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So Excited About Biofeedback!!


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I had my first biofeedback appointment today and I am so excited about it! I talked with the therapist for a while then she hooked me up to some equipment to monitor the movement of my diaphragm. She said the most striking thing is that I breathe really fast. I was taking 22 breaths per minute and she said anything over 18 is considered hyperventilating. So basically I have been walking around hyperventilating all the time! She had me follow a rhythm to get my rate down to 11 breaths per minute. It felt so good and I was totally relaxed within a few minutes.

We'll see where this all goes. Who knows what it will do for my lightheadedness. But clearly my nervous system is overstimulated and I am so excited to find a tool to help calm it!

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Amy, I know nothing about breaths per minute, but I agree...Biofeedback is amazing.

Causes the brain to switch from beta to alpha waves, and the impact of that is more powerful than any pharmaceutical drug I've taken.

Am glad for you. Does your insurance cover it?

Soak it up. It's a powerful modality in the hands of a good practitioner.

Keep us posted on your progress.

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Glad you had a good experience. My neuro and I had a discussion last year about meditative breathing (which I was using to calm adrenaline surges and get through presyncopal episodes) and he was rather glad to hear it. He had talked to me about a study that was done on patients with congestive heart failure and the effects of meditative breathing. The study found that patients were able to slow, stop, or in some cases reverse some of the damage to their hearts. I was able to find the article and posted it a while back. If I can find it in the next few days I'll add to this thread.

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Kitt, I will submit the bill to my insurance, but I am not sure if they will cover it. I have crummy insurance, so I am used to paying for most things out-of-pocket.

Katybug, I feel like I've known about some of the benefits of deep breathing, meditative breathing, etc. But this was a good way for me to see how "off" my breathing is. I'd never realized that I breathe so fast.

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For anyone interested in learning more about incorporating meditative breathing into their everyday activities, you might want to read the book "Where Ever You Go, There You Are" by Jon Kabat-Zinn. It is a very easy read with chapters that are very short (5-10 pages) . At the end of each chapter it gives you a little exercise to do that is usually less than 5 minutes or that you can actually incorporate into your daily activities, for example, counting your footsteps as you walk from one place to the next. It teaches mindfulness, being in the moment, and being aware of your body.

I read it in college and became so accustomed to the exercises that I sometimes laugh at myself because I find myself doing the exercises these days without even consciously thinking about it. The tools in the book have really helped me through some bad times with POTS.

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Thanks for the book recommendation Katybug! I will definitely read it!!

Future, I can't speak to the relationship between breathing rate and heart rate. The more I learn, the more I realize how much I don't know/understand. The body is so complex and I have realized that I have been looking at things in overly simplistic terms.

But with that said, here's my current understanding. I know that my sympathetic nervous system is over-activated. My therapist said that breathing fast (hyperventilating) triggers the sympathetic nervous system and sets off a whole chain of reactions in the body. I slowed my breathing way down and felt a huge change within about 5 minutes.

I did some reading last night and came across Chronic Hyperventilation Syndrome. Nobody has ever mentioned this to me before, but it fits me to a T! I downloaded a breathing app to my phone and I am already addicted to it. It feels so soothing for me to focus on my breathing that I don't want to do anything else!

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  • 2 weeks later...

I had my third biofeedback appointment this afternoon. I am still very excited about it. I can already see some improvements. Here’s what I’ve noticed so far:

--I feel very relaxed within a few minutes of practicing my breathing.

--I almost always have a headache. I have had way fewer headaches since I’ve started the biofeedback training.

--I usually have a hard time getting my mind to settle down. It seems like I’m always thinking about a million things at once. The breathing exercises really help me to clear my mind.

--My back and neck are usually very tight and sore. I’ve had less muscle tension since starting biofeedback.

--My worst POTS symptom is constant lightheadedness. I’ve had a few periods of time when I am not as lightheaded since starting biofeedback. I think this will take a lot of practice and time for me to learn to breathe at a slower rate all the time. I slip back to my fast, shallow breathing whenever I’m not paying attention. But it is very encouraging that I’ve had at least some improvement with my lightheadedness.

I’ve found a few apps for my iPhone that help tremendously with my breathing practice—and they are either free or cost just a few dollars:

Relax by Saagara – I use this one the most because I can just listen to it with my eyes closed. I use the beginner level and select the most basic options so that I am doing 7.06 breaths per minute. The graphic has you do 1/3 inhale to 2/3 exhale. This is too hard for me right now, so I just do a little extra on the inhale. I do multiple 5-minute sessions throughout the day. And I usually get in one 30-60 minute session per day. I am not usually this dedicated about practicing things. It’s just that I feel so much better while I am practicing that I am very motivated to get in as much practice as possible. Saagara has another app called Pranayama. As far as I can tell, it is the exact same thing as their Relax app—it just has a different graphic.

Breathe2Relax by National Center for Telehealth & Technology – This one is good because it has a little more instruction and the graphic they use to guide you is helpful. But you can only set it for a max of 16 breathing cycles. And it crashes a lot. I set the inhale to 3 seconds and the exhale to 3.5 seconds.

BellyBio by Relaxline – I just found this app yesterday and it is really crazy! It uses the gyroscope in your iPhone to measure the movement of your diaphragm. It synchronizes the sound of ocean waves or music to your breath. And you can see a graph of your breathing pattern—although this is a bit hard to look at while your iPhone is sitting on your stomach.

Inner Balance by HeartMath – This app hasn’t been released yet. But my biofeedback therapist uses a lot of HeartMath tools and this app looks very interesting.

Now for a little background on me….I think I have two components to my POTS. This is all based on my own conjecture based on everything I’ve read and learned. I’ve had mild POTS symptoms since I was a kid. I’ve noticed a slow worsening of my symptoms since I was about 30 (I’m now 41). I think this is due to chronic stress and anxiety which have caused my sympathetic nervous system to become way overactive. I had a lot of stressful things happen in my 30s. And then of course I’ve been super stressed about having POTS!! (Who here doesn't have a lot of anxiety related to POTS?!?)

I think the second component of my POTS comes from fertility treatments. I did 2 rounds of IVF in 2011 and my health really crashed when I was doing the second IVF round in November 2011. IVF is essentially an endocrine disruptor and I think it just trashed my system. I have had constant lightheadedness since 2011.

I think the biofeedback is helping with the overactive sympathetic nervous system component of my POTS. (Again, this is just the idea I’ve come up with on my own.) I think I am slowly recovering from the IVF, but I think that’s a different issue.

I’ve tried to practice deep breathing before, but it has never been presented in a way that works for me before. I used to do a lot of yoga, but I could never get the breathing right. I’ve also done meditation, but again I was always missing the breathing component. With biofeedback, I could instantly see what I was doing wrong and what my goal was. The first time I did biofeedback (2 weeks ago) and controlled my breathing, I felt incredibly relaxed within 5 minutes.

I also saw my chiropractor this week and asked her about a heart rate variability (HRV) test that she is offering next month. I did a lot of chiropractic work with her in 2009. I was having severe fatigue then (undiagnosed POTS) and she did a bunch of scans on me. It turns out that one of the scans was HRV. We reviewed all the scans I did in 2009. My HRV had “poor coherence”, but I had no idea what this meant. (I’m still trying to wrap my mind around the concept.) My HRV improved over several months, but then it crashed in Aug 2009. August is a very busy and stressful time of the year for me, and in retrospect it makes sense why my HRV was so much worse in August. My chiropractor said she tells people that they can improve their HRV coherence by getting chiropractic adjustments and by practicing deep breathing. I did a bunch of adjustments, which helped a little, but unfortunately I didn’t understand enough about the deep breathing in 2009. I really needed a lot of guided instruction on deep breathing.

Coincidentally, I worked on HRV with my biofeedback therapist today. She was able to use some of her equipment (a pulse sensor that was clipped to my ear) to rate my HRV and guide me to higher coherence. My mind felt so calm and clear when I was able to achieve high coherence. But of course my HRV dropped back to the normal, poor level for me as soon as I stopped concentrating. My therapist is going to let me borrow her portable pulse sensor so I can practice this throughout the day.

Like I said, the concepts of HRV and coherence are still new to me. I’ve been reading about them on the HeartMath web site. They have a lot of helpful information and here is one quote from their Research page that especially caught my eye:

Heart-Rate Variability and Autonomic Function:

IHM conducts ongoing research into heart-rate variability (HRV), a measure of the naturally occurring beat-to-beat changes in heart rate. HRV analysis is a powerful, noninvasive measure of autonomic nervous-system function and an indicator of neurocardiac fitness. HeartMath has published research demonstrating how HRV varies with age and gender and on the use of HRV analyses to assess alterations in autonomic function in conditions such as panic disorder and chronic fatigue.

This is further evidence to me that my poor HRV measurements are related to my POTS. HeartMath has a lot of info on autonomic function on their web site.

I know this is a super long post. But I’m trying to include as much detail as possible so that you can see if anything grabs your attention and makes you think that biofeedback might be a good fit for you. I really like the fact that there are no meds involved. And it is relatively inexpensive ($80 per session) compared to all the other medical stuff I’ve done for my POTS. I’ll keep posting as I get further into my biofeedback practice. I know that I will do some EMG feedback (muscle feedback), but my therapist said she wants me to really get my breathing consistent before we throw the EMG into the mix.


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I just did some more reading on the HeartMath web site. There is an article called "The Science Behind the emWave and Inner Balance Technoligies" at http://www.heartmath.com/personal-use/emwave-science-behind.html

It has a really good description of heart rate variability (HRV) and coherence. I always thought that your heart beats at a fairly consistent rate. Not true! It is constantly changing from second to second.

Here is a portion of the article that I found particularly helpful:

In general, emotional stress - including emotions such as anger, frustration, and anxiety—gives rise to heart rhythm patterns that appear irregular and erratic: the HRV waveform looks like a series of uneven, jagged peaks (an example is shown in the figure below). Scientists call this an incoherent heart rhythm pattern. Physiologically, this pattern indicates that the signals produced by the two branches of the ANS are out of sync with each other. This can be likened to driving a car with one foot on the gas pedal (the sympathetic nervous system) and the other on the brake (the parasympathetic nervous system) at the same time - this creates a jerky ride, burns more gas, and isn’t great for your car, either! Likewise, the incoherent patterns of physiological activity associated with stressful emotions can cause our body to operate inefficiently, deplete our energy, and produce extra wear and tear on our whole system. This is especially true if stress and negative emotions are prolonged or experienced often.

In contrast, positive emotions send a very different signal throughout our body. When we experience uplifting emotions such as appreciation, joy, care, and love; our heart rhythm pattern becomes highly ordered, looking like a smooth, harmonious wave (an example is shown in the figure below). This is called a coherent heart rhythm pattern. When we are generating a coherent heart rhythm, the activity in the two branches of the ANS is synchronized and the body’s systems operate with increased efficiency and harmony. It’s no wonder that positive emotions feel so good - they actually help our body’s systems synchronize and work better.

Copyright © 2013 HeartMath LLC. All Rights Reserved.

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