Breath holds

PurpleCat

Since so many of us have to hold our breath during radiation treatments for left-sided cancers, I thought it might be helpful to have a thread to share our experiences and tips for getting through it. I'll make a separate post later for my own experience so far.

egregious

I've had to hold my breath. I get through it by counting and thinking to myself "I can do this"

If you can't hold it long enough the machine turns itself off (at least here), then they give a little break, then try again for the remaining few seconds. So maybe you can't hold it for 20 seconds but you can do 10 + 10.

This is to protect my heart, so I do my best to comply.

PurpleCat

My setup includes a scuba-type mouthpiece connected to a hose connected to a sensor on the machine, a noseplug, and a pair of virtual reality glasses with a view of a really boring screen.

The screen displays a red light and a green light, a gray stripe across the bottom, and a line that goes up and down when I breathe in and out. When the green light goes on, a second gray stripe appears at the top of the screen, and I'm supposed to take a breath deep enough to move the line into the gray stripe at the top and hold my breath. Once I do, the radiation beam starts up. I've always been able to hold my breath until the red light goes on (signaling "finished") but if I couldn't, the beam would stop and then I'd get another zap to finish the dose. I don't think I've ever had to hold my breath more than about 20 seconds, and sometimes it's been as little as 4.

The noseplug was pretty uncomfortable until I figured out they'd let me adjust it myself if I asked. I asked to do it without the noseplug and they said no, that doesn't work, even though it sees like it would. Oh well. At least I asked.

The mouthpiece isn't bad either, or wasn't once I figured out I could adjust it during the setup phase too.

I first got through it by singing a verse of a favorite hymn to myself. Now it's become almost meditative, in a way. There's not a thing for me to do except lie there and be conscious of my own breath, watching that line go up and down, intentionally breathing deeply enough to touch the high and low stripes, and somehow that has begun to feel calming. In a way, I wonder if I'll have a harder time with the final 4 "boost" treatments that won't require the breath holds, because I won't be intentionally regulating my breathing and will also be able to see my surroundings without those goggles. That will mean being a lot more aware of being alone with that huge machine. Hopefully my excitement at being near the finish line will carry me through by then!

Spoonie77

I had gated RADs as well, meaning I had to hold my breath while treatment was "zapping" me.

At my center, my RADs team informed me that the system they had, takes in all my info that was gathered during my CT Simulation (measurements, images, breath in and breath out comparisons, etc), then they basically made a "topographical map" of my body.

That is how gated rads functions (in my case) --> if my chest level (think expanded measurement) fell below a certain measurement (this is the "gate") maybe because I couldn't hold my breath anymore, then the machine automatically shuts off so that my heart wouldn't receive any radiation by accident.

Each treatment for me consisted of 4 different "holds".

The longest was never more than 20 secs, the shortest was about 10.

A tech would say "take in a breath and hold when you are ready".

Sometimes I wouldn't hold it deep enough or not get it in the right range, so they might tell me "ok let that breath out and try again when ready".

If I had the breath held so all their doo-dads lined up and it was safe to radiate, they'd tell me "hold there" and I'd count for 20 or try to say the alphabet backwards or something to focus on.

Then when that hold was finished, they would tell me "ok you can breathe now".

After that, the machine would rotate around me a bit to the next radiation site and then the process would repeat.

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This is a handout my RO gave me that helped explain why this was needed - in order to protect my heart. Apparently, on a majority of people, when you breathe in deep to hold your breath, it subsequently pulls your diaphragm down which in turns pulls the heart down as well. This helps keep it out of range of treatment. Always a good thing.

Hope this helps someone. I was a bit apprehensive at the start but eventually you figure out a rhythm and how to breathe just "so". By the end of my treatments it was a piece of cake. Good luck to all who walk down this path. It may seem daunting but if you are concerned or confused, just ask questions. In my experience, techs are super understanding and willing to take the time to make you feel comfortable the entire time of the process.

Hugs and healing....

DiagnosisDisruption

I asked them to say "halfway" when I held my breath. That way it didn't feel like it was never going to end. I told them I didn't really care if it was halfway through the 25 seconds, just to tell me anytime, I couldn't tell anyway. It just gave me hope. I do the same thing for MRI's and other stuff.

And tell the radiologist if your chest or the side of your breast hurts/aches/burns when you breathe. I developed costocondrisis. Mimics a heart attack.

Oh, and if you do breathe because you cannot hold it anymore, the machine shuts off. For real. I tested it.

DiagnosisDisruption

Oh, and they tell you to breathe, then they tell you to go deeper and hold - don't. Tell them you are just going to start over. Hurts like a son of a gun when they tell you to go deeper and hold. Better just to waste the time and start over.

hdmom

When I was first being evaluated after my diagnosis, I went for a second opinion and that place told me to start practicing breath holds so I would be ready when the time came since I’d need to hold for up to 30 seconds. That has had me terrified! I have left sided cancer, and already a nerve conduction issue in my heart to begin with, so I have been dreading radiation. Well I ended up having my rads at the original facility (just finished my first week, yay!) and this is absolutely tolerable. The longest breath hold I do is about ten seconds. The thoroughly evaluated my breath holds and have cameras on me and everything so it would shut off if I start breathing prematurely, but the multiple shorter breath holds are completely doable for me. What a relief! I don’t think it would be possible to hold for 30 seconds. Add to that, having anxiety reduces your ability to hold that breath as well! So my great respect to those of you who are out there reaching for that goal. XOX

Skwashie

For me, breath hold was a positive and centering experience. As for many of us, a cancer diagnosis can cause one to experience anxiety. I had started experiencing shallow breath as a consequence of this. Then, I started breath hold for my radiotherapy.

I commenced treatment with a planned 30 second breath hold. You get to practice before the treatment starts. After a week one of the therapists realised I could hold my breath for longer (as I had asked for no counting out loud by the therapists so that I could concentrate on my treatment). He noticed that I was holding my breath beyond the length of the set-up. So, I went up to 40 seconds.

This technique, for therapy, resulted in my anxiety dissipating. My breathing became slower and deeper and I now breathe better than I ever have. After radiotherapy my resting heart rate dropped to 58bpm as an average (it is usually about 64 and in the lead up to my cancer diagnosis had gone up to 72, which is one of the reasons I started to enquire about my health with my GP).

I now practice deep breathing and breath hold to manage stress and or sleep disturbances. It changed my whole perspective on breathing, stress management and overall health.

Tips:

- ask for the nose clip to go on after the mouthpiece so that you can breathe during set-up

- be vigilant with therapists removing the hygiene wrapper on the mouthpiece. Don't place in your mouth a mouthpiece that has been handled without the wrapper. Therapists are touching dozens of people and their body parts and you are immuno-compromised. Be assertive (and polite) therapists understand and are human so they sometimes forget the routine.

- clasp the mouthpiece with your teeth and squeeze it. This will results in a narrowed mouth which will make breathing easier; as it is difficult taking a deep breath with one's mouth open very wide.

- stop thinking about breathing; stop thinking about salavating. Think of something else to interrupt either or both

- figure out what you will do during breath hold. Don't leave it to chance. I counted very slowly whilst telling my body that the treatment was a positive thing.

- tell yourself it will all be over before you know it.

- as soon as the treatment is over remove the mouth piece and take the clip off. Don't wait for the therapist to do this. Participate in your treatment routine.

And all the best

Ingerp

I was a little nervous before starting the breath hold but it turned out to be not a big deal at all. I’d count seconds to myself while being zapped—17-18 seconds was the longest one (of four every time). It was a great relief to hear the machine would automatically turn off if I moved out of position (and that the zap would only be for the remainder of the time) but I never had a problem.

moth

I didn't have any nose or mouth gear - just was told to inhale deeply and hold. I found it easy and not really anything to worry about.

kinderkel

I finished radiation on 12/11. For the first five treatments I struggled with the deep breath holds. It turned out that I had undiagnosed asthma! I started using an inhaler about 1/2 hour before treatments and it made a huge difference. No more problems getting the lines in the monitor to go together and turn green!

sneezyhead

I practiced before radiation started as this made me very anxious. I worked up to holding my breath for 30 seconds slowly and calmly and figured out what meditation tricks I could use to make it easier. The great thing was my longest breath hold was just over 20 seconds (which was great, because anxiety kicked in at the 27 second mark) and I'd just go to my happy place and before I knew it was over.

Good luck!

Mymomsgirl

I had my simulation the other day and it wasn't as bad as I thought it would be. The facility I'm at uses the nose plug and the snorkel and I have a button that I push in when I'm ready. With this setup when you take the deep breathe it cuts you off when you get to the point you need to be, I will admit it startled me at first, but it almost made it easier to hold my breathe. I will say that I looked at some videos on line first and I'm glad I did so I knew what to expect going into the simulation.

I do have a question, how many times did you need to hold your breathe during your treatment? I think some of you said something about 4 times, the tech said something about 20 which I thought was a lot. I have my image verification next week so I'm sure then I'll know how many times and how long it might take.

PurpleCat

Mymomsgirl, your treatment sounds very similar to mine. I had four breath holds per session. The first was about 20 seconds long, and the second was shorter, maybe 10 seconds. Then the beam apparatus would rotate around to the opposite side for two more breath holds of about 20 and 10 seconds each. I had 20 sessions total; maybe that's what your tech meant? It really wasn't as bad as I had thought it would be, although I was counting down the days to the last four sessions because they didn't require breath holds. Good luck!

keeshondmom

So...am almost through with radiation...have 6 sessions left out of 20. Yay!!! But...having problems with breath holds with only one radiation tech. Have worked with probably 4-7 techs, all of whom have been very upbeat and friendly. None of them has ever mentioned any problems with breath holds. All of them have had me hold my breath maybe 2-3 times before the actual breath hold with radiation. Just one tech has had me hold my breath 6-8 times BEFORE the actual radiation. As you can well imagine, after holding my breath that many times, it's a little difficult to hold my breath 2-3 times for the actual radiation. In addition last week he told me I was "only" holding my breath close to the "lower" end of what was acceptable and I was inhaling too slowly. WTF?! Has anyone else experienced this problem with any of their techs? Don't know if I should mention this to the doctor or not...but it definitely is upsetting to me. Would love to hear any comments...

Mymomsgirl

Keeshondmom I would say something to that tech. When you go in just tell him I know you said last time I wasn't holding my breath very well and I think it is because you are having me hold my breath so many times before the treatment. With the other techs I only need to hold it 2 or 3 times. If you are uncomfortable with that then I would definitely say something to the doctor or if they have an oncology nurse available. I hold mine 2-3 times for setup and 3 for the treatment. Remember you are your best advocate.

keeshondmom

Good advice, Mymomsgirl! Interesting that the last two days there have been some "trainees" with him and he has not had me hold my breath "in practice" for more than 2-3 times. I said something to the doctor today and he smiled and said, "You must mean John." So obviously he has done this several times. One would hope he has been talked to about this. Who knows.

Mymomsgirl

Keeshondmom good for you. For my set up there are always 2 techs, do you just have the one? If I recall you are close to being done, so maybe you won't have him solo again.

keeshondmom

I also have 2 techs, but John seems to be in charge. He wasn’t there today and everything went quickly and smoothly. Am on Boosts now anyway so no breath holds. Only 3 more!!! But in retrospect wish I had said something to him sooner so that maybe someone else could be spared.,