programme. BEET is a community gym-based pulmonary rehabilitation programme that has had over 2500 patients referred to it over the last nine years.

Paul has a strong belief that sensible movement and moderate physical activity are two of the key foundations of a healthy, balanced body and mind. He works with patients by explaining the impact inactivity and immobility can have on the many health systems in the body, to help them understand that they may be able to reverse their health issues if they put a little effort into being more active and more mobile. Paul shows patients what they should aim for and how they can progress, and helps to keep them motivated to reach their goals. These beliefs and approach have been fundamental to the development of the Brice Method.

Paul is passionate about making a difference and now works delivering exercise rehabilitation programmes and personal training for private clients, under his business Brice Exercise Specialists Ltd.

Acknowledgements

Firstly, I would like to thank my oldest and best friend, Don Thompson. He would not realise how influential his musings have been since we started working together in the same company, on the same day, over 30 years ago. Don has been a consistent fount of knowledge, and the worn-out books and suggested reading list he gave me over 20 years ago when he was studying osteopathy, Rolfing, Hellerwork and other body working techniques, prompted me to look outside the conventional sport and fitness box.

I need to acknowledge Heather Matthews, Carol Nicholls, Fiona Lang, Lesley Barber and Maria Hunter from the Respiratory Nursing Team at the James Paget University Hospital. Heather, Carol and Fiona have all been instrumental in enabling me to develop my method. They have played vital roles in the development of BEET, the innovative community pulmonary rehabilitation programme. Their drive and determination to meet patients’ needs are why they were recognised as the ARNS, UK Respiratory Nursing Team of the Year in 2016.

Finally, I would probably never have got around to finding a publisher for this book if it had not been for one of my former patients, Morag Minton. Morag had very severe COPD and was told her best opportunity to live a full life was a double lung transplant. She was referred to me having just spent eight weeks in hospital with a very severe chest infection over the Christmas and New Year. When I met her, Morag was very down, as weak as a kitten, and her shoulders were so tight we could hardly prise them from her ears. She spent most of her day hunched up trying to recover from the previous breath she had just taken. She had been a top fitness presenter and loved rock climbing. She took on board the exercises I gave her, and her breathing started improving almost immediately. She did her daily exercises until she could attend the gym, where she ended up not only getting stronger herself, but also talking to novice patients when they looked a little lost.

Morag continually pestered me to write this book. She had done exhaustive research, and nothing had worked for her until she did the exercises that were shown to her. She was insistent that it was important that other people with COPD got the chance to try them.

Amazingly, within seven months Morag was strong enough to have her lung transplant. I had planned for her to work for me after her operation, to train as an exercise specialist. Unfortunately, whilst her lungs transplanted well and initially worked, a complication from the operation meant that she did not survive.

As I complete my final draft, I wish to dedicate this book to the memory of Morag Minton.

Illustrations: I took all the photographs myself and the bar charts were devised by me and refined by Hammersmith Books. The following are included with permission from Shutterstock: Figure 1.1 Tewan Banditrukkanka; Figure 1.3 Alila Medical Media. Figure 1.5 Adapted from: Alison McConnell, Respiratory Muscle Training; Theory and Practice, Elsevier, Oxford, 2013. Other illustrations by Tech-Set Ltd, Gateshead.

Introduction

What is COPD?

COPD (chronic obstructive pulmonary disease) is an umbrella term used to classify a number of conditions of the lungs that impair breathing. Bronchitis and emphysema are the two most frequent conditions under this umbrella term, but there is a whole range of complaints and illnesses that are labelled under the same banner. The meanings of the terms which make up the acronym are as follows:

The UK’s Health and Social Care Information Centre questioned medical practices in England and reported in March 2015 that over 1,034,578 people were registered with their GPs as having a diagnosis of COPD, an increase of over 2% in a single year.

Many other people with breathing difficulties go undiagnosed and/or do not go to their GP for help or diagnosis. This means the issue may be even more common than these statistics indicate. This is borne out by The Health Survey for England 2010, which estimated that 6% of adults had probable airflow limitations consistent with COPD. If this 6% figure were true it would be equivalent to around 3 million people in the UK.

This book is the culmination of thousands of hours of work with a wide range of breathing and lung conditions under the banner of COPD. It includes a section that details the personal feedback from hundreds of patients suffering from COPD, and is designed to help readers understand how their breathing can be adversely affected by the way they behave, stand, sit and move, but conversely how they might be able to improve their breathing by doing these simple everyday activities differently.

The results from those who complete the programme are quite staggering. I have found that patients’ blood oxygen saturation increased during the first session with me from an average of 94.5% to an average of 97.6%. Blood oxygen saturation gives an immediate indication of how much oxygen is being absorbed into the bloodstream from the lungs, and is used extensively to monitor patients’ progress. I have also found that patients report on average a 64.5% improvement in their quality of breath within the first session. Hopefully, using the techniques in this book you will benefit as much as one of my average patients. You will get the opportunity to try this out for yourself if you do the first Landmark test at the end of this Introduction (page 13), and then re-do this test as recommended at various stages in the book.

The development of the Brice Method has, in part, been driven by the desire to find an alternative early stage intervention that might be able to delay the need for expensive pharmacological treatment of COPD. The development of the programme has been gradual. Many of the exercises are treatments that may have been used by previous generations of medical practitioners and, in some respects, it uses skills that may have been overlooked when ‘high tech’ alternatives were developed. As with most other lifestyle-related conditions, the use of physical activity for COPD is aimed at the causes of the condition, not the symptoms.

Built into this book is a series of simple exercises to help a person with COPD listen to their body, understand their dysfunctional breathing patterns and learn to manage and cope with their condition.

Whilst there can be no guarantee that the Brice Method will definitely help every person with COPD, the vast majority of patients have found this innovative programme useful to some degree or another. Most of the patients who have gone through it have said that the programme has dramatically improved their lives.

The method is designed to be simple to implement. It is based upon the idea that we should use our lungs the way nature intended. Despite the method being simple, patients who have done the programme have reported that there are profound changes that have helped them breathe better, move better and live better.

Who is the book written for?

This book is aimed specifically at the layperson with COPD, and as such you will not find