Back to Breathing

21/08/2026

20/08/2026

HAVE YOUR SHOULDERS FORGOTTEN HOW TO RELAX? 🫁

I thought today was a good moment to talk about those hunched shoulders again. I've spoken about this before, but I see it so often in people with COPD that I think it's worth bringing up again.

When we're struggling to breathe, what happens?

We tense.

There's often fear with breathlessness too, and before we even realise we're doing it, the shoulders come up, the neck tightens, the chest becomes tense and our whole upper body seems to join the fight for that next breath.

It's an instinctive reaction. We're struggling for air, so the body tenses and tries harder. But more effort and more tension don't necessarily make breathing easier. In fact, all that tightness around the neck, shoulders and chest can make an already difficult breath feel even harder.

We may instinctively lean forward or support ourselves on our knees, a chair or a table, and that position can help us regain control of our breathing. But leaning forward and hunching up are not the same thing.

We can lean forward while keeping the shoulders dropped, the neck relaxed and the chest open. The problem starts when fear and the struggle to breathe make those shoulders creep towards our ears, the neck tightens and the whole upper body becomes rigid.

And think about what we're actually doing. We're already struggling to breathe, yet we're tightening everything around the very area we're trying to breathe with.

Try it now…

Hunch your shoulders up towards your ears, tighten your neck and chest and take a breath.

See how much more difficult it is to breathe like this?

Now try again. This time let those shoulders drop away from your ears, relax your neck and jaw and allow your chest to open naturally.

Take a gentle diaphragmatic breath in, and as you slowly breathe out, let your whole body unwind. Let the shoulders drop even further, soften everything and breathe out all that tension you've been holding onto. Don't rush the exhale.

Feel the difference?

This is exactly what we want to start becoming aware of when we're breathless. The breath may be difficult, but we don't need to make it even harder by adding all that tension.
The problem is that when we experience breathlessness regularly, we can start carrying that tension around with us long after the breathless moment has passed and over time, shoulders creep upwards and forwards, the chest becomes tighter, the upper back rounds and we can become increasingly dependent on upper-chest breathing. Then even when we're NOT particularly breathless, we're still carrying ourselves as though we are.

Eventually it becomes a fixture, and we don't even realise we're doing it anymore. We walk around almost like little robots, shoulders raised, hunched and rounded, neck stiff, chest closed and arms hardly moving naturally.

So where are your shoulders right now?

Seriously. Before you move them, notice them.

Are they relaxed? Have they crept upwards? Are they falling forward? Is your jaw tight? Is your neck tense?

This is what I mean when I talk about Self-Awareness. It's noticing these little things our body is doing automatically and then doing something about them.

One simple chest and arm exercise really helped me.

Sit or stand comfortably. As you breathe in, slowly stretch your arms out to either side, opening across your chest. Hold that gentle stretch for a few seconds.

Then slowly bring your arms down and behind your back as you breathe out. If comfortable, clasp your hands behind you, or simply hold one wrist, allowing your shoulders to relax back and down and your chest to remain open.

Stay there for a couple of minutes if comfortable, breathing normally and relaxing into the position.

Then release and repeat several times.

No forcing. No huge breaths. No pulling yourself into an uncomfortable position. We're trying to teach those muscles to let go, not give them something else to fight against.

I also think chest and arm exercises are really important. Move those shoulders. Circle them. Stretch the arms. Open the chest. Strengthen the upper back and core. Let the arms swing naturally when you walk.

We concentrate so much on our lungs that we sometimes forget about all the muscles surrounding them and how much tension we're carrying around every day.

And start catching yourself during your normal daily life.

Waiting for the kettle... where are my shoulders?

Walking... are my arms moving naturally or am I walking like a robot?

Watching television... have I curled myself forward again?

Feeling anxious... did my shoulders just shoot upwards?

Each time you notice it, don't get annoyed with yourself. Just reset.

Shoulders down. Neck soft. Chest relaxed. Breathe in gently... and on that long exhale, let everything unwind.

Keep doing it throughout the day. Little by little those shoulders will start to remember where they're supposed to be, relaxed and away from your ears! Less tension and with more freedom to breathe.

So, I'll ask you again...

WHERE ARE YOUR SHOULDERS NOW?

16/08/2026

WHEN DO YOUR LUNGS GET TIME TO JUST BREATHE?

A conversation this morning really got me thinking again.

Someone with COPD said that after stopping smoking, rather than improving, their lung function continued to decline. Then many others began commenting that they had experienced something similar.

Throughout the comments on that thread, the same pattern kept appearing:

Stopped smoking. Started or continued COPD treatment. Continued to decline.

Now, that doesn't tell us WHY they declined. But when so many people describe a similar experience, I think it's worth asking questions. And it brought me back to something I've questioned for years.

We all know that stopping smoking is one of the most important things a smoker can do for their lungs. After years of breathing in cigarette smoke, that major irritant is finally removed.

But what happens to the lungs next?

Very often COPD has already been diagnosed and inhaled medications are introduced or continued. The ci******es disappear, but the lungs may never get a period of breathing space between removing years of cigarette smoke and continuing or introducing another inhaled substance.

And THIS is the part I question.

Our lungs are designed to breathe air and exchange oxygen and carbon dioxide. After years of exposure to cigarette smoke and inflammation, do our lungs deserve some breathing space?

What would happen if, where medically appropriate and under proper supervision, we looked at the individual rather than automatically assuming the next step must be the same for everyone?

What if we also concentrated heavily on giving the lungs what supports them? Clean air, an anti-inflammatory nutrient-rich way of eating, hydration, breathing exercises, appropriate movement to build strength and stamina, proper sleep and rest, reducing stress and anxiety, and looking at our environment and reducing other things that may irritate the lungs.

In other words, remove what may be burdening the lungs and actively support what they need.

Would everybody have the same result? Of course not. But wouldn't it be interesting to know what our individual lungs might do when given that opportunity?

I'm not saying inhalers caused the decline being described in that conversation. I can't know that. But equally, when someone's lung function continues to decline after stopping smoking, I don't think we should automatically stop asking WHY.

What else changed around that time? What was removed and what was introduced? How did the lungs respond? What was happening with inflammation, nutrition, movement, breathing patterns, sleep, stress, infections and environmental exposures?

The whole timeline matters.

I've spent the last six years studying holistic lung health, but a huge part of my questioning also comes from my own experience.

I followed the conventional route for years. I took the medications and inhalers I was prescribed and trusted that this was simply what I was supposed to do. And I continued to decline.

My doctor never sat down with me and went through those enormous information leaflets that come with medications. I wasn't encouraged to look at the possible side effects and then monitor how my own body and lungs responded. I was given prescriptions and I took them.

Eventually, I started questioning. I read, researched and studied holistic lung health, but most importantly, I started paying attention to my own symptoms and patterns. I began looking at my lungs as something I could actively support rather than simply something I had to medicate.

I changed my nutrition, worked on my breathing and moved my body. I addressed stress and anxiety, prioritised sleep and rest and became much more conscious of my environment and what I was exposing my lungs to. I became Self-Aware.

My experience subsequently changed dramatically, including improvements in my measured lung function.

That's my experience. It doesn't prove that somebody else's medication is causing their decline, and I'm certainly not telling anyone to suddenly stop prescribed medication. But my experience gave me every reason to keep questioning.

And I know some people reading this will immediately say, "But I can't live without my inhalers."

I'm not telling you to.

What I'm asking is: what are you doing for your lungs in between those puffs?

If medication remains part of your life, there are still hours every day when you can actively support your lungs in other ways. Practise your breathing exercises. Move within your capabilities. Get outside into clean air when conditions allow. Nourish yourself with anti-inflammatory foods. Hydrate. Work on stress and anxiety. Rest properly. Become aware of what triggers your breathlessness and what helps you recover from it.

Don't make the inhaler the only thing you're doing for your lungs.

Medication may be one tool, but it doesn't have to be the whole toolbox.

And what about those who still smoke?

There is absolutely no judgement from me. I smoked for over 40 years myself, so I know how difficult stopping can be. Ideally, of course, removing cigarette smoke completely is one of the best things we can do for compromised lungs. But if you haven't managed to stop yet, please don't think there's nothing you can do in the meantime.

This is another area that makes me think. If someone with COPD is smoking throughout the day and also using inhaled medications, their already compromised lungs are repeatedly being exposed to cigarette smoke as well as prescribed inhaled substances. I'm not saying the two are equally harmful, but they are two different inhaled exposures, and some inhaled medications themselves can cause irritation or respiratory side effects in some people.

So I come back to the same question: when do those lungs simply get to breathe clean air like they were designed to do?

The effects of one cigarette don't magically disappear the moment we put it out. Some substances are exhaled or absorbed, particles can remain deposited within the respiratory tract, and the lungs' natural clearance mechanisms are already working to deal with repeated smoke exposure. Then another cigarette comes along, and perhaps inhaled medication too.

Add COPD to that picture and breathing itself may already be less efficient. Many people develop faster, shallower breathing and may have difficulty emptying their lungs effectively, leading to air trapping.

This is why, even if you're still smoking and using prescribed inhalers, I would encourage you to make use of the time between those exposures. Give your lungs periods where what you're inhaling is simply clean air.

Practise gentle diaphragmatic breathing and concentrate on a slow, controlled exhale. Become conscious of using the diaphragm rather than constantly breathing high into the upper chest. Get outside into clean air when air quality is good. Move within your capabilities, hydrate and nourish yourself.

Let your lungs have some breathing space.

I'm not telling anybody to skip prescribed inhalers to create that space. And I'm certainly not judging anyone who hasn't managed to stop smoking. I'm saying that between each cigarette and prescribed doses, there is still an opportunity to consciously support the lungs and give them periods without cigarette smoke.

Perhaps instead of thinking, "I still smoke, so what's the point?", ask:

"What can I do for my lungs between this cigarette and the next one?"

And maybe, little by little, those smoke-free periods become longer too.

You don't have to wait until you've successfully stopped smoking before you start supporting your lungs.

And here's something else I think we sometimes forget.

Doctors have medical education, research, guidelines and clinical experience. That knowledge matters. But unless that doctor has COPD themselves, they don't know what it actually feels like to live inside your body and breathe through your lungs every single day.

They have clinical knowledge. We also have lived knowledge.

We know how we felt before something was introduced and we can notice what happens afterwards. We know whether our coughing or mucus changes, whether breathing feels different, whether our energy changes, whether we're sleeping differently or whether something simply doesn't feel right.

Surely both kinds of knowledge deserve a place in the conversation.

That's why I believe so strongly in becoming our own advocate. When you receive a medication or inhaler, take out that very long folded information leaflet inside the box and actually read it. Yes, the one with the tiny writing that seems to go on forever! 😂 That's if you can understand half of it!

But joking aside, it contains important information about what you're taking, warnings and precautions and, importantly, the possible side effects.

How many of us genuinely read all of that before taking a medication? I know I didn't for years. I trusted that because my doctor had prescribed it, it must be right for me.

I'm not saying that because a side effect is listed you're going to experience it. I'm saying be aware of what's listed. If something changes after starting a medication, you can recognise it, ask questions and investigate rather than automatically assuming it's just your COPD getting worse.

That's Self-Awareness too. Know what you're taking, know why you're taking it and pay attention to how YOU respond.

Just because a treatment has been studied and benefits many people doesn't mean every individual will respond in exactly the same way.

Healthcare shouldn't mean handing over all responsibility for our body to somebody else. It should mean being informed enough to participate in the decisions being made about it.

This isn't about being anti-doctor or telling anybody to throw away their medication. It's about being pro-awareness, pro-knowledge, pro-curiosity and pro-individual choice.

Because COPD isn't one-size-fits-all, and neither are our lungs.

So now I'm genuinely interested in YOUR experience, whether you smoke, stopped years ago or have never smoked at all.

What are you doing to give your lungs some breathing space and support them between ci******es, inhalers or whatever else they're exposed to?

I'm not looking for a right or wrong answer. I'm interested in our experiences and the patterns we may discover when we start asking WHY. 🫁💚

15/08/2026

KNOWING ISN'T THE SAME AS DOING 🌿

Most of us already know quite a lot about what we *should* be doing.

We know movement is important. We know fresh, nourishing food is better than ultra-processed food. We know we need sleep and rest. We know stress affects us. We know breathing differently can change how we feel.

So why doesn't knowing automatically change anything?

Because **knowledge without action is simply information.**

I can read about breathing exercises every day, but unless I actually practise them, my breathing isn't learning anything new.

I can know that movement builds strength and stamina, but my muscles don't become stronger because I understand the theory.

I can know which foods support me and which leave me bloated, sluggish or uncomfortable, but that knowledge only becomes useful when it changes what's on my plate.

I can know that stress affects my breathing, but unless I learn how to recognise it and do something about it, my body still experiences that stress.

And I can know that I need rest while continuing to push myself until I'm exhausted.

This is something I've learned over and over again.

**Knowing what to do is the beginning. Doing it repeatedly is where change starts to happen.**

And that doesn't mean changing everything overnight.

Maybe today it's five minutes of conscious breathing. Perhaps it's walking a little further than yesterday, preparing one nourishing meal, sitting quietly for ten minutes, going to bed earlier or simply noticing a thought or habit that isn't helping you.

**Then tomorrow you continue. And the next day you continue again. Little by little, those conscious choices stop being things you have to remind yourself to do and start becoming part of your everyday routine.**

This is why the six elements of Back to Breathing aren't six things to learn once and tick off a list.

**Breathing. Nutrition. Movement. Meditation. Rest. Mindset & Self-Awareness.**

They are six elements to incorporate into **our everyday lives, until they become a natural part of our daily routine.**

Some days we'll do more. Some days we'll need to do less. Life happens, illness happens and circumstances change. But the important thing is that we **keep coming back to them, every day.**

There is almost always something we can do. So perhaps ask yourself today:

What do I already KNOW I should be doing for my wellbeing, but I'm still not actually DOING?

Don't just answer the question.

Choose one thing and do it. 💚

**Knowing creates awareness. Action creates change.**

Let´s get Back to Breathing

12/08/2026

Believe in yourself 💎

10/08/2026

Meet Scarlet ❤️

There's a little story behind the dragonfly that has suddenly appeared on my new Back to Breathing logo.

It started while I was swimming. A beautiful bright red dragonfly kept circling around me, again and again. I became fascinated by him and, being me, of course I had to start researching. 😂

I discovered that he is a Scarlet Darter, and then things became even more interesting.

On the third day there were TWO red dragonflies circling around me. I initially thought I was witnessing some dragonfly romance 😂, but after doing a little more research I discovered quite the opposite. They were two males competing over territory.

Scarlet won. 😂❤️

And apparently my swimming has something to do with why he keeps coming back. As I move through the water, tiny insects around the surface are disturbed and become easy prey. So while I thought Scarlet was coming to visit me, there's every possibility he's actually thinking, “Oh good, breakfast has arrived.” 😂

But something else has changed. At first he would circle me and keep his distance. As the days have passed, he's allowed me closer and closer, until I was able to take that incredible close-up photograph I shared on my logo. Whether that's familiarity, tolerance or simply because he's learned that I'm not a threat, I love that he's now so comfortable around me.

And now Scarlet appears to be guarding his little territory while awaiting a female. She won't look like him either. Female Scarlet Darters are much less bright, generally more yellowish, ochre or brown in colouring.

So naturally, I've now become ridiculously invested in Scarlet's love life and I'm waiting for Mrs Scarlet to arrive. 😂

Somewhere along the way, this little creature became rather special to me. So when I was creating a new identity for Back to Breathing, there he was.

Scarlet now has a permanent place perched on the “g” of Breathing in my new logo. ❤️

And actually, the more I think about it, the more appropriate it feels. Back to Breathing is built around self-awareness and curiosity. Observe. Notice. Ask why. Learn. Understand. That's exactly what happened here. I noticed something happening around me, became curious and started learning.

So... meet Scarlet, the Back to Breathing dragonfly. ❤️

Now we just need Mrs Scarlet to turn up. 😂

08/08/2026

“This is why I do what I do. 💚 Receiving this today absolutely made my day and brought tears to my eyes.”

Malinda first found my Back to Breathing page and began reading the information I was sharing, but she then went a step further and joined one of my Back to Breathing retreats, alongside more than 70 other participants, where we worked through the six elements together and learned how to incorporate them consistently into everyday life.

Today she sent me this beautiful testimonial about what has changed since then.

What touched me most isn't simply how much more she can do today, but the everyday things she has regained that many of us take for granted. Getting out of bed and getting ready without having to stop, moving around her home, sleeping better, building strength and eventually going from watching people walking past her window to being outside walking 5,000–10,000 steps herself.

Malinda gives me an enormous amount of credit in her testimonial, but I want to say this before you read it: I didn't change Malinda's life. Malinda changed Malinda's life.

I gave her the knowledge, guidance and the six elements through Back to Breathing, but she made the changes, put what she learned into practice and, most importantly, stayed consistent.

I'm incredibly proud of how far she has come. This is her journey, in her own words. 💚Malinda's Back to Breathing Retreat Journey

💚 MY BACK TO BREATHING RETREAT JOURNEY – MALINDA

Before finding Diane, I had accepted that this was it. This was what the rest of my life was going to look like.

I would sit in my kitchen chair looking out of the window, watching people walk or jog past my house, wishing I could do what they were doing and enjoy life outdoors again.

Just walking to my mailbox or taking a few steps from one room to another would leave me breathless and needing a break. Going upstairs was brutal. Taking a shower felt like I'd put in a full day's work, let alone washing and blow-drying my hair.

Every movement felt like a chore. I was in full panic mode just trying to live and breathe, and I had started accepting that this was my life.

Then one day in December 2025, I went onto Facebook and a post appeared in my feed at exactly the right moment. It grabbed my attention. I kept reading, went over to Diane's page and ended up reading the entire thing that day!

I reached out and told her I needed help. She simply replied, “How can I help you?”

For the first time in a long time, I felt hope.

I joined the Back to Breathing Retreat and learned the six elements Diane teaches. They have changed so much for me in such a short time.

Nutrition:
My diet is better than it has ever been.

Breathwork:
My breathing has changed unbelievably. I've learned how to breathe using diaphragmatic and pursed-lip breathing, and they have been game changers for me. I no longer rely on my rescue inhaler. In fact, I forget I even have it! No more constant coughing, throat clearing or horrible mucus.

Movement:
WOW. Movement has changed my life.

I went from barely being able to get out of bed and walk eight feet to the bathroom without becoming so breathless that I had to stop or hold onto the wall...
..to getting out of bed, making it, walking to the bathroom, brushing my teeth, washing my face, putting on my makeup, getting dressed, doing my hair and then heading to the kitchen for my green tea.

And I'm no longer just watching those people walking past my window.

I'm one of them now.

On a nice day, I walk around my neighbourhood and can do anywhere from 5,000 to 10,000 steps. If the weather isn't good, I'll go to a mall or store or walk on my treadmill.

Strength training has also been a lifesaver. I went from struggling to lift myself out of a chair or open a jar to lifting 3–5 lb weights. I started with chair squats and now I can do standing squats and many other upper and lower body exercises.

I'm slowly building my strength back.

Meditation:
I'm getting better at allowing my mind to rest. This one is still a work in progress, but that's okay.

Self-Awareness:
I've learned so much about myself. I've learned to listen to my body and, importantly, to take time for ME without feeling guilty.

Rest:
My sleep is so much better. Getting a full night's sleep was something I hardly knew before this retreat!

I've always been busy taking care of everyone else and never realised how important it was to take even a short period during the afternoon to relax. Just a few quiet minutes can completely change the rest of my day.

My journey with Back to Breathing has been a Godsend.

Whatever you want to call it, perfect timing, fate or something bigger, getting onto Facebook at that particular moment and seeing Diane's post was exactly how my day was supposed to begin.
Diane gave me hope and knowledge when I desperately needed it.

I am amazed at how far I've come in such a short amount of time, and I thank her from the bottom of my heart every day.

Thank you for all you do, Diane. 💕
Much love,
Malinda

06/08/2026

COPD: Are We Treating the Cause, or Just Managing the Symptoms?

⚠️ This is a long read, but I genuinely believe it's worth taking the time to read to the end.

I've been away for a couple of weeks, but I haven't been on holiday. I've completed yet another course to expand my knowledge of natural ways to support lung health, and alongside that I've spent many hours researching COPD, respiratory health and the treatments so many people with COPD are routinely prescribed.

For a long time, something has been playing heavily on my mind: if what we're doing is working, why are so many people with COPD still declining?

I recently asked this question in the group, and response after response came back from people saying their lung function had continued to decline despite years of maintenance inhalers. I also heard from people who had stopped them and subsequently experienced improvements.

No, that isn't a clinical trial. But when I see the same pattern repeatedly, I become curious. That's what self-awareness is about: asking why rather than simply accepting.

And this subject is very personal to me. For eight years after my COPD diagnosis, I followed the conventional route. At one point I was taking nine different medications for various health issues and using three inhalers. During those years, my measured lung function didn't improve. It went in the opposite direction, eventually falling to 22%.

Eventually I asked myself a very simple question: why would I continue doing exactly the same thing while watching myself get worse?

That was the beginning of a completely different journey for me.

While researching over these past couple of weeks, I discovered several things I think people living with COPD deserve to understand.

1. COPD is NOT simply a smoker's disease

This one really bothers me because smoking dominates almost every conversation surrounding COPD.

Research shows that a substantial proportion of people living with COPD have never smoked. The international BOLD study found that never-smokers accounted for 23.3% of moderate-to-very-severe COPD, while broader epidemiological research estimates that globally around 25–45% of people with COPD may never have smoked.

Occupational exposure, air pollution, childhood respiratory illness and other factors can contribute. Then there's something fascinating called dysanapsis, which describes a mismatch between the size of the airway tree and the size of the lungs.

Research has associated smaller airways relative to lung size with poorer lung function and increased COPD risk. In other words, some people's susceptibility may begin with the way their respiratory system developed long before anyone ever lit a cigarette.

Perhaps we need to stop looking at every person with COPD through exactly the same lens.

2. From smoking straight to an inhaler

Something else kept coming back to me throughout my research, particularly when I looked back at my own diagnosis.

I smoked for over 40 years. For more than four decades, my lungs were exposed every single day to cigarette smoke and the thousands of chemicals and irritants that come with it.

Then I was diagnosed with COPD. I stopped smoking and was immediately prescribed maintenance inhalers.

Looking back, I now ask myself a question that I never thought to ask then:

When did I actually give my lungs a break?

After more than 40 years of exposing them to smoke and irritants, I finally removed that burden, but I went directly from inhaling cigarette smoke every day to inhaling medication into those same already damaged and sensitive airways.

There was no period where I simply stopped putting smoke into my lungs and observed what happened. No opportunity for me to discover how my lungs would respond once that enormous daily burden had been removed before another inhaled substance was introduced.

Our lungs are designed first and foremost for the exchange of gases from the air we breathe. They weren't designed for decades of cigarette smoke, pollution and the countless medicated substances we expose them to. And that made me question why, after finally removing such an enormous burden, there wasn't far more emphasis on creating the cleanest, least inflammatory environment possible for my lungs and supporting my body's natural recovery processes.

Where was the conversation about clean air, reducing inflammation, nutrition, hydration, breathing properly, strengthening the respiratory muscles, movement, stress, sleep and rest?

I'm not saying that somebody in respiratory distress shouldn't receive treatment. That's a completely different situation.

I'm questioning why medication became the immediate long-term answer while supporting my lungs and my body after 40+ years of smoking was barely part of the conversation at all.

Knowing what I know today, I would have wanted to ask: What happens if we remove the burden, support the body properly and give those lungs every possible opportunity to function at their best?

And that question leads directly into what I discovered when I began researching what inhaled medications themselves can do inside already compromised lungs.

3. Mucus isn't simply an inconvenience

Mucus is part of the lungs' natural defence system. It traps particles and pathogens so they can be moved out through mucociliary clearance and coughing.

But when the airways are chronically inflamed, as they often are in COPD, that inflammation can contribute to increased mucus production and changes in the mucus itself. It can become thicker, stickier and much harder for the lungs to clear. When mucus isn't moving effectively, it can contribute to obstruction and create an environment where infections become more of a problem.

This was another area where I began asking a different question. Rather than only asking, “How do I get rid of this mucus?”, I started asking, “Why is my body producing so much thick mucus in the first place?”

For me, inflammation became a major part of that answer.

When I changed my lifestyle and consistently incorporated all six elements of Back to Breathing, one of the changes I noticed was in my mucus. As I worked on reducing the inflammatory burden on my body through nutrition, breathing exercises, movement, meditation, mindset, self-awareness and proper rest, the thick mucus I had lived with disappeared.

That's my personal experience, but it completely changed the way I looked at mucus. I stopped seeing it simply as another COPD symptom that needed suppressing and started seeing it as information about what was happening within my body.

So yes, hydration and learning effective mucus-clearance techniques can be important, but I believe we also need to look further upstream and ask what may be contributing to the inflammation in the first place.

That question became far more important to me than simply trying to manage the mucus once it appeared.

4. But what is happening inside the lungs?

Anyone using a steroid inhaler will probably have been told to rinse their mouth afterwards.

Why?

Because some of the inhaled corticosteroid remains in the mouth and throat, where its local immune-suppressing effect can encourage oral thrush.

But that made me ask another question: what about the steroid that travels in the other direction, deep into the lungs?

We can rinse our mouths but we cannot rinse our lungs.

And this is where my research became particularly interesting.

Inhaled corticosteroids work partly by suppressing inflammatory and immune activity within the airways. That anti-inflammatory action is one of the reasons they're prescribed.

But this brought me to another question. If inhaled corticosteroids are reducing inflammation, why does that effect require continued treatment?

There is an important difference between suppressing an inflammatory response and addressing what may be contributing to that inflammation in the first place.

The medication can suppress inflammatory activity while it is being used, but it doesn't necessarily remove the factors contributing to that inflammation. And this was a huge turning point in how I began looking at my own COPD.

I didn't only want to suppress inflammation. I wanted to understand why my body was constantly inflamed and what I could change to reduce that inflammatory burden.

The same distinction applies to bronchodilators. They can temporarily relax the muscles surrounding the airways and open them, but once their effect wears off another dose is needed. Opening an airway isn't the same thing as resolving the processes happening within it.

And for me, the mucus was a very visible example. I had lived with the thick mucus and coughing so familiar to COPD. When I changed my lifestyle and consistently practised all six elements of Back to Breathing, reducing inflammation became one of my priorities. Over time, my thick mucus and constant coughing disappeared.

That made me question the difference between continually managing what inflammation produces and looking at everything within my control that might be contributing to the inflammatory burden in the first place.

And then we come to pneumonia.

People with COPD are already vulnerable to respiratory infections, yet large analyses of randomised COPD trials have repeatedly found an increased risk of pneumonia associated with inhaled corticosteroid treatment.

One large analysis involving almost 50,000 participants found an increased relative risk of pneumonia and severe pneumonia, although importantly the degree of risk varies according to the particular corticosteroid, dose and individual circumstances.

So, when I hear how many people with COPD experience repeated chest infections, pneumonia and hospital admissions, I think it's important that we at least ask whether medication could be one contributing factor rather than automatically assuming every infection is simply another inevitable part of COPD.

That doesn't mean an inhaler caused every case of pneumonia, nor does it mean everyone using a steroid inhaler will develop pneumonia.

I'm not questioning the need to treat pneumonia or a serious exacerbation. Of course, when someone is acutely ill, appropriate treatment may be necessary. What I'm questioning is why so much attention is placed on treating each episode once it happens, while seemingly far less attention is given to asking why the cycle keeps happening and what can be changed to help prevent it.

If someone is experiencing ongoing inflammation, thick mucus, repeated chest infections and hospital admissions, surely, we should be looking further upstream. What is contributing to that inflammatory burden? What can be changed in nutrition, breathing, movement, stress, sleep, hydration and everyday lifestyle to support the body and lungs before another crisis develops?

The aim shouldn't simply be to recover from one episode and wait for the next. The aim should surely be to do everything within our control to reduce the inflammation and other contributing factors that may be helping to drive that cycle in the first place.

This is what I mean when I talk about stepping outside the treatment cycle. For me, it wasn't about continually dealing with the next symptom, infection or health problem as it appeared. It was about asking why they were happening at all, changing what I could change and supporting my body as a whole.

But if pneumonia is a recognised risk of a treatment, surely people deserve to know that, so they can properly consider the benefits and risks?
And that's what struck me most while researching this. We hear plenty about rinsing the mouth and preventing thrush, but how often are ordinary patients encouraged to understand what that same medication is doing once it reaches the organ it was actually intended to reach? Do the lungs get thrush too?

5. Steroids and muscle weakness

This particularly interested me because breathing isn't performed by the lungs alone. We need muscles to breathe.

The diaphragm and other respiratory muscles work continuously, and people with COPD already place enormous demands upon them.

Corticosteroid-induced myopathy is a recognised medical condition. Research has documented that corticosteroids, particularly prolonged or higher systemic exposure, can cause skeletal muscle weakness and can involve respiratory muscles too. Studies in COPD patients with steroid-induced myopathy have documented weakness of both peripheral and ventilatory muscles.

That doesn't mean every steroid inhaler destroys the diaphragm. It doesn't.

But it reinforces something I've come to believe very strongly: muscle health matters enormously when we're trying to breathe better.

And that is why nutrition, movement and maintaining or rebuilding strength are such important parts of Back to Breathing.

6. And what about everything else we're taking?

Another part of this picture that I don't think we can ignore is the number of other medications many people with COPD are taking alongside their inhalers.

At one point I was taking nine different medications for various health issues, as well as three inhalers. Every medication has an intended purpose, but medications can also have side effects. When several are being taken together, that's a lot for one body to deal with and a lot for us as individuals to understand.

We talk openly about the consequences of smoking, eating highly processed food, being inactive, living under constant stress or not getting enough sleep. So, I believe we should be equally comfortable talking about the potential unwanted effects of the medications we put into our bodies.

For me personally, statins were one of the clearest examples. I experienced extreme body pain while taking them and felt that my breathing was being suppressed. My experience became severe enough that I genuinely felt extremely unwell. That was what happened in my body, and it taught me never to assume that every new symptom was automatically another illness or simply my COPD getting worse.

At that stage of my life, I seemed to have one health issue after another, with medication being added for different problems. Eventually I made the personal decision to stop the medications I was taking and completely change the way I lived through what became the six elements of Back to Breathing.

What happened afterwards was extraordinary for me. The health problems I had been dealing with disappeared and I no longer needed those medications. That is my personal history; it is not an instruction for anybody else to stop theirs.

But it left me with a question that I still believe everyone taking multiple medications should ask:

Do I know what each medication is for, what its possible side effects are, how it may interact with everything else I'm taking, and whether I still need it?

Because self-awareness isn't only about noticing what food, stress or lack of movement does to our bodies. It means paying attention to everything we put into them.

So, what changed for me?

When my lung function reached 22%, I stopped asking only, “What can I take?” and started asking, “What does my body actually need?”

I made a personal decision to change my life completely. Not gradually and not one little thing this week and perhaps another next month.

I committed to what eventually became the six elements of Back to Breathing: Self-Awareness & Mindset, Meditation, Breathing Exercises, Nutrition, Gentle Movement and Rest.

Every single one. Every single day.

What I have since found particularly interesting is that research supports many of these individual elements in COPD care, including breathing exercises, physical activity, nutrition, psychological wellbeing, self-management and pulmonary rehabilitation. Research into multi-component COPD self-management also supports looking beyond medication and addressing different aspects of a person's health together. Back to Breathing brings these areas together through my six elements, with the emphasis on consistently supporting the whole person rather than concentrating on the lungs in isolation.

I completely changed what I ate, focusing on foods that supported rather than added to inflammation. I learned how to breathe differently, moved and strengthened my body, dealt with stress and anxiety, meditated and gave my body proper rest. Most importantly, I became incredibly aware of what my body was telling me.
Within around three weeks, I was already noticing changes in how I felt and breathed. Over the years that followed, my measured lung function went from 22% to 61%.

That's my experience. I'm not claiming everyone will achieve those numbers, nor can I scientifically separate which individual change contributed what percentage of that improvement.

But I certainly wasn't prepared to dismiss what my own body was showing me.

So, what can we do about inflammation ourselves?

This is perhaps the most important question all of this research brought me to.

If inflammation is such an important part of COPD, what can we do every single day to help reduce the inflammatory burden on our bodies rather than relying solely on medication to address it?

For me, this is where looking at the whole body becomes so important because inflammation isn't influenced by just one thing.

What we eat matters. How much we move matters. Sleep matters. Stress matters. Smoking, pollution and the air we're breathing matter. Hydration, weight, muscle health and our general metabolic health matter.

Nutrition became a huge part of my own approach. I concentrate on fresh, whole, anti-inflammatory foods, good-quality protein, healthy fats, vegetables, herbs, spices and foods rich in natural antioxidants while avoiding the highly processed, sugary and refined foods that can contribute to an inflammatory environment in the body.

Movement matters too. Gentle, regular activity helps maintain muscle, circulation and physical fitness. Stronger muscles can make everyday activities less demanding, which becomes particularly important when breathing is already compromised.

Then there is breathing itself. Learning to use the diaphragm, becoming aware of dysfunctional breathing patterns and practising breathing exercises can help us use the respiratory system more efficiently and reduce some of the unnecessary work we're asking it to do.

And we cannot ignore stress and sleep. Chronic stress can influence inflammatory processes throughout the body, while poor-quality or inadequate sleep can also affect inflammation. This is why meditation, mindset, self-awareness and proper rest aren't little extras in Back to Breathing. They're part of the same picture.

None of these things works in isolation and there is no single magic food, breathing exercise or supplement that changes everything.

That's precisely why I work with all six elements together.

And this is what all of this research has brought me back to.

The question isn't simply whether medication can open an airway or suppress inflammation. We already know it can.

The bigger question for me is: what are we doing every day to support the body that those lungs belong to?

What are we eating and how are we breathing? Are we moving and keeping our muscles strong? Are we constantly stressed? Are we sleeping and resting enough? Are we hydrated? What are we exposed to environmentally? What causes inflammation in our own body? And are we actually paying attention when our body tells us something has changed?

COPD isn't just two damaged lungs sitting separately from the rest of us. The lungs are part of an entire living system.

That's why Back to Breathing doesn't focus on one magic exercise, one food, one supplement or one treatment. It looks at the whole person.

For me, the question became less about, “What can I take to suppress this?” and much more about, “What am I doing every day that may be adding to inflammation, and what can I change to help my body carry less of that burden?”

Stepping outside the cycle of simply treating the next symptom and becoming curious about WHY my body was struggling changed everything for me.

So don't stop asking questions.

Learn about the condition. Learn about the treatments, including their benefits and their side effects. Learn about nutrition, breathing, movement, stress, sleep and inflammation.

But above all, learn about your own body. No one knows your body as well as you do, and you are the only person who can decide to make the changes necessary to support better breathing and better health. Others can guide you, educate you and support you, but no one can make those changes for you.

The decision to become curious, to listen to your body and to change what is within your control ultimately must come from you. Self-awareness is key!

Because every symptom is information. 💚

Research sources:
I have added the scientific studies and research referenced in this post to the first comment below for anyone who would like to explore them further. Don't take my word for it. Read, research, ask questions and become curious about what is happening inside your own body.

⚠️ Important: This post describes my personal experience and what I have learned through my own research. It isn't an instruction to stop prescribed medication. COPD and individual health circumstances vary enormously, and medication changes should be discussed with an appropriate healthcare professional.