SHORTNESS OF BREATH (DIFFICULTY BREATHING)
What is Dyspnea (shortness of breath)?
Dyspnea is trouble breathing or difficulty catching your breath. Breathing difficulties sometimes occur when the body is not getting enough oxygen.
How do people describe shortness of breath?
Some people describe shortness of breath as an awareness of uncomfortable breathing. Some describe it as a feeling of working very hard to breathe. Some describe it as air hunger or a feeling of suffocation. When people are short of breath, they are not able to do their usual activities. They tire more easily. Some report that shortness of breath makes it difficult to sleep at night or eat meals or talk.
What causes shortness of breath?
People with cancer may experience shortness of breath due to a number of different problems including chronic lung disorders, fatigue, pneumonia, pain, immobility, malnutrition, obesity, stress, or anxiety. Surgery, anemia, side effects of chemotherapy or radiation therapy, tumor or fluid in the lungs may also result in shortness of breath. These problems prevent the lungs from breathing enough air, or prevent them from delivering oxygen to the bloodstream.
How do people cope with shortness of breath?
Here are some tips people use:
Remain calm-try to stay relaxed.
Plan your day to do important or fun activities first.
Limit unnecessary activity.
Avoid lying flat. Try propping your head up while in bed-pillows can be helpful. Some find it useful to lie prone (on stomach).
Use oxygen as prescribed by your doctor.
Sit upright and lean forward with arms on a table.
Pursed lip breathing can be used to decrease difficulty breathing:
a) Breathe in through your nose to the count of 2.
b) Purse your lips like you are going to blow out a match or candle.
c) Breathe out through pursed lips to a count of 4.
d) Repeat until shortness of breath is relieved.
Avoid smoking and avoid being around people who smoke.
Wear loose, easy to put on clothes.
Take part in activities such as board games, listening to music, watching TV, or reading.
Perform daily grooming activities (showering, shaving, brushing teeth, combing hair) while sitting down.
Take rest periods during activities. Pace your activities to provide rest periods.
Apply a cool washcloth on cheeks.
Try opening a window or turning on a fan.
Avoid warm temperatures, unpleasant odors and fumes.
Use a wheelchair as needed.
Take medications as prescribed that decrease shortness of breath.
Eat six small meals a day rather than 3 large ones.
Try relaxation exercises to help decrease your level of shortness of breath.
If you are breathing through your mouth, be sure to keep up your fluid level by drinking water -- 8 glasses per day (8 oz.).
What can family members and friends do to help me with my shortness of breath?
Ask for and accept offers of help from family members and friends for cleaning, grocery shopping and cooking.
Ask them to open a window or turn on a fan.
Ask them to coach you through breathing exercises, such as pursed lip breathing.
Ask family members and friends to remind you to take your scheduled medications.
Ask for help propping up in bed with pillows.
How can I talk with my family members and friends about my shortness of breath?
Try to describe how the shortness of breath affects your emotions and mood-you are the expert.
Ask for suggestions that might help relieve your shortness of breath.
Try describing how the shortness of breath may interfere with your usual activities and may make you tired.
What should I report to my doctor or nurse?
Pain with breathing.
Chest pain.
Wheezing.
Fever above 100.4º F for more than 24 hours.
Cold, clammy skin.
Night sweats.
Thick, yellow, green or bloody phlegm (sputum).
Flared nostrils during breathing-straining of neck muscles during breathing.
An increased pulse rate.
Pounding heart in the chest.
Unable to get out of bed for 24 hours.
Swelling in your ankles or calves.
It is important to note if the shortness of breath occurs even when you are resting or only after activity.
Where can I get more information?
Contact your doctor or nurse.
Call the American Cancer Society at: 1-800-ACS-2345 or visit on the internet at: http://www.cancer.org. Click on Patients, Family & Friends, then Coping with Treatment.
Call the National Cancer Institute at: 1-800-4-CANCER or visit on the internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer.
Call the Oncology Nursing Society at: 1-866-257-4ONS or visit on the internet at: http://www.cancersourcern.com. Click on Side Effects.
Visit the American Lung Association on the internet at: http://www.lungusa.org; or call 1-800-543-LUNG (5864). Call 1-248-784-2000 in Michigan.
Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
References:
Adapted from Shortness of Breath, American Cancer Society at: www.cancer.org.
The University of Pennsylvania Cancer Centers Oncolink website, at: http://www.oncolink.com.
Hood, L.E. & Harwood, K.V. (2003). Dyspnea. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 29-46). Boston: Jones and Bartlett.
