Chris Supalla, tossing and turning with a stuffy nose, was advised by several doctors that simple nasal surgery could help him get some rest, but then he lost more than just sleep.
“He was out of breath,” his mother, Mary Supalla, told the Post of her son’s waking nightmare. “I felt like I had a plastic bag over my head.”
Chris, 32, committed suicide three months later.
“I am very sorry to have to leave this way, but the suffering is too great,” Chris wrote in his suicide note. “My nose feels so empty that I don’t feel anything at all. I love you forever . . . Please send the lifeguards to recover me from the woods in the back. “You don’t need to see what happened.”
The Portland, Oregon, native’s 2021 death certificate says “asphyxiation due to ligature hanging,” and empty nose syndrome is a “significant” contributing condition.
Nearly 30 years after it was first identified, ENS is finally gaining greater recognition. The first medical textbook on this terrifying disease was published this year by distinguished physician Dr. Eugene Kern, professor of otolaryngology at the University at Buffalo.
In the early 1990s, while working at the Mayo Clinic, Kern became alarmed after two postoperative patients elsewhere told him they were choking with every breath. Later they both committed suicide.
Other patients compare that disgusting sensation to being drowned, suffocated or waterboarded. “These patients have nasal problems,” said Kern, 86. They can barely sleep and wake up with a start when the body feels like it is not breathing, even though it is. Breathing through the mouth doesn’t help.
Supalla wrote this heartbreaking farewell note to his family before ending his own life amid his fight against what his family believes was empty nose syndrome. “These patients have nasal problems,” Dr. Eugene Kern told The Post. Mary and Brian Supalla Supalla’s death certificate refers to “asphyxiation due to ligature hanging,” and empty nose syndrome is a major contributing condition. Maria and Brian Supalla
Kern wants his book to “shed light on an area where people have suffered enormously,” he said. “I saw the suffering.”
ENS is a complication of any nasal surgery that affects the turbinates, cylindrical structures in the nose that regulate incoming air. Turbinate reduction is sometimes an adjunct to septoplasty for a deviated septum or even a regular nose job.
“I had no idea what a turbinate was,” said David Troutman of Indiana, who had surgery six years ago for sleep apnea. “I trusted my doctor.”
CT scans show the inside of a normal nose and an “empty” nose with turbinates surgically removed. ENS is a complication of any nasal surgery that affects the turbinates, cylindrical structures in the nose that regulate incoming air. Turbinate reduction is sometimes a complement to septoplasty for a deviated septum or nose surgery. Eugene Kern/Mayo Foundation for Medical Education and Research
After his surgery, Troutman was exhausted, unfocused, and pacing incessantly, so listless and restless that his boss took him to the emergency room. “I was a shell of myself,” he said. “My personality was just gone.”
Troutman, 54, now moderates an Empty Nose Facebook group, full of “hard-to-read stories,” he said. “I foresee that I have a lifelong struggle ahead of me. “There was no relief or respite.”
The group, with about 3,700 members, has recorded 14 suicides in the past six years, some of which are memorialized on the Nasal Cripple website, according to a media collection.
Chris poses with his family (sisters Kara and Laura, mom Mary, and dad Brian) at Laura’s wedding in 2016. “Chris will forever be remembered for his wonderful, fun life,” his family wrote in his 2021 obituary. “We are proud of his many achievements, saddened by his loss and will love him forever. May he rest in peace.” Mary and Brian Supalla
The agonizing condition remains a mystery. The incidence is unknown and it is not clear who is susceptible. Some people feel fine when their turbinate tissue is removed; others face a life of torture.
A handful of doctors in the U.S. will try a treatment, which includes a variety of methods to hydrate the nose or alter airflow.
“If you remove a turbinate, you can have post-traumatic neurogenic-type pain, which is horrible,” Kern told the Post. “Some people have enough compensatory functional capacity that will help them live symptom-free for two, five, or even ten years. There is no test to determine nasal function.”
Chris Supalla, who worked in accounting, consulted with three doctors before the surgery, his mother said. He had septoplasty and microablation, and doctors said they removed just 1 millimeter of tissue from his turbinates. “Chris asked about ENS and was concerned,” he said. “The doctors were familiar with ENS but said, ‘I haven’t seen it.’ “They calmed him down.”
After Chris Supalla’s death two and a half years ago, his parents requested that Oregon Health & Science University hospital warn patients about the risk of ENS. Mary and Brian Supalla
Chris Supalla documented his rapid decline as he struggled to adapt to breathing difficulties after nasal surgery in a series of heartbreaking text messages with his mother Mary. Maria and Brian Supalla
Maria and Brian Supalla
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Maria and Brian Supalla
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After his death two and a half years ago, his parents requested that the hospital, Oregon Health & Science University, warn patients about the risk of ENS.
“The complications are so horrible and life-altering that the patient deserves to know about them,” Mary Supalla said. “Chris couldn’t breathe, he couldn’t sleep, he couldn’t do anything. He was more afraid of being alive than of dying.”
OHSU’s patient advocate wrote to the Supallas that the institution would educate doctors, medical students and staff. “While we cannot clinically substantiate the diagnosis of empty nose syndrome, we want to assure you that we believe in the experience you were describing.”
However, several months later, after the Supallas again asked that patients be warned, the patient advocate wrote: “As stated in previous communications, we did not find that your son had ENS. We are again very saddened by the loss of him and will not communicate further on this matter.”
In a statement, OHSU (authorized by the Supallas to correspond about their son) wrote to The Post: “We express our deepest condolences to the Supalla family… Before the operation, Mr. Supalla specifically asked about the empty nose and its clinical status. “The team discussed the condition as part of the informed consent process.”
After surgery, “your healthcare team at OHSU was unable to clinically corroborate a diagnosis of ENS” and “OHSU physicians discuss ENS as part of the informed consent process whenever it is relevant to the surgical procedure and/or procedures.” patient questions. . . At the family’s request, we have used what they have shared with us to teach and learn through our academic processes for continuous improvement.”
If you are having suicidal thoughts, you can call the 24/7 National Suicide Prevention Hotline at 988 or visit Suicide PreventionLifeline.org.
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Source: vtt.edu.vn