PSG report (or, addendum to updated update)

[goose]

echo, echo, echo.........
As I was reading along, I got out my 2x4......The smoking deal.......
But I put it away. Generally doesn't work that way......
You can put me in the former smoker barrel.....but unlike most I know, for me, stopping was one of the easiest things I ever did for myself.....

I'll give you a short picture -- I started cigarettes at about 8 and really got into them about 12-13......Until I went into the Navy it was maybe a pack a day by that point (19). During service time it varied -- in Vietnam there were times when it was 6-7 packs a day (yes. Someone had to kick me in the chest to get my lungs started each day ) and after that time, it rarely ever got much over 2 packs a day (depends).....At the time, I was doing a LOT of drugs - some that tended to cause more smoking..... (I'm a "child of the '60's from the San Francisco area -- I don't hide from my past....)
To make a long story a bit shorter, after the Vietnam experience I started getting bronchitis two or three times a year, and had full blown pneumonia 4 times (along with the lung damage that goes along with that)......
At 25 (1975 to put it in a time frame), I was so fried from the drugs I quit all chemicals - have never looked back, but I was at the point of "wanna".
That same year, I got bronchitis reeeeeelllly bad and after going through 2 runs of some pretty heavy duty antibiotics as well as some prednisone, I still couldn't breathe so I went back to the doc to get more pills (it's the American way).....The doc listened to my chest which was crackling, wheezing and in a few words, were very clogged. He looked at me and said, "You have healthy lungs for a smoker. If you want to continue breathing, you need to quit smoking and the only way to do that is cold turkey".....among other things......
I had 2 smokes left in the box - smoked one on the way home, sat on my living room couch and smoked the other, crushed the box and have not touched tobacco since......The magic word in all of that is "wanna". It was something I had known I needed to do, but hadn't had the impetus nor the incentive to actually do it.....But I did wanna. So it happened. I will admit to not going to a bar for 6 months (I was a drinker (moderate) at the time) because I knew that would be my downfall -- and to this day, when I do decide to have a drink in a bar (even if it's non-alcoholic) I chew the swizzle stick or the little straw to bits -- literally!!!! So that "oral thing" is still there, even after 34 years!!!!
As an aside, I'd always said that when cigarettes got to $.35 a pack I'd stop. It was $.50 a pack........Hell. Today, pot is cheaper!!!!!
Ninety percent of all the "afflictions" I had suffered miraculously went away. It took time, but I've only had bronchitis twice in those 34 years, and I've never had another bout of pneumonia.
Some here know, I'm a strong believer in the power of the mind. If you don't wanna, ya ain't gunna -- patches, pills, gum, whatever. Ya gotta wanna.....
All of that said, I do not EVER minimize other's difficulty in kicking cigarettes. To me, cigarettes are worse than crack!!! IMHO, the tobacco companies are worse than any drug dealer I ever met (and trust me, I met a lot of them in my younger days!!!!!!).....I'll leave it at that......

SAG can probably explain it better than I, but your swallowing pneumonia could somewhat be directly attributed to your smoking. When you smoke, the cilia in your trachea are "burned away" so that path is more susceptible to invasion. When the cilia is normal, it will help inhibit that invasion and actively move invaders back out (at least that's my understanding of how it works - in a nutshell).....It doesn't mean that nothing will ever go down the wrong pipe, it just means your natural defenses have been compromised....

Echo. Please. For me. For the rest of us, but more importantly, for yourself -- stop smoking!!!!
(note I didn't say quit!!!!!!! That's another "goose" mental trick I use with myself -- I didn't quit. I stopped - 34 years ago. For some reason, in my mind, quit seems to have some negative connotations, so...........)..

Take care
cheers
goose

[-SWS]

Echo, I am so sorry to hear about your aspiration pneumonia in the thread below:
viewtopic/t36604/Pneumonia-and-CPAP.html

I found the english name for it: aspiration pneumonia

Yeah, that is a fast incubation time... My lungs were painful immediately after the inhalation of the water, and it's just continued. I've been reading the symptoms of viral pneumonia, and I'm wondering if I had that first.

Also we're floating around a theory that I'm aspirating my GERD/reflux in my sleep -- which can also contribute to pneumonia?

Let's modify that theory: I wonder if prolific refluxing during your sleep might have also been causing or contributing to any or all of these:
1- that repeated "heavy" feeling in your lungs upon awakening,
2- that back-of-the-tongue "gunk" you mentioned occasionally feeling upon awakening,
3- those FL increases on the 420e that you correlated with sleeping or feeling poorly
4- GERD-based arousals during sleep
5- poor PFT diffusion
6- higher-than-usual HI during your recent NPSG titration
7- GERD-based dysphagia (wrong pipe & swallowing problems)
8- GERD-linked pneumonia
9- chest pains

Over time, untreated GERD causes difficulty swallowing, also called dysphagia

http://www.webmd.com/heartburn-gerd/gui ... ux-disease

People with GERD also appear to have an above-average risk for chronic bronchitis, chronic sinusitis, emphysema, pulmonary fibrosis (lung scarring), and recurrent pneumonia. If a person inhales fluid (aspirates) from the esophagus into the lungs, serious pneumonia can occur.

http://www.umm.edu/patiented/articles/w ... 0064_5.htm



Please get well real soon, echo!!!!! Rest up!

[-SWS]

However, on the topic of stressful vagal reactions, does your voice happen to crackle a lot----or do you have any other common symptoms of vocal cord dysfunction?

I tell ya -SWS I never had VCD before, don't know if you have, but when you have it you KNOW it, it will wake you like nothing else, I can remove the mask with all straps still attached. I've had it happen twice in the last 3-6 months during sleep, your discussion about it a long time ago and seeing videos is the only thing that got me breathing again, it was behind my adams apple, and I had to aggressively massage the hyoid bone to get them to open. CPAP seemed to make it worse as before I ripped the mask off I could feel the pressure against my vocal cords holding them closed, but at the same time I was trying to gasp for a breath. While I've had a couple strokes, I've had like 9 different MRI's and none show damage to that part of the brain, so I can't blame that on it, I assume it was from drinking a glass of milk w/nestle quick and having it too close to bed that and possibly some post nasal drip, it was acting like superglue on those vocal cords.

So from my experience with VCD there is no mistaking what it is especially when you are trying so hard to get a breath that you move the hyoid bone to open it. Having experienced it only 2 times in my life time here recently I can easily see why people die in their sleep. I could also see how it would/could turn into a very stubborn apnea from the machine's perspective.

I don't think it happens on a nightly basis, if it does the person is in a world of hurt.

Snoredog, yikes!

What you described sounds like a couple severe laryngospasms. And yours may or may not have been related to the disorder known as VCD. As it turns out there are several etiologies associated with laryngospasms. And very fortunately a pair of isolated laryngospasms do not necessarily make for any given disorder. Hope you never get them again.

Also, supposedly many patients with VCD can go for years without being diagnosed with VCD. As it turns out VCD symptom presentations and severity don't always entail full-occlusion laryngospasms. So some VCD patients and doctors suspect nothing more than voice crackle coupled with misdiagnosed asthma or bronchospasms.

So you probably had yourself a humdinger but hopefully isolated pair of laryngospasms. Glad you're okay!
http://en.wikipedia.org/wiki/Laryngospasm

[echo]

I won't be able to answer all the previous questions today but I'll work on them slowly over the next few days.

Pollution:
http://en.wikipedia.org/wiki/Environment_of_Belgium
http://www.irceline.be/~celinair/actair ... php?lan=en : I'm currently living just a few miles outside one of the largest cities, all the way up in the north, about halfway across horizontally. Pretty much where all the little tiny boxes are. I spend ~3 hours per day in traffic 3-4x times a week (I've started closing the car vents it's so bad in the traffic). During winter it's worse because everyone's burning either wood in the fireplace or fuel oil in their heaters. I've only been living in this house for under a year, but in this general vicinty of Belgium-Netherlands for ~5 years.

Smoking:
Up until last week I smoked 1 pack/day. (I'm only going on 4 days, but) I'd like to say I'm now an "ex-smoker"
(Thanks for sharing the story goose!! I agree with your quitting vs. stopping - I also prefer to refer to it at stopping! Quitting implies giving up - and I'm not really "giving up" anything but gladly getting rid of it!).

GERD:
I only noticed GERD when I had gained a lot of weight towards the end of uni. It seemed to go away after I lost a lot of weight and was doing the food combining diet. Since then, I have noticed heartburn off and on, but almost always correlated with poor diet. Most recently it's come back this year, slowly at first, but more noticable recently (or it was always there but I never noticed it!). I've only noticed the bad-taste-in-mouth-upon-waking quite recently (last month or two or so).

I'm wondering if the problem hasn't been weak LES all along. My dad also had lifelong GERD, even with massive amounts of proton pump inhibitors he still got esophageal cancer. Was his real problem the LES? (Never smoked, was very careful with his diet)
My sister and I both have GERD-related problems. There's something genetic here (which probably also means it's didn't magically show up at the age of 20 or 30).

Wow this post took way too long to write. I need another nap. Woah I am dizzy too.

I'm thinking the followup PFT will have to wait until I can breathe normally again

Thanks again for replying and for your help.

[echo]

Not sure what else I can add to the story at this point, except to say that I still need to reschedule the endoscopy (can you call me a procrastinator), and now a followup PFT as well.

The chest pains have come back , but so has the GERD (BIG TIME, due to the crazy antibiotics upsetting my system and my crazy appetite for all things carby and fatty). My 5-day liquid fast was quite nice and I miss it.

I was running on a pressure of 7.5 for the last three days, AHI and snores are higher, and so are flow limitations and my breathing (cycle states) looked really unstable. I'm raising the pressure back up to its normal value, I'm guessing my lungs can handle it, otherwise I'm going to suffocate in my sleep.

I've hit the peak of the "i've stopped smoking and now i'm getting annoyed" cycle. Every time I've broken down after 1 week and started again. I now realize that that the withdrawl lasts more than 3 days. So far am Stayin' strong (an' eatin chocolate). Starting to exercise (again).

One last question:
My breaths-per-minute was on average 16-17, sometimes up to 18. What does that mean, in the context of possible lung damage? Why would my night-time breathing be so fast if I'm breathing so slowly during the day?

Last few nights it's been around 15 BPM, the lowest it's ever been. I'm wondering if the drop is correlated with cleaner lungs (only after 1 week??), or a lower pressure.

[ozij]

Last few nights it's been around 15 BPM, the lowest it's ever been. I'm wondering if the drop is correlated with cleaner lungs (only after 1 week??), or a lower pressure.

I'm not a professional in this, and may be all wrong about you specifically, but as a rule pneumonia affects the lungs abilty to get oxygen from the air into your body --> which means you have too little oxygen in your blood --> and your brain gets slightly less oxygen --> so your brain instructs your body to breathe faster in an attempt to get more oxygen in.

O.

[echo]

Sorry, I should have been more clear Ozij. Since I started using the 420E + SL (Nov 2007), my BPM was mostly between 16-18 .

It was closer to 18 during the time I've been using the higher pressure of 10.5cm. Only the last 4 days have been low at around 15.

The only other time that my BPM were 15 or less was last year at the end of December, when I had another respiratory infection (while on holiday in a warm location, urgh) and again took antibiotics (and also missed CPAP for a few days due to the illness).

Anyway I am probably again over-analyzing the data! I've got some interesting trend lines though! If I track the running 1-week average, it looks like my breathing speeds up and slows down on a monthly cycle. Now that's interesting

[ozij]

On a monthly cycle, huh? Any correlation with that other monthly cycle?

O.

[-SWS]

Yeah, I had a friend whose heart rate and even respiration used to speed up monthly. For some reason every time that night sky would reach full lunar cycle, his hair and even fingernails would experience unusually rapid growth. Then his canine or eye teeth grew noticeably longer as well. That whole strange experience was understandably enough to make this guy howling mad---literally.

Anyway, I wonder why your heart rate might be doing that, echo.














J/K

[echo]

My boyfriend says to tell you that I'm feeling better and that you don't have to have sleepless nights trying to save me.

[-SWS]

Apparently my humor missing the mark once again. Sorry, echo.


[on edit: Hooray! My humor didn't miss the mark! It's been known to do that... ]

[echo]

Sorry SWS, I was trying to be funny too. Guess it didn't work either (i should've added a smiley or something). I'm just mad at the world today. I was reading this on the couch, BF next to me mocking me even more about the monthly cycle, I tried to be funny... .

Anyway I thought what you wrote was hilarious. I was really on the floor rolling laughing!

p.s. THE BPM really IS on a monthly cycle, neither of you believe me

[ozij]

I do believe you. While I was trying to be funny too -I serious as well. A woman's body can go through so many changes within a month, why not check if they're correlated with her breathing rate?

O.

[jnk]

. . .My boyfriend says to tell you that I'm feeling better . . .

What a nice guy! It is good he is so concerned about you, and us!



Better?

[edited to address echo's shame]

[echo]

OK, I'm going to just start a NEW thread, called "Monthly cycles, or What your doctor didn't tell you about about [censored] Breathing" (that was probably so not funny ). And then we can bury this whole complete miscommunication and start another one where we communicate even less effectively.

And JNK, now I am really annoyed with you, you have gone and quoted me so there is really no way I can remove the evidence of my shame.

Last night as I was falling asleep, I was thinking to myself: just how many different events can I correlate this BPM cycles with .... my other cycle, phases of the moon, temperature changes, .. and if I posted it would anyone take me seriously? Guess I will just have to take that risk, Ozij you have already committed to taking me seriously. (Body temperature is one very well correlated metric with respect to monthly cycles!). Now, time to massage the numbers....