Sleep Disorders: Part two of a rant in two parts.(Long. Vile)

The BBQ Pit
1

Sleep Disorders: Part two of a rant in two parts.

A couple of years back, I go to an ENT(ear, nose, throat specialist) in a nearby town.
The guy seems to be OK, answers my questions, spends some time with me, explains that my problem (occasional dizziness) Is called positional vertigo, and is not a great big deal, and suggests a few tests which his staff does right there. Nothing to worry aboput, he says, as long as I’m not climbing scaffolding, which I’m not.

He also suggests I participate in a sleep study. I ask him the purpose of this, and he tells me I probably have sleep apnea, probably pretty bad sleep apnea.

So I ask some questions and he answers them. What is sleep apnea? well, it’s basically when you stop breathing momentarily during sleep. What will the test do? It will tell us how bad it is. What will I do then? Well, you’ll have surgery, or you’ll start to wear a Cpap machine. What’s a cpap machine? it’s a small air pump which works to keep your airways unobstructed so you sleep better with less apnea and get more oxygen as you sleep.

Well, since at that time, and for that matter, now, I have NO interest in surgery, and NO interest in sleeping with some alien thing covering my face, I said, no thanks. Well, I told HIM no thanks. When the sleep center called a few days later to arrange an appointment I told THEM to pound sand up their asses.

Cut to a couple of weeks ago. I’ve just fired a doctor, I’ve just been referred to a new doctor by someone I trust a great deal, and the new doc tells me, get a sleep study.

I’m still not amused. He says, hey, we’ll do what we can for you, but you need to do this first before we can do anything else well. He’s speaking in strong enough terms that I figure he means business, and I think, well, I really don’t want to do this, but here goes. No sense going to a new doctor if you won’t listen to him and give his advice a chance.

So I make the arrangements. I go in on a tuesday night with my little bundle of spanking new pajamas and a book or two to read.

The examiner looks like he’s 12. I wonder how he got a driver’s license.

I sleep a lot like an eggbeater. I have slept naked since I was four. I have never, ever worn pajamas. I have never, ever slept in a room while someone was watching me. I have had in my life up to this point, one encephalogram. I have had stress EKG’s. I have not experienced this joy while attempting to sleep. I cannot sleep without the blankets tucked under my feet. I have never been able to sleep well the first night in a strange place.

but I’m going to try like hell to sleep now.

I take a shower and change into PJ’s. I am already annoyed. I try to apologise in advance to the examiner; to let him know that I’ve never felt more creeped out, to let him know that I know it’s not his fault and that I’m not personally upset with him nor do I hold the creepiness against him personally.

But it’s still creepy.

So I play fourty games of freecell. I read “Hannibal”. Cover to cover.(the thought of Dr L. carving up Paul Krendler’s prefrontal lobe has always been strangeley soothing to me) I fold my legs up and sit quietly watching local news until I can barely keep my eyes open.

I finally tell the examiner that I am ready. he leads me to a room where I sit in a barber-chair sort of thing and he starts connecting shit to me. There’s a belt, which goes around your chest, which I guess is to measure your respiration. There’s a hose which loops over your ears and pokes thingies up your nose. there’s a bunch of electrodes being jammed into your scalp and glued in place with a substance like kindergarten paste. there are wires on your legs, there are wires clipped to your face, your temples, your back, chest, neck, all over the bloody place.

I look as though I’m being simultaneosly attacked by a bagpipe whilst being skull-fucked by octopodes from nine directions. It feels a lot like having a scalp massage delivered by a vulture with sharpened steel talons. Now is no time to dance.

The examiner leads me back to the room. I lay down, and he connects the shit to the various devices. As I’ve previously said, I sleep like an eggbeater, I thrash around and toss and turn a lot. Not tonight.

I have about a total of ten inches of movement available to me. Each tiny movement causes one or more of the wires attached to me to pull loose, requiring the examiner to come in the room with his little flashlight and re-connect something or another. Each time he re-connects the thing on the right side of my head, he squirts more of the gluey stuff in my hair to hold the bastard in place. By morning I have four golfball sized lumps of gooey crap in my hair, and I look like I’ve just gotten off a bukake photo shoot.

Multiple times he comes into the room. Multiple times, I make some infititesimal movement which disconnects yet another wire. By the early morning hours, he is clearly becoming tired of this as am I. I ask him if he can just hit me with something big and get it over with; sadly, he can not. He asks me if he can get me something that will make me more comfortable, and i think for a moment, maybe a blowjob, but then, I’d probably be even more creeped out if he offerred, and he was clearly not what I had in mind. So I said “hey, can you tape a couple of angry live scorpions to my eyelids, and chew the eraser ends off a couple of #2 pencils leaving the jagged metal bands and drive them up my nose with a mallet?” he claims this, also, is out of the question. he bids me sleep well as I drift off to thoughts of quieter, more peaceful times, the crusades, the spanish inquisition, the holocaust. At whatever hour I don’t know, I do finally drift off to sleep. Here apparently are the results of my study:

I have sleep apnea.

No shit, sherlock, what clued you in? I’m not a doctor but I can pretty much tell you that!!!

okay, let’s quantify the results.

I slept 294 minutes. I had 255 apneas. 29 hypopneas, whatever they are. A total index of 58 events per sleep hour. Moderate to heavy snoring. (this made the wife laugh uncontrollably for nearly a half hour) 11% of total sleep time with an oxygen saturation below 90%. 80% lowest oxygen saturation.

There’s a lot of other mumbo-jumbo. The upshot? I need to have surgery or sleep with a CPAP. Hello? Am I the only one in here paying attention? The first doctor told me this months ago. Why the hell didn’t you just hook up the Cpap and try it and see what difference it makes.

More than a week goes by. My doctor calls me- Yes! He called me! to give me some news. No, not the sleep study, you already took that? good. I’ll get it for you soon. This morning, nearly two weeks afterwards, I get the results. I have sleep apnea. Big fucking revelation. Doc says, hey, they should have hooked you up to a CPAP machine and tested it. I call the center, they say, no, we can’t do that, a doctor has to write a prescription for that! In other words, we need to “study” you twice so we can get paid twice. Doc says, hey, anyone else would have gone right ahead and put the cpap on me, that’s what the scrip for the test was all about. Now I got this dim bulb at the sleep studies center telling me it’s the doctor’s fault, and the doctor saying “we won’t be using them anymore” when I just want to hear anyone say “I’ll fix this”.

Well, nobody’s going to fix it. I write, just on principle, the accrediting body who accredits sleep centers. They check it out, and not surprisingly, side with the center.

So I’m going to another center, hoping to do the Cpap titration and get this over with.

In the meantime I look at a lot of info online about Cpap and sleep apnea and other sleep/obesity/breathing disorder information, and I find that

a) the vast majority of the doctors out there act just about the same useless way mine does,
b) there are a dozen or so other possible methods for treating apnea and only two were described to me (wonder of wonders, they were the methods which involved my doctor making money) and
c) everyone on planet earth who has been through this has the same trouble but nobody bothers to do anything about it.

So lacking the mental skills I need to concentrate hard enough to make their spleens explode, lacking the temperament to do physical harm, lacking the financial resources to sue the barstards back to the cretaceous era, I have one and only one real recourse, and that is to rant here.

This is not going to be pretty, so cover your children’s ears and, in fact, go to another page if you’re easily offended, or have a heart condition. As a matter of fact, you might just want to go visit a site about fishing, or something, I’m sure it’ll be real soothing.

For those of you following along, here goes.
All of you bastards in the so-called medical profession (and you KNOW who you are!) can kiss my pimply white ass!

I mean, get down on your knees and use both hands to spread my enormous and muscular buttocks apart and plant your lips on my rosy red sphincter. And give me some tongue, while you’re at it. Tickle my prostate, if you think you can reach it. And lick your lips and smile and tell me how much you like it. Because I have no respect for the lot of you (present company excepted, especially you, Quag) and I hope that you make hundreds of millions of dollars basically ignoring people’s concerns and that all that money is used over and over again as fuel to keep your special part of hell especially warm. I hope that for every time your phlebotomist misses sticking me that you give breech birth to a giant flaming porcupine. Through the end of your dick. I hope that every test you perform to “rule out” something instead of listening to the patient and diagnosing based on real knowledge and understanding of his/her special needs, is performed on you in hell for all eternity. With flaming, red-hot pokers instead of the accepted instrumentation. I hope that for every time you run off to see the next patient before allaying the concerns of the previous one, there is a moment in hell where you can almost get a cool drink of water, and a laughing demon shits carnivorous crap into it.

I further hope you spend your declining years full of health, but incapable of communication, trapped in your extraordinarily healthy body with an active and complete mind, but with your mind separated from the world by some freak accident. I hope you watch helplessly as your family gradually stops visiting you. I hope you listen carefully as the doctors-(your comrades, remember?) begin to dismiss you as you dismissed all your patients. I hope you sit awake at night in a diaper full of your own shit, screaming helplessly, locked in your own mind, unable to even stop the night orderlies from repeatedly sexually abusing you. I hope you are afflicted by painful boils which seep and run down your rotting flesh and cause you to decompose like a corpse while still alive. I hope every nerve ending in your peeled and rotting flesh comes horribly alive as aides, tired of the stench, scrub your suppurating hide with bathroom disinfectant. And I hope that wasps, attracted and enraged by the aroma of the disinfectant, attack you en masse until you lapse into shock and die. And when you are travelling from this world to the next, I hope that all the patients you ignored or mistreated or took less than seriously get to line up and beat you with Saguaro cacti while making your ears ring with the inanity of your advice to them, and that you carry the horror of your own indifference with you to the tortures of hell for all eternity.

Not that I’m bitter or anything.

b

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You snore?

;)Glad you got that off your chest, aren’t you? Sorry you endured so much suckiness. That’s why they can’t get me into a hospital conscious.

3

Note to self: try to stay of Billy’s bad side.

On a more (hopefully) helpful note: reconsider the surgery. It has done wonders for my mother, and for a couple of friends as well.

4

I am in awe. This is surely one of the greatest rants I’ve read, and I’ve read my share of them. I especially applaud your sparing use of profanity. Too many people throw in gratuitous profanity, simply because this is the Pit. You, however, have used it only as needed.

Apart from that, I completely sympathize with you, in both your rants. I have been known to fire a doctor because his or her staff can’t be bothered to do the job right, whether it’s drawing blood with a minimum of pain or getting the paperwork done in a timely manner. I have serious doubts about any doctor who looks at me and tells me that I need to lose weight. Oh, REALLY doctor, do you think that I didn’t KNOW that? I know that there are good doctors out there…the problem is, they all seem to not be taking any new patients at this time!

5

I do sympathize with you. I also went throught the two nights of octopus sex. It felches big time.

However,
I do want to mention a few things. I don’t know if your doctor pointed it out, but normaly, if your blood saturation leve drops below 80%, they put you in an oxygen tent.

Also, they probably were hot to test you because if your apnea is severe enough, it can seriously effect your health. It is easy to treat, but severe cases are dangerous. (Mine was severe, 59% blood sat. and so forth. I read an article later that the five year survival rate for cases as bad as mine was roughly 50%. :eek: ) You didn’t say, but are you prone to falling asleep at unusual times? (At the movies, after dinner, in the afternoon, etc.) Other than the snoreing, that was the only symptom I was showing.
Yes, the CPAP sucks. But, since I have started using it, I have needed a lot less sleep. My wife can sleep in the same town as I do. And I have lost fifty pounds (in a year) without dieting because my metabolism has improved. I also don’t nod off to sleep even if I am tired. (Unless I want to.) This is a big plus as much as I drive.

6

Thanks, all.

Lynn, coming from you this is high praise indeed. Thanks, it means a lot.

Revedge, this is the most encouraging thing anyone has said so far. I hope my results are as good as yours.

Scoobs, I would do the surgery MYSELF if I thought it would help. My doctor says no, but I’m getting another opinion.

And Wisest Novel: I laughed my ass off. And I could afford to lose some.

b.

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I’ve read both your rants about physicians and the sleep apnea test and I’m a bit confused. Wait, make that very confused. Your main problem seems to be worry about heart trouble based on family history and obesity. As near as I can tell, the doctors told you to exercise and eat less. That makes sense. Maybe the regimen that they suggested is difficult or impossible for you, but you’re an intelligent person and can modify it accordingly. If you can’t walk 3 hours a day, walk what you can.

They gave you some pills (my guess is Lipitor). You didn’t mention anything else specific that you wanted from your doctor so it’s hard to evaluate whether they satisified your needs or not.
As for the sleep apnea, I’m not sure why a sleep study was even indicated. I bet your wife could have told them you had it. It’s pretty obvious – the sufferer snores and gasps, punctuated by periods of just not breathing. Still, the doctors did absolutely the right thing by insisting that you take the study. Sleep apnea can lead to all sorts of fatal things – congestive heart failure for one. The test is uncomfortable and humiliating? Well, boohoo. It’s no party for the people performing the test either. This is your life and health on the line. You don’t want to do another sleep study with the CPap? OK, just try it at home for a while and see if you feel better.

While some of your complaints are justified (not being notified of appointments, cryptic scary messages on your answering machine), I think you have to realize that a doctor can spend only so much time with you. Granted, that should be quality time, but there’s only so much they can do. And you don’t sound like a particularly cooperative patient (“pound sand up their ass” when they schedule a necessary test?).

So after bitching about the physician’s failures, what are you doing to improve your health? Tell us about your diet regimen. What’s your exercise program like? How much research have you done into the tests that the doctors have suggested? This will help you interpret the results.

8

Finagle, all the things you arer saying make perfect sense. Pity I can’t get anyone to give me answers to my questions about those specific things.

And I only told the sleep center to pound sand after they made an appointment for me which I specifically requested they not make. If someone follows my instructions, I’m polite to a fault.

As far as my exercise regimen:
I awaken each morning at 5:30, shit/shower/shave, get mail, leave for work at 6:30. Eat breakfast ( toast and coffee) in car.
Arrive at work at 8:00.
I walk about four miles a day (in 20 yard increments, just moving around doing my job) I actually measured this more than once.
Eat bowl of campbell’s soup for lunch.
Work runs until 6:30 or 7:30.
Drive home. Arrive at 8:00 or 9:00.
Eat dinner. Usually consists of a sandwich or two, or a burger.
Work around house untill about midnight, shower, bed.( we have an older home I’m restoring, a bit at a time.)
Lather, rinse, repeat.

Where would you suggest inserting that exercise? I have now had three doctors tell me three different contradictory things.

I don’t think it’s too much to expect to get a straight answer, a reasonable, do-able plan, and a little consideration. I just don’t get that, and I don’t understand either.

BTW I’m taking Lopid. Prilosec and allopurinol.
My blood pressure is fine. As is my most recent stress EKG. My cholesterol is under control.
I have a friend who runs five miles a day and I took him to work with me one saturday. After following me around all day, he slept all day sunday. It’s not like I sit on my ass all day.

My thyroid etc. is OK.

And after bitching about my doctor’s “failures”, I am still looking for someone who can tell me something consistent about what I should do to improve my health. As I may have described, I’ve tried about everything.The answer is completely different for everyone, and I’d love to find someone who can help me find the right answer for me.

I have researched all the possible methods for treating my disorder. Good thing, too, because my doctor sure wasn’t going to bother to explain them to me. I know my options now, and I have a document for my doctor and for the “new” sleep lab so I have no “surprises” this time. At least if they follow my instructions, which I doubt they will.
As for your boohoo- well, I’d not bitch if it was done right. If you knew as much as you seem to act like you know, you’d know that it is patently illegal in all 50 states to purchase, prescribe, or use a cpap without a sleep study. If it had been done right, as I said, not a problem. It wasn’t done right. I have every right to bitch about something that costs that much and is done wrong- you’d bitch if your car was treated that way, wouldn’t you? As you say, this is my body, my health. and all the people who are supposedly health care professionals are treating me in a less-than professional manner. But thanks for you’re concern. You’ll make a fine doctor, by the standards in effect at the moment.

b.

9

I read both parts of your rant and I guess I don’t understand your problem either.

You said that your doctor wanted to get you tested for sleep apnea but you didn’t want the test because you didn’t want surgery or a machine. You said you are worried about heart disease and dying young but you aren’t interested in dieting, exercising or treating your sleep apnea. You can lose weight with out eating a 900 calorie diet or walking three hours a day and I seriously doubt any doctor suggested you do either of those things. Besides, eating a low fat diet and exercising will reduce your risk for heart disease even if you don’t become skinny. Sleep apnea can cause weight problems too, but of course you aren’t interested in treating that!

Everyone I know that has sleep apnea (3 people in my family alone) have had to have two trips to the sleep clinic. The first one is to determine if they have apnea and how bad it is. After the diagnosis they have to discuss treatment options with their doctor. If the doctor decides a CPap machine will help they have to spend a second night at the sleep clinic to calibrate their CPap machine. A CPap machine isn’t something they can just hand you. It has to be calibrated for you personally. Also, the sleep clinic technicians aren’t the ones who get to decide you need a CPap machine. Your doctor has to prescribe it.

I don’t think that you are taking any responsibility for your own health. You want the doctor to wave a magic wand to make you live to be 100 years old and you don’t want to be discomforted at all in the process. It doesn’t work that way. Sometimes the tests are uncomfortable and the treatments aren’t fun. Learn to deal with it if you want to out live the other men in your family.

All of the above being said, I think that you can write one hell of a pit rant. I just wish you had something better to rant about.

10

Try eating a few vegetables and maybe a couple of pieces of fruit every day. Your body can’t run if you aren’t giving it any thing to run off of.

I would say that a job that requires a 3 hours in the car and a 11 hour work day is just too much for anyone. Move closer. Find a different job. You can work yourself to death but it won’t help you enjoy life.

Walking 4 miles in 20 yard increments is not exercise. You never get your heart rate up even a smidgen. You need to try to walk 30 minutes in a row every day. Maybe during lunch. Maybe when you get home from work. If being healthy is important to you then you will find the time.

Finally, I doubt 5 1/2 hours sleep a night is enough. Especially if you have apnea. Go to bed earlier. Restore the house on weekends.

Or maybe you can just keep crying about it. Some people are happier that way.

11

Even more confused:

Toast, 2 slices 160 calories.
Campbell Soup 260 calories
Burger 330 - 520

If above regimen is correct, you ARE on a 900 calorie per day diet.

As for when you should exercise – you’ve made it clear that your job and commuting doesn’t allow much leisure time for exercise. This sucks, but I don’t understand why you expect a doctor to be able to solve that problem.
Medical problems aside, though, you don’t have to be a doctor to identify some lifestyle problems. You DO live too far from work. You spend 3 hours/day sitting in a car. This may or may not be fixable, but it should be a goal to reduce this somehow. Apnea aside, you probably don’t get enough sleep – most people function poorly on 5 1/2 hours. And a 10 - 11 1/2 hour work day seems rather Dickensian. All this and you rant about doctors? I’d be eviscerating my employer.

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In Conceivable, next time I want a complete stranger telling me exactly what I said was totally unhelpful advice and acting like an arrogant know-it-all, I’m gonna give you a call.

13

Nice to know I am good for something LaurAnge.

Actually, the first paragraph of my second post was lost in a tragic “cut-and-paste” accident. It would have softened it a bit.

My advice was sound. In fact it was very similar to the advice posted by Finagle thirty minutes later. I just don’t have the same gift with words that he has.

I may sound like a know-it-all but at least I am not a cry baby grown man who thinks everything in life that isn’t easy shouldn’t be done.

14

Ah, we’re channeling miss Cleo. InConceivable knows all about me, fer sure. Dang, he even nailed it on the crybaby part, I’m bawling right now.

Wake up and grow some intelligence and a sense of humor. It’s the pit. It’s a rant.

b

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No, but seriously. If you are so anxious about your health and family history that it makes you act oddly at the doctor’s office, you need to prioritize a lifestyle change.

16

Billy, do you enjoy your job? If so, I can see why trying to change that could be difficult.

17

Billy, you may want to consider looking into a low-carbohydrate diet like Atkins or Protein Power. It seems particularly effective for people who cannot find time to exercise. (I don’t really want to get into the debate about whether it really works and whether it is good for you in this thread - if anyone wants to fight about it, start a thread and I’ll joint in).

18

Billy–I’ve been thinking about ya…and there is definitely something in your story that is not quite right…

Finagle’s right–for a moderately active 300+ lb. person to subsist on 900 calories a day just doesn’t make sense. The thing that I thought of first was a thyroid issue. You say your thyroid is OK, but there are thyroid tests and then there are thyroid tests, if you know what I mean. Maybe you should go to an endocrine specialist. I know all sorts of people who have all sorts of weird endocrine problems–thyroid and otherwise–who are on some medication and doing fine.

I had a horrible “mystery illness” for a year or more, and went to every doctor I could find. I was “diagnosed” with everything from Chronic Fatigue Syndrome to Lyme’s disease to hypochondria. Finally, someone thought to check on the effects of having too much progesterone in my blood. Bingo! The symptoms matched exactly. I went off birth control pills, and the mystery illness resolved itself. My point? Sometimes, the obvious gets overlooked, over and over and over and over and over…

Anyway, my gut instinct (and yours, too, I think) is that there is something going on here with your health that is not being diagnosed. I’m glad you are looking for answers. Please keep looking. This little legume is worried about you.
p.s. Why are you opposed to the sleep apnea surgery? It’s no big deal as far as surgery goes, and it is very effective.

19

All of you calling Billy a crybaby - this is a RANT BOARD, you dimwits, it’s where you go to RANT. As in - COMPLAIN. Blow off steam. Whine.

As for the surgical solutions to sleep apnea - ANY surgery is potentially a big deal. ANY surgery carries some risk. Also, the surgery is not appropriate for all cases of sleep apnea. If the particular cause of apnea in a person is not a cause that can be solved by surgery then surgery will not work.

Personally, I think Billy should give the CPAP a chance - every person I’ve known was really against it at first, and while it doesn’t work for everyone, those it does work for generally adapt to the little “face-grabber alien” device. At least a CPAP machine is reversible if it doesn’t work, which is more than you can say for surgery.