I can't believe this doctor would say this.

SleepingBeauty · Post by **SleepingBeauty** » Tue May 08, 2007 7:43 am

A while ago I posted about a coworker who decided (after me trying to enlightenen him) to go to his doctor and request a sleep test. Well, he went.

And his doctor told him she was an "expert" in sleep apnea (this is his GP) and that based on his physical appearance (no large neck) and his age (25) that he most likely didn't have apnea. The copay for him to get the test was $500.

So, going on his doctor's assurances and the fact the he didn't have $500 to blow, he's not doing anything. How frustrating is that!

I asked him if he told her he wakes up at night with his heart racing and gasping for air. He did.

Did he tell her he can't stay awake in a car and that he rolled one by falling asleep at the wheel after a full night of sleep? He did.

Her response: You just aren't getting enough sleep in general. Try to go to bed earlier. She also suggested having his mom watch him sleep for a few hours to see if she notices him stopping breathing.

If I had a backup machine, I'd lend him mine to sleep one night and check the stats on it. Imagine the number of patients that will not receive testing/treatment with her as their doctor.

My own neurologist said she wouldn't have sent me in for testing based on my appearance. (I'm not overweight and don't have a large neck) I brought my report to her to request her to write a prescription for my machine so I could buy one on this site. She did say she would change the way she did her initial screening and wondered how many "like me" slip through the cracks.

How many people have to suffer until the medical community as a whole "gets it"

DeltaSeeker · Post by **DeltaSeeker** » Tue May 08, 2007 7:56 am

SB, I'm so sorry to hear this! After we convince people to talk to their doctors, the doctors should at least listen and write the order! Especially after all the evidence this guy presented!

I work with someone who has been TOLD by his doctor to have a sleep study done since he presents with all the risk factors - excessive snoring, overweight, neck size >17, etc. Since I found out about OSA and that he was recommended for testing I've been on his case to get it done. 2 months later it's still on his "to do" list. I have a feeling it won't ever move off there. Even his wife bugging him doesn't work.

When I tell him about the risk of heart attack/stroke, etc. his reply is that at least he'll get rest in the hospital!!! Yeah - he'll rest when he's 6 feet under too!!!

Heck, I always used to joke I had narcolepsy because I could fall asleep at the drop of a pin. But no one thought to order a sleep study on me. When I jokingly told my psych about it he was just going to prescribe Provigil since I'd been complaining about excessive daytime sleepiness for over a year and we had been trying to juggle my medications to counteract it. Only when I said "Whoa, it's probably not narcolepsy but I'm sure it's sleep apnea" did he even suggest a sleep study!

I can't believe he was ready to hand out a $300 script just on the basis of my testimony alone without having any physical testing behind it!!!!! I did end up on Provigil but only because I couldn't wait for the results of my study and to get my machine since I was in imminent danger of losing my job of 14 years due to productivity problems and falling asleep at my computer while typing!

Now since I've heard of the connection of ADHD and OSA, I wonder if I shouldn't get my kids tested. They have both been diagnosed with ADHD and I KNOW my son snores as well as sleep walks. I think I'm going to call my pediatrician right now since sleep walking is a sleep disorder. My daughter is also anxiety disordered and has night terrors. Poor guys - we had to subject them to our gene pool

SB, I wish I had an extra machine too - I'd give it to you to help this guy out!!!

Linda

Wulfman · Post by **Wulfman** » Tue May 08, 2007 9:04 am

Sleeping,

What I would suggest for your friend would be to ask his doctor if he would write a prescription for an overnight pulse oximetry. It's FREE.
The doctor writes a prescription and either gives it to him to take to a local DME or faxes it to a local DME. The DME gives him a recording pulse oximeter to wear overnight (clips onto a finger) and then he takes it back to the DME to be downloaded and a report generated. The DME then sends the report to the doctor.
It would be a good idea if the DME can also give your friend a copy of it and go over it with him and let him know if and what his desaturations looked like. (They aren't that terribly hard to understand)

IF that report shows significant desats, then he'll have some "ammunition" to use on the doctor.

Some of these doctors are plumb stupid!

Best wishes,

Den

Nitro Dan · Post by **Nitro Dan** » Tue May 08, 2007 9:04 am

Tell him to kick this "doctor" to the curb and find another one. She is going to get someone killed.

Guest · Post by **Guest** » Tue May 08, 2007 10:08 am

Den, an overnight pulse oximetry is a great idea! I don't know if I can convince him to go back and ask for that now. He will undoubtedly blow it off. Maybe I can plant a seed in him to request that the next time he goes in for something else.

If he were family or a close friend, I could pressure more. But this is just a guy I work with. I probably already sound like an idiot to him.

SleepySandy · Post by **SleepySandy** » Tue May 08, 2007 10:10 am

Tell him to kick this "doctor" to the curb and find another one. She is going to get someone killed.

No kidding. How completely unenlightened can you be? We should do a poll here to see how many people don't fit the physical mold for sleep apnea. The mold is broken and doctors who use physical appearance to "diagnose" are irresponsible.

SB - my insurance allows me to go to a specialist without a referral. Can your friend call and make an appointment with a "real" sleep doctor? I saw the sleep doctor and reviewed all of my symptoms and he ordered the sleep study.

aeroscout17 · Post by **aeroscout17** » Tue May 08, 2007 11:53 am

Pulse oximetry isn't always the answer. My wife has suspected I had OSA for over 5 years; I often woke at night gasping for breath, snored, etc. My old Dr. did the overnight oximetry and said there was no problem.

Fast forward (five years) to about a month ago with my first sleep test. AHI=26 and O2 level dropped as low as 80% and averaged mid 80s. Never made it to REM in 8 hours of sleep.

BTW, body size isn't always an indicator. Any Dr. that relies only on that needs to find a new job. I am 5'11'', 160 lbs with a 16 1/2 inch neck.

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Lepeu63 · Post by **Lepeu63** » Tue May 08, 2007 12:20 pm

I've a good PCP and I had to push to get one. While I'm not overweight, I've a 16.5 inch neck, am over 40 and have been a heavy snorer for years. Ya think?

Mile High Sleeper · Post by **Mile High Sleeper** » Tue May 08, 2007 1:27 pm

Sleeping Beauty and Delta Seeker, maybe this would help your co-workers. Go to the light bulb above, article on Evaluating Your Sleep, and find the assessment quiz links, print one, and give it to your co-workers. The quiz might make their symptoms more real to them. Then the co-worker could give their responses to their doctor. It's a little harder to deny something in writing.

The most comprehensive online quiz with a large list of symptoms is from Sleep Apnea - Phantom of the Night. The quizzes with the most credibility with doctors are the Berlin questionnaire and Epworth scale.

SB especially, since your co-worker fell asleep at the wheel, tell them there would be huge moral, legal, and financial consequences if he/she falls asleep at the wheel and kills or injures someone in a traffic accident. A good reason to be tested, even with a large co-pay.

Ditto, in that sometimes people can have sleep apnea and still look OK on a pulse ox.

LDuyer · Post by **LDuyer** » Tue May 08, 2007 2:37 pm

SleepingBeauty,

Mile High Sleeper is wise in suggesting printing out the various sleep apnea assessment quizzes for co-workers, terrific idea.

But if you want to reach more than your immediate friends, family and co-workers, you might consider sending something to that co-worker's "doctor." I run an AWAKE support group for sleep apnea, perhaps there's one near you and a coordinator can send info, or I could send something to him, just PM me the contact info. My point is if you can change the attitude of a doctor (like you wonderfully did with your neurologist), then you can help so many more people. Even if the docs don't agree, maybe they would be persuaded to maybe include the right questions in their standard questions list and to at least refer their patients to sleep specialists. It's quite likely it won't work. But hey, you never know.

Linda

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