Chris Supalla, tossing and turning with a stuffy nose, was advised by several doctors that a simple nose job could help him rest – but after that, he lost more than sleep.
“He was gasping for air,” his mother, Mary Supalla, told The Post of her son’s waking nightmare. “He felt like a plastic bag was over his head.”
Chris, 32, killed himself three months later.
“I am very sorry to leave this way, but the suffering is too great,” Chris wrote in his suicide note. “My nose felt so empty that I couldn’t feel anything. I love you always. . . Please send the first responders to recover me from the backwoods. You don’t have to see what happened.”
The Portland, Oregon resident’s 2021 death certificate reads “asphyxia by hanging ligature,” with Empty Nose Syndrome as a “significant” contributing condition.
Almost 30 years after it was first identified, ENS is finally gaining greater recognition. The first medical textbook on the terrifying condition was published this year by renowned physician Dr. Eugene Kern, a professor of otorhinolaryngology at the University at Buffalo.
In the early 1990s, while working at the Mayo Clinic, Kern became alarmed after two post-surgery patients from another location told him they felt suffocated with every breath. Both then committed suicide.
Other patients compare the nauseating feeling to drowning, choking or being hit by water. “These patients are nasal paralysis,” says Kern, 86. They can barely sleep, jolted awake because the body feels like it’s not breathing, even though it is. Mouth breathing does not help.
Supalla wrote this heartbreaking goodbye note to his family before taking his own life amid his struggle with what his family believed to be Empty Nose Syndrome. “This patient is a nasal deformity,” Dr. Eugene Kern told The Post. Mary and Brian Supalla Supalla’s death certificate refers to “asphyxia by hanging ligatures,” with Empty Nose Syndrome as a significant contributing condition. Mary and Brian Supalla
Kern wants his book to “shine the light on an area where people have suffered terribly,” he said. “I see suffering.”
ENS is a complication of any nasal surgery that affects the turbinate – the cylindrical structure in the nose that controls the intake of air. Turbinate reduction is sometimes an adjunct to septoplasty for a deviated septum, or even a regular nose job.
“I didn’t know what a turbinate was,” said David Troutman of Indiana, who had surgery six years ago for sleep apnea. “I trust my doctor.”
A CT scan shows the inside of a normal nose and an “empty” nose with the turbinates surgically removed. ENS is a complication of any nasal surgery that affects the turbinate – the cylindrical structure in the nose that controls the intake of air. Turbinate reduction is sometimes an adjunct to septoplasty for a deviated septum, or nose job. Eugene Kern/ Mayo Foundation for Medical Education and Research
After his surgery, Troutman was exhausted, unfocused, pacing non-stop – so lethargic and agitated that his boss took him to the emergency room. “I’m a shell of myself,” he said. “My personality just disappeared.”
Troutman, 54, now moderates the Empty Nose Facebook group, which is filled with “hard-to-read stories,” he said. “I expect that I have a lifelong struggle ahead of me. No relief, no reprieve.”
The group, with about 3,700 members, has recorded 14 suicides in the past six years, with some memorials on the website Nasal Cripple, a collection of media mentions.
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 and fun life,” his family wrote in a 2021 obit. “We are proud of his many accomplishments, saddened by his loss, and will love him forever. May he rest in peace.” Mary and Brian Supalla
The painful condition remains a mystery. Incidents are unknown and it is unclear who was exposed. Some people are fine when the turbinate tissue is removed; others face a lifetime of torture.
Few doctors in the US will try treatments, including various methods to moisten the nose or change the airflow.
“If you remove a turbinate, you can get neurogenic type pain after trauma, which is horrible,” Kern told the Post. “Some people have sufficient compensatory functional capacity that will keep them symptom-free for two or five or 10 years. There is no test to determine nasal function.”
Chris Supalla, who works in accounting, consulted three doctors before the surgery, his mother said. He underwent septoplasty and microablation, and doctors said they removed only 1 millimeter of turbinate tissue. “Chris asked about ENS and was concerned about it,” he said. “Doctors are familiar with ENS but say, ‘I’ve never seen it.’ They convinced him.”
After Chris Supalla’s death two and a half years ago, his parents asked the hospital, Oregon Health & Science University, to warn patients about the risks of ENS. Mary and Brian Supalla
Chris Supalla documented his rapid decline as he struggled to adjust to breathing difficulties after a nose job in a series of heartbreaking text messages with his mother Mary. Mary and Brian Supalla
Mary and Brian Supalla
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Mary and Brian Supalla
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After his death two and a half years ago, his parents asked the hospital, Oregon Health & Science University, to warn patients about the risks of ENS.
“The complications are so horrific and life-changing that patients should know,” said Mary Supalla. “Chris can’t breathe, he can’t sleep, he can’t do anything. He is more afraid to live than to die.”
OHSU patient advocates wrote to Supallas that the institution would educate doctors, medical students and staff. “Although we cannot clinically prove the diagnosis of empty nose syndrome, we want to assure you that we believe the experience he describes.”
However, a few months later, after Supallas again asked the patient to be warned, the patient advocate wrote, “As indicated in previous communications, we have not found your child to have ENS. We are again deeply saddened by your loss, and will not communicate further on this matter.”
In a statement, OHSU (which was authorized by Supalla to write about their son) wrote to The Post: “We offer our condolences to the Supalla family … Before the surgery, Mr. Supalla specifically asked about his clinical and empty nose syndrome. the team discussed the situation as part of the informed consent process.”
After surgery, “his health care team at OHSU was unable to confirm the diagnosis of ENS clinically,” and “OHSU clinicians discussed ENS as part of the informed consent process when it related to surgical procedures and/or patient questions . . . At the family’s request, we have used what they shared with us for teaching and learning through our academic process for continuous improvement.”
If you are struggling with suicidal thoughts, you can call the National Suicide Prevention Lifeline 24/7 at 988 or visit SuicidePreventionLifeline.org.
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Source: thtrangdai.edu.vn/en/
