Paula speaks for herself

I was successfully resuscitated at birth, 65 years ago. I am interested in the function of the motor respiratory muscle pump over the lifetime of survivors like myself and others. I suspect that anyone who is resuscitated and survives, could have abnormal and fixed breathing at rest, resulting in mechanical difficulties in dealing with further respiratory challenges when weakened by physical illness. I have abnormally slow, deep, and effortful breathing at rest. I did not know it till fairly recently. I don’t feel any different than anyone else but it takes me a lot more muscular work to move air in and out of my body. Up till recently I thought this was normal. I thought it was true of everyone. It apparently, is not.

Abnormal breathing at rest is easy to count and I think that it is a risk factor for an attack of respiratory pump failure, if one gets significantly ill enough and weak enough or malnourished enough. Respiratory pump failure can lead to hypercapnia and hypercapnia can lead to a kind of hidden, unlooked for and unknown quiet delirium which requires supportive medical care. Without this knowledge the patient may be mistaken for having major depression, psychosis, mania , permanent dementia or permanent neurological impairment. Thus………I am interested in detection of chronically abnormal breathing rates in patients with mental confusion or in patients who appear depressed.

Do some of the seriously mentally ill have chronically abnormal breathing rates at rest? Because if they do, then in the 21st century we have supportive medical treatments that might hasten their return to health.

It is a simple question. And the answer is probably that no one knows. Measuring breathing rates at rest [set by the brain stem] is not traditionally done in medicine. Even though the respiratory system [mostly the muscles of the respiratory pump] is the first and fastest defence against buildup of acids in the body. 

I am concerned that chronically too slow or too fast breathing at rest makes defence of acid base balance of the blood and tissues more difficult. I am concerned that one of the default protective mechanisms that is initiated by the nervous system, is a kind of unpleasant physiological suspended animation state, where the person has mental confusion and altered mental status, which can be rescued [potentially]. But only  if we examine their vital signs more purposely, and try to solve the physiological problem. Especially if their regular rate of breathing  at rest is found to be abnormal, we may be missing opportunities to restore their mind.

I ask this question because all it takes to measure breathing rate at rest is one minute and a stopwatch.

I ask this question because my own breathing rate is way too slow and I feel it to be normal, but it is not; this indicates that there are problems with my respiratory muscle pump system, and I may require treatments to help me in the future.  Even mild respiratory acidosis will produce different levels of mental confusion.  And I can tell you there is no such thing as mild mental confusion. Mental confusion will destroy your life.

I am concerned that many neurological illnesses involve unseen and unlooked for worsening of respiratory pump failure at rest in patients with mental confusion who do not know what is wrong.

These patients are easy to access. They are sitting around uselessly at home, in psychiatric wards, in group homes, in jails. It would not be hard to investigate and follow their basic vital signs and look for abnormal patterns to determine what might be wrong.  That is what Kraepelin did. That is what my friend did for me.

 It is part of basic first aid to count respirations for one minute with a stopwatch. Anyone can do it. Any one can collect pilot data.

Kraepelin collected clinical scientific data and he did it  for decades during his long career taking care of patients who lost their mind and their ability to live normal lives. Some of these patients may have nerve and muscle damage they do not know about , which may respond to existing 21st century medical supportive treatments and future treatments we develop, as we learn more.

So really, it is a simple question I pose to the professionals and caretakers that are trying their best to help.

Can we learn more about how to help some of these patients regain their normal mental status and stop the progression of this terrible illness?

If I become partially demented tomorrow because my breathing rate at rest seems not to increase to deal normally with minor infection, if I cannot recover by myself because of my “broken breathing”,  will you remember to check my breathing rate and figure out how to bring me back?  I will not know that my breathing is broken because I do not feel it to be so. Yet it is.   And it is simple to measure.

Breathing rates at rest have not been studied for decades and the wide range of breathing at rest and the risks involved have been forgotten.  The range of breathing rates in health and illness was found to be  as low as 3 breaths per minute at rest [with difficulty raising breathing rate at rest during respiratory challenges] to 30 breaths per minute at rest [with difficulty decreasing breathing rate at rest during perturbations.]

People suffer accidents during birth or childhood, they have bad injuries, surgery, etc….all of which can cause mechanical difficulties to the ribs, spine, cartilage, nerves, etc…moving the chest and managing the respiratory pump. The body simply makes the best of it…till it can’t. Why not measure the performance and flexibility or lack of flexibility, of the mechanical pump in our chests that control the flow of air in and out of our bodies.

Can we learn more about how [unlooked for] broken breathing might lead to broken minds? Maybe we can examine ways to help some of the mentally ill and demented regain their normal mental status and stop the progression of this terrible illness.

I hope so.

It did happen to me once and it took years for me to recover. I remember my dementia .  I do not wish this on anyone.  Not recovering is no option, even with kind people like you around.

Why not look into breathing rates at rest and look for broken breathing in neurological patients?

I am trying to encourage doctors, scientists, caretakers and family members to explore this .

Please discuss with all who wish to investigate the source of this illness further.

If I fall demented again [and I am at risk]  I would hope that you would continue to try to figure out how to help me and others, even after I passed.   I would love for you to be kind to me in my suffering, but I would expect you to pester scientists and doctors to examine me regularly and to count my respirations to see if I require medical support to be myself again as much as is possible and to never give up investigating how to bring me back.

I would like more people to understand this besides myself and my friend, for obvious reasons.

You do not have to answer, I just want to encourage folks to think as well as to care.


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