This post has been difficult to write, and has taken over a week. Much of it I wrote while my teeth were rubber-banded shut, which was a state that lent itself to feelings of suffocation. It has now been four days since my teeth were freed, and though I thought that freedom was going to feel like nirvana, I’ve since found that I’m still struggling with conditions that make me feel suffocated.
That’s actually a general theme for my recovery: there has been no dramatic turning point at which all became easy and relieved. (Hint to self: there isn’t going to be.) The same thing was true in my recovery from gall bladder surgery last year, and the same thing is true day to day in this process – and my memory is so short, I seem to have to re-learn patience every day. Then comes frustration that I’m not better at being patient. But sometimes I can see, thinking along lines my counselor has suggested, that such frustration is just a story I’m telling myself about this event in my life, an interpretation which is itself causing much of my suffering in this moment. Let go of the story, notice what is, and the frustration drops away – at least for now. Then I just do what I need to do, and get on with life.
*** From last week ***
I've been thinking a lot about suffocation - asphyxia - this past week. I've experienced a fair amount of what I would describe as mild suffocation during my recovery so far, with my teeth rubber-banded shut, my lips numb and sometimes resting in a closed position, and intermittent congestion in both nasal passages. My options are limited when these conditions are present, because I am not allowed to use pressure to blow my nose and clear the airway – if I even could successfully do that. There have been a few times when I have had to hold my mouth open with my fingers to keep a path for airflow.
-- At this point I'll comment once again, thanks for Lorraine's combination of pragmatism and compassion! She came in the room to find me struggling to breathe as I re-enacted these conditions, and reminded me that I can run my CPAP, whose very purpose is to keep those airways open. OK, that's helping, and there's no reason to struggle for breath when I don't have to! --
Though the conditions are more extreme this week, some of them have been present for most of my life. The "septoplasty" procedure in my surgery was for the purpose of clearing away my deviated septum on the right side, which has partially blocked that airway for as long as I can remember. When combined with certain kinds of congestion, and a closed mouth, that blockage has often made me unable to breathe.
I experienced that sort of suffocation several times in the period when dentists used rubber dams to isolate teeth for putting in fillings. That rubber dam also blocked off breathing from the mouth, and I was told to "breathe through your nose". Unfortunately, by that point in the procedure I usually couldn't point out that I wasn't able to breathe that way. (After a while I finally got proactive and asked them not to use the dam at the beginning of the appointment.) I spent a lot of time in circumstances like that controlling my breath and controlling panic as well, usually for the whole time until the dam was removed.
Even when the rubber dam was not in use I had to learn how to manage breathing in dental and orthodontist appointments. I found that when I was partially congested, certain behaviors could worsen my congestion during the appointment. I learned that abrupt "snorting" breaths - the breaths I was likely to take when I felt suffocated and wanted a lot of air fast - would likely disturb the mucous in my nasal airway and create the very blockage I was trying to avoid. Only by taking in a controlled, slow-moving breath past the congestion could I keep the airway open. I often had to resist an impulse to panic at those times. I also had to remain calm when I had saliva or water in my throat that I was trying to keep from going down my windpipe. Sometimes I would be able to swallow the liquid, but other times I just had to manage it, keeping it isolated until someone noticed it and removed it with suction, while simultaneously maintaining that slow, steady breath to keep the congestion undisturbed and the airflow unimpeded.
Through most of my considerable dental- and orthodontic-patient experience, I didn't discuss this with anyone. Only recently, as I worked several times with a very experienced and informative hygienist at my periodontist's office, had I begun to broach the topic. Unfortunately she has retired, but I am hopeful I can continue exploring the topic with others and learning some better strategies for coping successfully with this issue.
*** Now, this week ***
Though the CPAP was helpful in this recovery period for waking use, I’ve tried several times to return to using it for sleeping, but had to abort, usually after disturbing and uncomfortable sequences of suffocation, panic, and frustration. Last night (8/28) was my first success with the CPAP for sleeping since the surgery. I hadn’t intended to use it, but I was experiencing complete congestion in my nose, and as I tried to sleep with my mouth open, severe dryness was setting in immediately each time I tried to fall asleep. The CPAP mask confines my mouth and nose to only the air coming from the machine, and hydrates that air to help keep me from drying out as much. Things began roughly, as the severe congestion led to pretty much immediate feelings of suffocation when I put on the mask. But last night the fear grew greater than I had ever experienced before, into an unreasoned panic that the machine might actually stop, I’d be unaware or unable to rip off the mask, and that I would die of suffocation. It took a while to “talk myself off the ledge” and be able to accept surrendering my breath to a machine. Finally around 4:00 a.m. this morning I was calm and breathing regularly with the CPAP, and fell asleep.
I’m still struggling with this panic that comes and overwhelms me when I can’t breathe. I don’t know if we all have this conditioned response, or if it’s more powerful in me. I don’t know how to make it better, and I don’t know how to not respond to the fear. It’s hard to trust that this is going to get better, and that I’m not going to feel starved for air for the rest of my life. My surgeon says it could be months.
I’m looking forward to a day when my lips aren’t numb and can be a little more helpful (staying OPEN; how about that?!) so they don’t accidentally block my breathing. I’m looking forward to experiencing that freedom of air movement through my nose that I found just after waking up from surgery, before the swelling kicked in and blocked it. I’m looking forward to freedom from congestion in my nasal passages, so that I can take an easy breath through my nose just like they do in the decongestant commercials.
And actually, I recognize that I do know something about making it better. I’m going to have to be more intentional about some things I do. Sometimes the conditions that cause my suffocation are brought about by my own impatience, like when I try to drink or eat just a little bit too much in this mouthful, even though I can feel my body wants breath right now, not food or drink. I can also help by revisiting my steps from the Alexander Technique – first asking for ease, which naturally lets me get out of the way and let my body breathe itself.
Dr. Adam Burdick has been a professional musician for over two decades. Teaching, conducting, and performing in various music genres, he is also a perpetual student with interest in a wide range of topics. He loves to ponder and share his discoveries with anyone interested!