There are anatomical physiological consequences to aging. I do not mean only reaching old age. There are anatomical and physiological consequences involved in reaching adult status, including major hormonal changes, maintenance of reproductive status, reaching peak height, and reaching peak bone mineralization…..all of this and more . The skeletal ventilatory system responsible for moving air in and out of healthy lungs under any conditions-[cold or hot-healthy or sick and through recovery and injury,] must adapt to any and all increasing loads, as best it can. Plus the body must maintain homeostasis [stable internal conditions] no matter what. Until it fails. There are many ways for the body to fail. Failure does not always mean death; failure can lead to ‘failure to thrive” in adulthood. And this “failure to thrive” can result in abnormal pH of the blood, deficient gaseous transmitters, mechanical and/or thermodynamic stresses on the organs, erasure of memory and disruption in one’s previous ability to function and more. All while staying alive, but with a diminished quality of life, and hidden disability resulting in inability to function normally and lots of distress over the loss of one’s previous competent self.

This happened to Paula, as she approached physical maturity. She did not understand then.. She had short episodes of mild private amnesia and cognitive dullness starting age 18. …..It was most obvious when it occurred during part time jobs that she took on in order to help pay for her studies. She woke up and learnt upon arriving at work that she forgot how and what to do. This was puzzling and disturbing and very private. She simply tried to do her work despite this strange occurrence ……..No one really noticed because the end result was a very mediocre performance instead of her normal great performance….still, from her perspective it was very frightening and she was very relieved when a month or so later, her memory suddenly returned. The episode seemed, in retrospect, to be a result of working in an old school building auditorium with poor ventilation, overcrowding and increased levels of indoor gases like carbon dioxide.

It make sense now that more CO2 in the air would mess with Paula’s brain function and gaseous transmitters [look up new knowledge of gaseous transmitters on Pubmed]] because of her risk of homeostatic ventilatory failure due to being unable to raise her breathing rate normally AND because her respiratory rate was too slow at baseline. It makes sense now; it did not make sense to Paula then. She pushed though it as best she could and then did not give it another thought when it lifted…….till the next time she worked on registration under the same conditions and it happened again. Since this was an occasional and short lived occurrence, she did not dwell on it. She had no explanations for this intermittent amnesia and cognitive dulling in any case; dwelling on it would not have helped. She never discussed it with anyone either because, ….she was unable to when incapacitated, and did not think about it much when the amnesia lifted. She had no words to describe it anyway; she did not see it as amnesia, yet it was loss of memories that should never be lost, intermittently or not. It was a spell of amnesia. But Paula only knows that now. Because of our work together………….and because of a very bad attack that I witnessed during her menopausal hormonal changes. The very attack that lead us to examine this phenomena in this blog.

…..to be continued…

Dr Kraepelin realized that the measurement of the pattern of vital signs, especially the vital sign of respiratory rate at rest, was the key. Abnormal ventilation stresses the body immensely and also affects brain function, cognition and memory….. reversibly. Memory and cognition and normal brain function and mood would spontaneously return in all patients with the syndrome of manic depressive insanity, BUT the months, years or decades that it took meant loss of independent function for much too long. Kraepelin realized that medical support and medications could be discovered to return the patient to normal brain function and mood faster, thus saving both the patients and their families from a lot of suffering and a lot of lost time.

If the patient was “not their usual self” and suddenly incompetent and non communicative and distressed, simply measuring the 4 baseline vital signs at rest,, could tell the doctor if the problem was physiological and due to homeostatic failure.. Measuring baseline respiratory rate, blood pressure, heart rate and body temperature is enough to get a glimpse of what is failing in the body, in order to be able to order additional investigations and discover supportive treatments to help restore normal brain function and normal vital signs [with the possible exception of the skeletal ventilatory system-which would probably require non invasive support for life.

Of the 4 vital signs, respiratory rate is the most sensitive indicator of serious impending issues signaling risk of declining physical and mental health. This is because respiratory rate, if too fast or too slow or chaotic, will tell you if there is skeletal muscle weakness or a “control of breathing” problem or possible issues with the pH of the blood or if there is an issue with newly discovered gaseous transmitters [CO, H2S, NO] or some other issue affecting brain health and function.

to be continued………..

[Aging of the respiratory system: anatomical changes and physiological consequences]

W Ketata ¹, W K Rekik, H Ayadi, S KammounA

• PMID: 22878135
• DOI: 10.1016/j.pneumo.2012.06.003

Abstract

The respiratory system undergoes progressive involution with age, resulting in anatomical and functional changes that are exerted on all levels. The rib cage stiffens and respiratory muscles weaken. Distal bronchioles have reduced diameter and tend to be collapsed. Mobilized lung volumes decrease with age while residual volume increases. Gas exchanges are modified with a linear decrease of PaO(2) up to the age of 70 years and a decreased diffusing capacity of carbon monoxide. Ventilatory responses to hypercapnia, hypoxia and exercise decrease in the elderly. Knowledge of changes in the respiratory system related to advancing age is a medical issue of great importance in order to distinguish the effects of aging from those of diseases.

Review Rev Pneumol Clin

. 2012 Oct;68(5):282-9. doi: 10.1016/j.pneumo.2012.06.003.Epub 2012 Aug 9.

Still working on this……

In the blink of an eye
Just a whisper of smoke
You could lose everything
The truth is you never know.

Let’s take our time to say what we want (say what we want)
Use what we got before it’s all gone (all gone
‘Cause no (no), we’re not promised tomorrow Meghan Trainor

Normal memory for yesterday is needed to function tomorrow. Tomorrow is not guaranteed. Death or failure to thrive can happen any time.

That is what happened to Paula…a sudden failure to thrive…..her tomorrow disappeared overnight.

But it doesn’t have to be that way.