Lung function

Although causal relationships are hard to establish, the frequency and reproducibility of association with lung function argue strongly for an influence on lung function. The increase of smooth muscle mass, a consistent feature of airway remodeling, correlates with lower lung function in patients with asthma. In COPD, the more extensive the pathologic changes, including increase of ASM, squamous cell and goblet cell metaplasia, and fibrosis, the lower is lung function. Patients with asthma and COPD with fixed airflow obstruction exhibited a more rapid decline in lung function and experienced more frequent exacerbations in a 5-year follow-up compared with patients with asthma with reversible airflow obstruction. In cystic fibrosis, the increase of inner wall and smooth muscle area are even greater than COPD, and these dimensional changes presumably contribute to severe airflow limitation.

Some investigators have argued for a favorable effect of some aspects of remodeling. For example, airway wall stiffness due to RBM thickening was reported to reduce mucosal folding during smooth muscle contraction, diminishing the magnitude of airway obstruction. The advantages to the host of many aspects of airway remodeling are hard to argue.

The improvement of the resolution by CT scanning has enabled the measurement of airway dimensions in relatively large airways. Measuring airway wall thickness remains a challenge, and because CT scanning is incapable of analyzing the airway composition, it cannot distinguish between true increase in airway wall thickness from remodeling and the effects of bronchoconstriction that will increase airway area for a given lumen size. There are emerging techniques that have been applied during bronchoscopy to assess airway structure. Optical coherence tomography, a light-based imaging technique, has been used to quantify large airways distensibility, and fibered confocal fluorescence microscopy has been used to visualize elastic fibers in central airway walls.

When you become addicted to the belief that your experiences are not your responsibility — that by taking responsibility you are being made to feel guilty — you are buying into a myth created by the Storyteller and the Blamer. They create this myth with the express purpose of encouraging you to hand over responsibility (and power) to someone or something else (your parents, your doctor, genetics, luck, fate, and so forth). This, in turn, makes it impossible to become your own authority or to move any closer to true freedom and to the divine source.

The Belief Inventory that follows parallels the fourth step of Alcoholics Anonymous. It’s a practical method for Focusing on the beliefs by which you live your life each moment yet that most of us rarely question or even realize exist. Once you know your limiting beliefs, you can begin to Undo them. This generates a shift in your body-mind that furthers your ability to live and breathe more freely in your everyday life.

THE BELIEF INVENTORY

In your notebook list at least one or more beliefs you hold about each of the following (you may write and/or draw a symbol for each). Though it may be difficult to state your beliefs in a few sentences, just do what you can without concern for how it sounds or if it would make sense to anyone else. Even a few words will do. The first thing that comes to you is fine. The less you deliberate, the better. You can always return and fill in the gaps.

1. Something you believe about change.
2. Something you believe about responsibility.
3. Something you believe about love.
4. Something you believe about your body.
5. Something you believe about loss.
6. Something you believe about sadness.
7. Something you believe about freedom.
8. Something you believe about your parents.
9. Something you believe about your worth.
10. Something you believe about your sexuality.
11. Something you believe about pain.
12. Something you believe about anger.
13. Something you believe about guilt.
14. Something you believe about forgiveness.
15. Something you believe about being a woman or man.
16. Something you believe about joy.
17. Something you believe about health.
18. Something you believe about asthma.

When you’re done, after each belief you wrote down, note whether it is (H) helpful to you or (L) limiting to you.

WORKING WITH YOUR BELIEFS

The beliefs in the inventory you just completed have the power to heal or harm. When talking to ourselves, even when the words are not spoken aloud, our thoughts can have a strong effect on the body. By saying, “I’m worried sick,” “my heart is broken,” “you’re suffocating me,” or the ultimate killer, “I’d rather be dead,” we’re constantly firing off unwitting messages that we can ill afford. In light of how our beliefs influence our experience and our lives, it’s important to know not only what they are but what to do with them.