Paula is the key. Paula has healthy hidden respiratory depression.
What is healthy hidden respiratory depression? Healthy hidden respiratory depression consists of being able to achieve normal blood pressure, normal heart rate and normal heart function, normal body temperature and better than normal cognition and better then normal ability to do physical exercise. Paula is also pretty happy, most of the time. Paula has been happily unaware of having healthy respiratory depression, for most of her life. It did not matter, till she got sick. Then her healthy hidden respiratory depression became unpleasant hidden respiratory failure. [without hypoxia or sleep apnea]. Then this knowledge was key to effective first aid treatments.
Paula’s brain stem cannot speak to her or to anyone, except though the monitoring all of these physical signs. Her baseline breathing rate at rest is stuck at a very low rate of 5 breathes per minute, all day, every day. We have been measuring it with simple tools and fancy tools for twenty plus years. The job of the brain stem is to deal with this. Paula is healthy. Paula is happy. Health and mood are related. Health depends on relatively normal enough acid base balance which depends a lot on being able to have a normal enough partial pressure of carbon dioxide in the blood.
The difference between healthy hidden respiratory depression and unpleasant hidden respiratory failure is clear. Unpleasant respiratory failure, like pain, is an internal sensation leading to changes in mood, cognition, behaviour, locomotor activity, and alertness. Alertness is very high in respiratory failure. To sleep is to risk it becoming worse. To eat or drink is to risk it becoming worse. To sit up straight or to move too much is to risk it becoming worse. To speak is to risk it becoming worse. To think is to risk it becoming worse. The brain stem takes over these semi voluntary behaviours in order to limit production of carbon dioxide by cells in ways other than breathing, when breathing is further obstructed.
Unlike healthy hidden respiratory depression, unpleasant hidden respiratory failure comes with increased blood pressure, heart rate, heart arrhythmia’s, lowered body temperature and vasoconstriction. Unpleasant respiratory failure is very stressful for the body and the mind.
Is it too much to ask that doctors look for signs of unpleasant hidden respiratory failure in other- wise healthy adults, no matter what their age?
Unpleasant hidden respiratory failure is easy to detect, as it affects production of mind. It alters mind. One no longer knows one’s address with unpleasant respiratory failure. It can cause phases of intoxication [euphoria, agitation, dysphoria] and delirium [hypoactive, hyperactive [mania] and mixed]. Carbon dioxide in the wrong ratio’s in the blood is a an intoxicant, except that it is produced inside our cells. The brain stem is very familiar with carbon dioxide produced internally. It has all kinds of tricks to manage carbon dioxide even if our breathing has become stuck on a slow mode. And the brain stem can also kickstart a survival method that is pretty effective in buying time until the airway clears enough, for long enough, to enable healthy respiratory depression once more. Paula can tell you that no one wants to stay in this survival mode for long, it keeps you alive, but is intensely unpleasant and yet very reversible, if one survives. [Effects of internal carbon dioxide imbalances are reversible, if they do not kill you.]
This is what happened to Paula. If it happens again, she could use some help from her doctors to restore her breathing in order to restore her mind, her mood, and her physical health.
Breathing is the key.