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What is Hyperventilation ?

‘You have to breathe to live. But if you breathe too much, life become* dominated by fear of symptoms, and fear of living life to the full/

Hyperventilation means moving more air through the chest than the body can deal with. Most people have experienced hyperventilation – also called over-breathing – to some degree, usually in the form of an acute attack. It’s a normal reaction to sudden danger or excitement, and the signs are easy to pick.

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  • Breathing and heart rates speed up.
  • Adrenalin pours into the bloodstream.
  • The nervous system is on ‘red alert’.
  • Muscles tense up.

Sometimes people faint or collapse – or find super-human reservoirs of strength. When the stressful event is over, the body returns to its normal relaxed state.
Less easy to spot is chronic hyperventilation, a

breathing pattern disorder in which over-breathing becomes a habit – usually in response to prolonged stress or tension. More widespread symptoms are felt, and at times these appear out of the blue. The symptoms may mimic serious disease or remind the sufferer of the perhaps frightening events surrounding a past acute attack. When this happens more widespread symptoms mysteriously occur.

  • Breathlessness at rest for no apparent reason
  • Frequent deep sighs or yawning
  • Chest-wall pains
  • Palpitations
  • Light-headedness and feeling ‘spaced out’
  • Tingling or numb lips or extremities
  • Gut upsets or irritable bowel syndrome
  • Achy muscles or joints, or tremors
  • Tiredness, weakness, broken sleep, nightmares
  • Sexual problems
  • Clammy hands and high anxiety or phobias

cascade of symptoms

cascade of symptoms

When over-breathing becomes chronic the balance between the oxygen-rich air we breathe in and carbon-dioxide-rich air we breathe out is upset: carbon dioxide levels start to drop.

Far from being just a waste gas at the end of the respiratory cycle, carbon dioxide is a powerful governor of many of the body’s systems – including blood flow to the brain. With chronic over­breathing the normal acid/alkaline balance (pH) of the tissues is altered. The body becomes more alkaline, and the nerve cells are the first to respond to this respiratory alkalosis. Dizziness and tingling or numbness are often the first signs.

The autonomic nervous system, which looks after the body’s involuntary functions (for example, heart rate, blood pressure and digestion), is affected too. This system is divided into two: the sympathetic, which governs action and ‘get up and go’, and the parasympathetic, which is responsible for rest, recuperation and calmness. Low carbon dioxide levels stimulate the sympathetic nervous system more than the parasympathetic, putting the body on continuous red alert.

If carbon dioxide levels in the blood fall further with continued over-breathing, body cells begin to produce lactic acid in an effort to balance their pH. Muscles ache. Metabolism is less efficient.

Exhaustion and chronic tiredness soon follow, with feelings of physical and mental depression – all typical signs of long-term chronic hyperventilation.

Not only nerve cells are affected.

Muscle cells become more twitchy, and the smooth muscles of our blood vessels, airways and gut tighten and constrict in response to lowered carbon dioxide. There is an increased release of

Autonomic nervous system, controller of involuntary body functions

Autonomic nerwus system, controller of involuntary body functions

histamines, which aggravates allergic responses. The heart starts pounding and the hyperventilator may feel panic-stricken, with palpitations and feelings of ‘air hunger’.

When carbon dioxide levels are too low oxygen clings to its carriers – the red blood cells – and tissues, especially the brain, become starved of oxygen. The brain may have its oxygen supply cut by as much as 50 per cent, making it difficult to concentrate, let alone feel part of this planet. The drop in oxygen supply to the brain stimulates the breathing control centre to increase breathing ** and the chronic nature of the hyperventilation is reinforced.

chronic-plan

As the oxygen and carbon dioxide exchanges fuel every cell in our body, every system is ultimately going to be affected – leading to a distressing as well as puzzling range of symptoms.

Why does chronic hyperventilation happen?

Over-breathing is a normal reaction to stress or strain: it only becomes abnormal when stresses and strains reach levels that lead to chronic hyperventilation and outbreaks of symptoms. These stresses and strains may have started from:

  •  organic causes, for example, asthma, physical pain, pneumonia, anaemia, chronic chest or heart disease;
  •  physiological causes, for example, fever, high progesterone levels, prolonged talking, high altitude, diabetes, liver or kidney disease;
  •  psychological and social causes, for example, fear, anxiety, depression, perfectionist personality, separation/divorce, redundancy, unemployment, loneliness;
  •  drugs, for example, nicotine, caffeine, aspirin, amphetamines.

While these original causes may be dealt with, stabilised or cured, in certain people the respiratory centre in the brain is reset and the over-breathing becomes habitual. Even though the bad times are over, the increased breathing rate stays.

World-wide, the 1990s have been a decade of change and uncertainty. Our minds evolved in an ancestral environment that lacked the Pressure, noise and speed of the present electronic age.

we’re constantly bombarded with information and our brains often can’t cope with it all. We need to consciously take time out to counter this mega­stimulation, but few of us do.

The increase in stress disorders and diseases is alarming. Computerisation has pinned many workers in front of screens for extended periods of time, but the human body is not designed for prolonged sitting. We experience maximum stimulation from minimum effort and breathing is affected.

Adapting to rapid change is especially difficult if the change is unwanted or out of personal control. Stress levels soar, and with them adrenalin levels and heart rate, and nervous exhaustion follows – all fuelled by over-active lungs.

Is hyperventilation a modem disorder?

For centuries philosophers and scientists have understood the importance of good breathing. Hippocrates, the father of Western medicine, noted in the fifth century BC: ‘The brain exercises the greatest power in mankind – but the air supplies sense to it’

Adherents of both Buddhism, which originated in India also in the fifth century BC, and Taoism, from ancient China, combined breathing with relaxation and exercise to harmonise heart rate, breathing, digestion and circulation. Yoga and t’ai chi are modem versions of these ancient wisdoms.

Despite well-observed accounts in Western literature of ‘breathless’ heroines or heroes with their ‘breath taken away’, little was understood about the link between over-breathing and ill- health. The first detailed medical description of

hyperventilation was not published until 1871, in a study of 300 American Civil War soldiers. A doctor noticed ‘disabling shortness of breath, irritable heart and oppression of breathing’ and thought the cause of these problems lay in the heart.

Around the turn of the century other medical researchers experimented with normal subjects, asking them to hyperventilate voluntarily; their results noted neurological effects (tingling and muscles spasms) as well.

The term hyperventilation syndrome (HVS) was coined in the 1930s. One British physician called it ‘one of the commonest chronic afflictions of sedentary town dwellers’. Breathing into a paper bag (re-inhaling carbon dioxide-rich air) became a popular treatment for acute attacks of HVS at this time.

No theatre would be without a paper bag in the wings ready for stage-fright victims, frozen in respiratory alkalosis (terror) while awaiting their cue. However, while the paper bag method may be useful in helping with acute panic attacks, it is of no use to chronic over-breathers. It may temporarily restore normal blood gases, but it does nothing to correct the underlying cause – breathing pattern disorders.

It is extremely dangerous during an acute asthma attack to tiy to control rapid wheezy breathing using a paper bag. Increased drives to breathe normal during an attack. It is on record that at least one person has breathed their last into a brown paper bag.

Recent medical research has revealed more about the physiological system derangements, metabolic imbalances and anxiety-related symptoms caused by habitual over-breathing, but it is still an under­recognised and under-treated disorder.

Whether it is primarily a mental or a physical health problem has been hotly debated. Fortunately, the move towards holistic medicine, in which body and soul are treated together, has been of benefit to the vast number of people suffering from chronic hyperventilation and to their doctors, who can add this distressing disorder to their diagnostic repertoire.

I had a medical file as thick as a phone book and I always seemed to be at the doctors having tests for this and that. Nothing was ever found to be really wrong. But a locum picked it straight away. My breathing was grossly askew and my symptoms were a result of this. At last I had something to work on.

Dr. Mike Thomas

Shining hair, Strong Nails

When it comes to looking and feeling good, healthy hair and nails have an important role to play. But caring for them is not just about looks and self-confidence. Their condition is also a barometer of your overall health, so it would be foolish to ignore them. In this chapter you’ll find lots of tips to keep hair and nails in good shape.

Caring for YOUR HAIR

We can all have bad hair days, and styling is not the only problem. Hair can become greasy, dandruff may take a hold and hairlines may recede. But there’s a lot you can do to keep your hair and scalp in top condition, and counter hair loss. Here are some tips.

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  • Don’t brush your hair or at least don’t brush it too vigorously or for too long. Following the traditional advice of ‘a hundred strokes before bedtime’ is now known to risk damaging the hair. Brushing pulls out hair that isn’t ready to fall out yet, often breaks healthy hairs, and scratches the scalp. Brush gently for styling only – not to stimulate the scalp.
  • Dye naturally If you want to colour or lighten your hair without resorting to the chemicals of commercial hair dyes, why not choose herbal preparations such as henna for a shining brown or chamomile to lift mouse to blonde. But be warned, while natural dyes are better for you, they can be messy to apply and the results are not always totally reliable. If you decide to use a commercial hair dye, choose a temporary or semi-permanent one, simply because there is a very small increased risk of breast and bladder cancer associated with the long-term use of permanent dyes. Whatever dye you choose, test a little on an unobtrusive patch before treating your whole head.
  • Rinse with herbs Calm over-greasy hair with this ‘leave-in’ herbal conditioner treatment, which can help to reduce the amount of oily sebum produced by the sebaceous glands in hair follicles. Mix a teaspoon each of dried rosemary leaves, dried chamomile flowers and dried stinging nettle leaves in a bowl and pour on 100ml of water and a tablespoon of fruit vinegar. Leave for 10 minutes then strain. Apply this liquid to damp hair after washing and leave it in without rinsing.

Using natural products eliminates the slight risk of cancer associated with permanent dyes

shining-hair-stong-nails

Blood and CIRCULATION

blood-and-CIRCULATION

Smooth-flowing Mood that brings oxygon and essential nutrients to every celt in the body is vital for health and wellbeing. To improve your circulation and reduce your risk of disease, you need a healthy level of fats and other blood constituents as welt as optimum blood pressure. Find out how to achieve this in effective and sometimes surprising ways.

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Better
BLOOD

There’s plenty you can do to keep your blood healthy and able to supply the body with the nutrients it needs. Your diet and the amount of exercise you take can influence the composition of your blood. Genetics and environmental factors also have a role to play.

Have beans with your steak Iron is the key component of haemoglobin, the oxygen-carrying substance in red blood cells. To maximise your absorption of this valuable mineral, eat vegetable, meat or fish sources of iron in the same meal. Iron-rich foods include meat, poultry, fish, dark green vegetables, dried beans and dried fruits. The adult body contains around 4g of iron, half of which is found in our red blood cells. If iron levels fall too low, anaemia (low levels of red blood cells) can result.

Drink orange juice with your muesli Did you know that some foods can actually block the absorption of iron from our diet? Notable iron-blocking foods include fibre-rich wholemeal cereals, dairy products, such as milk and cheese, and drinks such as tea, coffee and chocolate. It’s not possible – or advisable – to avoid many of these foods, but you can counteract their effect on iron absorption by drinking beverages between rather than with meals and by having foods or drinks that are rich in vitamin C, which boosts iron uptake. Citrus fruits, such as oranges, are particularly high in vitamin C.

Sprinkle nuts on your salad seeds, nuts, oats, barley and soya products actively lower your blood levels of cholesterol. A study has found that including a portfolio of foods that actively lower cholesterol may be more effective, especially for lowering heart-damaging LDL cholesterol, than a low saturated fat diet alone. Try adding cholesterol-lowering foods to your low-fat regime to maximise the benefits.

Drink green tea to improve your balance of ‘good* to ‘bad’ cholesterol. Chinese researchers have found that green tea helps lower blood levels of bad’ low-density lipoprotein (LDL) cholesterol without affecting ‘good’ hlgh-deroity lipoprotein (HDL) cholesterol. So while using other cholesterol-lighting tactics such as avoiding fatty foods, enjoy green tea as often as you like.

Watch the label For blood vessel health the most important ingredients to avoid are transfats, which appear on labels in the UK as ‘hydrogenated fats’ or ‘partially

Spinach, ricotta and pine nut ravioli with sage butter

Spinach, ricotta and pine nut ravioli with sage butter

MAKING RAVIOLI IS TRULY SATISFYING and fun – especially if you get others involved. In Italy, this typically happens, with the matriarch in charge of quality control. You should have enough filling here for about 20 ravioli. Any pasta dough that isn’t used can be re-rolled into thin sheets and cut into thick strips to make pappardelle or tagliatelle.

SERVES 4-5

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Pasta dough:

pinch of saffron strands
1 tbsp boiling water
550g Italian ’00’ flour
¼tsp fine sea salt
4 medium eggs, plus 6 egg yolks
2 tbsp olive oil

Filling:
2 tbsp olive oil
2 garlic cloves, peeled and finely chopped
500g spinach leaves
15g butter
1A tsp freshly grated nutmeg
sea salt and black pepper
150g ricotta cheese
75g Parmesan, freshly grated
75g pine nuts, lightly toasted squeeze of lemon juice, to taste beaten egg, for brushing

Sage butter:
75g unsalted butter, diced
2 tbsp double cream
6 sage sprigs, leaves shredded

To serve:
Parmesan, for grating

 

For the pasta, lightly crush the saffron in a bowl, pour on the boiling water and leave to infuse until cooled. Put the rest of the ingredients into a food processor, add the saffron water and whiz until the mix resembles coarse crumbs; add a little more water if needed. Tip into a bowl and press into a ball with your hands. Turn onto a lightly floured surface and knead until smooth. The dough should be soft but not sticky; if it feels too wet, knead in a little more flour. Wrap in cling film and chill for 30 minutes.

To make the filling, heat the olive oil in a large frying pan and fry the garlic until lightly golden. Add the spinach and cook for 2-3 minutes until the liquid released has been absorbed. Increase the heat slightly and stir in the butter, nutmeg and seasoning. Drain and roughly chop the spinach. In a large bowl, beat together the ricotta, Parmesan and toasted pine nuts. Stir in the spinach and a touch of lemon juice. Taste and adjust the seasoning if necessary, then cover and chill for at least 30 minutes.

Cut the pasta into 8 pieces, roll into balls and keep each wrapped until needed. Using a pasta machine, roll each ball into a long sheet, about 80 x 13cm, passing it repeatedly through the rollers and narrowing the setting gradually until you reach the thinnest setting. Cover with a damp tea towel. To shape the ravioli, follow my guide (on the preceding pages).

For the sage butter, melt the butter in a saucepan and heat until it begins to brown. Take off the heat and let stand for 1 minute, then strain through a fine sieve into a clean pan. Heat slowly, then stir in the cream and sage.

Bring a large pan of lightly salted water to the boil, add the ravioli and cook for 2-3 minutes. Drain well and toss with the sage butter. Grate over a little extra Parmesan and serve at once.

spinach-ricotta-and-pine-nut-ravioli-with-sage-butter

Steamed bream with ginger and spring onions

STEAMING WHOLE FISH IN THIS WAY enables you to retain all of its wonderful, flavourful juices and «es you a kwsty, aromatic sauce – perfect for spooning over accompanying plain white rice.

SERVES 4

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1 bream, scaled and gutted, about 700g
4cm knob of fresh root ginger, peeled
4 spring onions, trimmed
1 long red chilli, deseeded
2 tbsp Shaoxing or Chinese rice wine (or dry sherry)
2 tbsp light soy sauce
2 tbsp sesame oil

 

Make slashes in the fish, about 2.5cm apart, slightly on the diagonal, without cutting right through to the bone. Slice the ginger, spring onions and red chilli lengthways into thin matchsticks.

Scatter a little ginger and spring onion over a heatproof plate, large enough to take the fish. Lay the bream on the plate and stuff the fish cavity with a little ginger, spring onion and chilli. Drizzle the rice wine and soy sauce over the fish, then scatter over the rest of the ginger, spring onion and chilli.

Place an inverted heatproof bowl in a large wok and pour in enough water to come halfway up the sides of the bowl. Put the lid on the wok and bring the water to the boil. Now carefully lower the plate containing the fish into the pan, placing it on the upturned bowl; avoid touching the sides of the hot wok. Put the lid back on and steam over a high heat until the fish is just cooked – a knife should slide easily into the thickest part of the flesh. It will take about 10-15 minutes.

As soon as the fish is ready, carefully lift the plate from the steamer. Heat the sesame oil in a small pan until smoking hot, then immediately pour over the fish. Bring the plate to the table and serve at once, with rice and a vegetable dish on the side.

steamed-bream-with-ginger-and-spring-onions