My first week of nursing school was slightly tainted by getting ill on day two, I’ve had a really bad cold that apparently
Featured image – Inhale & Exhale prints from Printabold on Etsy – http://etsy.me/2frKedS
So I had surgery last Friday. That’s not what this post is going to be about but many of you will know that I have really suffered with endometriosis the past few years and this was my 5th surgery. This time endometriosis was removed from my diaphragm, which was a great relief for me as they have been unable to reach it in previous surgeries due to the awkward positioning of the diaphragm.
The diaphragm is a dome shaped muscle that separates the abdominal cavity from the thoracic cavity, it lines the inside of your lower 6 ribs is also connected to the lumber vertebrae of your spine. For a part of our anatomy that is such a key part of our respiratory system I feel like the only time I have ever really personally heard it talked about is in relation to singing.
I learnt a lot about where my diaphragm is and how integral it is this weekend through the pain that I experienced from having endometriosis excised from it. Once the anaesthetic and drugs wore off by the evening the pain in that area was intense, my breathing became shallow because I was literally afraid to breathe because it hurt and my blood pressure became low and I felt like I had been stabbed from my chest through to my back on the right side, pain killers and heat packs were just not touching it. I ended up having to have chest physiotherapy as they established listening to my breath that my lungs were not properly filling up with air and no air was reaching the bottom of my lungs and this was through my own tension of literally being afraid to breathe. Funnily enough we were just doing the respiratory system in biology at uni the previous week but this experience and having this physio was a real eye opener for me.
Breathing is controlled by the bodies autonomic nervous system, we are therefore not consciously aware of it, the nerve cells within the medulla (brain stem) automatically sends signals to the diaphragm and intercostal muscles to contract and relax. This same system makes it impossible for us to hold our breath for too long before we must give in to exhalation.
We all know that without breath there is no life, breathing is a fundamental part of our function as it feeds oxygen into the blood stream and dispels carbon dioxide through exhalation. These are things we all generally know, but my experience this weekend (with the addition of having had lots of time on my hands in recovery) led me to really think about breathing, both scientifically and logically and made me so aware of my own breathing and in doing so realise how much I take it for granted.
We often use the phrases ‘take a deep breath’ in encouraging someone to calm down or tell them to just ‘breathe’ when people are overexcited or nervous, we therefore instinctively know that conscious breathing allows us to alter our emotions but do we ever really think about why?
As I said, breathing is controlled by the autonomic nervous system – the two divisions within this are the sympathetic nervous system, which is constantly active and is our primary process to activate the body’s fight or flight response. Then there is the parasympathetic nervous system which stimulates the body to ‘rest and digest’. Our breathing activates the right system to get stability where we need it to be. In activating the sympathetic nervous system to protect yourself from danger – your body’s main focus is inhalation to keep you oxygenated and ‘keep you running’, it also activates muscles in your shoulders and neck which allow the lungs to expand further allowing in even more air. But exhalation therefore becomes less of a priority, and exhalation is vital in expelling toxins from the body. In fact over 70% of the body’s waste products are expelled through breathing and our skin. So, you see how this can be detrimental to our health? Running on this system which we all do even when are not ‘running away’ from danger keeps our breathing erratic and shallow. Stress, work, pressure and all things related are activating this system and therefore this type of breathing.
Whilst we breath to stay alive and this has to be the priority whatever the circumstances, we need to consider breathing to benefit our health. When you take a proper breath your diaphragm pulls down, ultimately to allow more air into your lungs but it also pushes on your vital organs within the abdomen. For example it moves your kidney 2-3cm with that contraction, this works the muscles in these organs and allows more nutrition to be delivered. The vitality of the internal organs depends on this and using air to fill your torso effectively is vital to organs and injury repair.
As babies, during developmental milestones we learn how to use breath to creative a positive internal environment and we have no preoccupations at this age because we are not in touch with all the bodies systems and do not experience stress like we do as adults. Somewhere in our life journeys this gets forgotten and we develop bad breathing habits. I have found in the last few days I have had to really tap into those lessons learnt so early in life and remind myself that our breath is so intimately tied in with the rest of your musculature. Our breathing muscles are the inner most abdominal muscles, they’re connected to our structure, our strength, our stability and our physiology as well as our mood. There is a tremendous relationship between breath and supressed emotions and grief. Which goes back to what I was saying earlier about stress and tension and living in sympathetic dominance, because when we stop breathing, we supress emotions and those emotions get stuck in the body. The body holds onto trauma and this is trauma we can often have expelled via breathing. This is why breathing is such a huge part of yoga, meditation and mindfulness….This is why I avoid all three!! My main problem with these pastimes is that I find the breathing part more angst provoking than anything else. In fact I was in Greece over the summer at a writing retreat and meditation was a big part of the retreat. Our teacher Daisy, who has now become a dear friend was very understanding of my fears of meditation and my reluctance to embrace ‘breathing’. When we first met, I voiced my hopes that she would be able to open me up to meditation because I just struggled so much with the ‘breathing part of it all’ – her response was ‘Well you’re breathing now aren’t you?’ As amusing as this was at the time, it has resonated with me ever since and even more so now after my recent experience. I’ve always dismissed yoga, mainly due to my so-called inability to breathe and the fact that my abdominal muscles have been recovering from surgeries for the large part of the last 3 years, I’ve found it a scary prospect. But the eye opening thought process surrounding my own breathing through my recent experience has made me see clear as day that the yogis are right! Not that I thought they were wrong, it’s just something that wasn’t for me so I avoided thinking about it.
As a student nurse, I now know the importance of breath as a key diagnostic sign. I was visiting a friend in hospital at the end of the last year and I had a great conversation with her nurse once she told her that I would be starting my training. She said the most important tip she can give me is to always monitor peoples breathing. According to the RCN ‘the pattern, effort and rate of breathing should be monitored’ and a normal respiratory rate for a man is about 14-18 breaths per minute and a woman 16-20 breaths per minute (RCN, 2015) This nurse pointed out to me that someone breathing too fast is obviously a sign of distress, but often also can indicate that they have internal bleeding. This simple observation alone is key to preserving life and the one piece of advice she felt was the most important thing to tell me in becoming a nurse.
So based on these figures from the RCN about the normal respiratory rate that means that we averagely take around 23000 breaths per day. When we think about vitality and wellness or making lifestyle changes our first point to target is usually nutrition or fitness. These are often influenced by our appearance – we want to lose or gain weight or we want better skin etc, so we eat better and we strive to drink more water and exercise regularly – and I say this because this is something I am personally so guilty of – what we see is easier to fear and easier to target than what we don’t see. Putting that into perspective for a minute – we can go 3 weeks without food and 3 days without water, but we cannot even go 3 minutes without breath. As hard as it is to avoid that cream cake or that Friday night bottle of wine with friends – isn’t it interesting how when we want to improve our lives we target the thing we can go the longest time without first, when you cannot reap the benefits of all the other things without breathing first. Somewhere in this theory our dysfunctional breathing is almost like the equivalent of actually eating ‘that cream cake’ 23000 times a day. How would it be if instead 23000 times a day we invested in our own vitality? Took our own selves to a place of calm – what if we visited a spa 23000 times a day? What if we were aware and conscious of every single one of those 23000 breaths and thought about how important they are to our structure and our wellbeing.
Whilst I don’t want to get on my high horse about breathing – I’m no better at it than anyone else – this week has shown me that more than ever in a harsh reality, but it has also woken me and warmed me to the concept of breathing and that actually stressing about breathing is completely ridiculous? To avoid doing something beneficial to me because I’m afraid of breathing? And that really is my mind set. This is even more interesting to me because I have learned through my own experiences, thoughts and research that breathing is about so much more than just being alive. It’s about quality of life. We hold the key to that and the best thing is we do it without even thinking about it – and we stay alive, but we could live better by just paying it a small amount of attention.
That leads me to question if there is a connection to how much breath we take in and how much life we take in? ‘Shallow breathing – the immediate feedback is that we are hardly present in our bodies more than likely we are lost in the labyrinth of our mind’ (Christian de la Heurta) The breath also is a reminder to become more present that alone is life changing.
What I have learnt, realised and come to value through my experience this week and by having my eyes opened to human biology through my nursing degree as well as considering breathing from a spiritual point of view which is new to me, is that breath can help you remember you are so much greater than so many things.
By simply slowing down the breath, the body follows and slows down, meaning that breath is actually able to bypass brain chemistry, the impact that can have on our mood and wellbeing is indescribable. There is wonder in the ‘complete breath’ – when both the abdomen and the ribs move in a beautiful rhythm. Breath is your most essential tool in life and so often gets neglected, believe me, there is nothing scarier than not being able to breathe, the pressure on your chest and the pressure on your life.
As I approach a new view towards my own breathing I ask you to consider this as your most vital asset – the ability to breath – the ability to be alive – the ability to take control. Next time you take one of your 23000 breaths a day, make it a deep one and see how it makes you feel. Place value on that breath. Whilst the medical interventions we have these days are often mind blowing – you simply cannot exist without your breath and unlike your heart and lungs – your breath is irreplaceable, you can’t have a breath transplant.
Make every breath count.