“I need some help here!,” said the anesthesiologist sternly as he struggled to squeeze the bag to help Jackie breathe. The sound pitch on the finger oxygen monitor was getting lower and lower, dropping into the dangerous 60% range. The circulating nurse paged STAT overhead for another anesthesiologist to come to our operating room.
The anesthesiologist then placed an oral airway (a curved hollow plastic tube) into Jackie’s mouth to bypass any blockage due the the tongue falling back, but it was not helping. While he pressed on the facemask tightly on Jackie’s face with the left hand and squeezed the anesthesia balloon with his right, I could tell he was struggling be get adequate air into the Jackie’s lungs, despite raising the oxygen level to 100%.
I was standing by observing this tense scenario just after the breathing tube had been removed during a routine tonsillectomy. Jackie started to obstruct and her oxygen level dropped rapidly. She was still heavily sedated and sleeping, but was making abdominal efforts to breathe. At this point I took action by offering to hold the mask on the patient’s face with my two hands while the anesthesiologist used his two hands to squeeze the bag on the anesthesia machine to help blow air through the patient’s mask. Rather than pressing the mask down tightly on the patient’s mouth and nose, I lifted up the patient’s lower jaw with my 3rd to 5th fingers while squeezing the mask on the patient’s face using my thumbs. Almost immediately, it became much easier to squeeze air into the patient’s lungs and the oxygen level started to come back up again.
After a few minutes of letting Jackie breathe like this, she was able to breathe on her own again, with an oxygen level of 99% on 100% oxygen. In the few minutes it took to transfer her to the stretcher, the nasal oxygen prongs were off, but she was able to breathe on her own and still oxygenating at 97%. Despite this “normal” oxygen level on room air (around 21%), the anesthesiologist insisted on placing her back on 100% oxygen during transfer to the recovery room.
If you look at health trends these days, the perennial message is that your body needs more oxygen. We are inundated with countless oxygen-enhanced beverage options, and even more breathing devices and techniques to increase oxygen levels in your brain and your body. For most patients who undergo surgery, it is expected that you will be given oxygen through plastic nasal prongs hooked up to the wall. The basic assumption is that either due to illness or after surgery, you will not be able absorb oxygen in your lungs, or you won’t be able to breathe deeply enough after surgery.
However, in the scenario given above, Jackie was given 100% oxygen, and yet there was no air moving into her lungs. I started with this story to make the point that despite applying 100% oxygen, Jackie was not able to breathe properly. So why was she not able to breathe after surgery?
Some of you that are knowledgable about health matters may make the observation that perhaps Jackie had obstructive sleep apnea. A sleep study performed 3 weeks before the procedure did not reveal any significant apneas. However, she did have 15 “respiratory” arousals every hour, meaning that she literally stopped breathing 15 times every hour, despite not officially having sleep apnea. What was happening in Jackie’s sleep also contributed to what occurred at surgery.
Jackie was not overweight at all, being on the skinny side. Her anatomy was remarkable for a smaller than usual lower jaw. Looking at her airway with a thin flexible camera during sleep but just before the tonsil procedure, Jackie’s tongue and soft palate tissues fell back severely during deep sleep every time she inhaled. The best way to get more oxygen into Jackie’s body was not to give more oxygen, but to promote unobstructed breathing during sleep.
What we have been told in the media, magazines, and health and wellness books is that we need to breathe better to get more oxygen into our bodies. There is no doubt that many of these techniques can help to calm your nervous system, making you feel more relaxed. Other methods advocate slowing down your breathing rate or volume, essentially “breathing less.” The basic problem with these approaches is that your breathing is not addressed while you’re sleeping. Since you’re asleep, you can’t do any breathing exercises.
Modern humans have a fundamental anatomic problem that prevents us from breathing properly during sleep due to our shrinking faces. I described the reasons why our jaws and faces are shrinking, and the consequences of poor breathing during sleep in my book, Sleep, Interrupted. I have also debunked the most common misunderstanding about obstructive sleep apnea and why sleep studies may not be helpful for the vast majority of people with sleep-breathing problems at night. As a result of interrupted sleep, our diets and lifestyle factors can make an enormous difference in how you feel and live on a daily basis. Massive total-body inflammation will result from interrupted sleep, as well as over-reactivity to not only toxins in your environment, but also to the food we eat.
Yes, how well you breath can significantly impact how you feel during the day, but without addressing your breathing during sleep, I guarantee it will be a major challenge to achieve total wellness.
This is Part 1 in a series of articles describing the “Oxygen Illusion.” On my next post, I will reveal my gripe with sleep studies in general.