Physio

Hi everyone,

This week I had my first appointment with a physio and was talking to a friend about it today. When she asked how it went, my reply was that I am not sure really. After being a little hesitant about the referral (I was struggling at the time and thought my cons was going down the anxiety route), I eventually thought this would be quite good as I know I am a mouth breather and really struggle to gain control after coughing (one of main symptoms). The appointment was meant to be an assessment but the physio simply talked me through some breathing exercises (not dissimilar to the ones I do for singing) and positions which are good for when you are SOB. I was told to practise these and then try them out when struggling and the physio would give me a ring in a few weeks and we can take it from there. When I mentioned that the breathing through the nose would be tricky for me as I have a lot of allergies which cause sinus problems, she didn't seem that bothered. I may be wrong As she could have been watching me all the time but it didn't feel much like an assessment. Apart from one good position which really cleas the mucus when coughing, I don't feel I have gained much from it.

I was just wondering what other people have experienced with a first physio appointment. What should I say to my cons about it when I see her next week or the physio when she phones?

Many thanks

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I think I should reply to this as I've seen quite a few physios!

Generally there has been a fair bit of assessment eg Nijmegen questionnaire which looks at classic 'hyperventilation' markers (I used to score just over threshold on this when I had an odd dizziness thing but now score well under - even with a subtle breathing pattern thing). Also counting resp rate - some are more or less obvious about this; one actually told me she was doing it which I thought was a bit weird, others pretended to be taking pulse, the latest one could take it while talking to me and I only knew when she told me it was a bit fast!

The one I had most recently was an hour of assessment, no treatment, and was pretty thorough: she felt my ribs/chest while breathing (also done by an earlier physio), looked at my breathing lying down, got me to do walking on the flat and up stairs so she could observe, listened to chest when I said I felt a bit tight after the exercise portion. and got me to breathe into a machine to test how much CO2 I was exhaling.

A previous physio, who I saw when asthma was getting worse, was also pretty thorough - she asked lots of questions, looked at chest muscles which she said were a bit tight and might be affecting things, also felt ribs/breathing and listened to chest as I had a very persistent cough which she was a bit worried about.

Also did the bleep test with another physio to see how I breathed when exercising.

They don't all do that but it does seem like there wasn't that much assessment in yours. The first one I saw was lovely but it did feel a bit like this as she told me how to breathe correctly -I know how but as other physios explained, I can get into bad habits when not paying attention esp as it's very often not symptomatic with me! I felt with the first one and a later one that they hadn't really taken into account that I knew stuff from singing, whereas the RBH one was really good at remembering and taking into account what my life was like and about other stuff that might affect things.

I think you could say to cons much of what you've said here esp re sinus concerns - practice as much as you can with the sinus issues (shows willing) and mention that again to physio and to cons. Maybe say you'vre tried what was suggested but don't feel it's helped much?

Hope this helps...I've not always got that far with physio but sometimes cons seem to pin an awful lot on it! Then they don't actually listen to what the physio says! The most recent one did help me along with the exercises but otherwise they've not helped with the main bulk of symptoms. It is nice to have improved some things I didn't realise I was doing though like extra sneaky breaths.

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Thank you Philomela,

I think I was expecting more like what you described but then when I looked at my cons letter it said about developing coping mechanisms. I didn't think much of it until I was talking to a friend today but I was kind of hoping they would look at breathing pattern as I do think I have picked up a few bad habits (like the mouth breathing and sneaky breaths).

To be fair, my physio did say that I should be able to do the exercises with the singing/woodwind background and this would mean I wouldn't have to do too much practise when well. I am trying to breathe through my nose more too! The physio said that a combination of this and meds would help to improve my night time attacks. Good advice re the cons also but like you say I am not sure how much of it she will listen too (the referral was just mentioned in passing). At least I can report some improvement since starting atrovent last week!