Breathing and My Name

This week has not been a good one. My dietitian left the area, I found out I may have a heart problem, I lost no weight and John was extremely busy, and not available. With all that was going on, I wanted to fall into my old bad patterns and turn to food for comfort and security. I thought I had overcome that issue, but apparently not. Because I plan all of my meals and snacks the day before, I was able to stop myself from giving in to that kind of eating. But it was a struggle. It was on my mind.

Thursday I had to go for a breathing test, or Pulmonary Function Test. Of course there is paperwork to fill out first. The woman registering me asked for my driver's license as ID. There are two problems with my driver's license: First, I have lost over 100 pounds since the picture was taken, so it does not look that much like me; second, in NJ, Motor Vehicles will only put your first name on the license with a middle initial. Those of you who know me, realize I have always been called by my middle name. All of my official documents, my checks, my accounts etc either have Ruth or M Ruth. Our medical insurance just has Ruth. When I made the appointment it was as Ruth, no mention of an initial or first name. After I was registered, she put a wrist ID band on me for the test. From there, I went into the ladies room, where I noticed the name on the wrist band was Mary. I returned to her and told her if she wanted the insurance to cover the test, she needed to put it in as Ruth, not Mary. But, but, but she tried to say. I told her do what she wants but my insurance does not recognize me as Mary. (and neither do I).

When I got called in for the test, the respiratory technician, of course had more paperwork to be filled out. When she tried to pull up my file on the computer, she could not find it. Of course, not, she was looking for Mary. I told her to try my actual name, Ruth. She said she could only go by what the woman had registered me as. I told her that she would not find it under Mary. Somehow she managed to pull up Ruth, and she wrote on the file Mary Ruth. She advised me to change my name officially to Ruth Mary. It would make things easier.

I did the test - breathing a lot of different ways, inhaling some medicine, and breathing some more. I will find out next week, when I see the sleep/pulmonary doctor, the results.

Friday I picked up the heart reading from the doctor to take with me to the cardiologist.

Next I went to CVS and got a flu shot (my doctor has been all out of it). Then I wanted to go to the radiologist, as it is a new one for me, and make the appointment for a CT scan of my chest. My doctor's office had called me with the number I thought I needed as approval from my insurance company. But I found out it was just a reference number and I had to call the company for the approval number. But, at least I found out exactly where I have to go to have it done.

When I got home, I called the insurance, and the person I spoke to was extremely helpful (for a nice change). At the end of the conversation, she even connected me to the facility so I could make the appointment. I will be having the CT scan on Monday morning. Hopefully the results will be available in time for my appointment withe the doctor on Thursday morning.

In the afternoon , I went to the gym and also worked with my trainer for half an hour.

Last night I felt awful. I ached all over, my eyes hurt and my stomach hurt. I never sleep well and I was exhausted. Even so, I did not sleep well again last night. I wonder if the flu shot was making me feel sick.

SO that is the latest. I'll update after I have some more information to report.

Medical Update

After the sleep test last week I was feeling pretty good. I was encouraged that finally, after all of this hard work, eating healthy and exercising, having lost over 100 pounds, I was seeing some positive benefit. My sleep apnea was less severe.

Now two things have happened to discourage me again.

First my dietitian has decided to change jobs. I do not blame her. The company she works for is not good with either client or employee relations. If it had not been for her, I would have given up on them a long time ago. SO I am happy for her, but sad for me. She has been my rock in my healthy eating/weight loss battle. I had to say goodbye to her today for our last appointment. I would like to think we could stay in contact. She would like to think she can continue to support me. But I realize how life gets busy and time gets out of control. SO now I have to figure out what I am going to do about finding a new dietitian. I do not like the thought of starting over from scratch. Having to catch someone up on all I have been through and tried. All of the frustrations and victories. I feel like I have a team of people who have been helping me with all of my medical issues and now thee is a hole in that team.

Monday I saw my primary doctor. We went over the information from the sleep doctor. She wants me to have another CT scan of my chest. We got that approval process in the works. We talked about my blood pressure and he agreed for me to go off of my water pill for two months to see how I do. Part of this decision is to see if I will not wake up so often at night and thus sleep better.

Yesterday when I returned from the gym, I had two messages on my phone from the sleep doctor saying she needed to speak to me and call her right away. I left a message and she called back within a few minutes.

During my sleep test last week a heart issue surfaced that was totally unrelated to the sleep apnea. It happened only once during the night and it occurred during a time I was awake. I was not having an apnea. My heart started to race at 130 beats per minute and it was triggered in an area of the heart that was not usual. She said I needed to see a cardiologist, that she would fax the information to my primary doctor and I should get the name of a doctor from him. I asked if there was any concern about my continuing to exercise. She said she had no idea.

Since it was already late in the day, I figured I would give my primary doctor a chance to get and read the information from her, and be in touch with him on Wednesday.

This morning I had my appointment with the dietitian, said a sad goodbye and lost no weight. Then I went to the grocery store. After lunch, the doctor called me, saving me the trouble. He told me about the report from the sleep doctor. He feels looking at the "strip" it was just a one time incident and nothing to worry about. But he said it is better to get it checked by a cardiologist to make sure. He referred to it as possible "vtach". He gave me the name of a group of doctors.

I called and have an appointment on November 10th. My primary doctor said I should continue to exercise and do what I normally do.

Please continue to pray for me. At first I felt disappointed that here is yet another medical issue popping up after I am doing so much to regain my health. But I had to remind myself of all of the years I was not making healthy choices and there will be consequences for that. I do not feel worried, but have the peace of God, knowing it is all in His hands. And really it is a blessing I had the sleep test and this showed up, so I can get it checked out before it presents a bigger problem.

Sleep Test #4

Last night I had my fourth sleep test. This one was done at a different hospital than the first three. Having had the previous tests, I pretty much knew what to expect.

When I arrived, I was shown to my room. Of course there was paperwork to fill out. I changed into my jammies and read a bit, while they "hooked up" another patient.

This is a teaching hospital so there was a trainee observing my "hookup". Wires were attached to m y head, my legs, my chin, my side, - well, you get the idea. I had a band around my chest and one around my waist. These were attached to heart monitors - EKGs. I had an oxygen reader on my finger and tubes attached to my nose. I guess I looked like something from outer space with all of the wires and tubes.

The hookup takes about 45 minutes.

Before the testing can begin, I have to lay still for five minutes, so they can get "calibrations". After the five minutes are up, they ask me to look left and right, up and down, only moving my eyes; to make a snoring sound, to hum, to blink, to close my eyes, to breathe through my nose, to breathe through my mouth and to move my legs.

During the first part of the test, I had to try and sleep without a machine. I had difficulty getting to sleep. IN addition, some of the wires on my chin were coming loose and the technician had to come in twice to re-attach them.

Of course at some point, I had to make a pit stop. When she came to unhook me for that, she told me to put my sleep mask on, she was going to put me on a regular sleep machine to see how I would do.

Once we got going with that, she realized one of my leg wires was no longer attached and had to come back to fix that. I finally did get some sleep, but woke up several times.

She saw I was awake at 6:45 and told me to do all of those eye, breathing and leg things again, then told me to remove my mask. In a few minutes, she came in and unhooked me.

She said she'd check my sleep machine while I got dressed to leave.

Although she is not a doctor, she did tell me a couple of things.

During my original sleep test in February, 2008, my oxygen levels dropped into the dangerous zone, 50% or less. Last night, even without the machine, my levels did not drop below 88%, which is not bad.

Without the machine, I only had 9 episodes of apnea.

During my first test I had over 600 in 6 hours.

My sleep machine is set at pressure 18 (inhale) / 12 (exhale).

Last night I did not use the type of machine I have. I used only a regular sleep machine and the pressure was 8 (inhale). I did not require help with exhale.

Her conclusion is that I have only mild sleep apnea now. She is sure that as I continue to lose weight I will be complete apnea free and not have to use a machine! Again, she is not a doctor, but I liked her positive attitude!

When she checked my machine, she said it shows that it is giving me a pressure of 8, which affirms what she found in the test last night. She also said my mask is working perfectly and not leaking air at all, even while I am asleep.

I am encouraged by this news. I will see the doctor in two weeks to find out what her recommendations are. But what great news to go from severe sleep apnea, the worst case my previous doctor had ever treated, to mild sleep apnea is awesome! Thanks to all of you who prayed!

New Sleep Doctor

For the past several months I have been looking for a new sleep doctor. If you have followed this blog, you know I was having many issues with the former doctor. I was looking for a couple of things in the new doctor. First I wanted a sleep/pulmonary doctor, who could also deal with my breathing-lung problems as evidenced in the CT scans I had done. I also wanted someone who could read the Smart Card in my sleep machine. this was the most difficult of the list to fulfill. In addition, of course, I needed a doctor who took my insurance.

I am happy to say I finally found such a doctor, (thanks to the help of Audrey). I had my first appointment yesterday. I went armed with my Smart Card, reports from my xrays and CT scans, copies of my blood work and information about my medical supplier.

The receptionist took my Smart Card and downloaded the information. She came back and told me I win the prize for the best report they have ever seen. She said my line was all green and green is good. (Later when the doctor showed me the report, green means I use the machine every night).

I had more paperwork to fill out, besides what I had already received in the mail and brought with me.

First I had to watch a short video of the doctor explaining what sleep apnea is. At first I thought this would be nothing I needed, but it was very informative and explained sleep apnea very clearly. I have to admit, after seeing it, I really did not understand it previously.

I was disappointed when the doctor came in, that she was not the doctor who I thought I was going to see. But this doctor was very nice, and very thorough. She questioned me in great detail. She answered all of my questions. She was knowledgeable.

When she took my blood pressure, it was 124/58 and she asked was the bottom number always so low. After about 40 minutes with me, she told me that I was to watch another video and she was going to consult with another doctor about my pulmonary issues and then return to discuss the plan of treatment.

The second video concerned treatment options for sleep apnea.I thought it was interesting that her first option was weight loss. She said, if this will not work for you, then there is surgery, which has a 50% success rate for curing sleep apnea, or using the machine, which has a 100% correction rate.

After the video, the doctor who I thought I was going to see in the first place returned with the other doctor. They spent another 40 minutes with me, discussing my case.

My first question was since seeing the video, I wondered having lost over 100 pounds already, did she foresee a point when I would have less severe sleep apnea or even not have it at all anymore.

She replied that she wants me to have another sleep test - this time a split night test. For the first part of the night I will sleep without a machine to see if I still need a machine. If I am still having apnea episodes, they will put me on the machine and monitor pressures to see if I can reduce the high pressures I am currently using. That will take place on October 20.

Another concern this will address, is the fact that it takes me so long to get to sleep, and once I wake up during the night, it takes me so long to get back to sleep. She thinks the pressure may be contributing to that.

She is reporting to my primary doctor that she would like another CT scan (he has to order that) to see if there have been additional changes to my lungs.

IN addition, I am having a series of breathing tests done on October 29th, to determine lung function and breathing capacity. My oxygen level yesterday was 96%, which she said at my age is good.

I will see her again in three weeks to go over all the results and hear her treatment plans.

I felt good about this visit. I felt like my concerns were heard. I felt like my needs were addressed. With this doctor, I am a more informed patient and can ask better questions. They gave me a lot of information I never had in the past.

Please continue to pray for me as I have these tests to give the doctors wisdom in making right choices for my treatment.