Author Archives: Jackie Aim

Other coping strategies

You may already be using strategies which help you cope, or have found you have no choice but to change your daily routines.

Other people may have given you suggestions for coping strategies to help you to manage your breathlessness, symptoms and situations. There are many strategies which may be helpful and we would suggest, if you haven’t already done so, trying out some of the strategies below:

Community fitness class

© Crown Copyright 2009

Lifestyle choices

  • Healthy eating (for more information see our section on Healthy eating for people with Asthma).
  • Exercising in a manageable way (for more information see our section on Exercise, sport and asthma).
  • Avoiding too much tea / coffee / energy and fizzy drinks.
  • Stopping smoking (for more information see our section on Help to stop smoking).
  • Limiting your alcohol intake.
  • Getting enough sleep.
  • All other activities that help YOU take care of yourself.

Sources of support
If stress and anxiety are causing you major distress and affecting your function and involvement in daily life, your mood, relationships it may be worthwhile speaking to your GP or another health care professional. Other local agencies include:

The effect of anxiety in your body

Day to day we all live with adrenalin in our bodies. It has a positive effect which helps us get up and going. More adrenalin is released when we are stressed, anxious or worried and this can triggers physical changes and sensations in the body. This is often called the Anxiety or the Fight / Flight Response.

This anxiety response affects your body in many different ways:


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  • Heart: Adrenalin triggers increased heart rate and faster pulse feeding more blood to the muscles, preparing the body to cope with the stressful situation (fight or run away).
  • Stomach: Digestion slows down or ceases as blood is directed away from the stomach and this can cause nausea, indigestion, or the feeling of butterflies in your stomach.
  • Lungs: Breathing can become faster and shallower as oxygen is supplied to the muscles. This can cause breathlessness, chest pains, tingling, palpitations as the body prepares itself to fight or run away.
  • Neck and shoulders: Neck and shoulder muscles can tense as your body prepares itself to fight or run away. This can trigger aching and tightness in neck / shoulders and back.
  • Body and skin: Adrenalin causes blood vessels in your skins surface to open up making you to feel hot. Sweating is the body’s natural way of cooling itself down.
  • Legs: Muscles tense as the body prepares itself to fight or run away. This can trigger shaking or trembling in the body.
  • Bladder and bowels: muscles in the bladder or bowels relax and can cause you to rush to the toilet.
  • Brain: you can only think about the stressful situation and problem solving becomes more difficult. As an automatic response to this you may also get a dry mouth.


It can be difficult to make sense of these symptoms which you may feel you cannot control.

Remember Breathlessness related to anxiety is normal. It is our body’s way of trying to help us in situations which we find difficult.

Vicious cycle of anxiety

Anxiety is an emotion not only effects our bodies. It also impacts on out thoughts and what we do at these times (our behaviours).
This chain of events is often described as the ‘Vicious cycle of Anxiety’ and can be seen in the diagram:

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This chain of events is often described as the ‘Vicious cycle of Anxiety’ and can be seen in the diagram:

Thoughts: What we think – When stressed or anxious your thinking can become very fixed on the problem or issue at hand.
You can struggle to see the bigger picture. This limits your ability to think clearly, find solutions, and make the best choices to support your self management.
A situation you may recognise is increased breathlessness even though you have not done any of the things which would normally make you breathless. You may find yourself thinking things such as “Oh I’m breathless….. Oh my god, I’m very breathless, I can’t cope with this, I don’t know what to do”.
This then can lead to a change in our emotions, our body and behaviour.

Emotion: How we feel – Being stressed or anxious can trigger further emotional change – worry, stress, anxiety, frustration, irritability, low mood being some of the emotions experienced. These emotional changes can be subtle or be sudden.

This can lead to a change in your thoughts, your body and behaviour

Physical change: How our body reacts – This anxiety response can be experienced in our bodies in many different ways:

  • Heart
  • Stomach
  • Lungs
  • Neck/shoulders
  • Body/skin
  • Legs
  • Bladder/bowel
  • Dry mouth
  • Brain

This can lead to a change in our emotions, our thoughts and behaviour

Behaviour: What we do – Being stressed or anxious can affect what you do or your behaviour. You may stop doing things you enjoy or avoid situations which trigger increased breathlessness or anxiety.

This can help you to feel safe, and in control, in the short term but in the longer term it affects routines and coping. As you do less, de-conditioning becomes more of a problem. Your confidence is affected and you may start to worry more about what you can or can’t manage to do. This can lead to more anxiety about doing certain things, and can lead to more avoidance or doing even less.

This can lead to a change in your thoughts, your emotions and your body

Emotional change and your illness

A young adult woman showing signs of distress

© Crown copyright 2009

Being diagnosed with asthma, managing chest infections, attending clinic appointments, changing life roles, can all be challenging.

Dealing with these challenges can trigger emotional change – worry, stress, anxiety, frustration, irritability, low mood being some of the emotions experienced. These emotional changes can subtle or be sudden, and can trigger the anxiety response.

Addressing any emotional change is important. Understanding what is going on in your body, and the emotional impact of this, is important. It helps us in developing strategies which help us cope day-to-day and supports self management.

Anxiety related to your asthma

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  1. Coping with your illness and symptoms day to day
    • You may worry about your symptoms, and the impact of your lung condition on your ability to manage day-to-day. This can be challenging, and cause you to worry more.
    • You may delay contacting your GP when you notice a change in your normal symptoms as you worry about being a bother.
    • You may try to keep going as before, triggering more symptoms including breathlessness, and this may cause you to worry about how you will cope.
    • You may just be worried. This may be because you are more breathless than you are used to, or expect yourself to be.
    • A previous difficult experience because of breathlessness may put you off doing the same activity again for fear of triggering symptoms, e.g. walking up a slope or up stairs, or going out when you have a chest infection.
  2. Worries about your health declining
    • You may worry about what the future holds and about the effect your lung condition will have.
    • You may worry about lots of things:
      • Losing your independence.
      • Having to rely on friends, family or neighbours for help with certain things.
      • That you are less able to get out and about to do the things which are important to you.
      • Your current housing is no longer suitable (e.g. 3rd floor flat).
      • That your symptoms become so problematic that you need extra help with personal care.
      • You need to recognise breathlessness and anxiety when they feed each other and become worse. By recognising your symptoms you can take action to prevent their problems escalating.
  3. Worries about hospital visits
    You may worry about staying overnight in hospital because you have never liked hospitals or heard ‘bad news’ stories from others or in the media. You may worry if you have a morning appointment and feel this will be a struggle for you to get there on time because of your breathlessness.
  4. Effect of your illness on your family
    You may worry about how changes in your health will effect your family and family life. You may not be able to do all the things you did before, or be able to do them in the same way. Families can then step in to help but may end up doing too much for you, or may expect you to carry on as before not realising how your symptoms are affecting you.
  5. Money worries
    You may worry about the effect of your lung condition on your finances, about loss of income or having to claim benefits for the first time.
  6. Employment issues
    You may worry about you or your partner having to take time off work, and the impact of this. You may worry about being able to continue in your current job or in fact being able to work at all.

Is anxiety normal?

anxiety_wordcloud

Everyone experiences stress and anxiety at some point in their lives.

Anxiety is normal when faced with difficult / stressful situations.

Living with a long term health condition, such as asthma, poses different challenges day-to-day. For some people living with anxiety / panic can affect some or all of the things they do.

Symptoms of anxiety to look out for include:

  • Feeling shaky, feeling sick, having stomach cramps.
  • Feeling dizzy or faint.
  • Breathing fast or finding it hard to breathe.
  • Heart beating fast (palpitations), sweating, tense muscles.
  • Feel clammy and look pale.

Not all people who are anxious will display all of these symptoms. Anxiety is usually a short term event which passes. If you feel you are often anxious and that it is affecting your ability to think and cope with daily tasks it could be time to seek help.

In-flight advice

in_flight
To have a comfortable flight you should:
Keep hydrated:

  • Give your child drinks and plenty of fluids to ensure you stay well hydrated.
  • Try to avoid or limit their intake of and caffeinated drinks, such as tea, coffee or fizzy drinks, as these can make your child more thirsty.

Move hourly:
Move around. Get your child to do some simple exercises as you fly:

  • Bend and straighten their legs.
  • Press the balls of their feet down hard against the floor.
  • Walk around the cabin when they can.

Fitness to fly – medical forms

These are some examples of the forms they may ask you and/or your GP to complete for your child:

Important

Make sure you have the right forms for your airline.

Useful sources of information:

  • The airline website – look for a section on special travel assistance.
  • The airline helpline or customer care centre.
  • Some airlines have a separate department for people with medical conditions.

Travel outside the European Union

  • Outside_EUSome countries outside Europe have an agreement to provide emergency medical treatment to people from the UK. You will be treated in the same way as a resident of the country you are in, although this may not cover all the things you would get for free on the NHS.
  • The high commission, consulate or embassy of the country you are visiting should be able to give you information on the health care services available.
  • More information on this can be found at the Department of Health website
  • There can be also be unforeseen costs of falling ill, for example living expenses and the cost of being flown back to the UK. These costs can also apply to your travel companion.
  • Some insurance providers may ask your child to have an assessment by one of their own doctors before they will give you insurance.
  • Try to arrange your travel insurance before booking your holiday, just in case your child gets ill before you travel.
  • Companies are often reluctant to insure patients for travel to countries where healthcare is expensive, for example, the USA and Canada, or for trips that involve long flights, such as to Australia or New Zealand.

Information

It is very important that you have adequate private travel insurance. Make sure this will cover your child’s asthma and any other long term health problems. In non EU countries you will have to pay the full cost of any healthcare that you have if you become ill.

Some insurance providers may ask you to have an assessment by one of their own doctors before they will give you insurance.

Chest Heart & Stroke Scotland can provide information on sympathetic insurance companies that may be cheaper.