What the Breathlessness Intervention Service (BIS) does

When you meet a member of the BIS team for the first time, they will ask you about your experience of breathlessness, the impact it has on your life and those around you, and the things that you already do which help to manage it. Usually, they will then discuss some additional tools that can help:

Fan

The fan is a great tool which has evidence to support its use in reducing breathlessness and aiding a quicker recovery. In BIS, we encourage people to use small hand held fans as it is a very effective way of controlling their symptoms that can be used anywhere. There are a number of studies which provide scientific evidence of its effectiveness and these references can be found on our research pages.

Breathing techniques

We teach people specific breathing techniques which include the recovery breathing method and breathing control. These techniques can help people experiencing breathlessness to regain (and maintain) some control over their breathing.  We aim to help people to breathe in the most efficient way possible to try to reduce the overall effort of breathing.

Breathing retraining

Some people who are referred to us may have been diagnosed with a dysfunctional breathing pattern. Using simple but effective techniques, we can help them to have a more efficient breathing pattern which will reduce breathlessness and the impact it has on their lives.

Secretion clearance

The physiotherapists in the team help patients who struggle with secretions by teaching them specific clearance techniques. In more complex cases, we discuss drug treatments with the general practitioner.

Mindfulness and Relaxation

Mindfulness and relaxation can be very effective in helping with the management of breathlessness. You can listen to some of the tracks from our cd on the website or find information on how to purchase a copy in our resources section.

We also design personalised written relaxation scripts or give patients a recording of their relaxation session with us.

Acupuncture and acupressure

There is a growing interest in the use of acupuncture in the NHS. Within BIS, we sometimes use acupuncture and acupressure treatments to help with their breathlessness and associated anxiety. People who have received acupuncture with BIS often report that this has a positive impact on their management of breathlessness.

Exercise

A body which is fit uses oxygen more effectively and therefore requires less oxygen to function than a body which is not. Keeping active is a good way of improving (or stabilising) breathlessness symptoms. We always explain the importance of keeping as fit as possible and encourage people to engage in some form of exercise or activity.

Exercise does not necessarily mean having to go to the gym 3 times a week, and we work with people on practical things that can be done to improve activity levels or design with them personalised exercise programmes to do in their own homes. We also have a 6 week walking diary which we give out to some people together with the loan of pedometers.

Often people become so keen on keeping active that we refer them to pulmonary rehabilitation courses or to local council or community exercise schemes for longer term activities.

Anxiety management

We know that breathlessness can often trigger feelings of anxiety or panic and this in turn makes the breathlessness worse. BIS works with people to establish the triggers for anxiety and the related thoughts, emotions, physical symptoms and impact on behaviour. We then look at ways of trying to manage the impact of these to reduce breathlessness.

Energy conservation and activity pacing

People experiencing breathlessness will often have reduced energy levels which can have a significant effect on their daily routine and activities. BIS can help by suggesting ways in which people can use their energy in the most effective way and reduce the impact it has on day to day activities.

Pharmacological Management

A small number of our patients are offered pharmacological support for the management of their symptoms following an assessment by our Consultant in Palliative Care. 

Psychological assessment and support

Because breathlessness can be very frightening and is often associated with other symptoms such as anxiety or depression, it can affect people in more than just one way. People who we feel would benefit from it can be offered to be seen as an out-patient by the Consultant Clinical and Health Psychologist form the palliative care service.