Did you know that we have pulmonary vagal irritant receptors? Irritant receptors lie between airway epithelial cells and are stimulated by noxious gases, cold, and inhaled dusts. Once activated, they send action potentials via the vagus nerve leading to bronchoconstriction (which can lead to cough) and increased respiratory rate. When stretched, these receptors also increase production of pulmonary surfactant, which allows our alveoli in the lungs to be more flexible and compliant. Our treatment, when these irritant receptors are activated is supplemental oxygen and airway clearance. You can do this yourself! Just take a long, deep, deliberate breath – right now! That brings in more oxygen into your lungs (supplemental oxygen), and helps to clear your airway with the prolonged exhalation.
Keep your pulmonary system healthy, avoid cough, and your vagus nerve toned during these times in the pandemic with this technique of slow, diaphragmatic breathing. Keeping the pulmonary vagal irritant receptors inactivated and at rest!
Patience. The last 10 years have been a long, at times, painful lesson in patience. Literally 10 years ago, I applied to medical school (for the 3rd and last time), and 7 months later, I was accepted. And now, as I come near the end of my formal medical training, so many of the endeavors that I have worked so hard towards are now coming to fruition. But again, patience rears its omniscient head and teaches me: not yet. Because nothing has quite yet manifested… I am 5 weeks from completing residency. 3 months from taking the final board certification test for my specialty medical practice. 2 months from starting my job(s). 1 year from publishing my next book. And only now starting work as a medical advisor for a tech startup. It’s been a long time coming. And I am now only on the cusp of all these visions coming into being. All these manifestations that are bursting from my heart; it’s hard to contain it all. I am ready. So ready. Thanks for the lessons, patience. I know there are reasons for your “not yet”. I don’t know what they are, but I believe in your wisdom. And I’m listening. Ready in wait and ready to burst forth. Because when you’re ready to let me go, patience, I am going to be running down that road as fast as I can.
May is national ALS month. We’ve usually heard of this because of the well-publicized “ice bucket challenge”, where one can donate to the ALS foundation to watch a friend or celebrity be doused with a bucket of ice. That was fun, and for a great cause, but let’s also talk about other ways you can help your ALS friends. Start by giving them the present of breath. ALS is known for its neuromuscular deficits, which eventually affect the diaphragm. After all, the diaphragm is a muscle. Diaphragmatic weakness is the core mechanism behind respiratory difficulties in those with ALS. So, the best gift would be to remind them to take deep breaths. Always. The more you exercise any muscle, the stronger it becomes. Remind them to take in a big, diaphragmatic breath, filling up the lungs. Try the instruction of asking them to sip the air in slowly, and thus deliberately and steadily depressing the diaphragm on the inhale (which contracts the diaphragm). You can even think about how contracting the diaphragm is like contracting a bicep; the slower you contract and more resistance you give it, the more you will feel the strength building. Try doing this by counting with the breath and increase the count with each subsequent breath cycle. Conditioning the diaphragm is no small feat; but with time and training, breathing will become easier and more spacious. Do you know someone that has ALS? Remind them to breathe, and give them the greatest gift you can offer.
Almost all human cells reproduce on a cycle. Up to 10% of your heart is replaced each year. Red blood cells are replaced every three months. Skin cells, every two weeks.
But it has traditionally been accepted that neurons, the cells that make up the brain and spinal cord, do not regenerate. Based on recent discoveries, it turns out that, under the right conditions, neurons can indeed recover. They just need a break. That’s why, in modern medicine, we will sometimes induce comas and hypothermia in patients with brain injury; so that their brains can rest. It’s pretty incredible that if you can break your neurons from normal operations and focus on healing, they have a chance at regrowth.
So that just begs the question, how can we give our neurons a break, with less extreme measures such as induced hypothermia or coma state? How can we take a deep breath, in this moment, and stop all the bustling chaos in our brains and give our neurons the break they need in our muddled daily lives? It’s human nature to want to fix what’s broken. And we have the tools to fix it. Take a moment right now to close your eyes and take a deep breath in and out. Try it again. And one more time. We may not be able to replicate exactly what we lost. But in its place we can grow something new. And slowly, but surely, we can grow until we have everything we need.
In our busy, modern lives, we have to rely on our innate automated system more and more each day. From our instincts when we get behind the wheel of a car, to our muscle memory when we unlock our phones, the efficiency of our autonomic nervous system is integral to our daily survival. On average, our hearts beat 70 times per minute. In that same 60-second period, we blink between 10 and 15 times, swallow once, and take up to 20 breaths. Our hearts beat. Our lungs breathe. Our bodies keep us alive.
And most of us barely notice. We just take it all for granted. So much of the world operates without us ever thinking about it. We just expect it to work out in our favor… and most of the time it does. We worry about the future and think about the past. But we hardly ever focus on the present; about what is right in front of us. And in doing this, we so often miss what is right in front of us. We take what’s good and easy and working for granted. Until it’s no longer good and easy and working for us… until we sprain our ankle and can no longer walk, until we get a cold and can no longer breathe, until we have a stroke and can no longer use our dominant hand. It’s normal. It’s part of being human.
But we can do better. I know we can. We can do better for us and for those around us. Because there are tiny, beautiful gifts we are given every day. The breath. The heart beat. The grace. It is up to us to appreciate them to the fullest while we can. In this one precious life, what can you notice to bring you more present; whether the breath, the heart, the perspective? Where can you be more present and more aware of the miracle of all the systems it takes to keep you alive? This life. This, that which we, just by the sheer act of paying attention, can be more present and connected to. This life.