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How it feels to experience three different causes of respiratory failure
  1. Clare M Galtrey1,
  2. Michael Faulkner2,
  3. Damian R Wren1
  1. 1Department of Neurology, St George's Hospital, London, UK
  2. 2Retired Research Scientist for Ministry of Defence, London, UK
  1. Correspondence to Clare M Galtrey, Department of Neurology, Atkinson Morley Wing, St George's Hospital, Blackshaw Road, London SW17 0QT, UK; clare.galtrey{at}gmail.com

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Introduction

This is the experience of Mr Faulkner (figure 1A,B) who worked as a research scientist at the Ministry of Defence, UK, and experienced three quite different causes of respiratory failure over the course of his lifetime: (a) altitude hypoxia, (b) myasthenia gravis and (c) pulmonary embolism (PE). The narratives of his subjective experiences are interspersed with what is known about the pathophysiology of respiratory failure and the sensation of breathlessness. Mr Faulkner's experiences draw several parallels with the career of the late Professor John Newsom-Davis (figure 1C) and the depth of knowledge of both the physiology of breathing and myasthenia gravis.1

Figure 1

Aviation and hypoxia training. (A, B) Mr Michael Faulkner (A) 2 months after diagnosis of myasthenia gravis and at the start of treatment on the Royal Research ship James Clark Ross. (B) After thymectomy and successful treatment. (C) Professor John Newsom-Davis (image reproduced from BMJ image library). (D) Gloster Meteors, 77 Squadron RAAF, Korea, c.1951 (photograph: AP/PA) . (E, F). Standard chamber flight profiles used for hypoxia familiarisation training (adapted from Smart and Cable, 2004).4 (E) Standard hypoxia training flight. Ascent at 4000 fpm to 8000 feet, then rapid decompression to 25 000 feet. Two student groups, maximum 3-minute hypoxia experience each; 10 000 fpm descent to 10 000 feet then 4000 fpm descent to ground. (F) High-altitude flight for fast jet crews. Ascent at 4000 fpm to 25 000 feet. Rapid decompression to 45 000 feet. Pressure breathing experience for approximately 40 s. Descent at 10 000 fpm, then 4000 fpm to ground.

Decompression chamber training at Royal Aircraft Establishment Facility

‘All research scientists in military aviation at the Aeroplane and …

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