Welcome And Scrubs Stories

SPEAKER_03 0:46

We are live for another Beauty of Breathing episode today with my dear friend Dr. Karen Parker Davidson. How are you today?

SPEAKER_00 0:58

Good morning. I'm good. It's been a busy day, still in scrubs. So anytime I get to wear scrubs in my leopard clogs, just I'm there. It's a good day.

SPEAKER_03 1:09

I miss wearing scrubs. Can't believe it's been six years.

SPEAKER_00 1:14

It's a good excuse. So anytime they say, come on to wearing, let's let's play it. I'm like, okay, whether it's in the OR or clinic, I'm there for it.

SPEAKER_03 1:23

I love it. Uh, you know, we don't wear scrubs in Brazil. And I so I took all my old scrubs and gave it to my sister. She's literally this week sent me a photo of her wearing scrubs, going to work, which is a non-clinical job. And she was like, Oh my gosh, it's so comfortable wearing this uniform.

unknown 1:39

Right.

SPEAKER_00 1:42

Back in the OR days, it's so funny. You use you throw on sweats and then you go out to the OR and you know, change into scrubs. It's like, what a uniform, right? And of course, wearing, you know, and you get OR hair out, you have to put hair up. So it's like an excuse, right?

SPEAKER_03 1:58

Nobody could understand why I dressed up to like go to Walmart. Just because I wear scrubs all day long. If I'm gonna get out of the house, I'm gonna, and that's a Brazilian thing too. We're gonna, we're gonna put heels on and we're gonna put a lipstick and we're gonna, you know, feel good about ourselves. Shut up.

SPEAKER_00 2:14

Shut up.

SPEAKER_03 2:15

Um, and let me go ahead and introduce you. So today we are thrilled to welcome Dr. Karen Parker Davidson, our and founder of the International Society of Airway Function Diagnostics and Therapeutics, and a globally recognized airway clinical nurse specialist with nearly 40 years of experience. Karen has dedicated her career to understanding airway function with a particular uh focus on the role of the nose and the importance of objectively measuring nasal resistance. She is the creator of Airway AI and the Davidson Maneuver, CEO of MedTech Research, an author, an internationally recognized speaker and educator whose work continues to change the way we understand airway health. And today's conversation is extra special because we're celebrating five years of collaboration with Dr. Karen and five years since her introduction to myofunctional

Who Karen Is And How We Met

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therapy. It's been an incredible journey of learning, collaboration, and connecting the dots between nasal function, breathing, and the rest of the airway. Karen, welcome to the Beauty of Breathing podcast.

SPEAKER_00 3:24

Thank you. And you know, it's like beauty of breathing. It almost reminds me of Martha Cortez. Yeah, you know, she just came to my mind as I was reading that. Oh my. And you know, I I want to ask you, how exactly did we meet? I know it's February of 2021. You just started Airways Circle. I'm like, this is really cool. And you gave me my first speaking opportunity. And I shared this on the Thursday net live, so I won't bore anybody because I can always go back to that. But it was you you put me on this platform, and I'm not a big public speaker, so I'll never be a politician. Okay. I will never be a politician. Right. And and I I decided like myofunctional therapy. I had no idea. I mean, I've been around respiratory therapy, critical care, flight nursing, infusion nursing, all these different things in the ENT world since 2002. So think about that. I'm like at Hopkins, University of Maryland, calling all these big accounts, um, George Washington University, Georgetown University, the VAs, and I never heard of myofunctional therapy. And I'm like, what is going on here? When I was doing health and I was working like with speech language pathologists, it occurred to me that what they were doing in the hook, these exercises that was myofunctional therapy. So what you do in the dental world is just so important. And and I have to say, I was talking with Dennis yesterday. He said, What do you think about taking a myofunctional therapy course? So I might do it.

SPEAKER_02 5:05

Yes.

SPEAKER_00 5:08

And I want to share some news. So I got a little frustrated um because I was trying to finish my PhD in business. I thought international business and entrepreneurship. And you and I are very much faithful people. I'm a I'm a good Catholic girl. And and I always feel like there is this inner voice always telling you something, and usually you're right, kind of that sixth sense. And and over time, I was seeing some different things in the airway world: diet, nutrition, gut, and I had this calling, and I changed my major and my complete focus to functional medicine. So no. So by the end of November, December, somewhere in there, maybe sooner, um, I will have my doctorate, PhD functional medicine.

unknown 6:05

Yay.

SPEAKER_00 6:07

And I want to get a I have ghost bumps. And I want to get a nutritional, um, like a nutritional science certificate because it's just amazing how this is all integrated.

Finding Myofunctional Therapy Late

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Let me share an example with you. So in functional medicine, we look at the five major organs, like the brain, the heart, the stomach, the gut, and the lungs. Now think about that and how it's connected to the nose. If you read in my first book, a little shout out, this one, this breathe your nose on painter, was kind of a healthy dose of cynicism of the current medical system. You know, I always felt like, are we given a pill to treat the disease, or are we given a pill and prescription to compensate the symptoms and the effects of that disease? What are we doing here? So it just got me thinking. And what's really interesting, we talk about the amygdala and airway, right? Hypoxia, the whole nine yards. We talk about the amygdala and that emotion, how it's like that emotional part of our brain. What's really interesting is that in the airway world, we can have that kind of fear. The amygdala kicks in, we have fear, and then the frontal cortex kind of picks up and says, Okay, things are better, things are better. What's really interesting is that we can actually trick our brain into not fearing fear. There's there's things that they do at ABCO, but in my world, you uh oh.

SPEAKER_03 7:46

You're skipping a little bit.

SPEAKER_00 7:48

Is that better now? Yeah. But in my world, going through this program, it occurred to me, Renata, this one thing. I was trained not to feel fear. So through like battlefield thirsting, um, survival training where they like threw us out of the woods, I don't know, put us in the box for like 12 hours. All these exercises we have to do have trained us to let our frontal, the prefrontal cortex really take as far as rationale thinking and processing executive function. And we're trying to kind of shut off the amygdala.

A Turn Toward Functional Medicine

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Well, think about that in children, right? Because their little brains are so underdeveloped, right? And they can't really sense that fear. And I'll tell you, the worst, almost the worst feeling ever for a fairy is not being able to breathe. That is the almost the hilarious thing is not being able to breathe. The children, so I really got passionate looking at all these different things, and yeah, you know what I heard today?

SPEAKER_03 9:05

What there's this guy that I follow on uh Facebook is full of tattoos. He used to be a convicted felon, and he gave his life to Jesus finally. Whenever he was in in uh prison, he read the Quran three times from front to back, and the Bible twice from front to back, and still that was not enough. It wasn't until after he left there that he gave his life to Jesus. But he said something today that you started talking about fear, and I was like, Oh my gosh. Um, he said the fear is the reverse of faith, it's the opposite of faith, so it's having faith in res in reverse. Pretty much, if you fear something, you have faith that a bad thing is gonna happen. And in the Bible, they talk about having faith like a child, and you just mentioned that children don't really have fear.

SPEAKER_00 10:05

They just they just don't have that fear because their neurological pathways are so underdeveloped. So think about the world. How long do they have to be hypoxic? And I call it slow airway hypoxia or slow airflow hypoxia, like nasal resistance is very cumulative. So think about that. Their little neuropathways are not very mature, and they're compensating to the point where they adapt. And the adaptation is what we really see in our clinic: the mouth breathing, the bed wedding. The the problem didn't start a month ago, two months ago. It started long before that. So I'm talking to a dentist yesterday, the one who inquired about you know, rhinominometry and myofunctional therapy. I'm like, do the full power, the services you can do for your patient, right? And airway story. I'm like, well, I said, he said, my personal experience brought me into the airway world. So tell me more. And it was about his son. And his son became colicky two weeks after birth. Think about that. I mean, children, babies, because and I say this a lot. What I learned in the in the ICU, the PACU, and the OR is that children are not little adults, and that drives me crazy when I hear that. I mean, they have a larger tongue related to you know, in relation to the oral cavity. I mean, there are so many physiological changes of nose, isn't it? So protrusive,

Fear, The Brain, And Hypoxia

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but they're very different than adults, and they already have high nasal resistance. I mean, it drops by the age, usually drops by 50%. So you can see how that growth pattern is affecting nasal resistance, pressure. Pressure drives our breathing, not flow. And I hear that a lot. And I really appreciated one of my readers reaching out to me last night. They bought book number two, The Nose Decoded. Book number three.

SPEAKER_03 12:07

That looks awesome.

SPEAKER_00 12:09

Actually, there's 63 nasal functions. 63. There's 63 in here, y'all. Wow. So I go over the function. I have an introduction about the function, I go over the anatomy and physiology, the mechanism of that function, uh, how it relates to the brain, nervous system, and that function, diseases that affect it, and how to prevent that function from becoming a dysfunction. And one of my readers messaged me. He said, This is like a manual, like a car mechanic manual for a car. And it was really fascinating because this person, he's like, I really had no idea how intense this was. So I have the privilege of doing a talk is for ASAP pathways. I'm doing like neurorespiratory complex because, you know, especially in children and how important this is. But um, so that's kind of what's been happening over the past, I don't know, while that's incredible.

SPEAKER_03 13:10

I mentioned Dr. Martha Cortez in the beginning. And if people do not know this, when I started Aerie Circle, she was there from the beginning. And we started a podcast called Area Circle Radio. And in Area Circle Radio, since it was like a radio station, there were three different shows. And one of the shows was uh hosted by Dr. Martha Cortez, and it was called Beauty of Breathing. So they did it for a while, and it was her and Jenny Hobson, and they did it for a while, and then I decided to stop all the podcasts and just keep one of them. Um, that was uh Airway Answers by Nicole Wildfarb. So we kept Nicole's show only, and I stopped the other ones, and then all of a sudden, well, Dr. Martha, uh Dr. Um Marta Cortez unfortunately passed away. Uh, and nobody really knew when this happened. Um, and I had all of a sudden in my heart to bring Beauty of Breathing back. And I kid you not, my first day, the launch day, was the day she passed away, and I had no idea.

SPEAKER_00 14:22

Did I check and that was April, was that April 16th, 2024, she passed away.

SPEAKER_03 14:27

Yeah, it was April. And that's the day I brought it back, and I was like, I had it, I you know, I found out way later um from you, and I just could not believe that it was the day. I just felt it in my heart to bring it back, and it was the day she passed away. And I was like, oh my gosh. So I know that she's present still in our lives, and I just wish that we could get just a little tiny ounce of her wisdom because she was so, so intelligent in so many different levels, not just in airway, but in life. Uh, and I'm just so blessed that to have known her and spent time with her and call her one of my mentors and a friend, right, for both of us.

SPEAKER_00 15:03

She she gave me my first opportunity of writing a book in July of 2022. I was already starting to write breathe through no stone pages. And the reason I wrote it is I was just so frustrated with the whole medical system, the whole airway, what I was seeing in social media. And and I used that one as a public education book to let people know who are all these credentials? What's an LPN, RN, APR, what's a first-year resident, what is an attending, what's a fellow? If you go to the hospital, there's all these different levels of healthcare, you know, practitioners. Who's who in the airway world? And such a billion-dollar market. And and we I I always say to my patients that you know, when they come to me and that's well, I saw this on the internet, and in my mind, you know, my mental health light nurse brain just shuts it off. Okay, stay off the internet. There's so many things out there, Renata, and I and I don't know how you feel about this, but I'm probably gonna hurt some feelings because I'm good like that. But I'm gonna be brutally honest. There's so much out there that who do you know to believe? And people are so I told another doctor the other day, people are so desperate to breathe and sleep. Yeah, so who do you believe? And I want to hear your perspective. Um, you know, because here I I mean I'm in the airway world and I'm more in an

Marta Cortez And Podcast Legacy

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advanced practice nurse role and you know, healthcare policy, things like that. But oopsie, it's so but in your I want to hear your perspective and tell the audience what do you see? I I can tell you the medical side of what I see, the ENT side. There's a lot of things in the ENT world. Surgeons are like, whoa, don't do this, don't do that. I mean, we really have to drill down and look at these sources, right? So I want to hear your perspective, you know, what do you see? And over the past five years, it's it's grown ever since like COVID. Everyone talks about the nose.

SPEAKER_03 17:12

Yeah.

SPEAKER_00 17:14

I hear this a lot, and I'm gonna just say it. When I hear so quiet breathing with no resistance, let me just stop right there because we all have a love, love or negative pressure breathing, which is healthy.

SPEAKER_03 17:29

We need to.

SPEAKER_00 17:29

Yeah, we have to have a little bit of resistance to slow that air down. Like in my world, we wouldn't do CPR and bag somebody in the cold because of what? Boom, like that, a bronchospasm. And and one other thing, too, that I've learned through my functional medicine program was that there's a huge difference between respiration and ventilation. We can ventilate, we can push air in somebody, but if they don't way, way down in the lungs at the alveoli level and the capillary level, if they don't have gas diffusion and perfusion, you're not you know what I'm saying? And so I found that really interesting. The differences, you know, ventilation is just taking air in respiration is the oxygen exchange and getting into your blood so we can survive. So I got off on a tangent, but anyway, tell me what you're seeing and your thoughts in the dump from the dental world perspective.

SPEAKER_03 18:31

Of nose, they're still not looking at the nose, they still don't understand enough about the nose to even consider it. I wish the dentist understood that the roof of your mouth is the fore of your nose. And every single time that you're uh making any skeletal changes to the maxilla, you're also making skeletal changes to the nose. Um, and it's just important for us to learn more about it and have a great relationship with an ENT who we can collaborate with in these cases. But I believe that the prognosis of dental work would improve if then to start looking at the nose also and making sure that your patients can breathe. Um, it's not simple, it's an extra thing that they have to do. Um, not sure if it's ever gonna go somewhere, but I think it's important for us to start having this conversation. Um now, in terms of who to believe, I feel like after COVID, people have really become their own advocates, and I think that that's the key because you can walk into 10 different enter offices and you're gonna get nine different um recommendations for your treatment. Um, so it's not why is that uh because of different schools, different training, different beliefs, different experience, different uh tools that they use, different um products, uh, because all of that is going to influence uh your decision. Um, if you work for, well, I'm not gonna go there in the corporate world, but um I don't know. Yeah, I'm not

Who To Trust For Airway Help

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gonna say that. But but I don't know. Uh I think that people becoming their own advocates and doing their own homework is really what's help helping them find the the answers that they're looking for. Just going to one place like right now, I'm looking at my blood work, and I'm having three different functional medicine doctors look at my blood work to help me. What's the next step? You may be the fourth. Fourth one. Yeah, because you know, one person looked at me and told me something, gave me 20, you know, 15 different supplements, and then somebody else looked at it and gave me a different diagnosis. So who do you believe? You know, you want to believe and to to have something to follow. So I feel like the more people study themselves, the more they read research, the more they they find ways, or even in this podcast, um, to find easy digestible ways of learning more information. We're always learning, things are always changing. Um, it's the best way for us to find our own answers. It's not one treatment and one answer that's going to be good for everybody. You tell me.

SPEAKER_00 21:40

Yeah, and yeah, it's really important you bring that up. And and I'll tell you one thing I absolutely love. And I'm gonna give a shout out to Emma Cooksie because she has been such a huge advocate for CPAT. Yeah. And as long as I the medical world, the sleep world, and full disclosure, I used to work for Idamar Medical and I used to sell the watchpad and the endopat. And I love the watchpad. Um, but I think she has such a huge voice and is such a level of reason. Like she's Switzerland, you know, when it comes to I love that. And I remember when I worked in children's mental health back in the mid-90s in North Dakota, um, we really got things moved. One of my families, the mom was just so fresh schools, trying to get accommodations and things like that, regardless of the amount of documentation she had. She went to the state. So we all, you know, I supporter, we all went to Bismarck, and she got things done for kids diagnosed with ADHD in the schools. And it was really fascinating. And really before didn't really come around until later. Even the Vanderbilt assessment, in the Vanderbilt assessment, and I highly recommend that if somebody says that your child has ADHD-like behaviors, or you suspect them yourself, meaning they're inattentive, not just one day or two days, but you see this for you know month after month after month, performance issues in school. I want people to look this up. It's called the Vic Built Assessment Tool. Okay. I think in the book number one, I can't remember. But it's a really valuable tool. And what that does is gives the parents perception and the teachers they put the to create a 504 plan on IEP, which is the individual uh educational plan for that particular child. Take advantage of those resources, especially the public schools. Use the guys counselors, you know, that's advocate as well. So I love, love, love parent advocates, and shout out to the ones that do this and really share their own experiences. But you're right, everyone's individual, like nasal resistance. Everybody has their own level. There's over 500 variables I have found. That's so we can't say, okay, you have uh the a vaulted palette, nasal resistance. No, it's bigger than that.

SPEAKER_03 24:16

Wow.

SPEAKER_00 24:17

It's much yeah, so yeah.

SPEAKER_03 24:21

I I have so many questions about nasal resistance. Uh you often say we don't just breathe, we breathe against nasal resistance. For those who have not heard that before, what does that actually mean? And why should clinicians care about the resistance required to breathe?

SPEAKER_00 24:40

Yeah, so nasal resistance and nasal function. Um, they're different breathing. Nasal breathing is the habit, that that's the actual uh behavior. Nasal breathing is a behavior, nasal function and nasal resistance are mechanisms. So we're negative pressure. As soon as we take an air in, the negative pressure in our chest cavity pulls that airband down into the lungs. There's a few things that happen. We have humidification. So at each point, from the the time the air goes in the nose to the time it goes to this level and our next, there's a there's a relative humidity change. You can see how the air humidifies as it comes down into the lungs. If the air moves too fast, it doesn't get those accommodations of humidity and uh filtration

Dentistry, The Maxilla, And The Nose

SPEAKER_00 25:37

and things like that. So we talk about the main characteristics of the nose warmth, humidification, things like that, filtering. But there's more to it as I talk about in the nose decoding. Um, and we also want to look at nitric oxide production. We want that function to and the nasal resistance to so that air down, so that we have the nitric oxide production. Now, here's one thing that I hear on social media when they're like the nose produces nitric oxide. Well, not the nose itself, it's the perinesal sinuses, but they do produce it, but it's actually your endothelial status in the vascular system, your blood system is what produces most of your nitric oxide, the highest concentration of nitric oxide, so not the amount, but the concentration happens in the parinesal sinuses. Yeah. And in my world, like in my old trauma days, nitric oxide can actually be produced by the gut and the liver when you like breed out. Another fun fact. It's in book number two, another nasal function. Wow. So we have we have to breathe against the that resistance and those pressures to slow the air down so that the air can warm, humidify before it gets to the lungs, because we don't want bronchospasms.

SPEAKER_03 27:05

So can someone can someone feel like they're breathing perfectly well through their nose and still have abnormal nasal resistance?

SPEAKER_01 27:13

Absolutely.

SPEAKER_00 27:15

Yeah, so we use so I want to clarify another thing too. Um, Pasulis Law, which talks about the radius of the fourth power to the 15th power. In my world for nasal function, nasal resistance, we don't use that. We don't. The nose is not a tube, it's a pressure regulating organ. And it's a resistor as well. So in our world for nasal function and nasal resistance, we use the starling resistor model, which is a cardiology theory from way back when. We use Bernoulli's principle that talks about the speed of air coming in and the velocity of air coming in. And more importantly, we talk about the Weber-Feigner Law. Now, the Weber-Feigner Law to your question: a patient can feel like they're breathing well, but not responding to the stimuli. So if we go back, and Dr. Vaughn, Klaus Vaught taught me this that the Weber-Feichner law is that our perception to breathing can be actually different than our actual action of breathing.

SPEAKER_03 28:25

Wow. I gotta digest that one. Um, one of the things that makes your work so unique is that is your emphasis on objective measuring nasal

What Nasal Resistance Really Does

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function. Objectively measuring nasal function. Why isn't it simply looking inside the nose or asking a patient, can you breathe through your nose? Why isn't that enough?

SPEAKER_00 28:48

Yeah, and that's a good question because a lot of times they we everybody looks at nasal cavity. They look at how why they make the nasal cavity. But here's the misnomer. A wider nose does not mean better function. Um, a wider nose does not mean better function. And this was presented from European Rhinology by Kern, who's one of the big names, along with Maurice Cobb, Copever, and of course Watt and Peter Clement, a lot of these different big names in rhinology. Um, but what's really interesting is sorry, my phone is going off there. Um what they said was that when you expand and you make that nose bigger and bigger and bigger, it's not so much the air moves faster or whatnot. The body will compensate and that pressure gradient will kind of like move. So we have a certain amount of pressure in our nose, a certain amount of pressure in our oral cavity, parynal cavity. And when you adjust pressure, you adjust all pressure. So it's kind of a dominant effect, right? And we have about eight to ten pressures in our body to help us. We have about 36 to 40 total pressures in our body. Um, I mean, we have abdominal pressure, uh uh urinary pressures, uterine pressures. I mean, all these pressures keep things moving in our body, right? Even in our blood system, we have higher pressures, blood pressure, right? Um, you know, what did we use in the critical care world was arterial pressure, and we use what's called the line that goes like right into the radial artery, and that's that's where we need a lot of our blood to check blood gases. So, to your point, we can look at the structure, that's great, but one millimeter of change in structure, the skeletal structure can have complete um difference in.

SPEAKER_03 31:01

Uh oh. We're skipping. Ah, we lost our all right. Well, I know she's coming right back. However, we were talking today and we said let's make this a quick 30-minute and we're gonna have her back. So maybe this is the perfect time for us to end. I had one more question before we were gonna be finished, but let's just go ahead and end right here as we're talking about. Um, my next question is gonna be about four phase right now. I'm gonna three. Yes. Um finish, go ahead, finish your thought, and then I have one more question, and we're gonna hear you. Uh-oh. Okay. It's probably because your phone might hear you. Oh my god, I know. All right, thank you, everybody. Thank you, Dr. Karen, for being here. Guys, catch part two of this episode. It always comes out on Tuesdays. Um, it's gonna be on Instagram, on Maya Moves Instagram, and on Beauty of Breathing Podcast platform. Thank you for being here and listening with us. We'll catch parts two, part two next time. Thank you so much. Okay. Thank you.

SPEAKER_02 32:14

Bye.