Friday, February 3, 2012

Sleep apnea and the writer.

I used to say I wrote novels because I didn't sleep much. That was true. I have a power job as a Federal executive for a tense agency in the Department of Defense and I raised two boys to be responsible adults. Plus, I wrote novels. Okay, I never watched much TV, but honestly, there should be only so many hours in a day! The truth is, I've never been a great sleeper and I'd get up in the night and write some scenes, maybe crash for awhile, then get to the intense day job. But as the years went on, this lifestyle took its toll. The older I grew, the more I realized my sleep habits could kill me. Plus, my husband's sleep was being disturbed by my crazy, often loud, breathing when I was attempting to sleep. I say "attempting" because people with sleep apnea don't actually get the healing sleep normal people get. And that lack begins to catch up with you. Succinctly put, sleep apnea can be on your death certificate.

So here is my sleep apnea saga:
We moved to rural Pennsylvania in October of 2010. We love it here on our six acres of nature. But running a place like this while commuting two hours one way to work began to affect me in unexpected ways. I became desperate for sleep. I thought I could just tough it out until I retired in two mor years, but the tanking oconomy began to put that time frame in doubt. So, before I endangered someone on my long drives to work, I started to explore my sleep problems. First, i tried a mandibular advancement retainer in my mouth. That worked for awhile. But then it pulled my front teeth so far back that my back teeth could no linger touch. I had to have orthodontics at 52 years old! They made me another one that wouldnt allow my teeth to move out of alignment, but which gave me excruciating TMJ after a few months. I had to choose between wearing it or chewing food. Could not do both. About the time I stopped wearing the mouth piece, I also began staying over in a hotel near work sometimes, to give myself a break and to let my husband have an occasional night of peace.

Yes, I snore. But that isn't necessarily apnea. You have to STOP BREATHING more than 15 times an hour for insurance companies to find you suitably in trouble to agree you have apnea. My first sleep study was hard, but I managed to sleep enough to get some results. At first glance, I did not qualify. But my wonderful doctor noted that if you took my episodes from when I was on my back, I qualified for severe obstructive sleep apne (OSA). He told me there were devices to keep me on my side as I sleep, but having had two back disk fusions, that idea sounded awful. I need to change positions in the night or wake up crying. So the doc moved on to the idea of a CPAP. We were both eager for this to work. I knew others who'd used them with great success. So he set me up for another sleep study, this time with the CPAP. I was very sure this was the answer to my prayers and went to the study center with a very positive outlook. Four hours later, I was on my way home sobbing. We tried a variety of masks and pressures and the people were so nice, we all wanted it to work. But my heart raced uncontrollably for the entire four hours I tried. It was basically torture. I couldn't catch my breath or calm my heart for long enough to actually sleep. And the air kept going into my stomach and choking me, making my heart race faster. Finally, the kind attendant came in again and asked if she could do anything else for me. Frankly, I think they were terrified of what my heart rate was maintaining. I begged to be set free. This felt like defeat and like the end of all hope as I drove home in the wee hours of that morning before dawn.

But my doctor wasn't defeated. He said my reaction is called phobic - like claustrophobia almost. It can't really be controlled or managed and isn't all that uncommon. He suggested I'd be a good candidate for OSA surgeries. Two parts, one for my severely deviated septum (yup, broke my nose in a couple of places during college) and swollen sinuses, the other to de-obstruct my throat. Sounds as awful as it has been. The nose surgery was first and quite awful while the packing was jammed inside. Surgery on Friday, packing out on Monday. It was just like giving birth out of each of my nostrils, the packing felt like golf balls, but the migraine left me after that so I could keep my eyes open and swallow without suction pressure making my ears pop. A few weeks out from that and I could tell I was sleeping more soundly. So worth it!

But not soundlessly. Still snoring and breathing inconsistently, so one more surgery to get through. This was to remove tonsils, uvula, and harden palate and base of tongue. I'm now a week post-op from a UPPP and improving. I only got fluid up my nose from the back of my throat one time - funny how adaptable we are. They tell you plainly how much this will hurt, but until you do it, you just can't imagine. I took everyone's advice and answered 10 whenever asked what my pain level was at the hospital. Funny, though, the morphine didnt do much and so i stopped asking for it. Vicodin worked best, but the elixir is alcohol based and like red hot fire going down. Plus, if you take too much, other parts of the body start to hurt. Or maybe it was the oxycodone that gave me the muscle spasms after awhile. Got off all the pain meds by day three and have stuck to Tylenol and occasional vicodin since. Seems to be working. As long as I don't swallow, I'm feeling okay. But who cannot swallow for long? And the liquid diet is no fun at all, except for the lost weight I hope to keep off. My OSA wasn't from weight, but the less weight, the better, say the docs. Now that a week has passed, things should improve quickly. Looking forward to the annoying stitches dissolving in a few more days, but they don't really trouble me as much as I'd feared.

The jury is still out on whether the snoring is gone. It takes awhile for swelling to go down. But I'm hoping. And I'm looking forward to writing for the love of storytelling and not because I just can't sleep. Plus, it would be lovely if my commute felt safer through my improved alertness. Doubtless I will comment on my progress as things develop. Meanwhile, if you're not sleeping well, figure out why. No one should have a death certificate that gives sleep panes as the cause.

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