SUNDAY SPEICAL – Based on announcement by health ministry in april’21

51 Days Yoga Consciousness Series 2nd May-21st June 2021

Namaste All My Yoga Yaatris! May Yog Bless You!

Knowledge of Yoga is infinite, boundless and timeless. “Learning Yoga is an everlasting journey that leads you within and Within is where you find the world of immortal bliss”. –Mitraasha

The idea behind running this 51 Days Yoga Consciousness series is to proffer my modest learnings and share the divine pearls of Yoga science with people at large. Let’s have a conjoint intent to learn, implement and extend the wisdom of Yoga with a positive co-action and harmonious reverberation amongst each other.

Covid-19 and prone breathing

Second wave of Covid-19 has hit the world with mortal ramifications. And in India, with regards to this disease the circumstances have become very challenging and abominable,  with a tremendously rising caseload of infections each day, accompanying huge oxygen insufficiency and undersupply across all the hospitals. Medical infrastructure is collapsing by a surge of patients multiple times more than it can provide for. In such a situation, doctors across all the regions have begun urging and endorsing proning exercises in which coronavirus positive patients with respiratory troubles are made to lay on their stomach to expand the dispensation and volume of air in their lungs and raise oxygen levels, both in home quarantine as well as in hospital.

The government of India, ministry of health and family welfare, not long ago through a press release commended the general abidance of the prone posture to revamp breathing and for increased oxygenation in the lungs. 

Through its official Twitter handle, the ministry of health made public the eminent and essential self-care advice for all those who are in home isolation at present and combating COVID-19 infection. 

“During the pandemic, prone positioning has been largely recommended by health experts, as the posture not only enhances breathing, but is also linked to a reduction in mortality among patients with ARDS under critical care”, according to the National Institutes of Health (NIH).

The center emphasised on the significance of the position, predominantly in those cases where Oxygen saturation (SpO2) goes below 94. In such cases prompt proning and keeping good ventilation can save a life. 

What is proning and how does it help in COVID?

As per multiple studies including the Lancet, Proning is accepted as a physical posture of high advantageous prospects in COVID-19 disease. It is a medically acknowledged position, also being encouraged by the Union Ministry of Health and Family Welfare, in which patients are made to lie on their abdomen to amplify their oxygen levels. It is the process of turning yourself/ a patient with precise, safe motions, from back to your/ their abdomen(stomach), so you/they are lying with your/their face down, which in turn improves ventilation, and makes breathing easy by keeping alveolar units(tiny balloon shaped structures that are the smallest passageway in the respiratory system) open. (Refer pic 1)

PICTURE 1

This is supported by scientific data where hospitalized patients that were prone positioned showed improved oxygenation. The ventilatory procedure in early COVID-19 was efficacious in aiding patients’ breathing, whereas the supine position (lying face up that exerts pressure on lungs) was observed to be deleterious. Health specialists have gone to term the prone positions as a ‘nasal oxygen therapy’. 

How to do proning?

For proning we need 4-5 pillows. One pillow is to be positioned underneath the neck, 1-2 pillows under the chest through upper thighs, and 2 pillows further down below the shins. (Refer pic 2)

A patient should lie on their belly, right and left side alternately. However, experts advocate that not more than 30 minutes should be spent in each prone position and should be changed for better outcomes and less strain.(Refer pic 3)

PICTURE 2
PICTURE 3

Other helpful positions than lying down on your back are:

  1. Right Lateral Recumbent (Lie on your right, arm below head, legs parallel : 30 minutes to 2 hours) (Refer pic 4)
  2.  Left Lateral Recumbent ( Lie on your left, arm below head, legs parallel : 30 minutes to 2 hours) (Refer pic 5)
  3.  Sitting Up/ Fowler’s (Sit straight up, legs straight out or bent : 30 minutes to 2 hours) (Refer pic 6)
PICTURE 4
PICTURE 5
PICTURE 6

Who should avoid proning?  

Proning should be avoided by pregnant women, patients who have deep venous thrombosis, patients with serious cardiac conditions, unstable spine femur and pelvic fractures.

Important things to keep in mind

  • Proning is essential only when the patient experiences trouble in breathing and the SpO2 falls below 94.
  • Regular monitoring of SpO2, along with other signs like temperature, blood pressure, and blood sugar is important at home isolation as compromised oxygen circulation (hypoxia) can lead to aggravation of the problems. 
  • Avoid proning for an hour after meals.
  • One should stay in one position for as much time as it is bearable for them.
  • Pillows can be rearranged moderately to alter the pressure areas and comfort.
  • The room in which the patient is proning should be well aerated.
  • One should not overlook any pressure sores and injuries, mainly around bony prominences.
  • The Ministry of Health says that one can be prone for upto 16 hours a day in multiple cycles, if it is restful for the patient.

Other techniques to boost oxygen levels when in home isolation

The Health Ministry propounds that practicing deep breathing, yogic pranayama, staying in abundant fresh air, keeping hydrated, consuming iron-rich foods, doing light exercises also aids in increasing oxygen level of patients.

Take good care of yourself, your family and your neighbourhood. Do your bit and save your country. Stay safe.

Thought of the day: Inhale the future, exhale the past

Link to day 07 Introduction to Ashtanga Yoga : https://kreately.mars-cdn.com/51-days-yoga-consciousness-series-2nd-may-21st-june-2021-mitraasha-day-07/

Link to day 09 : Sequence and guidelines for the practice of yogahttps://kreately.mars-cdn.com/51-days-yoga-consciousness-series-2nd-may-21st-june-2021-mitraasha-day-09-sequence-and-guidelines-to-the-practice-of-yoga/

Source and Reference: https://www.mohfw.gov.in/pdf/COVID19ProningforSelfcare3.pdf

DISCLAIMER: The author is solely responsible for the views expressed in this article. The author carries the responsibility for citing and/or licensing of images utilized within the text.