Thursday, September 20, 2007

A $2000 A Night Hotel -- And Not Even Cable TV!

For the past 2-3 years I have been experiencing a lot of fatigue and tiredness. There have been days when I could hardly hold my eyes open at work.

I have noticed that It has been hard for me to concentrate and stay engaged in difficult, mentally challenging tasks.

Also I have developed over the past few years edema (swelling of the feet and calves). My Dr. has prescribed water pills until my kidneys have begged for mercy, but with only marginal results. In the quest to find the cause of the edema, tests were performed to make sure that I didn’t have leaky heart valves – which can result in edema. The test results showed that my heart was doing just fine, so that was not the cause.

My Dr. finally referred me to a pulmonologist to be evaluated for sleep apnea. Sleep apnea can also result in edema, as well as be a reason for the fatigue and tiredness that I have been experiencing over the last few years.

The pulmonologist did an initial oximetery test, where you wear an “alligator” clip on your finger, which is attached to a recording device that measures your heart rate, and blood oxygen percentage overnight as you sleep.

From this test, I learned that my breathing was stopping at a rate of about 40 times per hour. I also learned that my blood oxygen percentage went down to 72 (90 and above is considered normal).

The pulmonologist diagnosed me with Obstructive Sleep Apnea (OSA). The therapy for this condition is to begin using a CPAP machine (Continuous Positive Airway Pressure). However, I learned that in order for insurance to help cover the cost of the machine, that you had to first undergo an overnight sleep study. I crunched the numbers, and I figured that I would be dollars ahead to follow the insurance protocols, rather than skipping the sleep study, and just buying a CPAP machine outright on my own.

So I checked myself into a “Sleep Disorders Center” at a nearby hospital. I actually felt like I was checking myself into a jail or a halfway house. – Like I was doing time on evenings and weekends. Perhaps it was the confinement and the lack of freedom, for the night that made it feel jail-like. (Actually, I’ve never spent any time locked up in a jail cell, so I wouldn’t know what that might really feel like.) All I know is that I felt like a jail bird. I even wore my stripped convict pajamas.

Like jail, first thing I had to do was strip down and put on my convict pajamas. Next they had me try out a couple of CPAP masks, to see if I found one preferable to another. I picked out my “favorite” mask, and then was told that I could watch TV or read for awhile.

I turned on the TV, and much to my dismay, it was regular broadcast TV only. Here I am staying at this place for the night – with a list price in excess of $2,000. You would think that they would at least have Cable TV for that price!

I don’t watch anything on network TV. I am a denizen of the Discovery Channel, TLC, HGTV, The Travel Channel, Food Network, with a little Animal Planet mixed in. I might watch something on the History Channel, or A&E. But I haven’t watched anything of interest from the broadcast networks since Frazier went off the air.

Next they came in to wire me up. There were 21 wires in all, attached to my body. I had probes attached near each eye, and probes attached under each side of my jawbone. There was another probe attached on my forehead, right above the bridge of my nose. I had a wire attached to each earlobe. There were probes attached on my chest on either side of my heart. There was a probe attached to each of my legs just below the knees. Then there were several probes attached to my skull. Fortunately, they didn’t have to shave little holes out of my hair to make these attachments. (Although they could have used my bald spot on the crown of my head if they wanted to!) Instead they put this goop into my hair, and then braided wires into the goo. After the goo set-up, it was just about the consistency of silly putty.

Next they put two belts around me. One of them was around my chest, and the other was around my diaphragm. These two belts were also wired, and were there to sense the depth and frequency of my respirations.

At this point I felt like I was about to be strapped into an Electric chair.

To top it all off, I had an oxygen sensor attached to one of my fingers – similar to that of the oximetery test I had received before.

After being hooked up to all the wires, and then being tethered to the bed, I was also told that I MUST sleep for a minimum of 2 hours, and that my breathing MUST stop at least 30 times per hour, or insurance wouldn’t cover a CPAP machine.

If I “achieved” those goals, then they would put me on the CPAP machine for the 2nd half of the night. If I didn’t make the cut, they would just let me sleep on until morning.

No pressure at all! Can anyone else see the irony here? I am at this place because I have a probable sleep disorder in the first place! Then I am told that I must sleep, on-demand, in this strange place, with all these wires attached to me, while trying to find a comfortable position without pulling all the wires out. Got that!

I did a little reading, called home, and prepared to go to sleep. I discovered why they don’t have Cable TV there. The real reason is that they really don’t want to have anything interesting on TV -- which might keep you up at night. After all, they want you to sleep, not watch TV. The TV fare made that an easy choice for me!

I paged the attendant, and had them help me get the covers straight on the bed without pulling out all the wires, and then the turned off the lights.

I said my evening prayers, and eventually drifted off to sleep. I woke up after a while with a sore shoulder. I had been sleeping in an awkward position because of all the wires and probes, and now my shoulder hurt. They gave me some Tylenol and I slowly drifted off to sleep again.

Next thing I new, at about 1:30 am, a technician came into the room and told me that she was going to put on the CPAP mask. Whew! I passed the test! I must have slept the requisite amount (I figure I had been asleep for about 2-2½ hours) and that my breathing must have stopped in excess of 30 times per hour. I don’t think I ever really got into a deep sleep though.

They put the mask on, and made sure it was fitted properly, then I laid back down on the bed – on my back! I just laid there for about 20-30 minutes, and I actually drifted off to sleep!

I NEVER sleep on my back. My airway usually does close off when my muscles relax just before falling asleep. With the CPAP, the airway was kept open. The mattress was also comfortable enough for me to sleep on my back as well – it was a nice pillow-top mattress.

The CPAP machine did make some noise. It sounded like a small hand-held hairdryer on a low setting, with a bit of a whooshing sound because of the air movement. It was an easy kind of a “white” noise that I got used to it fairly quickly. Of course that’s easy for me to say. My ears were partially plugged from the earlobe probes, and I am already half-deaf in one ear to begin with. I guess my dear sweet wife will be the ultimate judge of whether or not the CPAP machine is noisy or not. Who knows, if the machine is too noisy, I might be sleeping in the basement from now on!

After a while, I rolled over onto my side, which is my normal sleeping position. I was able to get to sleep on my side for awhile too. However, with the wires and probes, I was not able to get into a really good sleeping position. Twice during the night, the staff had to come into the room and re-attach probes that had come off during my limited movements. I hope I will be able to find a comfortable sleeping position with the CPAP machine at home. I will often switch from sleeping on my left side, to my right side. I don’t know how well its going to work to have the air hose crossing over the top of my body when I am attempting to sleep. I guess we’ll see how that works out.

I woke up just before 5:00 am, and was done for the night. At about 5:30, the staff came in and started disconnecting me from all my wires and probes.

I changed into my “street” clothes, got the manufacturer and model of the CPAP mask that I used, and got out of there. Not only did this $2000-a-night hotel not have cable TV, but I didn’t get to sleep either! No continental breakfast, no newspaper, no nothing! However, I was glad to get out of there – even if I did have a serious case of “crazy hair” with all the silly putty still stuck in it. The staff reassured me that “hot water and shampoo” would get the putty out. I made my move and broke out of that place, and headed for home!

Going home, I noticed that my gas gage showed empty, and the nearly out of gas warning light was coming on. So I stopped on the way home, crazy hair and all, and filled up the gas tank.

By the time I got home, it was just before 7:00 am. That’s about the time the family starts to stir. I did my morning back stretches. Then we had family scripture study, and got Amy off to school.

Then after everything had settled down, I set out to get the silly putty out of my hair. After two very vigorous shampoos, I was able to get the gunk out of my hair. I don’t know how much hair it took with it (I noticed that my hair was even a little thinner than usual on top) but at least the goop was gone!

I had previously arranged with work to come in late that day, so that I could get some actual sleep after the “Sleepless Study”. I rested for awhile, and finally made it in to work by around noon.

The sleep study staff told me that the full report of the sleep study would be sent to my Dr. in about 2 weeks. In the meantime, sleep specialists will review all the data from the sleep study, and make recommendations. My Dr. will then make his recommendation based on the study, and will undoubtedly prescribe a CPAP machine.

In the meantime, I await the results, and anticipate the adjustments and hopefully the changes for the better that will be coming in the next few weeks and months as a result of CPAP therapy.

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