Breathing Easier

Coming To

A wave of disorientation floods over me as extraneous noise is the first to emerge to my consciousness. A slow beep… beep… beep… overlaid with voices, stern but not harsh. They are talking about things. Things that need to be done. Important things that cannot wait for me to wake up.

I now feel the weight of an object over my eyes. It’s heavy, yet comforting. It makes me feel safe and I want to leave it there as I lie here a while longer. It’s comfortable. I feel high. Even if I wanted to remove the dark shade that covers my face, I don’t know if I could. My arms feel like they are covered in lead.

I don’t have to remove it myself. What feels like five minutes later, a nurse does it for me. She peels back the ice pack that was resting against my face to help with the swelling. Light floods into my eyes, as I try to make sense of my surroundings; a run of the mill post op room is revealed, although to call it a ‘room’ would be generous to say the least. It’s more of a nook. A small, 10 ft by 10 ft space lined with curtains. A carbon copy of the dozens of others on either side and wrapping around the larger floor within the outpatient center.

The nurse looks at me.

“How are you feeling Michael?” she blurts out in a drab but assertive tone.

“It’s over already?” is what I think. But it’s not what I say. Instead I go with “ughll”, coupled with some drool and blood from my nose.

I’m surprisingly conscious though, and once I gain the ability to form words after about a minute, I ask if I can lie in the bed just a while longer while I come back to life.

I’m so parched. My mouth feels like someone took a blowdryer to it for an hour. I ask the nurse for water and when she brings it to me, I chug, despite her chiding for me to sip.

I’m so drowsy. I ask for a coffee. She obliges once more. I sip this time.

The last thing I remember before waking up here was being wheeled into the operating room, with a couple of nurses putting on gloves and scuttling around me. I see my name sketched on a white board in blue ink with some medical jargon written around it, and then … black.

How I Got Here

One week ago today I had the above experience. The journey that brought me to this operating room started four months prior with a book. The book is called Breath, and I bet you can guess what it’s about. It was recommended to me by a friend years ago but it took me a while to actually pick it up. I wish I had sooner.

Some books inspire. Some books get you to think. Some books get you to act. In my life, I’ve read no more than a handful of books that have inspired me to take drastic, almost immediate action. Breath is one of them.

Breath explores how the human species has lost the ability to properly breathe, namely breathe through the nose, over the past several hundred thousand years, and how humans are now suffering from a plethora of health problems because of this

Breathe Through Your Nose

The book Breath highlighted for me the importance of nasal breathing and how it ensures that the air you take in is properly filtered and delivered throughout the body to aid in the proper functioning of our many vital systems. It also highlighted the many dangers of mouth breathing, from the seemingly harmless symptoms such as dry mouth, bad breath and drooling to the more severe ones such as malocclusion, sleep apnea and even structural changes to the face.

I had no idea the importance of nasal breathing on overall physical and mental health. Proper breathing ca impact erectile health, regulate hormones, control blood vessel dilation and reduce anxiety. It can lower blood pressure, improve sleep and aid in the functioning of overall health. One particularly startling part of the book for me was an experiment run by the author where he decided to breathe only through his mouth for 10 days and observe the reactions of his body. His blood pressure shot up, athletic performance dropped off significantly, he started snoring and developed sleep apnea, which led to extreme fatigue, and he developed Sinusitis.

What’s more startling is that ~50%-60% of people breathe through their mouths during sleep, and because of this, experience similar (albeit less intense) symptoms chronically. It begs the question: How much are we limiting ourselves because of this seemingly simple yet critically important bodily function?

The more of the book I read, the more I couldn't help but pay attention to my own breathing and attempt to shift my own behavior towards proper nasal breathing. Over the next weeks, I would practice keeping my mouth closed unless I needed to speak or to chew. When I was exercising, I would use a timer to determine how long I could run breathing only through my nose. I would take note of my breathing during conversations, and count the number of mouth inhales between sentences. I even paid for a number of sleep apps to measure snoring, indicating if my breathing was affecting my sleep.

Not surprisingly, I quickly self diagnosed some issues, especially during exercise. The ideal way to breath during exercise is through the nose but after about 10 mins of moderate cardio, I could feel the air being severely constricted as I tried to breathe in through my nostrils. Whereas before I had been subconsciously switching to mouth breathing without realizing it, I now realized this was a habit I picked up to compensate for my inability to intake air properly.

Nasal strips helped a bit until they would inevitably fall off after they became soaked in sweat. And nasal dilators only opened the bottom of my passageways whereas my blockage was coming from further up. After a month of trying different solutions and driving myself crazy trying to force every breath through my nose, I got a referral to an ear, nose, throat (ENT) doctor who upon performing nothing more than a quick exam, confirmed my suspicion that I had some issues.

First, I was suffering from nasal airway obstruction, meaning I was either born with small nasal passages or they didn’t develop properly due to poor breathing habits throughout my life. Second, I had issues with my nasal turbinates. Our turbinates cleanse and humidify air that passes through the nostrils into the lungs. They are necessary for proper nasal breathing, but mine were enlarged, potentially due to chronic inflammation from allergies. Last, the actual shape of my nose, in particular the tip of my nose, was preventing optimal airflow.

The doctor recommended a three part plan. First, he would insert Latera implants. These are basically permanent Breathe Right strips that can be surgically inserted in order to open up the nasal airways. Second, he would perform a turbinate reduction procedure to reduce their size, allowing for more airflow.

The last option recommended was a tip-plasty, which would change the structure of the nose so that air could better flow through. It’s basically a nose job, but with the side effect of aiding in the flow of air through the nasal passages. To imagine how this works, take your pointer finger and place it on the tip of your nose. Now push up a little bit. Does this help you breathe? For me, it increased airflow by about 75% — 100%.

These procedures promised to help me breathe more easily through the nose, allowing me to increase my nasal breathing over time, improving breathing habits overall, and allowing me to reap all the aforementioned benefits of better overall health and wellness.

Three to six weeks of recovery and a few thousand dollarsˆ1 for a lifetime of improved health? The opportunity to remove a pre-existing ceiling on how my athletic performance and overall wellness? It felt like a no-brainer.

I decided to move forward with just the first two options. I like to think it’s because I couldn’t bring myself to change the cosmetics of my face, but more likely it’s because insurance wouldn’t cover the tip-plasty, despite the clear health benefits. Maybe next time.

After a plethora of office calls, paperwork and insurance claims later, I found myself groggy, a little high, and sipping hot coffee in a post-op surgery room, bleeding slightly from the nose.

Who Cares

I have a little system whereby I do a different fun (at least for me) challenge each month. December 2022’s challenge was to ask myself everyday: “What is one thing you can do today such that by doing it, everything else becomes easier or irrelevant?” (Thank you Gary Keller).

There is no arguing that when trying to accomplish anything, a small % of action taken produce an outsized % of the value. These specific things have a ripple effect and positively impact other areas. The key is finding what those things are, and focusing 100% of our attention on them for a specific period of time. We all have that one thing that if we did it, it would improve every other area of our lives. What might this look like?

• Health: No eating after 7pm → More disciple, better sleep
• Fitness: 30 mins of something fun yet challenging everyday → Makes it simple, builds the habit, creates positive association with exercise
• Relationship: One hour of “together time” with no phone daily → forces us to tune into the lives of the other and be present
• Mental Health: Sleeping with your phone outside of the room → No temptation to look at the phone late at night or first thing in the morning, less anxiety, more restful sleep.

Personally, I was looking for a way to improve my physical and mental performance. For this objective, better breathing was the one thing that I saw had the potential to positively impact other areas and a bilateral Latera implant with turbinate reduction surgery was the best way to achieve it. It’s still early, but it’s already starting to pay off for me.

So from the outside looking in, it might seem silly to voluntarily choose to have a surgery costing weeks and thousands of dollars to have a little more air flowing through your nose. The way I see it, however, it would be insane not to have done it, passing on an opportunity to enable better performance across all areas of my life. Present Mike is sacrificing so that Future Mike can experience the outsized benefits.

December challenge complete.

Closing

I finish the coffee. The nurse helps me up out of the operating bed to take a walk around the room. I feel like Jake Sully from Avatar the first time he tries out his new body, stumbling around the room and pulling on cords in my hospital gown.

Interestingly, the swelling has not yet started and the bleeding is still mostly cauterized from the drugs, so I’m feeling the full effects of the increased nasal airflow basically immediately. It’s a feeling unlike any other to go to sleep with a physical limitation and to wake up without it.

I get dressed and walk to the waiting room where my brother is there to pick me up. We walk outside, I’m blinded by the sun, covering my eyes with my hand. I close them, and take a big inhale through my nose. The air rushes in like water flooding through a dam. I feel the air tingling the hairs and a dull pain under my eyes from the implants. My diaphragm expands, then my belly and chest fill up with air. I hold it for half a second, then exhale. I can’t tell if it’s the air flow to the head, or if I’m still high from the drugs. I don’t care. It’s going to be a great day.

[1] A few thousand dollars is not an insignificant amount of money but much of it might be covered by insurance. For those interested, below is the breakdown of my exact costs. What’s interesting (and frustrating) to me is how absurdly expensive office visits are. Also those little Latera f**kers were over $5k / pop …