And this physical condition will affect her ability to flexibly adapt to respiratory challenges affecting blood pH. And the visible behavioural consequences will be neurological, affecting mood and behavior, obscuring the mechanical nature of the issue.. No one wants to measure Paula’s ability to move air in and out of her body. No one wants to know whether it is intact or broken. Why not? She is still a delightful human being, unlike some. . She has baseline hypoventilation [too slow breathing rate] , which normally should cause acidosis of the blood, which normally should cause a feedback response of increased ventilation (to remove carbon dioxide). This “normal” feedback response does NOT occur. We are not sure why. [well, that is not entirely true-we think that damage occurred at birth – we wrote about it elsewhere in this blog].
No one has done any studies on broken mechanical motor functions of breathing. The reason this important feedback mechanism does not occur may be due to hidden internal damage to the parts of the ventilatory motor system that physically moves air in and out of the body into the [in her case, healthy] lungs. Healthy lungs AND a healthy neural/motor ventilatory system are needed to be able to manage pH of the blood effectively. and easily.
Paula cannot do this because this part of her breathing, the neural/mechanical/motor part, is damaged. She does not know. She thinks she is fine. No one can tell. She can’t tell that she is different than others. It is not at all visible. Measuring her respiratory rate along with the other vital signs is the only way to unmask the damage to her body. During health but especially during neurological dysfunction affecting the brain and the mind, in visible and stereotypical ways.
If someone you know is suddenly acting weird [and is not taking mind altering drugs], measure their breathing rate! This is the crucial first step in addressing any illness but especially one that changes the function of mind, locomotor activity and mood. Abnormal pH of the blood affects mood! Yes mood…and it affects it in stereotypical physical involuntary ways.
Since oxygen does not seem to be a problem for Paula, we will look at PCO2 regulation. Chronically abnormal carbon dioxide in the blood will be caused by physical mechanical damage to the ventilatory system making air exchange more difficult and limited. lack of a working feedback response to rising CO2 in the blood is not good for mood, motor activity, energy levels, the heart, the kidneys, the liver or the brain. CO2 is an important cerebral vasodilator AND can become a deliriant [dysphoric, euphoric], an intoxicant [psychosis] and an internal invisible blood asphyxiant. And no one will be their regular selves without a functional ventilatory feedback system or even a functional ventilatory system period…which Paula clearly and obviously does not have, if one bothers to count her baseline ventilation at rest for one minute with stopwatch. I do not think I should have to explain it further.
Brains live in bodies. Brains need normal regulation of the pH of the blood to function normally. Human bodies are essentially large bags of water, and damaged physical ability to keep pH in check will alter normal chemical and electrical processes in the body and this will be evident in the responses of blood pressure, heart rate and function , body temperature and the basic neurological functions of internal and external arousal [level of wakefulness] , motor activity, mood and cognition.
Interestingly enough, Paula’s heart function, heart rate , blood temperature and body temperature are always normal, even with her chronic ventilatory hypoventilation. It is only when she is physically ill [with a cold or other upper airway obstruction] that her sympathetic nervous system kicks into action raising her blood pressure, heart rate, yet lowering her body temperature and causing circulatory vasoconstriction [hence the high blood pressure] and heart problems [arrhythmia’s, murmurs, etc..], WITHOUT raising her breathing rate at all…and remember that it is very slow and effortful during health.
This suggests that her breathing rate is stuck due to physical damage somewhere in the body and that she has adapted to this. During challenging physical illness, further affecting her ability to move air in and out though, she does not have the normal physical mechanisms of response and might need help with the motor part of ventilation or breathing.
It seems that the body and the brain go into a regulated orchestrated response to keep an other wise healthy person alive [if not completely lucid] in order to prevent pH of the blood from getting worse and also to slowly try to nudge pH into a safer level, with the remaining tools that the body has, no matter how long it takes.
The main problem seems to be with CO2 control, which, since it is a NORMAL product of cell metabolism, is well understood and handled by the body even with limited control over venitlation and ability to put fresh air back into the system.
To be continued……
Paula almost always has “too slow breathing per minute” at rest AND with respiratory obstruction [ie. a cold with a drippy, stuffy nose]. It takes a lot of work for Paula to breath this way, she needs the help of her abdominal muscles to keep the ratio of O2/CO2 OK enough at rest. Her Feedback System is broken. Her breathing rate does not go up normally when she moves to answer the phone or when she is walking or when she is running. [all of which she can do easily when she is not sick with a cold. Paula does not show the normal feedback response of increased breathing rate when she has an upper respiratory infection obstruction. Her breathing rate when ill remains the same, stuck on a “too slow” dial, if you will. If her blood pH worsens a lot, her breathing rate finally goes up, but much too high and much too fast and even chaotic [what is called periodic breathing].