# The importance of breathing (and how it can help ectopic heart beats) part 2 ## Метаданные - **Канал:** York Cardiology - **YouTube:** https://www.youtube.com/watch?v=2TjXANEP6JM - **Дата:** 19.04.2026 - **Длительность:** 48:29 - **Просмотры:** 5,751 - **Источник:** https://ekstraktznaniy.ru/video/52318 ## Описание In this second interview with Dr Venetia Young, we talk more on the benefits of breathing better and how this can improve symptoms of ectopic heart beats ## Транскрипт ### Segment 1 (00:00 - 05:00) [] So, today's largely about you, Dr. Young. Tell us more about breathing because that's what we all want to know. Um well, I read some of the feedback after the first couple of weeks when it seemed to take off. Um and there were things on there that I thought yeah, I would quite like to cover. Mhm. Um and I also want to just uh talk about how when I talk with patients, I tell them exactly the same as I do when I'm talking to clinicians. Um and that really surprises the clinicians who tend to keep something back. Mhm. Sure. Kind of interesting. And um one of those and also it engages men much more if you're going [clears throat] into the nuts and bolts of the chemistry. Mhm. Women want to be told you can do this and it'll work and they'll just accept it, but men want to know how it works. Okay. And that's always for me that they often don't like mindfulness or don't like meditation as much. Um so that was one of the things I wanted to cover was um the Bohr effect, you know, how carbon dioxide affects the oxygen going into the red blood cells and out of the red blood cells. Um and one one patient just said, "I was told a lie in my A-level biology. Why didn't I learn about this? Cuz I just thought carbon dioxide was a dirty gas and you need to get rid of as much as possible. " And he'd been over breathing and feeling quite dizzy and getting brain fog. So, I do recall reading or learning about the Bohr effect, but I must confess I've forgotten all about it. But tell us tell us more I learned it in Ireland on Patrick McKeown's course in Galway. Well, it's simply that carbon dioxide sort of modulates the acidity which we did talk a little bit about last — Yes. Um but you need a certain amount um of carbon dioxide to help the oxygen get into the hemoglobin and then to help it get out to the cells. Okay. And if you over breathe, you get rid of too much carbon dioxide, then the oxygen just won't go in, won't go out. And so people are actually making themselves hypoxic by breathing too much, um which is sort of counterintuitive really. Um and uh so that's something that the um elite athletes really enjoy knowing about because they feel they need to breathe through their mouths to get more oxygen in. Yes. Actually, some of them do collapse cuz they've been hyperventilating. Um and uh so that then causes them to collapse cuz their acid-base balance has gone completely upside down. So, that's really interesting. So, what you're saying is you can actually increase the need for oxygen, Yeah. but actually in trying because you're hyperventilating, so you're working harder, you need more oxygen, Yeah. but actually the act of hyperventilation Yeah. If you overdo it — the double whammy. It's an absolute double whammy. Yeah. Wow. Um and I just think that it's really interesting, really important. Um and when I know when I was a GP because in when I was first a GP, I used to see people having heart attacks, um but then it all got taken over by ambulances, but I used to get people to slow their breathing down um because they were often really frightened with the chest pain, frightened with waiting for — Mhm. and hyperventilating and because they were hyperventilating, they were not getting enough oxygen. Making everything worse. Um causing their coronary arteries to constrict, so they were making everything worse worse. Um so that's kind of interesting. Um cuz one of the things you said and when we talked last was well, what can doctors do? You know, do I need to go on a training course? And my kind of sense is you don't need to, but you can think differently about the situations when you see people um and how you respond to them. And I remember you saying that the average breathing rate Yeah. Mhm. of the population has gone up Yes, it has. over the course of the past few decades. So, our average breathing rate has gone up. Yeah. So, what is a good breathing rate and how do people realize that perhaps they're breathing they're over breathing? And is that over breathing only in situations of anxiety or does it become something that we start doing all the time? It's habitual just to breathe ### Segment 2 (05:00 - 10:00) [5:00] a bit too much. Um so if you Google um what's the normal breathing rate, it will say I think about 12 to 16 or — Yes. Um which is okay, but um if you breathe at six times a minute, which we talked about last time, then you do trigger the vagus nerve and the calming nerve. And that's quite a lot slower. Yeah. Um and that's the rate that um if people are sitting in Psalms or choral music like that, that's what you're doing is you're getting a breathing in and a long breath out, but and it's about six breaths a minute. Which is kind of interesting. What would you attribute this increase in breathing rate to be due to? Now, why are we breathing harder and faster? Um the pace of life has got faster. Um we're expected to deliver much more quickly, so it's sort of a like a seedbed for hyperventilation. Um — [snorts] — So, do would you say it's largely mental stressors or do you think it could be again, I'm just throwing this out there, could it be additives in the food? Could it be sugar? Could it be it could those things also contribute? It could be um sugar because that has a very profound effect on metabolism. I don't know enough to really comment on that, but I would guess that's um a fairly potent cause. Um because that, you know, the sugar will increase insulin production and that will alter your chemistry. Mhm. And yeah. So, it could well be the diet tree thing, but I don't know. That's the honest answer to that. And it [snorts] could also be, couldn't it, that the average weight of the population has also gone up? We carry a lot more fat now compared to say 50 or 60 years ago. Yeah. We're probably less fitter. Yeah. And that could be another reason, but I agree with you. I think the pace of life is so extreme now. Yeah. And I think I you may recall perhaps when I was younger, certainly, you know, if you wanted to do any kind of scientific writing, we would go to the library and we would seek out Index Medicus. Yeah. And you know, that just trying to find that and trying to write anything and just trying to get the references could take a whole day. Yeah. And now you can do it within 30 seconds on your on the palm of your hand and your phone. Mhm. But actually, I truly believe I have less time now compared to when I was a student. I had more time then. Yeah. It just It's incredible how much we've overloaded ourselves with. Yeah. So, that's really interesting. Um So, so that was one thing and because that particularly interested the men when we did the teaching. Um that to the Bohr effect. And most doctors have forgotten about it. You know? I'd forgotten about it until I was taught it in Ireland a couple of years ago. Um and it is really important. So, one of the ways you can measure somebody's carbon dioxide sensitivity is by doing the control pause. So, you take a breath in and out and then you measure with your stopwatch how long it is before you you're desperate to have a breath in. Okay. So, I did when I first started having Buteyko sessions online, mine was nine and then it went up to 20. I did it just before we logged on and it had gone down to 15, so I need to do a bit more work. So, when you say 15, do you mean uh you count or is it seconds? — It's 15 seconds. Yeah. Okay. Use a stopwatch. Um and what that is a measure of is your carbon dioxide sensitivity. Um and that is set in the brainstem during childhood. So, if a child grows up in a stressed environment, they're going to be wired for responsiveness and can I get out of here? So, it will be setting um your brainstem um at a level where you're more likely to hyperventilate if you're given stress in the future because it has a survival value. You'll move quicker, you'll get out quicker. Um but it's actually these days it's because we don't have to get out quickly. It's actually ### Segment 3 (10:00 - 15:00) [10:00] can be a bit of a hindrance really. After one of the talks I gave, young woman came up to me and she just said, "Thank you. Now I understand why I am the person I am um because of the childhood I had and I know I can calm myself. " So, it was quite a simple. It didn't take psychotherapy. Yes, therapy [snorts] for her. It was just needing to understand how the jigsaw of her breathing mechanism fitted together. It is incredible, isn't it? I did a I was interested in looking at what medications people are on when they come to see a cardiologist. And I found two medications, two sets of medications which are almost universal. Uh one is a proton pump inhibitor. Yeah. So, they're very commonly prescribed, you know, for indigestion, et cetera. And the second is usually an antidepressant or an antianxiolytic. Yeah. Which demonstrates what a big problem mental health distress is. Yes. Yeah. And it also tells us how we are always so keen to stick a sticking plaster on it Yeah. by just giving them medication and not addressing the root cause. Some of which requires a lot of gentle questioning and finding out everything about that person and their childhood, et cetera, et cetera. With regards to the um proton pump inhibitors I had There was a phase when I was working as a GP when they were beginning to say, "Well, actually, you're losing um vital minerals by taking these and actually it's quite dangerous and you may not be absorbing B12 properly. " And so, I had a series of people who came in and what I taught them was how to use their diaphragms um so that um they could um encourage the blood flow around their abdominal cavity um and to just encourage the blood to circulate properly around the esophageal um sphincter. Um and I had three people in a row over a period of weeks who just were able to come off um PPIs and — Really? Yes. And they really appreciated understanding how their body worked. One woman in particular, she was a um she ran a bed and breakfast, so she was always bending down, changing beds, and that sort of thing. Um and so, she said, "Well, how will it work for that because gravity's not helping? " And I said, "Well, maybe if you do a few slow breaths really engaging your diaphragm before you change the beds, um that will help your sphincter function properly. " So, she did that and it worked. And I'd learned about that from a respiratory physiotherapist up in Glasgow who'd said, "You know, there's lots of research that we read that shows that breathing abdominally, when you're with your diaphragm, really helps that. " So, how do you do that I mean, how do you actually do that? What If I were to going to try and do that because I'm interested. Well, I what um what I get people to do is to put a hand on their chest — Okay. and just to notice where you're breathing from. Um is it both? Is it one or is it the other? — [snorts] — I think I'm I don't think I'm breathing from my abdomen. I just below where I have my hand. Okay. Yeah. Cuz you look as though you're breathing from your upper chest. Yeah. Whereas I'm not, I don't think, at the moment. Um so, I get them to do that and just to be aware of what their breath is. Mhm. Um with children in school, I'll get them to count a number for their breath in and out. Um so, they get familiar with what their breathing pattern is. [clears throat] Okay. And so, that can be quite helpful for adults as well. And then I get them to um experiment with just not breathing from the top of the chest at all. Just not letting that happen. And just breathing from the abdomen. And finding where their diaphragms are by um putting their hands [snorts] your hands on the side sort of with fingers like that and ### Segment 4 (15:00 - 20:00) [15:00] and feeling the ribs expand outwards. Yeah. And then once Does the abdomen go in or out when you're breathing? — The abdomen When you breathe in, the abdomen will go out. But belly breathing isn't exactly the right sort of breathing. You really need to be engaging the whole of your diaphragm. Um because that will really um take the blood down to the lower lobes of the lungs. So, if I wanted to improve my breathing, should I be focusing on my abdomen and seeing whether that's coming out every time that I take a deep breath in? Yes, you should be noticing whether your stomach is moving. But people often find it a lot easier to breathe properly um diaphragmatically with their belly with their hands on the side of their chest like we're doing now. Okay. I am very I am now conscious that my abdomen comes out when I breathe in. Yeah. Some people who are really, really anxious do a paradoxical breathing and they get they go — [snorts] — and they say that they their stomach goes in and out. Oh, And those people you I can't I couldn't as a GP get them to breathe properly without lying down. Lying down alters the sort of uh gravity effect. Um and some people find it really difficult to breathe with their diaphragms. And I tended to send them off to respiratory physiotherapists. — [snorts] — Wow. In terms of um with I remember last time you talked about the Buteyko method. Yeah. Mhm. I think we talked about the 7-11 the method. Is the Buteyko method, which I've just heard of, I don't know enough about it. Well, what is that? Well, it will it's very definitely about breathing slowly. Mhm. And a longer breath out and also breathing from the diaphragm. That's the sort of foundation of what they teach. And then there are all sorts of things you can add on. Um sort of various exercises to So, for instance, in um Ireland, he got us running without taking a breath at all. Which as somebody who'd had asthma, I thought, "Well, I can't do that. I can't do that. " But he had me running 30 paces around the room without taking a breath. Really? Yeah. And that's one of the ways you get your toler- tolerance of carbon dioxide up is by practicing different methods of uh of breathing. Um How does the Buteyko method differ from the 7-11 method? They haven't used When I was there, we discussed the 7-11 method. Um and we had a really good group discussion. They don't That's not something they particularly recommend. Um but they could see that it's very much like their the YouTube videos you've got of breathing in to the count of four, breathing out to six, or breathing in for six seconds, out for six seconds. — [snorts] — Um so, it's it goes with that sort of continuous breathing. Um whereas the methods which stop and you hold your breath um for seven seconds or hold your breath for four seconds that sort of interrupts the natural flow. Um So, they will talk about those, but on the whole they'll recommend the more continuous sort of breathing but at a much slower rate. And as I do that, the idea is that I should be concentrating on spending more time breathing out. Yes. Yes, cuz that stimulates the vagus nerve. And Okay, so whatever time I'm spending breathing in Yeah. I will spend more time breathing out. Yes. And that goes with heart rate variability. Mhm. So, that's one of the things we introduce the patients to. And I did slightly scare myself with one gentleman who was awaiting cardiac surgery who had no heart rate variability. — [snorts] — Um so, we get them taking their own pulses and feeling as you breathe in, you're stimulating the adrenergic system and your pulse rate goes up. Okay. And as you breathe out, that's because you're stimulating the vagus nerve. So, that your pulse rate will go down. People were absolutely fascinated about this effect. Um and that they could really get to grips with that. Um I did a demonstration on ### Segment 5 (20:00 - 25:00) [20:00] for a group of people with a colleague of mine in Edinburgh, Alister Dobbin, um who's very keen on heart rate variability, and he has the whole sort of setup on computer. Mhm. You can see the heart with a nice sine wave heart rate variability. Um this people then they're doing um short breath in, longer breath out. You can watch it happening in real time. Um and it's sort of quite beautiful to see, really, the body working that way. And um he then had a sort of volunteer from the audience, and he invited her to think about something that was stressful. Okay. Immediately, her heart rate variability went all over the place. Um and so he then got her to calm down again. Um and to get back her heart rate variability um by watching a little thing going up and then down, much more slowly. And so he said, "While she was watching that, um he said, 'Now think about the thing that was troubling you so much. '" And she was able to think about that, to concentrate on the blue thing going up and down. And then she said spontaneously, "What I was really worried about isn't as upsetting when I'm breathing properly. " Oh. Which is really interesting. Um and it had a profound effect on the audience um because they were all people who worked with victims of domestic violence across the county. Um and they started then using observing breath as that they shouldn't be talking about something distressing um with somebody until they'd got their breathing sorted out, or they could be retraumatizing them. Um and that behavior, 2 years later, I went in to see them, they said, "Oh, remember? We're still doing that. " Um so it was something again, something simple, that really worked and made a difference. — [snorts] — But what we're saying is that breathing correctly could be an antianxiolytic. Yes. Like an anti you know, an a treatment for anxiety. Yes. Yeah. And actually, you shouldn't be talking to people if they are in a aroused state, because you may be retraumatizing them. That's really important. Um So counselors who've come on our workshops have said they've just used it with patients and found it really helpful. Um — [snorts] — Could I ask you a little bit about the heart rate variability, because a lot of people now have watches and Fitbits and you know, apps. What how does one look at heart rate variability? Uh and how do you make sense of that? Well, my daughter is an elite athlete, and she's very keen on her heart rate variability and improving it, so making the variability much bigger. Okay. So some of the breathing platforms talk about you know, you need to improve it by making it smaller, but no, you don't. You actually want heart rate variability to be bigger, cuz you're more in control of your autonomic nervous system, if that's the case. Um I'm not really familiar with that sort of an app. — [clears throat] — Um but I do know that athletes use it a lot. My daughter will say that if she's stressed in any way, um her heart rate variability just diminishes. If she has a bad night's sleep, her heart rate variability diminishes. So it's a really interesting, easy-to-access measurement. And think, but I don't know. I've not read the papers on the impact of low heart rate variability on mortality. Mhm. If you lose [clears throat] it, if you lose your heart rate variability, you're much more likely to have serious ectopics. Um which [snorts] could be life-threatening. So that I have read. — [snorts] — So doing the breathing work will increase heart rate variability. Yeah. Yeah, which is what you want. — Yeah. I'd always looked at heart rate variability, and I have to confess, you know, I don't I have I was I can't even remember from physiology, but I've come across the term heart rate variability. Uh I'd always thought, "Oh ### Segment 6 (25:00 - 30:00) [25:00] you know, when we are young, for example, and healthy, our pacemakers are very sensitive. It's like having a new car, you know, you can go from zero to 60 very quickly. When you want to slow down, it slows down. It's very responsive. Goes up, down, you know, as you need it. And as you have more wear and tear, Mhm. then obviously things are not as responsive, and therefore the heart rate variability should go down in disease states. " And as you get older. older, that's that's been my kind of mental explanation, that heart rate variability is just a sign that your body and your functions are not as responsive as they should be. Yeah. But [snorts] you can improve it. But Yeah. And breathing would be is one way. I need to ask my daughter all the other ways she improves heart rate variability, but And does it just indicate your state, or does heart rate variability and improving your heart rate variability result in an improvement in your state? So is it a Yes. Yeah, it is a Yeah. I'm really aware um if I'm very stressed, my heart rate variability isn't good. I don't feel I have the stamina to do stuff. Mhm. But if I do if I'm calm, I'm okay, and problems in with the world are sorted out, my heart rate variability, now even I'm sort of in my early 70s now, um my heart rate variability is good. Um So it could be a therapeutic target. Yeah. Yes. Treat the heart rate variability, ideally through good lifestyle, breathing, etc. Yeah. And that results in you feeling better. Yeah. Yeah. Oh, how interesting. sending a message when your heart rate variability is good, it's sending a message to your brain, you're safe, you're okay. Um cuz the vagus nerve has got fibers going in both directions. How interesting. Yeah. And last time we touched on things like heart palpitations and ectopic beats, and that's a very big you know, lots and lots of people struggle with ectopic beats. Mhm. Have you any experience of using breathing as a means of suppressing ectopic beats? I have. Um I mean, I had I got ectopics after a virus infection last year. Mhm. And got to lots and lots of contradictory advice, which didn't help my health anxiety. Um but then, you know, having got advice from you that actually my heart was pumping fine, it was just choosing not to beat as regularly as I wanted, Yeah. I stopped worrying about it. Um but then in the autumn, I had a chest infection and landed up in on a drip in A& E. And I used breathing, slow breathing, to bring bring my heart rate down. Um and but mainly was important, because every time it went up above 140, there was this machine that went beep beep beep. And I wanted to sleep. — [snorts] — Um so I found using the slow breathing was really effective. Um and the nurse was really intrigued with what I was doing to actually control my own heart rate when I was quite poorly. — [snorts] — It's really interesting, you know, because as a cardiologist, what I find is your ectopics are more noticeable for most patients when their heart rates are slower. Yeah. And actually, many patients say, "I get them during rest and digest phases, not when I am running around and my heart rate is fast. " Mhm. But at the same time, calming oneself down, activating the vagus nerve Yeah. through breathing, I slowing the heart down as well. Yeah. Mhm. It's actually a treatment. So the it's really interesting that um a slow heart rate is more likely to make you have ectopics, but at the same time, deliberately trying to slow your heart down through you know, so my question, I suppose, is is it because the ectopics are being caused by electrolyte imbalances and that by doing the breathing you're correcting those electrolyte imbalances and maybe that's why the ectopics go ### Segment 7 (30:00 - 35:00) [30:00] away. Yeah. Yeah, it could well be that. And the other thing we didn't cover last time was actually looked through our video just to see what I'd said and we covered a lot. Um it was actually magnesium that if you do hyperventilate the magnesium gets excreted through your kidneys. Mhm. Um and that's why people um you know, it's known that people with high blood pressure are more likely to be magnesium deficient. It's known that people with migraine are more likely to be magnesium deficient. — Yeah. Um and there's a lot of sort of resistance to you know, well, this is just another fad. Actually, it's not. I completely get agree with you. And the reason it's not is because the patient comes back and tells you. Yes. Yeah. — They say, I had this, I took the magnesium, I feel better. Yes. Yeah. And I've had that experience as a result of doing the workshops is people just say, that's what that worked. And it's interesting, isn't it? It's not just the magnesium, although magnesium is interesting because we're more deficient in magnesium because it's more difficult to measure uh and so there's not as much focus on magnesium because the blood test can often be wrong and um uh and what is really interesting about magnesium is you can get a relative magnesium deficiency. So, you're you're okay, you have enough magnesium in your body, but when you go into a hyperventilation state Yeah. uh then you become more acidotic. I'm sorry, you become more alkalotic and the magnesium is has to go into the cells to restore the pH and you can be relative deficient. So, the patient will say, oh, my magnesium levels were fine and actually I went back a week later to my GP and he says, my magnesium levels are fine. So, Yeah. And I say, well, just take it because that's probably Mhm. the best way of finding out because A, the blood tests are not reliable. B, you could get this relative deficiency if you're running a little bit low that could — That's really interesting. Thank you. Yes, that's really helpful. Um Yes, but I sort of don't like the way it's dismissed. I tried to get um some writing published by the British Journal of General Practice on magnesium. Yes. And it was you know, I was saying it's you know, it's used for heartburn, it's used during pregnancy, it can alter urine infections, it can alter whether you're constipated or got diarrhea. It's you it's got a use all over the body. It's really important. It is. And you need to join all the dots rather than to see every system as separate. Um but they weren't quite ready for it. I might try them again. Magnesium intravenous magnesium used to be used for asthma, didn't it? Asthmatic attacks and also even now when you have heart rhythm disturbances, so when people come in with ventricular tachycardia, etc., we often give them an infusion of magnesium straight away regardless Yes. of measuring their magnesium. So, it is a really important um mineral, but breathing seems to have a very big impact Yeah. on magnesium levels or effective magnesium levels within the body. And the other thing I talk about in my talks is the foods that are high in magnesium. Um and my two favorite ones are chocolate and avocado pears. — Really? Okay. — All right. And of course the other thing is of course, you know, we're taking more diuretics in these days, relying more on things like coffee, etc., and that gets rid of magnesium, etc. as well. And I think also the other thing that has struck me is that a lot of the supplements that are available, you know, they contain a very small amount. It's not like it's all it's not effective uh replacement unless you go to a proper health food shop and get a proper pure Yeah. just magnesium, not magnesium and a bit of zinc potassium and a bit of this and a bit of that, but actually that I think is really important. Wow. How interesting. And so that's how I first found you was I wanted some more information about magnesium. Right. So, I found that all your um videos on that. So, I was referring people to look at your videos. Yes. And me saying what you should take magnesium citrate, avoid magnesium sulfate. I said, you know, work it out for yourself cuz I think people do need ### Segment 8 (35:00 - 40:00) [35:00] to work things out for themselves a bit. I know. I have to share a story with you. I um A few years ago I met a lady in my private clinic and she came to see me and she and I said, oh, I think you look familiar and she said, yes, you you've met me before. And I said, remind me and she said, well, you know, I was seeing one of your colleagues and they'd booked me for a heart scan because I was getting these ectopic beats. And you did the scan. And when you were doing the scan, you said, oh, you're getting ectopics, why don't you try some magnesium? And I said, and then what happened? And she said, well, I did go and get some magnesium. And then what happened? She said, well, they went away. So, I said, and so what brings you to see me today? And she said, um I uh the problem is I stopped taking the magnesium. And I said, why? And she goes, well, what happened was I took the magnesium, I felt better, I went to see your colleague and I told him that I was taking the magnesium and he took the bottle out of my hand, threw it in the bin and said, there's no evidence it works. And so she said, so I stopped the magnesium and then I said, and then what happened? And she goes, well, the ectopics started up again. And I said, well, what evidence does he need? Well, you took something, you feel better, you stop it, they come back again. And so this idea of evidence that is very much like, oh, unless there's a big multicenter randomized control trial that has been run, there is no evidence. But actually, you know, case histories are incredibly important because patient anecdotes, this is something that we should never disregard, you know, because everyone is different and research studies don't cover everything and a lot of research is actually based around making money now, you know, I have a product which will sell really well if I can show that benefits. And some of these traditional you know, perhaps less um financially Well, it's not so profitable. — Yeah, financially profitable um are not advocated for simply because no one does the research. And I've become very interested in that. And the other thing I wanted to share with you, which I think has changed my perspective a lot uh is that, you know, in the old days, for example, you know, when someone comes in and they're young and they, let's say, some young guy comes along and he's not diabetic and he leads a good lifestyle, etc., and he comes and has a heart attack and we're often left saying, oh, you know, why have you had the heart attack? That's is a question the patient would ask me, why have I had a heart attack? I'm young, I'm healthy, I'm doing all these things. And I would my answer would be, oh, it's genetics, you know, it's probably your genes. You've got bad genes. And the conversation would end there. You've got bad genetics, you can't do anything about it. But the question really that we have to ask ourselves is, do we inherit a heart attack Mhm. or do we inherit abnormal biology? And the truth is we probably inherit abnormal biology, you know, and some of us probably need these things more than others because we may have small deficiencies in a variety of enzymes, etc., etc. So, there is a lot to be said for being inquisitive and not disregarding these things which are not proper pharmaceuticals and don't have that kind of evidence base because maybe the modern lifestyle is not only depleting us, but perhaps we have these genetic polymorphisms that just make us more vulnerable in the absence of Mhm. certain nutrients in our body and maybe that could be a contributor. So, we have to stop stop ending the conversation at genetics. Yeah. And we have to be again more inquisitive about how the body works, what's going on in the body, the autonomic system, Mhm. factor of intracellular alkalosis, acidosis, etc. You do to about all of it. What's being brought to mind is a patient who had an inferior infarct while he was in surgery with me. Um straight out of the hospital. Um and then he came back probably about 6 months later to see me um because he wanted to know, he said ### Segment 9 (40:00 - 45:00) [40:00] "You're probably the only person I can ask, but do you think my heart was broken because my wife died? " Aw. Um and we sort of talked through how that might be that And he was very clear that it was heartbreak um which affected um affected him very, very badly. And even though he got a new partner who he loved, he didn't quite love her as much as his wife who died. Um And you have to think about these emotions. The heart's not just a pump. Sleep. — Yeah. And I think Dean Ornish, who was one of my favorite cardiologists who is at the HeartMath Institute, I think it was him whose his first question to anyone who's had a heart attack is, "Who do you talk to about your feelings? " Um and that that's really moving. Um and uh cuz I think they've got evidence in the States if you talk about your feelings, you're less likely to have a recurrence. Um I totally get that. Yeah. And I think this is a real unmet need out there. Yeah. Um But yes, no, it was a very powerful consultation cuz it was one of the ones where I think, "Right, how do you respond to that um as a medic, as a person? " And uh yeah. So, understanding how the body works is really really, really important. — [snorts] — Are there uh any centers uh that you're aware of where people can access breathing instruction? I know you very kindly agreed to Um I will do a session. Um Well, I mean, I would certainly trust the Buteyko clinics. Mhm. They do um lengthy workshops in the UK and internationally. Um I like going to Ireland cuz of the Irish voices and the Guinness. Um and uh So, they do good workshops, but there's not that much around, really. There's a lot of um people who seem to me to have slightly jumped on a bandwagon. Yeah. A little bit controversial here, but um Patrick McKeown will say that there've been no deaths associated with the Buteyko method. But with the I think I mean, you know, we definitely know that meditation is a good thing, isn't it? And actually, when you meditate, your breathing does slow down. Yeah. And it's very interesting, isn't it, that when, for example, I get patients who come in who've had a heart attack and they say, "Well, I do plenty of exercise because I work, I'm always up and down and doing this and doing that, you know, my work is a very physical thing. So, I think I'm very fit because I do all that. " Mhm. But actually, ironically, that's not that that's not meditative. No. That's stressful. Mhm. So, the exercise you may do, but if it's stressful exercise, Yeah. that's not if it's stress, whereas actually, one of the things that very few people talk about is the meditative virtue of exercise, meaning zoning out Mhm. and it being a form of meditation. And I think maybe that that's where the real benefit of exercise is. Yeah. Yeah, it allows you to meditate when you're doing it. — When you go into the flow. Yeah. Yes, so meditation is good in yoga um these days. Um I've been working with a yoga teacher and she does a lot of breath work um in her yoga. But she says if she goes to other practitioners, she finds they breathe too fast um cuz they followed the sort of trend. Yes. Of fast faster breathing. And I think in the beginning, yoga was being just to be a breath work practice. Um it's then it become much more physical as um the West has interpreted it. Um So, there are those places that you can go to. Um This is wonderful. This is um so interesting again. Yeah. And [snorts] yeah, I would very much love to take you up on your offer of uh of running a session for breathing. Yeah. And um ### Segment 10 (45:00 - 48:00) [45:00] I'll put it out after we put this video out. Okay. And uh I think it'd be amazing. I think it's just a very gentle, kind way. Yeah. Yeah, I think it's a gentle, kind way and um it would also give me an opportunity to show everybody how I use the stress flow chart and to put um which Patrick McKeown adopted for his advanced training, which just shows how stress gets into the body and how you get it out through breathing. And then how it all links together and how all people's symptoms just make sense when you see it on that A4 piece of paper. So, uh um yes, he said it's You've put this You've put my book in pictorial form. So, uh Wonderful. I can't wait. I'm so excited. And you know, I have uh and there is a huge number of patients with unexplained medical conditions which you can when you look in, it's often due to a dysfunction of the autonomic system. So, long COVID, POTS, inappropriate sinus tachycardia, many of these things are due to an imbalance of the autonomic nervous system. And I guess what you're talking about is rebalance readdressing that balance. Yeah. So, I think there would be a very interesting You will find a very interested audience in the dysautonomia population of patients. — Yeah. Um I mean, the POTS side, I think 90% of people with POTS have disregulated breathing. Yeah. Yeah, absolutely. And um yeah. I mean, I I've probably had something a bit like POTS most of my life cuz I've always hated standing up on long trains. Yeah. I just sit down and often use lying down to get me back together again. Um so, I do understand what it feels like for people a bit. I don't get the tachycardia particularly. Yeah. Um And actually, that is lots better Is it? Yeah. Wow. when I'm doing the breathing. There was a paper um published by Charles Riley or Dr. Riley, who's a respiratory doctor in King's. And they studied the breathing patterns of dysautonomic patients and they basically say that when you're breathing in and out, there's a little gap, you know, you breathe in and there's a little gap and you breathe out gap, etc. And when they've looked at the breathing patterns in dysautonomic patients, they say they lose that gap. Oh, that's interesting. Yeah. So, they're Okay. boom boom right, and which is again So, it's fascinating, really, but yeah, uh I am so grateful and uh I can't thank you enough Yeah. for um for adding this little I look forward to doing that. Um yeah. Wonderful. So, I will uh share our video cuz I'm sure that um a lot of people will again be very interested in everything you have to say. Mhm. And then, whenever is convenient for you, please let me know so that I can uh put it out and uh that would be just such a lovely thing to do and I Great. Yes. Yeah. — So glad that we met. — Excellent. Yeah. Thank you.