Meet Joan

Scene 1

Joan is a 76 year old widow who lives alone.

When she is well she enjoys going out to the local lunch club, library and bowling club but she feels sad and lonely when at home.

Recently she had frightening symptoms at home:

• Sudden episodes of blurred vision, dizziness, nausea and stomach bloating, weakness and tingling in hands and legs- legs may give way and on one occasion she drops a cup of tea in the kitchen.

Scene 2

Her GP takes a history of the symptoms and notices some bad breathing habits. Joan says when she is at home she:

• Frequently sighs, yawns.
• Weeps at times.

During her appointment the GP notices that Joan takes excessively deep breaths when she describes how sad she feels. This could result in chronic low levels of CO2 and some of the above symptoms. A diagnosis of breathing pattern disorder is a possibility.

Scene 3

The following referrals are made:

• A neurologist - who found no sign of serious illness but noticed that she sighed and held her breath a lot.
• Respiratory physiotherapist for breathing retraining:
  • Explains of how Joan's feelings are linking to poor breathing habits and symptoms.
  • Recommends avoidance of sighing and yawning. To be replaced by relaxed slow, shallow breathing when feeling sad.
  • She is given breathing exercises to practice at home.
  • She has been referred to a local charity who provided a befriender to visit Joan regularly at home.

Scene 4

Outcome - Joan’s mood improved. She found that her frightening symptoms could be avoided or controlled by keeping busy. She looks forward to meetings with her new befriender and she is practising her new breathing techniques.