20/20 Breathing in 2020

20/20 is often associated with vision. But what if your breathing can be 20/20, too? Dive into the new episode of ADVENTing to learn about 20/20 breathing.
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Published on
January 3, 2020
Updated on
November 24, 2020

Like 20/20 vision, 20/20 breathing is considered to be the optimal level of breathing. On this week's episode of ADVENTing, Dr. Madan Kandula and Dr. Ethan Handler speak in-depth on what it takes to get control of your compromised nasal passages and on your way to 20/20 breathing.

Dr. Kandula: Okay, all right, I got a ground-breaking new thought process, a new construct for people to work off of.

Dr. Handler: Okay.

Dr. Kandula: So, when I say 2020, what do you think of?

Dr. Handler: Vision, typically.

Dr. Kandula: Correct, vision. Vision, which is good, 20/20, I guess theoretically you can have better than 20/20 vision, but typically 20/20 vision is like, man, 20/20 you can see, everything's clear, wonderful. If you have less than that, then you put glasses on, you go to the eye doctor and they'll do their test. And you were in a blurry world and all of a sudden you can see clearly.

Dr. Handler: Right.

Dr. Kandula: Now, 20/20 breathing is a different concept which is basically, a lot of the folks that we treat and help don't know the blurred-up, messed-up breathing life they've been living until we get them better. And so, it's really the concept of, really trying to set the bar out there that you should be breathing clearly. Everybody, I think, aspires to have good vision, because it's important to have good vision. To see, to read, to do all the things that you want to do in life. It's just as important to have proper breathing. And yet, nobody ever thinks about it, it's sort of out of sight, out of mind. I would even venture the fact that a lot of folks who go and seek help, go to the doctor, try and get their breathing better, are dismissed. Versus somebody who, back to the analogy, if somebody, the world is blurry to them and you went into any doctor or P.A., M.P., and say, "Man, I can't see, everything's blurry." What are they going to say? "Go to the eye doctor, get your vision checked out and "see clearly."

Dr. Handler: 100%

Dr. Kandula: On the flip side, let's say you go into your doc and say "Man, I can't breathe properly through my nose." What they're gonna do is they're gonna say, "Hey, try this thing" that they know isn't gonna work, "and get out of my office because you're kind of annoying me." kind of a thing. It's the truth.

Dr. Handler: It's true. It's unfortunate but it's true.

Dr. Kandula: It's unfortunate. To me, it's really like, I think we need a construct that people can identify with, and I'd say well, 20/20. In a way, and as we're thinking through this, it's sort of like, you could say well, 20/20 could be from another standpoint, 20 on the right side, 20 on the left side from a breathing standpoint is optimal. And anything less than that is sub-optimal. And there are issues that can happen on the inside of the nose that can compromise somebody's breathing, but our goal is to get somebody as close to that optimal 20/20 breathing as we can. So, what do you think about that concept?

Dr. Handler: I like it. I like it a lot.

Dr. Kandula: Yeah?

Dr. Handler: Yeah, I mean it makes sense and I think that, and it's always that, what is perfect breathing? Which is an interesting question to ask anyway 'cause most people, again, they know their own baseline. A lot of people, some people are aware that their breathing's not very good, others are less aware. And it's just, they believe that it's just the way that they are. So, it's communicating what does that mean for patients.

Dr. Kandula: Right.

Dr. Handler: And then also understanding that there can always be little ebbs and flows around whatever that near-perfect baseline is.

Dr. Kandula: Sure, absolutely.

Dr. Handler: We want to get it as optimal as we can as much as we can.

Dr. Kandula: Yeah, and it depends, I think there are times where it's a calculation on, to me, I guess what I would say, what is 20/20 breathing mean to me personally, as a nose doc. To me, 20/20 is really, both sides equally divided. To divide the nose, there's the septum divides your nose into two. And so, if somebody's septum is reasonably in the middle? Okay, we're starting off at a good point, and there's enough breathing capacity down both sides of the nose where the passageways are open where you can keep your mouth shut and you can breathe and you're pulling roughly equal air through both sides of the nose. That's as good as you get. Basically, you're taking your nose and you're making equivalent to dropping your mouth open kind of a concept.

Dr. Handler: Right.

Dr. Kandula: I think, which is ideal, that's great, and then anything less than that you start going down the list. You get a deviated septum, you start knocking yourself down. You get enlarged turbinates, which means the passageways of the nose are too narrow, knock it down. Sinuses are plugged up, knock it down. And a lot of folks are knocking it down. They're living lives where it's constantly knocked down. Including other issues, like allergy issues would certainly knock you down from 20/20. For us as a mindset, it's really trying to get somebody optimal by whatever means necessary. Again, though, the power in that is, because it's stuff that unfortunately gets diminished, dismissed, swept under the rug. A lot of folks are just sort of going through life not knowing what it's supposed to be like. How many times do we see people on the back-end, tends to be procedures, on the back end of a procedure where it's, how would I describe it? It's almost like you can feel like the chains are off of this person. They're happy and happier in a way that I didn't really understand that noses could make somebody if that makes sense.

Dr. Handler: Yeah, absolutely.

Dr. Kandula: Which is cool, and I think you see that one time and it's like, "That's great!" And you see that all the time pretty well. Most of the time, most of our patients have those sort of dramatic changes, which is wonderful. Basically, from my vantage point, makes me wanna get the word out on, "Hey, you don't have to live that compromised life. You can live. Again, to me. Life happens to you sometimes and meaning that for everything that your body, everything in your life, trying to get it as optimal as you can is great. Some things are out of your control. There are things in life that you're dealing with that you just can't get at that optimal level. This isn't one of them. Typically.

Dr. Kandula: No, right. It's a rare instance where we can't fix somebody's nose that is sub-optimal, that's less than 20/20, and get it up to where it needs to be. So, this is sort of a burden or barrier on somebody that is correctable.

Dr. Handler: So, if that's 20/20, 20/20 breathing is both sides of the nose working well. So, then what would 20/20 sleeping be? Would it be getting nose working, 20, throat open, 20?

Dr. Kandula: Yeah, although I'd say it starts with that first thing. Starts with, you cannot, from a sleep standpoint you can't have 20/20 sleep without 20/20 breathing. Back to that start of the airway. To sleep properly you've got to be able to breathe properly and the only way to breathe properly is through your nose. Mouth shut, nose open.

Dr. Handler: Right.

Dr. Kandula: And so, by definition, you can't be there unless that, the nose needs to be optimal and optimized. Which again, I mean the nice thing nowadays is we're talking, it's just weird, massively impactful situations for a lot of folks that we can resolve and help with minimally invasive procedures.

Dr. Handler: Right.

Dr. Kandula: It's that weirdly sort of, it's just almost unfair that people, to me it is unfair that somebody's walking around the world with tools that are hindered and hampered, where the fix is simple.

Dr. Handler: Yeah.

Dr. Kandula: Kind of a thing. And it's just a matter of I think--

Dr. Handler: Getting the word out.

Dr. Kandula: Getting the word out and also part of the attitude that I have, and I think that we tend to have is a little bit of, how do you say this? I think a lot of people settle and my attitude for folks is, if that's what you want to do, settle, but if you're settling because there's something you didn't feel like there was anything you could do about in this particular area that we could do a ton for, that's not like, It's almost like, being somebody's champion is what we need to be because a lot of times people are their worst own champions. They tend to kind of just accept, what shouldn't be versus aspiring for what should be.

Dr. Handler: And so 20/20 breathing is a good concept that could get them there.

Dr. Kandula: I think so. I think so, I mean, we'll see. I think that it's a helpful concept. Now, it also just so happens to be the year ahead of us, so we'll see if that kind of plays into some of that,

Dr. Handler: Sure.

Dr. Kandula: Some of the talk or the thought there. It doesn't hurt. And I think for us simple old and younger nose doctors having a bar to work towards is good. It's helpful. Don't let the eye doctors have all the...they've got a nice standard that everybody knows about. From a nose standpoint, nobody really knows anything about anything. It's sort of this tucked-away hidden area that there's just a lot of dark. And I think we can be sort of some light shining on that. Anyway, 20/20 breathing. We'll hit that topic or get some more meat around that topic as we move forward, so hopefully, you guys have it, and if you don't have it, we want to get you there.

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First published by ADVENT on
January 3, 2020
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20/20 Breathing in 2020