Just got back from Doctors appointment

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Enchanter
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Just got back from Doctors appointment

Post by Enchanter » Wed Apr 22, 2015 5:40 pm

I listened to Robysue. I didn't start telling strange stories to my doctor. It was probably the right choice because it's important to address the major concerns. I simply told him that I'm fatigued, don't sleep well, and don't wake up refreshed. I learned that it would have taken too long to tell him stories about what I think is going on when he is the doctor.

He checked my throat and said that I probably have sleep apnea, based on throat/neck area. Can someone explain to me what looking in your throat tells you?

So they're going to call me in the next couple of days and the sleep study should be sometime next month, if not sooner. He said that if you're tired in the day, it could be from sleep apnea. I asked him what we're going to do if I don't have it. He said he thinks I do have it but if the tests said I didn't have it, we'd have to start looking elsewhere to see what's causing me to be tired and not sleep well. But he said I probably have it.

Now he didn't prescribe me sleep medicine for the study. I was adamant about the fact that there's a strong chance that I won't sleep through the test. He just kept on saying that I'll probably get some sleep. So... I guess I'll have to take a good dose of my melatonin though to ensure that I do sleep a little bit.

I guarantee that the struggle weight lifting and the other stuff that suffers is largely due to just being tired. I think being fatigued is a good enough reason to feel strange. Maybe my brain is just tired from not sleeping well and all the stuff about oxygen is just my opinion or imagination, but I'm not a doctor.
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Tatooed Lady
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Re: Just got back from Doctors appointment

Post by Tatooed Lady » Wed Apr 22, 2015 5:50 pm

If you were unclear as to neck/throat has to do with OSA, why didn't you clarify with your doctor? He is the doctor, we aren't, and you had his focus at the time. Could be circumference, lumpiness, nodes, whatever. We won't know unless you turn your head and cough, please.

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kaiasgram
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Re: Just got back from Doctors appointment

Post by kaiasgram » Wed Apr 22, 2015 5:57 pm

Docs can see just by looking if your airway appears crowded (for example size of tongue and uvula, and how much "space" they take up). I have a cool graphic my doc used to show me some of the differences they can see in different people. I'll dig it up and post it for you after work.

I hope the appointment put your mind a little more at ease.

Edit: Here's the graphic. You can see how just looking in the mouth gives the doctor some clues about a person's risk for obstructive sleep apnea.

Image

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SleepDisturbed
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Re: Just got back from Doctors appointment

Post by SleepDisturbed » Wed Apr 22, 2015 5:59 pm

Enchanter wrote:I listened to Robysue. I didn't start telling strange stories to my doctor. It was probably the right choice because it's important to address the major concerns. I simply told him that I'm fatigued, don't sleep well, and don't wake up refreshed. I learned that it would have taken too long to tell him stories about what I think is going on when he is the doctor.

He checked my throat and said that I probably have sleep apnea, based on throat/neck area. Can someone explain to me what looking in your throat tells you?

So they're going to call me in the next couple of days and the sleep study should be sometime next month, if not sooner. He said that if you're tired in the day, it could be from sleep apnea. I asked him what we're going to do if I don't have it. He said he thinks I do have it but if the tests said I didn't have it, we'd have to start looking elsewhere to see what's causing me to be tired and not sleep well. But he said I probably have it.

Now he didn't prescribe me sleep medicine for the study. I was adamant about the fact that there's a strong chance that I won't sleep through the test. He just kept on saying that I'll probably get some sleep. So... I guess I'll have to take a good dose of my melatonin though to ensure that I do sleep a little bit.

I guarantee that the struggle weight lifting and the other stuff that suffers is largely due to just being tired. I think being fatigued is a good enough reason to feel strange. Maybe my brain is just tired from not sleeping well and all the stuff about oxygen is just my opinion or imagination, but I'm not a doctor.
Outstanding! Sounds like you handled it just fine.

When they call you to setup a time for the test ask them if they have a cancellation list, where they call you if they have a cancellation. If you can be flexible you might get lucky, I did. I had an appointment for a month in the future but got in in just three days.

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Julie
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Re: Just got back from Doctors appointment

Post by Julie » Wed Apr 22, 2015 6:13 pm

A major reason people who are otherwise slim have apnea is anatomic - small recessive jaw and/or narrow internal neck/airway... so you must fit the second bill, just luck of the draw, tho' no more unlucky than those for whom weight is an issue.

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Re: Just got back from Doctors appointment

Post by yaconsult » Wed Apr 22, 2015 6:30 pm

Yes, that kind of diagnosis is often made and then a sleep test is done for confirmation. You have a narrow throat opening. The doctors in that department looks in throats every day and know a narrow opening when they see it. Congrats on being able to get a sleep lab appointment so soon - you're a lucky man! Oh, and you might want to ask if they can do what's called a "split study". This is where, if they determine that you have apnea in the first half of the night, they will put a mask on you and determine what pressure you need to stop the apneas. Otherwise, if you only have the sleep study you will need to go back for a second night in the sleep lab for what they call a "titration".

In my case, before I had ever tried cpap, the ENT doctor looked down my throat and said that my throat opening was too small and didn't think cpap would be enough and she thought I should consider a tracheotomy so that I could leave it open at night and be able to breathe. I said, let's try the cpap. And, thankfully, it worked wonderfully for me.

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Enchanter
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Re: Just got back from Doctors appointment

Post by Enchanter » Wed Apr 22, 2015 6:42 pm

yaconsult wrote:Yes, that kind of diagnosis is often made and then a sleep test is done for confirmation. You have a narrow throat opening. The doctors in that department looks in throats every day and know a narrow opening when they see it. Congrats on being able to get a sleep lab appointment so soon - you're a lucky man! Oh, and you might want to ask if they can do what's called a "split study". This is where, if they determine that you have apnea in the first half of the night, they will put a mask on you and determine what pressure you need to stop the apneas. Otherwise, if you only have the sleep study you will need to go back for a second night in the sleep lab for what they call a "titration".

In my case, before I had ever tried cpap, the ENT doctor looked down my throat and said that my throat opening was too small and didn't think cpap would be enough and she thought I should consider a tracheotomy so that I could leave it open at night and be able to breathe. I said, let's try the cpap. And, thankfully, it worked wonderfully for me.

He said something about a double study
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Enchanter
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Re: Just got back from Doctors appointment

Post by Enchanter » Wed Apr 22, 2015 6:43 pm

Tatooed Lady wrote:If you were unclear as to neck/throat has to do with OSA, why didn't you clarify with your doctor? He is the doctor, we aren't, and you had his focus at the time. Could be circumference, lumpiness, nodes, whatever. We won't know unless you turn your head and cough, please.

I think he said there wasn't a lot of room in the neck area. He said I have a little ''thing'' I think.
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Tatooed Lady
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Re: Just got back from Doctors appointment

Post by Tatooed Lady » Wed Apr 22, 2015 6:47 pm

Enchanter wrote:He said I have a little ''thing'' I think.

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archangle
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Re: Just got back from Doctors appointment

Post by archangle » Wed Apr 22, 2015 6:52 pm

A quick look at the throat can give the doctor a good clue that you're a good candidate for sleep apnea and should take a sleep study. Especially when you have other symptoms of apnea.

I think the good doctors know who has apnea a lot of the time long before the sleep test starts.

I think any doctor who sends a patient for a sleep test without a "just in case" sleeping pill should be horsewhipped.

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Enchanter
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Re: Just got back from Doctors appointment

Post by Enchanter » Wed Apr 22, 2015 7:33 pm

archangle wrote: I think any doctor who sends a patient for a sleep test without a "just in case" sleeping pill should be horsewhipped.

That's what I didn't understand. I tried to convince him and he just said most people sleep some and I probably will too.
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Malibu
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Just got back from Doctors appointment

Post by Malibu » Wed Apr 22, 2015 8:51 pm

Just out of curiosity what is your age and basic things like height and weight?

And I totally agree with archangle a one time Ambien (basic short term sleeping pill) would be beneficial. The room isn't like home. The techs are in and out checking/fixing leads etc And if they do a split study with a titration I would bring some foam ear plugs. If you can sleep through noise and changing pitches of fan motors then ear plugs might be over kill. It took me two years to finally get things figured out. Your mileage may vary

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Re: Just got back from Doctors appointment

Post by robysue » Wed Apr 22, 2015 9:54 pm

Enchanter,

I am glad to hear that the doctor's appointment was mostly positive.

It is a shame that the doc was unwilling to prescribe one ambien for the night of the sleep test.

Do keep in mind that if you get as little as 2 hours of highly fragmented sleep, that's still enough to get diagnosis.

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Re: Just got back from Doctors appointment

Post by kteague » Wed Apr 22, 2015 11:59 pm

Enchanter wrote:He said something about a double study
There's a couple ways to test in the lab. One way is to do a full night for the diagnostic study then come back for another night if the first test shows a need to be titrated on CPAP. The other way is to do what's called a split night study. If one sleeps enough the first half of the night the second half is spent finding the right pressure on the CPAP. If one can't get to sleep early enough to collect enough data to do a split night and they capture data later into the night, a second night will be scheduled.

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Re: Just got back from Doctors appointment

Post by tedburnsIII » Thu Apr 23, 2015 12:34 am

Malibu wrote:Just out of curiosity what is your age and basic things like height and weight?

And I totally agree with archangle a one time Ambien (basic short term sleeping pill) would be beneficial. The room isn't like home. The techs are in and out checking/fixing leads etc And if they do a split study with a titration I would bring some foam ear plugs. If you can sleep through noise and changing pitches of fan motors then ear plugs might be over kill. It took me two years to finally get things figured out. Your mileage may vary
My bro-in-law went for the study and was tossing and turning and uncomfortable the entire night. He practically swore that he did not sleep at all! I was not going to let the study interfere with my sleep and I did not want to feel uncomfortable.

In my case, for the study, I took more than my usual dose of sleeping medications when I would take them. As far as I was concerned, I slept through the entire night and was not the wiser, and my own overnight oximetry testing is basically in accord with the titration study, though I am reading Sp02 probably a bit higher than Sa02. Then again, they had me on my back for that and Sa02 readings might be lower in that scenario, in addition to being lower overall.

I was told that one could take their usual medications (in order to duplicate one's usual regimen). However, and I am not a sleep tech or doctor, I don't think it ill-advised to take a mild prescription sedative even if one doesn't regularly take them. After all, one is in unfamiliar surroundings, with unfamiliar bed, and 17 or so wires/probes whatever, sticking out of your body, and a belt around your waist/chest area as if you were to be brought to the electric chair! lol!

In my case, and YMMV, I took 2.5 mg of Valium (small dose) and 10mg of Ambien (moderate dose), which were double the dosage that I would normally take. I waited til the tech told me it was ok to take them.

If you are not used to Ambien you might hallucinate a bit on it the first few times. I found that amusing and kind of pleasant. It was nothing radical. 5 mg on empty stomach and in bed and not walking around or reading, watching TV, etc. is a usual starting dose of Ambien. Good luck in getting the medication. I can't believe that the doctor refused to write a script or give you a few pills, but perhaps he was concerned about your ability to drive the following morning- I really have no way of knowing.
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