October 29, 2025 • 17 mins
***@ 14:42 my podcast software thinks "voo-ing is a "removable background noise" so this episode may be best experienced on YouTube
Have you ever searched for wellness resources that truly understand what it means to be a Certified Anesthesiologist Assistant? You're not alone. Wellness Wednesday are candid conversations about the unique challenges and opportunities facing CAAs in their pursuit of sustainable wellbeing.
In this episode I relate how OR life can jack your nervous system into overdrive... constant alarms, literal hammering, a sudden “patient’s moving", and yet our role as a Certified Anesthesiologist Assistant demands we have steady hands and a clear head. I unpack three discreet, science-backed techniques you can use behind the drape to quiet the buzz without calling attention to yourself. Think long, quiet exhales that nudge your vagus nerve, a quick dose of tension-then-release to steady your hands, and a soft “voo” on the breath that taps the laryngeal branches of the vagus for an extra parasympathetic boost.
Whether you're a practicing CAA, AA student, or prospective applicant, this episode marks the beginning of a community-centered approach to wellness that finally names and validates your experience. Welcome in.
FYI "To "regulate" means to monitor and adjust one’s internal state—such as emotions, thoughts, or physiological responses—in order to maintain balance and support adaptive behavior." so says ChatGpt
Attention AA Program Leaders and Educators. Learn More about bringing CAA Matters to your AA program HERE
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
This Wellness Wednesday is brought to you by
CAA Matters, the firstcomprehensive wellness and
professionalism curriculumdesigned to truly support the AA
student experience.
We all know AA education isstreamlined to produce competent
providers in a fast-pacedprogram.
Meanwhile, wellness andprofessionalism often get
(00:22):
overlooked, lumped in withmedical students, or addressed
too late to help.
CAA Matters fills this gap,centering student
anesthesiologist assistance andequipping them with the tools,
resources, and mindset shifts tosucceed in school and build
long, fulfilling careers.
(00:42):
It's a turnkey curriculum, fullyprepared, facilitated, and
supported from planning todelivery.
Program leaders and AA educatorscan learn more, read reviews
from early adopters, and explorepiloting CAA Matters at
awakenedanesthetist.com or byclicking the link in the show
notes.
(01:03):
It's hot.
I just went for a walk and satback down, and now I'm sweaty.
Let me cool myself here.
I realize I'm talking to no onebecause I'm just here by myself.
Okay.
Here we go.
(01:29):
Welcome to Wellness Wednesday,CAA community.
I am so grateful to be here.
So this episode, I'll be sharingthree methods to regulate
yourself in the operating roomundetected.
So I'm sitting in a chair.
It's my podcast chair, butimagine it's a roly black chair
that we have from the operatingroom.
Um, and you know, there's adrape in front of me.
(01:52):
I'm in a mask and a hat andscrubs, and maybe they're
completely by myself.
Maybe there's a student sittingnext to me, or my attendings
coming in and out.
These are all techniques that Ihave done in that environment.
So truly in the operating room,as well as between cases, maybe
as I'm walking to pre-op, as I'mwalking into the operating room
(02:14):
for the first time.
Like, so these are so, soapplicable to the CAA experience
or the student experience or thepre-AA shadowing experience that
I wanted to share.
So we're gonna run through allthree of them quite quickly.
I'll probably demo a little bit,but this is more of an
information sharing, and I hopeyou get a lot out of it.
(02:34):
So the first technique toregulate undetected in the OR,
and it's where I started, wassimply deep breathing.
So if you've been to any levelof a yoga class or a, you know,
mindful moment in some likecommunity setting, like maybe
before your church, or umsometimes in operating rooms,
they've started to incorporatethis, which I'm all for, is just
(02:56):
like a slow down, mindfulmoment.
Almost always, what's cute is toslow down your breathing and
take a big deep breath.
And while love it, awesome, it'swhat I'm teaching you here.
It didn't resonate with me untilI really understood what that is
doing, like what is thephysiology behind that?
I needed that level ofevidence-based buy-in in order
(03:20):
to, I don't know, release alittle bit of shame or like
that, like woo-woo, that's notfor me.
Like seeing myself as someonewho would regulate in the
operating room has been ajourney.
I did not just come into thislevel of like acceptance and
okayness, kind of talking aboutsome of these softer parts of
(03:40):
me.
Deep breathing is a criticalimportant skill to regulate
because it's always available toyou.
So if you're breathing, you'realive.
So I know that if I tell you totake a big deep breath, that it
is likely possible.
Um, you know, of course, if youhave asthma or there's some sort
of like trauma that you havewith deep breathing, which I
(04:01):
know sometimes people have, um,then this technique's not for
you.
But a deep breath activates yourvagus nerve.
And it does that by um the wayour diaphragm pulls down and
releases during breathing.
So when you are deeply exhaling,our diaphragm is actually
pushing up, and that changes ourcardiac output, changes the
(04:24):
amount of blood going to theheart.
And we know from physiology thenthat that triggers our vagus
nerve to be stimulated and tellthe heart to slow down.
And that heart rate drop, again,is one of the um symptoms of a
parasympathetic, an activeparasympathetic system.
It's just a sign that your vagusnerve has been triggered, that
(04:45):
your parasympathetic system hasbeen triggered.
And so deep consecutive breathscan just trigger the
parasympathetic system over yoursympathetic system.
So that system starts to quiet,your parasympathetic system
starts to upregulate, and youare actively managing that by
doing some deep breathing.
So you very likely have heard oflike box breathing or maybe
(05:08):
four, seven, eight breathing,which is a four-second inhale, a
seven-second hold, and aneight-second exhale.
And I love structure, and thoseare important and also great
tools, but the bigger picture isjust a deep exhale.
Generally, longer than yourinhale is a good measure to know
if it was deep enough.
(05:29):
So a nice big inhale, but alonger, deeper exhale is going
to activate that umparasympathetic trigger, that
vagus nerve trigger from thechanges in your cardiac output,
which is caused by the changesin your diaphragmatic movement.
So it can look like this (05:44):
an inhale and a deep exhale.
Notice you don't have to makenoise, you don't have to like
anything.
Of course, you can, butsometimes when you have a
student sitting right next toyou or your attending's like
(06:04):
rounding the corner, coming backbehind the drape, you maybe want
to regulate yourself, but youdon't want everyone to know.
And so you can just keep itquiet.
You have a mask on, of course,which is a nice little um safety
as well.
So a nice big inhale.
Our diaphragm pulls down, and adeep exhale.
(06:25):
Our diaphragm pushes up, changesour cardiac output, triggers
that vagus nerve, drops ourheart rate, and all these little
pieces I hope are falling intoplace about how to regulate your
system or how to control yourparasympathetic system, but it's
absolutely just about activatingyour vagus nerve.
Okay, so the number one way toregulate in the operating room
(06:45):
undetected is deep breathing, adeep exhale.
Number two way that I love wasuh a shout out actually to Mr.
Dave Zagorski, who is a CAA fromCase Cleveland.
I recently ran into him at theQuad A, I think it was this
year, 2025, and was able to tellhim that I've remembered this
tip since he told me when I wasin school in 2006, on through
(07:07):
now.
And I've been telling AAstudents about it.
And it was sort of during my ownjourney of um understanding what
I needed to like get out of thelike buzzy, stressful high of
fight or flight that I'd been infor decades, that I kind of came
back to this technique and waslike, huh, that worked.
Why does that work?
So, what Mr.
Dave Zagorski told me years andyears ago is that before
(07:30):
starting an IV, so he was kindof helping us learn how to
control nerves before an IV, youshould duck behind some like
private corner and make fistswith your hands, bulb them up,
hold them as tight as you cantill it gets uncomfortable, and
then let them go.
And it allows your hands to notbe super shaky.
And it worked.
And I did it all the time.
And then I started teachingother AA students how to start
(07:53):
IVs, and so I passed along thislittle tip.
And then as I got into, again,my own journey into mindfulness
and self-regulation and all ofthe process that I've been in, I
was presented with somethingcalled paired or progressive
muscle relaxation.
You'll hear it termed both ways.
And I remembered that DaveZagorski told me about this
(08:14):
years and years ago.
So progressive muscle relaxationis just the progression of
tightening your muscles manuallyand then purposefully releasing
them.
And you generally kind of do itover a wave of your body.
So you start, you know, head ortoe, either way, and you kind of
do it with your feet, your legs,your abdomen, your shoulders,
(08:35):
your jaw, your forehead.
And, you know, there's a wholemethod, and like you can get
really into the weeds.
But Dave was right that justdoing this is enough.
And so oftentimes, for years andyears, in fact, I have found a
little hidey hole corner.
Maybe, you know, in pre-op, ifI'm about to start an A-line on
an awake patient and I feel likenerves in my body.
(08:57):
Um, I currently work PRN, and sothere are times when I don't
feel 100% comfortable.
I've not done something likelet's say a spinal for six
months and I'm about to do one,and I'll find myself feeling
that upregulated, that buzzy,like nervous, anxious,
sympathetic system response.
And I will just quick do um likea tight muscle grip on my hands.
(09:20):
What has also developed is thatI've noticed I carry a ton of
tension and stress in myforehead.
So if I can manage itundetected, maybe I'll turn
around and like face like I'mdrawing up drugs or something,
facing away from people if ifanyone's in there.
And I will tighten my forehead,tighten my jaw, and then do a
purposeful release of both myforehead, my eyebrows, and my
(09:42):
jaw.
And it just tells my body, likewhen you're doing this, your
sympathetic system turns on andyou're like, oh God, this is you
can almost even feel sort oflike tingly sometimes if you've
ever felt that.
It's like almost uncomfortablewhen you're like um making a
muscle or like cringing yourface.
And then you're overriding thatsensation with a purposeful
(10:02):
release.
There's that paired musclerelaxation part of it.
And that tells your body, oh,and your brain, oh, we must be
out of that, like need to keepour muscles on tight.
We are out of that sympatheticresponse.
And you're kind of againmanually overriding into your
parasympathetic response bymanually releasing and relaxing
(10:23):
and telling your brain and mindI'm safe, it's okay to relax.
I can have the and both.
I can be kind of having a stressresponse that helps me kind of
keep my brain and mind sharp inorder to be able to put in this
IV or put in this A-line orspinal, but I also can um have
the and both of being regulatedwhile I'm doing this task.
(10:44):
So paired muscle relaxation inthe operating room can look just
like this.
Just your fists.
I, you know, often I'm holdingthem up because I want you guys
to see, but oftentimes, likesometimes I'll even just do this
and like do my fists this way soreally no one can see, or down
by my sides, or I'll find alittle cubby hidey hole and
pre-op to do it.
Um, and I hold it usually untilit's uncomfortable, like kind of
(11:07):
you get like itchy and you wantto release it.
I'll keep it for another one ortwo seconds after that, and then
a big release, sometimes ashakeout.
And I'll do it two, three, fourtimes until I can really feel my
body responding.
Um, and if I'm doing my foreheador jaw especially feels good,
and I have a mask on, I'll justtighten my jaw or like squint my
(11:29):
eyebrows, you know, hold it fora few seconds and then release
it, kind of soften my eyebrows,part my back molar, so like
separate my back teeth.
And then something that feelssuper damn good is take your
tongue off the roof of yourmouth.
So like drop your tongue insideyour mouth.
I, you know, you can have yourmouth open, you have your mask
(11:50):
on, but generally I keep mymouth shut and just kind of like
let my tongue fall, and you justfeel this release of tension.
And I'll do it again if I wantto, or if it feels good.
Again, this is all for me, allfor you.
And um, it just feels good tohave something to go to when you
are in those high stress momentsor after those high stress
(12:11):
moments, and you want to bringyourself back down.
Okay, so deep breathing.
We've heard a deep exhale,paired or progressive muscle
relaxation.
And the third one is somethingI've been teaching to CAA
Matters students and to pre-AAmatters students, and it's
called vooing.
I've just started calling itthat.
It was introduced to me umthrough actually a
(12:33):
neuroscience-mindedmanifestation company called To
Be Magnetic that I've been doingfor years and years.
Um, very much about parentingand reparenting your inner child
and like um making tacticalapproaches to your dream life.
If you at all um have heard metalk about process episodes or
(12:54):
expanders or taking alignedaction, like those are all
things that they talk about inTubo Magnetic.
But, anyways, they teach thisbreathing that involves
vocalization.
So, this is very much if you'veever um, you know, like been
nervous and like startedhumming, or if you are hurting,
(13:14):
um, I know I did this when I washaving my kids, like during
childbirth, I was like, uh, orlike you're sick or you don't
feel good.
Oftentimes you find yourselfreflexively kind of um making
some of these vocalizations.
And it is because our bodies aretrying to calm us down, are
trying to regulate and sootheus.
(13:36):
Uh news flash, your vagus nerveinnervates your larynx.
So surprise to know CAA or SAAwho is learning this anatomy,
but the vagus nerve innervatesyour larynx.
In particular, there are twobranches of your vagus nerve
that go directly to your larynx,your superior laryngeal nerve
(13:56):
and your recurrent laryngealnerve.
And those control your voice,your vocal cords.
And so when you phonate, whenyou make noise, it's activating
those nerves.
Of course, they're branches ofthe vagus nerve.
Vagus nerve controls ourparasympathetic system, and lo
and behold, you are regulatingyourself.
(14:16):
You are pulling down yoursympathetic system, you're
turning up your parasympatheticsystem.
That's what regulation is.
And so what I love to teach inCAA Matters and Pre-AA matters
is a combined deep exhale with avo.
So it looks like an inhale, justlike we were practicing before.
Nice big inhale.
(14:38):
And then a longer, deeper exhalewhere you're phonating the sound
voo.
So I take the voo as long as Ican, as long as I can exhale,
and I just can feel my bodyregulating, especially when I'm
(15:02):
not doing it on camera and notdoing it to like show people,
but I'm truly doing it toregulate myself.
I do this all the dang time.
I do this walking into theoperating room, walking into the
hospital.
I do this during ortho cases,like with all the hammering and
noise.
You can be vooing there behindthe drape and no one knows
what's going on.
Um, of course, maybe I'm notchoosing this as my go-to if
(15:24):
there's a bunch of like peoplein the room or if it's really
quiet, but you can do it kind ofquietly as well.
Like, I now have no shame.
I know this makes me feel good.
I know this helps me get out offight or flight to regulate
after some big event in theoperating room, or maybe the
patient's moving.
Like, you know, when the surgeonleans over or is like, hey,
patient's moving, and you getthat like like surge of like
(15:47):
fight or flight, sympatheticresponse, and you do whatever
needs to get done, and then yousit back down, but you're like
buzzy.
I will do this deep breathingwith a voo or one of the other
methods to help myself regulate.
Okay, I'm gonna put some linksin the show notes, some graphics
that will hopefully help you.
Um, but yeah, three ways toregulate in the operating room
(16:09):
totally undetected.
Deep breathing with a deepexhale, paired muscle
relaxation, and voo breathing.
So I hope this helps, and I willsee you next wellness Wednesday,
everyone.
Bye.
Thanks for listening to AwakenedAnesthetist.
If this episode resonated withyou, share it with a CAA friend,
(16:29):
an AA student in your life, or aperspective, and let them know
why you loved it.
It's the most important thingyou can do to support this
podcast and its mission.
You can always find more ways toconnect with me and this CAA
community atawakenedanesthetist.com,
including an invitation to joinseason five Mindful Connections.
(16:52):
These are free virtualgatherings open to anyone in our
Awakened Anesthetist community.
And while you're scrolling thewebsite, check out my trusted
CAA partners who make thispodcast possible with a special
thank you to my season fivesponsor, Harmony Anesthesia
Staffing.
Talk soon.
This Wellness Wednesday is brought to you by
CAA Matters, the firstcomprehensive wellness and
professionalism curriculumdesigned to truly support the AA
student experience.
We all know AA education isstreamlined to produce competent
providers in a fast-pacedprogram.
Meanwhile, wellness andprofessionalism often get
(00:22):
overlooked, lumped in withmedical students, or addressed
too late to help.
CAA Matters fills this gap,centering student
anesthesiologist assistance andequipping them with the tools,
resources, and mindset shifts tosucceed in school and build
long, fulfilling careers.
(00:42):
It's a turnkey curriculum, fullyprepared, facilitated, and
supported from planning todelivery.
Program leaders and AA educatorscan learn more, read reviews
from early adopters, and explorepiloting CAA Matters at
awakenedanesthetist.com or byclicking the link in the show
notes.
(01:03):
It's hot.
I just went for a walk and satback down, and now I'm sweaty.
Let me cool myself here.
I realize I'm talking to no onebecause I'm just here by myself.
Okay.
Here we go.
(01:29):
Welcome to Wellness Wednesday,CAA community.
I am so grateful to be here.
So this episode, I'll be sharingthree methods to regulate
yourself in the operating roomundetected.
So I'm sitting in a chair.
It's my podcast chair, butimagine it's a roly black chair
that we have from the operatingroom.
Um, and you know, there's adrape in front of me.
(01:52):
I'm in a mask and a hat andscrubs, and maybe they're
completely by myself.
Maybe there's a student sittingnext to me, or my attendings
coming in and out.
These are all techniques that Ihave done in that environment.
So truly in the operating room,as well as between cases, maybe
as I'm walking to pre-op, as I'mwalking into the operating room
(02:14):
for the first time.
Like, so these are so, soapplicable to the CAA experience
or the student experience or thepre-AA shadowing experience that
I wanted to share.
So we're gonna run through allthree of them quite quickly.
I'll probably demo a little bit,but this is more of an
information sharing, and I hopeyou get a lot out of it.
(02:34):
So the first technique toregulate undetected in the OR,
and it's where I started, wassimply deep breathing.
So if you've been to any levelof a yoga class or a, you know,
mindful moment in some likecommunity setting, like maybe
before your church, or umsometimes in operating rooms,
they've started to incorporatethis, which I'm all for, is just
(02:56):
like a slow down, mindfulmoment.
Almost always, what's cute is toslow down your breathing and
take a big deep breath.
And while love it, awesome, it'swhat I'm teaching you here.
It didn't resonate with me untilI really understood what that is
doing, like what is thephysiology behind that?
I needed that level ofevidence-based buy-in in order
(03:20):
to, I don't know, release alittle bit of shame or like
that, like woo-woo, that's notfor me.
Like seeing myself as someonewho would regulate in the
operating room has been ajourney.
I did not just come into thislevel of like acceptance and
okayness, kind of talking aboutsome of these softer parts of
(03:40):
me.
Deep breathing is a criticalimportant skill to regulate
because it's always available toyou.
So if you're breathing, you'realive.
So I know that if I tell you totake a big deep breath, that it
is likely possible.
Um, you know, of course, if youhave asthma or there's some sort
of like trauma that you havewith deep breathing, which I
(04:01):
know sometimes people have, um,then this technique's not for
you.
But a deep breath activates yourvagus nerve.
And it does that by um the wayour diaphragm pulls down and
releases during breathing.
So when you are deeply exhaling,our diaphragm is actually
pushing up, and that changes ourcardiac output, changes the
(04:24):
amount of blood going to theheart.
And we know from physiology thenthat that triggers our vagus
nerve to be stimulated and tellthe heart to slow down.
And that heart rate drop, again,is one of the um symptoms of a
parasympathetic, an activeparasympathetic system.
It's just a sign that your vagusnerve has been triggered, that
(04:45):
your parasympathetic system hasbeen triggered.
And so deep consecutive breathscan just trigger the
parasympathetic system over yoursympathetic system.
So that system starts to quiet,your parasympathetic system
starts to upregulate, and youare actively managing that by
doing some deep breathing.
So you very likely have heard oflike box breathing or maybe
(05:08):
four, seven, eight breathing,which is a four-second inhale, a
seven-second hold, and aneight-second exhale.
And I love structure, and thoseare important and also great
tools, but the bigger picture isjust a deep exhale.
Generally, longer than yourinhale is a good measure to know
if it was deep enough.
(05:29):
So a nice big inhale, but alonger, deeper exhale is going
to activate that umparasympathetic trigger, that
vagus nerve trigger from thechanges in your cardiac output,
which is caused by the changesin your diaphragmatic movement.
So it can look like this (05:44):
an inhale and a deep exhale.
Notice you don't have to makenoise, you don't have to like
anything.
Of course, you can, butsometimes when you have a
student sitting right next toyou or your attending's like
(06:04):
rounding the corner, coming backbehind the drape, you maybe want
to regulate yourself, but youdon't want everyone to know.
And so you can just keep itquiet.
You have a mask on, of course,which is a nice little um safety
as well.
So a nice big inhale.
Our diaphragm pulls down, and adeep exhale.
(06:25):
Our diaphragm pushes up, changesour cardiac output, triggers
that vagus nerve, drops ourheart rate, and all these little
pieces I hope are falling intoplace about how to regulate your
system or how to control yourparasympathetic system, but it's
absolutely just about activatingyour vagus nerve.
Okay, so the number one way toregulate in the operating room
(06:45):
undetected is deep breathing, adeep exhale.
Number two way that I love wasuh a shout out actually to Mr.
Dave Zagorski, who is a CAA fromCase Cleveland.
I recently ran into him at theQuad A, I think it was this
year, 2025, and was able to tellhim that I've remembered this
tip since he told me when I wasin school in 2006, on through
(07:07):
now.
And I've been telling AAstudents about it.
And it was sort of during my ownjourney of um understanding what
I needed to like get out of thelike buzzy, stressful high of
fight or flight that I'd been infor decades, that I kind of came
back to this technique and waslike, huh, that worked.
Why does that work?
So, what Mr.
Dave Zagorski told me years andyears ago is that before
(07:30):
starting an IV, so he was kindof helping us learn how to
control nerves before an IV, youshould duck behind some like
private corner and make fistswith your hands, bulb them up,
hold them as tight as you cantill it gets uncomfortable, and
then let them go.
And it allows your hands to notbe super shaky.
And it worked.
And I did it all the time.
And then I started teachingother AA students how to start
(07:53):
IVs, and so I passed along thislittle tip.
And then as I got into, again,my own journey into mindfulness
and self-regulation and all ofthe process that I've been in, I
was presented with somethingcalled paired or progressive
muscle relaxation.
You'll hear it termed both ways.
And I remembered that DaveZagorski told me about this
(08:14):
years and years ago.
So progressive muscle relaxationis just the progression of
tightening your muscles manuallyand then purposefully releasing
them.
And you generally kind of do itover a wave of your body.
So you start, you know, head ortoe, either way, and you kind of
do it with your feet, your legs,your abdomen, your shoulders,
(08:35):
your jaw, your forehead.
And, you know, there's a wholemethod, and like you can get
really into the weeds.
But Dave was right that justdoing this is enough.
And so oftentimes, for years andyears, in fact, I have found a
little hidey hole corner.
Maybe, you know, in pre-op, ifI'm about to start an A-line on
an awake patient and I feel likenerves in my body.
(08:57):
Um, I currently work PRN, and sothere are times when I don't
feel 100% comfortable.
I've not done something likelet's say a spinal for six
months and I'm about to do one,and I'll find myself feeling
that upregulated, that buzzy,like nervous, anxious,
sympathetic system response.
And I will just quick do um likea tight muscle grip on my hands.
(09:20):
What has also developed is thatI've noticed I carry a ton of
tension and stress in myforehead.
So if I can manage itundetected, maybe I'll turn
around and like face like I'mdrawing up drugs or something,
facing away from people if ifanyone's in there.
And I will tighten my forehead,tighten my jaw, and then do a
purposeful release of both myforehead, my eyebrows, and my
(09:42):
jaw.
And it just tells my body, likewhen you're doing this, your
sympathetic system turns on andyou're like, oh God, this is you
can almost even feel sort oflike tingly sometimes if you've
ever felt that.
It's like almost uncomfortablewhen you're like um making a
muscle or like cringing yourface.
And then you're overriding thatsensation with a purposeful
(10:02):
release.
There's that paired musclerelaxation part of it.
And that tells your body, oh,and your brain, oh, we must be
out of that, like need to keepour muscles on tight.
We are out of that sympatheticresponse.
And you're kind of againmanually overriding into your
parasympathetic response bymanually releasing and relaxing
(10:23):
and telling your brain and mindI'm safe, it's okay to relax.
I can have the and both.
I can be kind of having a stressresponse that helps me kind of
keep my brain and mind sharp inorder to be able to put in this
IV or put in this A-line orspinal, but I also can um have
the and both of being regulatedwhile I'm doing this task.
(10:44):
So paired muscle relaxation inthe operating room can look just
like this.
Just your fists.
I, you know, often I'm holdingthem up because I want you guys
to see, but oftentimes, likesometimes I'll even just do this
and like do my fists this way soreally no one can see, or down
by my sides, or I'll find alittle cubby hidey hole and
pre-op to do it.
Um, and I hold it usually untilit's uncomfortable, like kind of
(11:07):
you get like itchy and you wantto release it.
I'll keep it for another one ortwo seconds after that, and then
a big release, sometimes ashakeout.
And I'll do it two, three, fourtimes until I can really feel my
body responding.
Um, and if I'm doing my foreheador jaw especially feels good,
and I have a mask on, I'll justtighten my jaw or like squint my
(11:29):
eyebrows, you know, hold it fora few seconds and then release
it, kind of soften my eyebrows,part my back molar, so like
separate my back teeth.
And then something that feelssuper damn good is take your
tongue off the roof of yourmouth.
So like drop your tongue insideyour mouth.
I, you know, you can have yourmouth open, you have your mask
(11:50):
on, but generally I keep mymouth shut and just kind of like
let my tongue fall, and you justfeel this release of tension.
And I'll do it again if I wantto, or if it feels good.
Again, this is all for me, allfor you.
And um, it just feels good tohave something to go to when you
are in those high stress momentsor after those high stress
(12:11):
moments, and you want to bringyourself back down.
Okay, so deep breathing.
We've heard a deep exhale,paired or progressive muscle
relaxation.
And the third one is somethingI've been teaching to CAA
Matters students and to pre-AAmatters students, and it's
called vooing.
I've just started calling itthat.
It was introduced to me umthrough actually a
(12:33):
neuroscience-mindedmanifestation company called To
Be Magnetic that I've been doingfor years and years.
Um, very much about parentingand reparenting your inner child
and like um making tacticalapproaches to your dream life.
If you at all um have heard metalk about process episodes or
(12:54):
expanders or taking alignedaction, like those are all
things that they talk about inTubo Magnetic.
But, anyways, they teach thisbreathing that involves
vocalization.
So, this is very much if you'veever um, you know, like been
nervous and like startedhumming, or if you are hurting,
(13:14):
um, I know I did this when I washaving my kids, like during
childbirth, I was like, uh, orlike you're sick or you don't
feel good.
Oftentimes you find yourselfreflexively kind of um making
some of these vocalizations.
And it is because our bodies aretrying to calm us down, are
trying to regulate and sootheus.
(13:36):
Uh news flash, your vagus nerveinnervates your larynx.
So surprise to know CAA or SAAwho is learning this anatomy,
but the vagus nerve innervatesyour larynx.
In particular, there are twobranches of your vagus nerve
that go directly to your larynx,your superior laryngeal nerve
(13:56):
and your recurrent laryngealnerve.
And those control your voice,your vocal cords.
And so when you phonate, whenyou make noise, it's activating
those nerves.
Of course, they're branches ofthe vagus nerve.
Vagus nerve controls ourparasympathetic system, and lo
and behold, you are regulatingyourself.
(14:16):
You are pulling down yoursympathetic system, you're
turning up your parasympatheticsystem.
That's what regulation is.
And so what I love to teach inCAA Matters and Pre-AA matters
is a combined deep exhale with avo.
So it looks like an inhale, justlike we were practicing before.
Nice big inhale.
(14:38):
And then a longer, deeper exhalewhere you're phonating the sound
voo.
So I take the voo as long as Ican, as long as I can exhale,
and I just can feel my bodyregulating, especially when I'm
(15:02):
not doing it on camera and notdoing it to like show people,
but I'm truly doing it toregulate myself.
I do this all the dang time.
I do this walking into theoperating room, walking into the
hospital.
I do this during ortho cases,like with all the hammering and
noise.
You can be vooing there behindthe drape and no one knows
what's going on.
Um, of course, maybe I'm notchoosing this as my go-to if
(15:24):
there's a bunch of like peoplein the room or if it's really
quiet, but you can do it kind ofquietly as well.
Like, I now have no shame.
I know this makes me feel good.
I know this helps me get out offight or flight to regulate
after some big event in theoperating room, or maybe the
patient's moving.
Like, you know, when the surgeonleans over or is like, hey,
patient's moving, and you getthat like like surge of like
(15:47):
fight or flight, sympatheticresponse, and you do whatever
needs to get done, and then yousit back down, but you're like
buzzy.
I will do this deep breathingwith a voo or one of the other
methods to help myself regulate.
Okay, I'm gonna put some linksin the show notes, some graphics
that will hopefully help you.
Um, but yeah, three ways toregulate in the operating room
(16:09):
totally undetected.
Deep breathing with a deepexhale, paired muscle
relaxation, and voo breathing.
So I hope this helps, and I willsee you next wellness Wednesday,
everyone.
Bye.
Thanks for listening to AwakenedAnesthetist.
If this episode resonated withyou, share it with a CAA friend,
(16:29):
an AA student in your life, or aperspective, and let them know
why you loved it.
It's the most important thingyou can do to support this
podcast and its mission.
You can always find more ways toconnect with me and this CAA
community atawakenedanesthetist.com,
including an invitation to joinseason five Mindful Connections.
(16:52):
These are free virtualgatherings open to anyone in our
Awakened Anesthetist community.
And while you're scrolling thewebsite, check out my trusted
CAA partners who make thispodcast possible with a special
thank you to my season fivesponsor, Harmony Anesthesia
Staffing.
Talk soon.
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