Stop Waterboarding our Senior Citizens

OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY 2011

“ Dyspnea is a common and often debilitating symptom that affects up to 50% of patients admitted to acute, tertiary care hospitals and a quarter of patients seeking care in ambulatory settings”

Chest Editorial 2017

“Although randomized clinical trials demonstrate that various medications provide clinically meaningful relief of dyspnea during daily activities in patients with COPD, there is no treatment approved by the FDA for relief of breathing difficulty.”

Timed release morphine appears to be prescribed as an off label use but does have adverse side effects aside from potential misuse.

When optimal treatments for underlying lung issues, including Mucolytic, Anti-inflammatory, Adjunctive Therapy and blood oxygen levels are within normal limits a number of patients still have ongoing dyspnea (air hunger/shortness of breath).

Research has shown that applying room air or oxygen at two liters/min provides significant relief of breathlessness.  The suggested mechanism providing relief is that air flow in nasal passages is stimulating TRPM8 receptors which counteracts signals from stretch receptors in the chest.  Providing a device that is able to provide 2 l/min of room air through nasal cannula could provide relieve but this would still interfere with normal activities by limiting mobility.

There are alternative recommendations including to splash cold water on face, inhale vapors from a bowl or hand-held container of hot water with menthol crystals.  Or using a hand held fan to blow air on face.  All these approaches limit a user’s activities and provide only short term exposures.

Since Menthol and or 1,8 Cineole are agonists (stimulants) to TRPM8 receptors suggests that inhaling vapors of these substances into the upper airways over a short or extended time could provide similar benefits.

These agonists have good safety profiles for inhalation and it is suggested that a simple absorbent pad held under a user’s nose that contains significant amounts of Menthol and/or 1,8 Cineole could allow for sufficient inhalation of these therapeutic vapors able to relieve the panic response to the sensation of poor air flow.

A newly invented device released at Sporthaler.com permits athletes to inhale menthol and/or cineole vapors that can improved endurance, strength and speed.  If classified as a class 1 medical device it might just be effective on many cases or refractory dyspnea.

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