Paula has what we call broken breathing. Her respiratory rate is 3-5 breaths per minute at rest. No one knows why she doesn’t have a normal breathing rate of 12-15 breaths per minute. No one knows what happens to her breathing rate during infection or upper respiratory obstruction or exposure to increased gases [respiratory rate and volume should increase during metabolic challenges]. No one knows if she can raise her breathing rate in response to adverse internal [invisible] metabolic conditions. No one knows she needs to put in lots of effort in order to raise her tidal volume at rest in order to keep her metabolism and acid base balance in check. She doesn’t feel her own respiratory rate, it seems no one is aware of their respiratory rate- they simply breath and the autonomic nervous system takes care of it. She is aware that breathing, for her, takes work. She figures this is normal and the same for everyone. She is wrong. It is not normal and it is a sign of a possible problem, when her current strategies to manage her metabolism begin to be overwhelmed and start to fail.
Our hypothesis is that the sequence of events that occur during metabolic challenges at rest, results in changes to all organ systems and to altered mood [it feels very bad and physically stressful], altered cognitive status [dulled compared to baseline] and personality [quiet versus excited physical state – as shown by abnormal vital signs, in addition to respiratory rate, which is too slow until it becomes [in excitement] irregular, with apneas.
Once the medical profession becomes aware that broken breathing can occur, most likely due to some kind of neural, mechanical and motor peripheral injury, then they can begin to assess respiratory rate, tidal volume, and minute ventilation, along with the pattern of HR, BP and Body Temperature, when a patient becomes delirious [quiet, mixed, excited locomotor states] and stays delirious or appears demented [partially or completely-as in psychosis or agitation or combative].
Even though, this is a form of autonomic system injury, the researchers and clinicians interested in autonomic nervous system injuries do not seem to realize that injuries can affect the ventilatory system. to be continued………..