Can I skip some days?

[Chevie]

I also acknowledge the legally established moral right of all people to choose for themselves based on their own opinions formed in consultation with their medical team.

So, if one doesn't consult with their medical team, then they have no right to choose for themselves?

Try telling the Federal Motor Carrier Safety Administration that drivers have a "right to choose".

[jnk...]

Thanks, Hang Fire. Corrected.

[chunkyfrog]

If he is driving a big rig, and has apnea, oh, Lordy, please somebody hogtie this menace before he kills somebody!

[carbonman]

Consider this place an intergalactic bar that serves ALL kinds. Not so much a tea room for balancing breakable dishes on your knee. It takes some getting used to, but a little time here once in a while can pay off in the long run.
But if this place ain't the place for you, enjoy your cup of tea. You will always be welcome here when you find yourself itching for a lightsaber fight.

JNK, my cpap brother. Thought you were lost in the ether.
So glad to see you back. Perfect description.

bluetrout.....what's a few nights.....what's a few brain cells.
Your choice.

......by the way...I "camp"...in a small trailer....in the boondocks.
I have only missed 3 nights of cpap in almost 8 yrs. Two nights in the hospital
w/my Dad, one night on the floor in the San Francisco airport.

[Susie Kay]

what's a few nights.....what's a few brain cells.

I am sure that some of mine were lost before CPAP started taking care of me.

[jnk...]

. . . has apnea . . .

This is a phrase that is especially difficult to define, in practice. In some cases, naturally, it is very clear cut. In other cases, though, not so much. The gray areas make the issue problematic legally and ethically. Especially if we add words like "treated" or "untreated" to it.

Most all adult humans 'have apneas' in the sense of occasionally pausing in their breathing overnight. And at least for now anyway, we need humans, if we're gonna have big rigs on the road. Google is trying to fix that, I think.

So now we're left with the concept of where the line should be drawn for "diagnosing" and "treating" obstructive sleep apnea.

Generally speaking, an asymptomatic person can have an AHI/RDI as high as 14 (on one night at one clinic) and still be considered NOT to have OSA. On the other hand, a person who subjectively reports daytime sleepiness (which, keep in mind, may or may not relate to the pauses in breathing overnight) and (on one night at one clinic) has an AHI/RDI above 5 can be diagnosed as 'having obstructive sleep apnea.' Why? This is to allow for people who are particularly sensitive to breathing disturbances at night to get their machine paid for by insurance.

The problem is that if we draw the line at 5 AHI/RDI to force insurance to pay when a person subjectively reports sleepiness, that implies to some authorities that that is where the line should be drawn for all professional drivers, whether they subjectively report sleepiness or not. In other words, for milder cases, diagnosis is all about Epworth. Not Chicago. Now we have a situation ripe for an industry's ethical standard to be based on something totally, arbitrarily, subjective, or to be based on a misunderstanding of the objective criteria for clinical diagnosis.

OSA, as a syndrome, requires judgments of clinicians who differ in their interpretations and testing methods, no matter how "standardized" everything is supposed to be. That puts the clinician in the awkward position of judging the employability of a fellow human based on what are difficult judgment calls on things that vary night to night, that can be measured many ways, that can be interpreted many ways, etc.

It would be nice if OSA were as clear cut and matter-of-fact as some people make it out to be.

In my opinion, it just ain't so.

The reasons we want pilots, train conductors, and big rig operators to be held to a higher standard than the general population are all commendable. But once you do that, why not just make it against the law for any human to drive who has yawned after waking up in the morning, and then let the economy collapse? People with young children, noisy pets, loud neighbors, or who live near an airport can all be considered sleep-impaired to one degree or another. Will we make it against the law for them to drive?

Add to that the ambiguity of "treated" and we have a real mess on our hands. Can a trucker choose a dental appliance? surgery? sleep-position therapy? And what if a trucker's untreated RDI is above 100 but his treated RDI, with CPAP, is still above 5? Is he allowed to work? Do you consider him treated or untreated? And who decides? Based on what study?

Life just isn't that clear. If a trucker is found to have been drinking coffee before a crash, does that prove he must have been sleepy and thus guilty of negligence? or does it prove he was taking his wakefulness seriously? I don't know. Lawyers could make a case either way. And win.

I think we should be careful what we wish for. We can't decry the hair-splitting of doctors and lawyers and then demand that they do more hair-splitting for us. Sleepy driving is a complicated question without an easy fix in practice, no matter how clear it may seem to some minds. There is no breathalyzer-type sleepiness test that can print out the true state of someone's degree of impairment. So for me, instead of thinking of it all in terms of the extreme cases everyone would agree on, some problems must be approached by thinking in terms of the gray areas and potential for abuses based on bad judgment and misunderstandings.

OSA diagnosis and treatment is mostly gray, not black and white.

In my opinion.

And goodness knows I have no shortage of those.

[jnk...]

. . . JNK, my cpap brother. Thought you were lost in the ether. . . .

CARBONMAN!!!

Good to 'see' yuz! Thought of you when I twice drove through and stayed in your state last July. Had never been there. Was seriously blown away by it.

And hey, I do get lost in the ether all the time. But I try every once in a while to pop in just to cause trouble. It's what I do.

I still admire your form of 2x4 therapy.

And no matter which galaxy, I would be proud to be in the same band with you any time, friend.

[bluetrout]

WOW! I just discovered the "foe" list possibility. This Forum is a source of information and help now. A wonderful tool.

[Sticky Fingers]

WOW! I just discovered the "foe" list possibility. This Forum is a source of information and help now. A wonderful tool.

You are exhibiting that you are what you condemn. Welcome to the forum. I am sure you will misfit in well.

[BlackSpinner]

WOW! I just discovered the "foe" list possibility. This Forum is a source of information and help now. A wonderful tool.

Make sure you block out people whose facts don't agree with your unsupported opinion!

[jnk...]

WOW! I just discovered the "foe" list possibility. This Forum is a source of information and help now. A wonderful tool.

Make sure you block out people whose facts don't agree with your unsupported opinion!

I don't think he can hear you now.

But wouldn't it be better to block out the people whose opinions don't agree with supported facts?

Then again, I learn more from the foe-like than I do from yes-persons. Just sayin'.

Will all who agree with me please raise their hands? -- Anybody? Anybody? -- Bueller? Bueller? -- Hello?

OK. Then would everyone who has blocked me please send me a PM to let me know about it?

Thanks.

[chunkyfrog]

You are too entertaining to block; wrong opinions (if any) notwithstanding.

[Wulfman...]

Thanks jnk. Intelligent and constructive amidst the "don't run with scissors" babble that seems to dominate here. I love the advice not to pay attention to a PM because it's not "vetted" by the forum members. Are you kidding me? Some great people here but a large % of folks needing mental care...and some other hobby.

Hmmmmm....... I always thought that's why we WERE here.

We get the "mental care" and enjoy our "hobby" by TRYING to help others.
They come here seeking help and information and we try our best to assist them.
They're not obligated to take any advice and sometimes that's evident.
But, we try.......
Many of us have had years of personal experience and/or reading others' experiences.......and try to use that to answer the questions that are asked of us.
I've always compared this forum to a backyard party at the Goodman house. Some people bring the goodies and some just enjoy the hospitality, eat the goodies and leave without offering anything in return (paying it forward). Some people stay and some people leave. Some just peek over the fence and watch for awhile before they either join in or leave. Some get rowdy and obnoxious and wear out their welcome. It is what it is. But, if EVERYBODY with any knowledge and experience left, who would answer the questions of those seeking information. Oh, most of it is here in the archives, but too few people search for it and keep asking the same questions over and over.
Take the bad with the good. Accept it for what it is and try to understand who we are and why we're here.

Welcome to the forum!


Den

.

[Air Jordan]

We get the "mental care" and enjoy our "hobby" by TRYING to help others.
They come here seeking help and information and we try our best to assist them.

I still consider myself a newcomer, and I do appreciate the advice received from the senior members. Funny that someone comes in new and starts slamming those who are trying to help him.

[BlackSpinner]

We get the "mental care" and enjoy our "hobby" by TRYING to help others.
They come here seeking help and information and we try our best to assist them.

I still consider myself a newcomer, and I do appreciate the advice received from the senior members. Funny that someone comes in new and starts slamming those who are trying to help him.

It is part of the "denial" and "anger" phases of adjustment. They really don't want to hear the real facts, they are hoping their fantasies will be fulfilled.