COVID-19: A Respiratory Physio’s Firsthand Experience

This week’s blog is by Emma Tucker (@emtucks), Post COVID Rehabilitation Specialist/Service Lead from the Oxford Long Covid Service

Back in June 2020 I was invited to speak in front of a room full of senior managers to discuss how we were going to be able to deal with the onslaught of patients being discharged from hospital with likely lung fibrosis. I’ve got a long background of treating patients with COPD and asthma, doing regular exercise and education classes; Pulmonary Rehabilitation. Apparently, this meant I would know how to be able to deal with this… What I can tell you is what came next certainly was not what I expected!

We started to accept referrals via GP’s for people who had acute COVID in the community that were a lot younger then the hospitalised cohort, but were continuing to experience significant problems with breathlessness and fatigue. My usual approach of exercise and ‘go go go’ was challenged, as this certainly did not seem to be the correct approach for these growing numbers of individuals.

I remember standing in the park on a Friday afternoon watching my children play and having a phone call with a colleague working in the Leeds Long COVID rehab service, and I asked her ‘have you found that all these patients seem to have altered breathing patterns?’ This was certainly the presentation of many patients to other respiratory physio colleagues around the country. Now as I said I’ve got a background in promoting exercise in lung disease, and I have managed many asthma patients with a diagnosis of dysfunctional breathing, but I recognised that I may have a learning need here. I’m lucky enough to have an excellent network around me with experienced respiratory clinicians and together we addressed each others skill gaps and reached out nationally to learn from each other.

From this I was lucky enough to complete the BradCliff Breathing Method programme which equipped me with so many more skills, and increased my understanding and awareness of what to do for those more problematic symptoms of breathlessness, that were not responding to the basics.

Two years later I’ve been lucky enough to write a chapter on breathlessness, and how to manage this, in the first Long COVID Self Help book, and with colleagues produced YouTube videos to enable patients to be able to understand how to get back control of their breathing in that post COVID phase. I’ve taught and spoken at national training events on both breathlessness in Long COVID and Returning to activity after COVID-19.

Being breathless is terrifying, especially when is out of context to the activity that is being performed. This is the case for so many individuals suffering with long COVID. Being able to take an active role in retraining the breathing, and understanding why and how, is one of the most valuable tools that I feel I can give to patients both when I see them in clinic, or be able to signpost to if it’s a quick message on Twitter or a friend in need.

We underestimate the power of the breath, but hopefully we have helped people understand how we can take power over it!