Are breathing exercises helpful?
Dr S.K. Jindal

Undoubtedly, physical exercise is an important component of strategies for both prevention and management of diseases. Exercising in the form of participation in sports and physical games increases the body stamina and cardio-respiratory reserves. It helps maintain an optimum weight, a good physique and a healthy mind. It is also useful for the prevention of several chronic diseases of the lungs, the heart, the cerebro-vascular system and of other organs.

The value and benefits of exercises are different for patients with diseases and physical problems than those for healthy individuals. There are several restrictions and limitations to exercises imposed on patients with diseases of the heart, lungs, musculo-skeletal problems and other disorders. It is, therefore, important to consult the doctor in such specific circumstances.

Respiratory exercises constitute an important group of physical activities involving not only the lungs but also the total breathing apparatus. Miraculous effects from cure of asthma to that of cancers are sometimes attributed to different forms of respiratory exercises. Many a patients are eager to know of exercises which may relieve them of their diseases and avoid drugs. It is another matter that very few to them are likely to indulge in doing so, even when advised.

There are different kinds of exercises which affect the respiratory system. In healthy individuals, all kinds of sports and other physical activities strengthen the respiratory muscles, delay the onset of and increase the tolerance to breathlessness. General physical exercises involving the repetitive movements of arms and legs and walking are also helpful for patients with lung diseases such as asthma and chronic obstructive pulmonary diseases. Introduction of structured exercising is an essential component of rehabilitation programmes for chronic lung diseases.

Inspiratory muscle exercises are important to maintain the tone and health of inspiratory muscles and inflate the lungs with air. Commonly described as “deep inspiration followed by breath holding”, the inspiratory exercises are prescribed for patients before and after different types of surgical operations. Such exercises are better undertaken with the help of small instruments called “incentive spirometers” which allow the inspiration through varying degrees of resistance and provide a semi-quantitative self-assessment of the inspiratory hold.

Respiratory exercises are sometimes confused with “expiratory exercises” involving blowing out, inflating bladders and balloons. Forced exhalation should, in fact, be generally avoided except in specific circumstances. Such exercises may increase the intra-alveolar pressure within the lungs and also put the respiratory muscles at a disadvantage. Patients with obstructive lung diseases are actually advised to adopt slow and prolonged exhalation rather than a forced and blowing out effort.

Breathlessness is a common complaint especially of patients with lung and heart diseases. Exercise has both beneficial and sometimes harmful relationship with our system. It can aggravate breathlessness by increasing the cardiopulmonary decompensation. On the other hand, breathing exercises also include respiratory retraining to control the fast respiratory rate. As an example, patients with chronic obstructive lung disease or emphysema learn to adopt slow and prolonged expiration called “pursed lip” breathing to relieve themselves of air trapping and breathlessness. The same effect can be augmented through proper training. Similarly, patients with other causes of breathlessness can also be helped through exercise training.

Exercise is also known to precipitate an attack of asthma, commonly known as “exercise induced asthma”. Factually, exercise can exaggerate bronchospasm in any asthmatic patient. It is for this very reason that the parents of asthmatic children tend to restrict their physical activity and participation in games. This is, however, not advisable in the interest of overall health of such children. Such a phenomenon must be avoided through appropriate control of asthma with treatment.

Yoga and “pranayama” comprise an important group of exercises which benefit the lungs. Yoga exercises often involve the different groups of muscles combined with a kind of meditation which relaxes the mind. These exercises are especially useful to remove the component of psychological stress and burden. The role of yoga in the management of functional and psychosomatic disorders cannot be denied. Howevers there is lack of proven effects through evidence from meticulously conducted scientific studies. Their benefit in the treatment of serious physical diseases and cancers is entirely unsubstantiated.

“Pranayama” provides different kinds of inspiratory muscle exercises coupled with a meditative effect on the mind. Like that for “yoga”, the quantitative proof of their benefits is yet to be documented. Exercises should be learnt and undertaken under the supervision of experts to avoid undue damage to the muscles, joints and sometimes to other organs. Exercises cannot serve as panacea for all problems. It will be preposterous to attribute magical reliefs to any such form of management. Nonetheless, breathing exercises and respiratory retraining can significantly add to the benefits of treatment in some groups of patients. Both “pranayama” and yoga exercises also require training and supervision, at least during the learning phase.

The writer is Professor and Head, Department of Pulmonary Medicine, PGI, Chandigarh.

Dietary fads can put your health to risk
Dr R. Vatsyayan

The term “food faddism” or “fad diet” refers to certain eating patterns that promote short-term benefits like weight loss but has no concern for long-term effect on health. Some of the so-called fad diets are projected to be a panacea for many health problems, but the manufacturers hardly follow any scientific method in establishing their validity. Everyday we see catchy advertisements of food items appearing in print and the electronic media making tall claims about their health benefits, but practically nothing worthwhile is coming out of these foods.

In big and small cities, it has become elitist fashion to climb on the diet-food bandwagon and people are spending a huge amount of money on it. Go to any big grocery shop and you can find more and more people asking for sugar-free colas, fat-free dressings, cornflakes, low calorie butter and so on. From this mass paradigm one gets the impression that we should eliminate all our original foods from our kitchen and shift our eating plans to include these so-called diet foods.

Physicians in every part of the world are now arriving at the conclusion that most of these foods cannot be called “diet or low fat” as they claim to be. Practically also, it is not wise to eat diet foods in endless quantities and cease to worry about their results and other effects. Apart from the numerous health hazards, most of the diet foods not only taste bad, they are also more expensive than the regular food items and leave us lighter not in the weight but definitely in the wallet.

Most of the times we do not thoroughly read the labels of the food product we intend to buy. A dessert that is advertised as “completely sugar free” may be using artificial low calories sweetener, but we become totally oblivious of its fat contents. A sugar and fat-free cake may not contain actual sugar or butter, but inclusion of a few eggs in its recipe can definitely shoot up our cholesterol levels. Recently there was a news item bursting the myth of the brown bread and it was found that mostly we were paying an extra amount for a coloured white bread only.

The same is the case of diet colas. Drinking colas, whether of the diet variety or otherwise, once a while is not bad, but going for such drinks too often has its own side-effects. Since all colas have caffeine as their essential ingredient, their regular and too often use makes a person addicted to them. The artificial flavours and other ingredients used in the colas are known to cause digestive upsets besides causing harm to the teeth and bones in the long run. Even if we buy a pack of roasted grains thinking that it is fat free, little we pay attention that it is laced with oil and has been sprinkled with excessive salt. No doubt, salt acts as a preservative, but what if the person consuming these grains is suffering from high blood pressure?

Many times we come across persons, specially women, who just to reduce their weight have given up all types of foods that contain any amount of sugar and have even banished fruits which taste sweet from their diet. Some others have stopped taking milk or any other milk item. It is hard to explain to them that a reasonable amount of sugar or natural food items that are sweet in taste are necessary to maintain the body’s energy levels and milk is natural source of protein, calcium and a lot many vitamins. If this ill-executed nutritional deprivation continues for a longer period, its most serious fallout is metabolic and hormonal irregularities in men and women. Calcium deficiency, osteoporosis, hair fall, joint pains and menstrual disturbances occur in women of menopausal age, but nowadays these problems are also being faced by young girls undergoing faulty dieting.

Our traditional Indian kitchen is replete with so many things which taste good, are economical and also readily adopted by our body system. A bowel of whole grain “dalia” accompanied by a cup of skimmed milk or as much curd can be an ideal breakfast menu. The diet colas can be replaced by simple coconut water, lime soda or a glass of “shikanjavi” having a judicious combination of lemon, sugar and salt. It not only tastes good but is a freshening and energising drink. A bowel of mixed fruits can be an ideal choice for evening times as it contains less calories but adds adequate fibre into our diet. Home-roasted grains are definitely a better choice than what we purchase in packets, and the list is endless.

We are living in an era where first we pamper ourselves by adopting a faulty lifestyle and abandon all types of exercise. Then a few kilos of grains make us over-react in the shape of taking up certain dietary fads. In fact, dieting is a serious business and dietary fads seem to exhibit more of style and less of substance. If we keep a wider and safer approach towards health matters, our traditional diet has adequate checks and balances and can handle problems of obesity and weight gain in a better way.

The writer is a Ludhiana-based senior Ayurvedic consultant and Guru at the Rashtriya Ayurveda Vidyapeeth. E mail - ayu@live.in

Agonising night itch: What to do?
Dr Vikash Sharma

If you are having an itchy sleepless nights its very likely that in spite of keeping a neat and clean hygiene, you have been infested by the mighty mites. The persistence of intermittent rain has also led to an increase in skin problems caused by one of the smallest organisms on earth, the mites. Slightly damp interiors, wet clothing and humidity favour the overgrowth of these mites. The house dust mites also tend to increase in these conditions and worsen the already existing eczemas.

Most of these mites easily invade our skin as they are unseen and unfelt. These so-called invisible skin invaders are very clinical in their action as they start multiplying in our skin and finally start producing the resultant skin inflammation which tends to appear as red rash, micro-papular and nodular lesions, and then the person concerned suffers the inevitable and the most agonising sensation the “ITCH”. Itching is so severe that a person is just not able to resist from scratching vigorously.

The itching is more intense during the night as these mites become very active during then. Along with the intense itching a person infested with mites always has a feeling that something invisible is moving on his/her skin. He/she is right as these agents are rapidly moving, playing and multiplying just within the skin. These mites usually infest the skin, especially where there are creases such as between the fingers, on the front of the wrists and in the folds of the elbows, armpits, buttocks and genitals.

Sarcoptes mites cause intense itching, especially when the body is warm; for example, after a hot shower or bath or while in bed at night. Thread-like “tunnels”, approximately 10 mm long, may be visible as grey lines in the skin, but they are often difficult to detect. The infestation may appear on the genitals as small itchy lumps.

These mites are easily transmitted by direct skin-to-skin contact or, less commonly, by bedding, clothes and towels freshly contaminated by an infested person. The face is usually spared in adults thanks to sebaceous gland rice facial skin which, via its sebaceous secretions, renders these mighty mites impotent.

Treatment

The affected person should have a warm shower/bath with soap, and dry body prior to treatment.
Change your clothing, towels and bed linen immediately before and after treatment.
Apply medication (permethrin 5 per cent cream/lotion) from the neck down ensuring that all skin-folds are treated.
If medication is washed off during the treatment period it needs to be reapplied.
Mites may be found under the fingernails after the affected person has been scratching. Fingernails should be trimmed and a thin layer of medication applied under these.
A second course of treatment is recommended seven days after the first application to ensure that mites that may have hatched after the first treatment are killed.

Over-treatment is common and should be avoided because of the toxicity of some of the treatment agents. The presence of mites should be confirmed with a skin scraping prior to any further treatment following the application of the second course.