Fall transition in the Time of Covid-19
Keeping your lungs healthy
· Lungs are fascia, metabolically active, and an immune tissue.
· Viniyoga breathing exercises will strengthen your respiratory system.
· Air purifiers will help prevent inflammation in the respiratory tract.
Fall is a time of transitions and sensations of fatigue and shortness of breath are typical. Recently, we were able to purchase our own space at 429 N Central Ave, Upland, CA. Although we moved just down the street, the transition has left us winded but grateful that we have a permanent home. This is exemplary of fall- a time of transition that leaves our hearts filled with gratitude. This is also a particularly vulnerable time and our focus needs be on Health.
This transitional season in the context of the Covid-19 Pandemic, particular attention on the respiratory system is warranted. The lungs are not inert tissues- they are alive and a means by which we process the external world. The respiratory tract is fascia - visceral fascia to be specific. The visceral fascia is separated in the thorax into 2 components: the endothoracic fascia on the thoracic wall and the visceral fascia expansion surrounding the great vessels of the heart, aorta, esophagus, trachea and primary bronchi, and the thoracic duct. This visceral matrix is loose to allow distension of the esophagus upon swallowing. The visceral fascia surrounding the bronchi as they pass through the root of the lung is continuous with the stroma of the airways and the septa of the lung.
A highly effective method of training/optimizing the respiratory tract is pranayama in the tradition of Viniyoga.(1,2) We can look to our hypermobile population to investigate the complex physiologic processes that occur in the respiratory fascia. Pulmonary physiological studies show that in the hypermobile population there is increased lung volumes, impaired gas exchange and an increased tendency of both the lower and upper airways to collapse.(3) Structurally, if fascia is altered, then lung function is altered. Inspiratory training can strengthen the structure of this tissue(4) and aid in improved ventilation. In the Viniyoga tradition, a strong emphasis is placed on the Breath and the body’s connection to the Breath. To strengthen your respiratory tract, continue on those breathing exercises that you have received in your sessions.
Environmental modification with a good air filter is the best tool to minimize inflammation in the lungs. An abundance of mast cells reside in connective tissue that borders with the external world (skin, gastrointestinal system, respiratory system, urogenital tracts).(5) There is a remarkable association with eosinophilia in hypermobile EDS(6) and mast cell activation with symptoms of asthma including cough, wheezing, throat swelling.(5) In the non-hypermobile population, this may be seen as mild trouble breathing, fatigue, seasonal allergies, mild cough, runny nose, rashes. These symptoms become particularly problematic during autumn with the seasonal transition. The treatment of mast cell activation is controlling environmental triggers: dietary, chemicals, medications, allergens.(5) Environmental modification is the best tool. In terms of household allergens, a good air purifier is key.
Due to the pandemic, we spend 90% of our time in-doors- the quality of the air we breathe in our house is foundational to good lung health. Studies on indoor air quality show an underlining increase in pollutants. Indoor pollution accumulates from a mix of outdoor pollutants from vehicular traffic and industrial activities and indoor contaminants which originate from gas stoves, emissions from building materials and furnishings, central heating and cooling systems, electronic equipment, household cleaning products, and pets.(7)
Air purifiers can significantly reduce indoor air pollution(8) and exposure to COVID-19 aerosols and droplets.(9) The CDC and EPA recommend air purifiers and HVAC with MERV13 filters.(10) In our new clinic home and our family home, we utilize both the MERV 13 as well as multiple Molekule air purifiers, one per room and common space. The HVAC provides air flow, while the Molekule cleans the air. The Molekule uses Photo Electrochemical Oxidation (PECO) technology employing free radicals to break down pollutants at a molecular level, including VOCs, bacteria, mold, viruses, and allergens. PECO uses nanotechnology to destroy pollutants 1000 times smaller than High Efficiency Particulate Air (HEPA) filters. The Molekule is able to remove airborne viruses like MS2 bacteriophage (a proxy virus for SARS-CoV-2 able to travel on tiny droplets that can linger for hours before settling on surfaces) by 99.99% in 30 min in a 16 m³ chamber. PECO technology is California Air Resources Board (CARB) certified for electrical safety and less than 50 parts per billion (ppb) of ozone production.
1. Birdee G, Ayala S, Tyree R, Buchowski M. Oxygen consumption during viniyoga practice in adults. Int J Yoga. 2018;11(3):194.
2. M. Fouladbakhsh J, E. Davis J, N. Yarandi H. Using a standardized Viniyoga protocol for lung cancer survivors: a pilot study examining effects on breathing ease. Journal of Complementary and Integrative Medicine [Internet]. 2013 Jan 26 [cited 2020 Dec 1];10(1). Available from: https://www.degruyter.com/view/j/jcim.2013.10.issue-1/jcim-2012-0013/jcim-2012-0013.xml
3. Morgan AW, Pearson SB, Davies S, Gooi HC, Bird HA. Asthma and airways collapse in two heritable disorders of connective tissue. Annals of the Rheumatic Diseases. 2007 Oct 1;66(10):1369–73.
4. Reychler G, Liistro G, Piérard GE, Hermanns‐Lê T, Manicourt D. Inspiratory muscle strength training improves lung function in patients with the hypermobile Ehlers–Danlos syndrome: A randomized controlled trial. Am J Med Genet. 2019 Mar;179(3):356–64.
5. Seneviratne SL, Maitland A, Afrin L. Mast cell disorders in Ehlers-Danlos syndrome. Am J Med Genet. 2017 Mar;175(1):226–36.
6. Abonia JP, Wen T, Stucke EM, Grotjan T, Griffith MS, Kemme KA, et al. High prevalence of eosinophilic esophagitis in patients with inherited connective tissue disorders. Journal of Allergy and Clinical Immunology. 2013 Aug;132(2):378–86.
7. Alessandra Cincinelli, Tania Martellini. Indoor Air Quality and Health. IJERPH. 2017 Oct 25;14(11):1286.
8. Cheek E, Guercio V, Shrubsole C, Dimitroulopoulou S. Portable air purification: Review of impacts on indoor air quality and health. Science of The Total Environment. 2020 Sep;142585.
9. Chen C, Zhao B, Cui W, Dong L, An N, Ouyang X. The effectiveness of an air cleaner in controlling droplet/aerosol particle dispersion emitted from a patient’s mouth in the indoor environment of dental clinics. J R Soc Interface. 2010 Jul 6;7(48):1105–18.
10. United States Environmental Protection Agency. Air Cleaners, HVAC Filters, and Coronavirus (COVID-19) [Internet]. Available from: https://www.epa.gov/coronavirus/air-cleaners-hvac-filters-and-coronavirus-covid-19
The content on this newsletter is for educational purposes only and should not be used as a substitute for medical advice. Please consult with your healthcare provider prior to initiating treatments.