Teaching with a Twist – Stress and Weather

This article was written by Stephanie Williams, BS, RRT. Stephanie is the Director of Community Programs and Volunteer Management for the COPD Foundation.

My mother-in-law has a saying that, I am ashamed to admit, has applied to me more times than I can count. Her saying is, "those who can't listen have to feel." It took me a couple of times hearing her say that to really understand what she meant by that, but I get it now and say it to myself and my family ALL the time.

Let me preface my humbling story by mentioning two things: 1) I don't have COPD - I have reactive airways which means my breathing difficulties behave more like asthma. 2) I'm an RT who works for the COPD Foundation, but have worked in many healthcare environments.I mention the first point because while I don’t know exactly how you feel, I can sympathize with the struggle to breathe at times. I mention the second because, well, I should know better than find myself in a situation like I did last night.

So picture it - 9:30 pm on a Nashville evening. 88° with the humidity about 78%. Yes, it was gross and terribly stuffy. But, as has been my habit recently, I set out for what I thought would be about a 45-minute walk with my son and our new dog. The point being to burn off some of the dog's energy before bed and as a bonus - I get exercise.

Several days this week, I have noticed that I am audibly wheezing while just working at my computer - my son and RT husband have also commented on my breathing. Would I ever let a little bit of wheezing stop me? Nope. Should I have paid better attention to the warning it was trying to give? Yep.

So, there we are on our walk, being pulled along by a feisty four-month-old, 30-pound dog in this humid Nashville air that is NOT moving. I mean, I could really feel myself trying to pull air into my lungs as we moved along at a really good clip. My son had stopped to catch a little frog on the sidewalk, but our pup Riley pulled me on down the hill - her nose to the ground following *something.*

And then I saw it. A huge German Shepherd/wolf hybrid that has lived in our neighborhood for years. He is usually on leash with his owner, but last night, he was on the loose. So there we are looking at each other and I am about 150 feet away from my son Hayden. The wolf dog shifts position and is now focused on Hayden, who is still bent over looking at the frog.

My heart rate instantly went up and all I could think about was how far away Hayden was from me, and how I was not going to be able to protect him if that giant animal started to move for him. I said Hayden’s name – using his middle name, too, so he would know I meant business – and he looked up and saw the dog. He loves animals and has recently become our resident expert on animal body language and how to react to it. Noticing the body position of the dog, Hayden started to take small steps backwards up the hill. None of the rest of us was moving. He kept walking backward and I finally saw the wolf-dog relax and lower his head and turn away from us.

Walking as quickly as I felt I safely could up the hill, I noticed it was getting particularly hard to get my breath. Knowing that big animal was still out there in the dark was frightening. Trying to climb that hill with my lungs tightening was frightening. I had gone out for a walk in terrible breathing conditions, ALREADY wheezing without my rescue inhaler. Brilliant. I looked behind me, and we were in the clear – no dog. I slowed my pace, began to *try* and relax my shoulders and focus on my breathing. It did not immediately work, but after a minute or two, I found the breaths coming a little easier. I finally made it home and after taking the rescue inhaler, felt almost good as new.

I have seen some questions recently asking if stress or weather can impact your breathing. The answer is yes. Does humidity negatively impact everyone? No. Does cold, dry air impact everyone? No. But you certainly need to know what your triggers are and pay attention to your body when it is giving you warning signs. And you should also know that stress WILL make your breathing worse. You can count on it. We talk about this kind of thing a lot here – know your triggers, follow your action plan, have your rescue medicine with you all the time. Practice your pursed lip breathing and relaxation techniques so you can use them without having to think about it when you are in a bad situation.

What if I hadn’t known about breathing techniques and trying to relax to ease my breathing? The normal response is the opposite, and had I followed my natural instinct, I would have been in big trouble.

So, in summary, I found myself thinking about my mother-in-law’s wisdom once again last night. I couldn’t listen to my own advice, so I had to feel pain and discomfort. But tonight, when we head out for our walk, guess what I will make sure I have with me? My trusty rescue inhaler (and maybe a bigger walking stick.

Here are things you should do to be proactive about your health:

1. Do a self-check every day to see how you are doing. Notice anything out of the ordinary?
2. Armed with that information, what does your My COPD Action Plan say you should do?
3. If you have trouble breathing during exercise, talk to your doctor about using your rescue inhaler about 10 minutes before you start your exercise.
4. Practice your pursed lip breathing throughout the day. Just do it. If you will practice it when you don’t need it, you will find it easier to do it when you are having trouble getting a breath.
5. Know your triggers. Certain weather conditions, allergies, fragrances, smoke, dust – everyone is different. What are your triggers?
6. Take your maintenance medicine every single day – even when you feel fine.
7. ALWAYS have your rescue inhaler with you. ALWAYS.

Now the twist:

Imagine you are going on a hike. What are you going to take with you? It has to be an item that starts with your initials.

Mine might be Snacks because my first initial is “S”.

What would you bring?