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Microsoft word - asthma article about pippa kiraly.doc

Breathe. Don’t wheeze.
There was never a time when long-term asthmatic, Pippa Kiraly, did not have a tight chest, and it took very little to make her desperately straining to breathe. As a child her asthma had been severe but infrequent, and when she reached her 20s, it became constant. Pippa nearly died a number of times, and her worst experience was when she also developed surgical emphysema due to the severity of the asthma attack. Her breathing was so bad that air was forced into her tissues, making her skin feel like bubble-wrap and her face ache because there was so little oxygen reaching it. Pippa’s asthma became less worrying as a mature adult. However, she was taking the maximum recommended doses of asthma medication, and she was still having symptoms when her doctor suggested she try a system of Russian breathing exercises called the Buteyko Method. Because she had been asthmatic for 66 years, Pippa felt that this was almost certainly a waste of time, a desperate clutching at straws by her doctor. Her experience as a Registered Nurse had taught her that asthma usually worsens with age. More people over the age of 60 die from asthma than those who are younger, and so Pippa had no expectations of improvement. This ‘fatal attraction’ of asthma was not always the case. In the 1870s asthma expert Dr. Henry Salter, wrote that asthma did not kill. By the 1940s it was said that this statement was not always true, because people did occasionally die from asthma, usually when the heart could no longer cope with the stress, or if pneumonia developed. However, things had changed dramatically by the 1960s when asthma was killing thousands of people. The primary problem asthmatics have is not being able to move air in and out of the lungs easily, and taking a drug that opens up the airways seems like the obvious choice to remove this problem. From the 1930s people with asthma were encouraged to use bronchodilators [drugs that relax the smooth muscle surrounding the airways, reversing airway narrowing] on a regular basis. Paradoxically, as drugs became more successful at opening up the airways, more people died. In the 1960s hundreds of children and hundreds more adults in the UK and Australia died during the first epidemic of asthma- related deaths due to this faulty thinking. The second wave occurred in the 1980s, and the death rate continued to rise until the 1990s when research set the underlying cause of asthma as inflammation in the airways. Since that time there has been a world-trend in asthma management for asthmatics to use a daily dose of inhaled steroids in an attempt to reduce the need for bronchodilators. Instead of opening up the airways, the inhaled steroids reduce airway inflammation. However, in spite of this change of tactics, the expected outcome of asthma is still the same: the condition worsens over time, and while taking daily inhaled steroid medications saves lives, it does not alter this expected outcome, and the morbidity, or sickness Ventolin, which is possibly the most well known bronchodilator, can worsen asthma control if it is taken every day. The FDA lists Serevent, which is a long-acting bronchodilator, as one of the five most dangerous drugs in USA. Inhaled steroids can cause adrenal suppression, cataracts, oral thrush and alter the normal growth of children. In spite of these facts asthma medications are taken by thousands of Americans every day, seemingly oblivious to the potential danger they are placing themselves in. Pippa was aware of this information, but because she was unable to breathe without the medication, she continued to take it. However, on her doctor’s recommendation she decided to enroll in Buteyko classes with Seattle Practitioner, Liv Browning. To Pippa’s amazement, she started to get positive results and within a year her asthma symptoms were so minor that Pippa only required the occasional puff of bronchodilator and inhaled steroid each month. Four years after learning the Buteyko method, she still remains in control of her asthma, and says, “I still get asthma, but it is no where near as severe, and most of the time I can make it go away by doing my breathing exercises. “Being almost asthma-free is like being given the moon. I can do so much now that before I would have been constrained from doing for fear of the consequences. I get far fewer colds or flu and they are much less severe; I can travel to places I would never have dared to go because of pollution, and I can visit friends with cats. Perhaps the best thing is I'm not dependent on drugs for a decent quality of life. “Two delightful but unexpected results from practising the Buteyko exercises are that my feet are warm for the first time since my teens, and I look younger! I met someone two weeks ago that I hadn't seen for a few years, and she looked at me in shock and said: ‘Have you had a face lift?’ So that is an added bonus to my good health!" The objective measures of asthma control are based upon quality of life factors, such as the ability for the person to take part in day-to–day activities without asthma symptoms and to have no asthma during sleep. No more than two puffs of short-acting bronchodilator should be required in a week, and the ‘peak flow’ reading, which is one of a series of lung-function tests, should be normal. It is not expected that a long-term asthmatic’s peak flow reading will improve to any great extent, even when steroids are added to the daily regime. In clinical trials of the Buteyko Method lung-function tests have not changed in participants, and some doctors claim this is proof that the Buteyko Method makes no real change to the asthmatic condition, even though participants greatly reduce their medication use, improve their quality of life, and are less fearful of the future. Pippa’s experience is similar to those who have taken part in clinical trials. Her lung function has not deteriorated in spite of reducing all her medication by more than 90%, but it has not improved either. However, her daily symptoms have dropped so dramatically that she sleeps well and is easily able to tend to her garden and take regular hikes in the Mount Rainier National Park that is home to some of Washington’s glaciers. In 2004 she trekked in the Himalayas, having no more trouble with this than the other members of her group. Pippa's doctors Bruce Milliman and Fernando Vega of Seattle have followed the changes in Pippa's asthmatic condition and agree that the Buteyko Method has attributed to Pippa's improved standard of health. "After years of having asthma, Pippa requires almost no medication to control her breathing now. I am very pleased that she has been able to make such an improvement." says Dr. Milliman. Dr. Vega adds, "I have seen other patients improve with the Buteyko techniques too and I refer the majority of my asthmatic patients for Buteyko education. I would like to see more research into the Buteyko Method because there are millions of asthmatics in USA, and many of them are likely to benefit from using these simple techniques." Pippa was so impressed with her good health that she joined the growing group of Buteyko Practitioners in North America, and now teaches the techniques to people who have difficulty breathing in Seattle. Pippa says, “Drugs must be filtered out of the body or they would build up and cause extra problems, so every drug that is consumed adds to the work that the skin, liver and kidneys needs to do to excrete these chemicals. The Buteyko Method does not include any drugs, but instead it involves using a series of techniques that retrain the body to breathe more normally. When this happens the airways do not close like they do prior to learning the techniques. Pippa adds, “Initially Buteyko is used an adjunct to the prescribed asthma treatments, but as the breathing pattern returns to normal the need for these drugs dramatically drops. Studies with adults show that there is around an 85 – 95% reduction in the need for bronchodilators and a 50% reduction in inhaled steroids within a few weeks of commencing the Buteyko course. In my case it was even more. Since there are no extra drugs involved and most of the prescribed ones are generally not required, it seems healthier for the person to use this natural method of asthma control. I want to help people get the same benefits as I have, and this is why I agreed to be interviewed for this article. Buteyko is not well known in USA, and it should be because we have thousands of asthmatics here. Everyone has the right to breathe easily, and I think that Buteyko will help them do this.” Written by Jennifer Stark, Buteyko Practitioner. Email: This article can be fully referenced, and contact details of Pippa Kiraly, Dr. Milliman and Dr. Vega provided to verify their story, if this is required.


Microsoft word - dse consent form - supine bike.doc

You have been booked to have a Combined DOBUTAMINE and SUPINE BIKE EXERCISE STRESS ECHO at Hearts West, Subiaco Purpose of the test Dobutamine stress echocardiography (DSE) is used to measure how your heart responds to stress, under medically supervised conditions. The test gives us very important information, and is usually performed for suspected coronary artery disease.

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