My doc is only in two days a week (travels down from another town apparently), and I didn't hear a word about my request in those two days, but I'm hoping "no news is good news" and that he is trying to process the request through the insurance hoops rather than that he just blew me off. I am frustrated with a capital F, but what more can I do? I'll see him in person on Monday and hopefully will be able to be more persuasive if that is what is needed.
Peggy
Swallowing Air
When I complained about my air swallowing problems to my sleep doc, he said he'd never heard of that problem.
He tried to prescribe Reglen for me to take long-term because he'd "heard" that may help. I checked and it seems there are potential serious irreversible side effects from that drug.
yeah... i haven't been back to him again.
JQP
He tried to prescribe Reglen for me to take long-term because he'd "heard" that may help. I checked and it seems there are potential serious irreversible side effects from that drug.
yeah... i haven't been back to him again.
JQP
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OldLincoln
- Posts: 779
- Joined: Wed Mar 26, 2008 7:01 pm
- Location: West Coast
[quote="pjwalman"]Gosh, I can relate, and I'm so sorry you are suffering through this, too! My stomach pain woke me up last night. I laid there trying to ignore it so I could go back to sleep but finally admitted defeat and went to get up. I was immediately doubled over in pain, stumbled bent over to the bathroom where I threw up ....
Thank you for the new terminology and knowledge, Earle. If aerophagia isn't enough of a concern, then gastric insufflation it is. I will keep you all posted on what happens Monday. Bottom line, I know I can take control of my own situation if I have to, but I want to go into it wisely and informed about how the centrals might be affected by changes I take into my own hands. Hopefully I won't have to go there, but I know there's a possibility I will have to, and thank goodness for all the kind and brilliant people on the forum who will help me figure things out!!
Peggy
Peggy
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NightHawkeye
- Posts: 2431
- Joined: Thu Dec 29, 2005 11:55 am
- Location: Iowa - The Hawkeye State
Thank you, OldLincoln. As one who has endured my share of pain from "gastric insufflation", I appreciate being enlightened.OldLincoln wrote:On the other hand, they take gastric insufflation as something that happens to you and can kill.
Here's what one study from the British Journal of Anesthesiology has to say about it:
These are certainly non-trivial concerns. I don't recall anyone posting about "gastric insufflation" here before.BJA, [url]http://bja.oxfordjournals.org/cgi/content/full/88/1/127[/url] wrote:Gastric insufflation is a major hazard of positive-pressure ventilation in non-intubated patients and can predispose to regurgitation, impaired ventilation, reduced cardiac output and visceral rupture.
Regards,
Bill
[quote="OldLincoln"][quote="pjwalman"]Gosh, I can relate, and I'm so sorry you are suffering through this, too! My stomach pain woke me up last night. I laid there trying to ignore it so I could go back to sleep but finally admitted defeat and went to get up. I was immediately doubled over in pain, stumbled bent over to the bathroom where I threw up ....
Finally got to see the doc today. He was very reluctant to prescribe the APAP for me because he said, "You're doing so well, almost 100% compliant, that I hate to change anything." This despite the fact that I'm doubled over, throwing up at times along with the burps, miserable. (Jeez, that's what I get for being a stubborn cuss that refuses to let this thing win! It almost cost me my chance to try something that could give me some relief!) But he finally acquiesced and asked me to come back in a month to assess things. So my range is 6-11 now, no ramp, and I'm hoping it will help. I've been starting my ramp at 7 the last couple weeks so hope I won't have trouble being at 6 most of the time, but I'm thrilled that I'll have access to more data now and can see what pressure I spend most of my time.
Thanks again to all for all the support!
Peggy
Thanks again to all for all the support!
Peggy
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NightHawkeye
- Posts: 2431
- Joined: Thu Dec 29, 2005 11:55 am
- Location: Iowa - The Hawkeye State
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socknitster
- Posts: 1740
- Joined: Fri Jun 01, 2007 11:55 am
- Location: Pennsylvania
- Contact:
I read thru this whole thread and was shocked that no one mentioned GERD.
I suffered from severe silent GERD to the point that my esophogus was swollen and damaged and I didn't know it. Silent GERD is basically heartburn that you can't feel or don't notice. The symptom that tipped off my ENT doc was the persistent thick mucous glob in my throat that I complained of--I thought it was from allergies. He said it is the body trying to protect the esophagus from all the acid. No matter how often I swallowed or cleared my throat I couldn't get that glob to go away.
I suffered terribly from aerophagia when I first started cpap last summer. Eventually when i got the GERD under control it went away.
The keys for me were--using an auto bipap (which I was lucky enough to have from the beginning), sleeping on a wedge called Medislant (available at amazon), sleeping exclusively on my left side and taking acid reducers.
I'm now 7 months pregnant and don't suffer from aerophagia AT ALL anymore. I still take a zantac (doctor ok'd) every night before bed to prevent any acid from causing any damage.
Another thing that helped but is a little bit extreme for most is that I got my tonsils out (they were huge--touching at times) and that allowed me to reduce my pressure by 3-4 cm water pressure within 6-8 weeks of the surgery. Actually after addressign the GERD and the tonsils I am down from an original scrip of 16/12 to the current 10/7 bipap--and the reduction in pressure surely helps.
The cause of the air getting into your stomach is the Lower Esophogeal Sphincter isn't tight enough and lets air get by. That is also the spot where GERD does the most damage so it makes sense, to me at least, that most of the folks dealing with aerophagia likely have GERD problems. A sphincter that is swollen and damaged from being bathed in acid all the time is not going to function properly. Likewise those with very high pressures may be affected by GERD--swollen tissue is hard, not soft, and may be harder to move out of the way to open the airway.
So, you may want to talk to a doctor about it. I, for one, had to use acid reducers for a long time before I saw relief. My preference now is to take zantac at bedtime and I will continue this for the long term. It is a shorter acting drug so it allows me the full acid complement to digest my food all day, but cuts off the acid at night when it is not really needed and can do the most damage.
Hope that helps!
jen
I suffered from severe silent GERD to the point that my esophogus was swollen and damaged and I didn't know it. Silent GERD is basically heartburn that you can't feel or don't notice. The symptom that tipped off my ENT doc was the persistent thick mucous glob in my throat that I complained of--I thought it was from allergies. He said it is the body trying to protect the esophagus from all the acid. No matter how often I swallowed or cleared my throat I couldn't get that glob to go away.
I suffered terribly from aerophagia when I first started cpap last summer. Eventually when i got the GERD under control it went away.
The keys for me were--using an auto bipap (which I was lucky enough to have from the beginning), sleeping on a wedge called Medislant (available at amazon), sleeping exclusively on my left side and taking acid reducers.
I'm now 7 months pregnant and don't suffer from aerophagia AT ALL anymore. I still take a zantac (doctor ok'd) every night before bed to prevent any acid from causing any damage.
Another thing that helped but is a little bit extreme for most is that I got my tonsils out (they were huge--touching at times) and that allowed me to reduce my pressure by 3-4 cm water pressure within 6-8 weeks of the surgery. Actually after addressign the GERD and the tonsils I am down from an original scrip of 16/12 to the current 10/7 bipap--and the reduction in pressure surely helps.
The cause of the air getting into your stomach is the Lower Esophogeal Sphincter isn't tight enough and lets air get by. That is also the spot where GERD does the most damage so it makes sense, to me at least, that most of the folks dealing with aerophagia likely have GERD problems. A sphincter that is swollen and damaged from being bathed in acid all the time is not going to function properly. Likewise those with very high pressures may be affected by GERD--swollen tissue is hard, not soft, and may be harder to move out of the way to open the airway.
So, you may want to talk to a doctor about it. I, for one, had to use acid reducers for a long time before I saw relief. My preference now is to take zantac at bedtime and I will continue this for the long term. It is a shorter acting drug so it allows me the full acid complement to digest my food all day, but cuts off the acid at night when it is not really needed and can do the most damage.
Hope that helps!
jen
_________________
| Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
| Mask: ResMed AirFit™ F30 Full Face CPAP Mask with Headgear |
Thanks, Jen! Rested Gal has talked about that before, and I think probably that is part of my problem. I have been taking Prilosec OTC every morning for many months now because of acid reflux at night, and sometimes when I eat I feel like it gets stuck partway and there's no way to get some relief other than burp or clear it out somehow, so I think that means I take in air when I eat sometimes, too, and likely that sphincter is the cause of it. However, I am kind of overwhelmed at this point and don't even want to think of having to have anymore procedures for a while. It would seem a doctor would be unreasonable to expect a person to have a surgery rather than a BiPAP machine, but I'm not counting out the possibility that that could be a stance a doctor would take.
I really appreciate hearing your take on this, am glad things have improved so much for you, and I will look into the wedge at Amazon. I've just been sleeping on two pillows, have looked for a wedge before in stores but have never had any luck finding one. Don't know why it never occured to me to look at Amazon as I've done plenty of other damage there in the past. My tonsils were gone years ago, along with my adenoids. When I was young, they just yanked those things practically automatically. I'm afraid the mucous glob sounds kind of familiar, though. I notice it sometimes when I've first put on the mask and wonder why I'm clogging up all of a sudden. Your explanation of it trying to protect against anticipated acid sheds some real light. I don't suppose you know why many of us are congested at night, too. Seems like a lot of us have that in common -- just wondered if a lot of this commonality is part of a kind of apnea syndrome, like a metabolic disorder. An intriguing thought anyway.
So when you take your acid reducer at night, it is still effective enough to get you through all your meals the next day? That might be a change in routine for me to consider also.
Peggy
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): bipap
I really appreciate hearing your take on this, am glad things have improved so much for you, and I will look into the wedge at Amazon. I've just been sleeping on two pillows, have looked for a wedge before in stores but have never had any luck finding one. Don't know why it never occured to me to look at Amazon as I've done plenty of other damage there in the past. My tonsils were gone years ago, along with my adenoids. When I was young, they just yanked those things practically automatically. I'm afraid the mucous glob sounds kind of familiar, though. I notice it sometimes when I've first put on the mask and wonder why I'm clogging up all of a sudden. Your explanation of it trying to protect against anticipated acid sheds some real light. I don't suppose you know why many of us are congested at night, too. Seems like a lot of us have that in common -- just wondered if a lot of this commonality is part of a kind of apnea syndrome, like a metabolic disorder. An intriguing thought anyway.
So when you take your acid reducer at night, it is still effective enough to get you through all your meals the next day? That might be a change in routine for me to consider also.
Peggy
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): bipap
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socknitster
- Posts: 1740
- Joined: Fri Jun 01, 2007 11:55 am
- Location: Pennsylvania
- Contact:
Peggy,
First of all, there is a surgery that can tighten the Lower Esophogeal Sphincter, but that surgery is only marginally effective from what I've read about it. Many people find it only causes temporary relief. However, that has been only a small amount of research--because I have had three surgeries in three years and am not up for any more any time soon (hoping my pregnancy won't end in c-section, but my first son was a very big baby, over 10 lbs so we will see!)
The congestion you mention could very well be acid related. It is well documented that the acid can get all the way up into the sinuses and cause inflammation and mucous production. Just bending over when you have bad acid problems can squirt some acid up into the upper airway from what I have read.
The idea for me with the Zantac is that it is a short term acid reducer (and safe for pregnancy--prior to it I took prilosec). Zantac only lasts 8-12 hours. Being pregnant, I need the acid to digest my food during the day--I need to get every nutrient out of the food for me and the baby. And I actually don't get much heartburn during the day--gravity actually seems to take care of that for the most part. I might chew an occasional tums, but only a few times a week, not every day.
My real problem is at night or if I bend over a lot or take a nap during the day. Lying down takes away the help of gravity. This is why lying on the left side is critical because in that position your organs are situated in such a way to make acid coming up less likely. Also, sleeping on a wedge gives back a little help from gravity. Be careful about the ones that only support the head and shoulders--they can put a "crimp" in the tummy and may make acid worse. The Medislant (and I'm sure there must be others out there like it) is LONG enough to reach to the hips. That helps with back issues and keeps the stomach from getting pinched. I've had mine for about a year and it is still great. I don't like sleeping without it on trips etc.
I completely understand about being overwhelmed. Apnea is not a simple disorder. It is complicated. There are so many factors that can contribute to it--GERD, tonsils and adenoids, tongue size, mouth size, palate conformation, airway size and structure, fitness and weight, prescription drugs, even alcohol. All can play a roll in varying degrees for each person. And there are probably other considerations I haven't thought of or don't know about.
I have actually been pleasantly surprised that for me anyway, the Zantac, used only when I need it is actually more effective for me than Prilosec OTC was even though it is my understanding that Prilosec is the more powerful drug of the two. Maybe it IS the fact that I'm only using it at the time of day that it is most needed that is bringing the relief. I don't know.
Also, I should really mention that if you feel your food gets stuck in your esophogus when you eat sometimes--you should really see a gastroenterologist or ear nose throat doctor to talk about this. This could be more serious than you think. There is a condition called Barrett's esophagus that has this symptom--although with testing it seems to get ruled out often enough. And acid damage is nothing to play with.
The truth is acid reflux and apnea are a viscious cycle. The acid could have been a contributer or cause of the apnea--but it is the apnea that keeps it going. Every time you gasp for breath during an apnea event you create suction which can bring a TON of acid up your throat to continue the cycle of swelling/damage that can worsen the apnea. It is a terrible thing.
Since being pregnant and having to switch to Zantac at night only I have noticed another interesting thing. My AHI has gone down. I used to have an average AHI of 1-2 with about half apnea, half hypopnea. Now my obstructive apnea index is consistently zero and my hypopnea index is usually less than 1.
The changes I have made that could have contributed to this are: eating more frequent, smaller meals, not eating for 2-3 hours before bedtime, the zantac at night and being pregnant (which I would not advise for this purpose, lol!). I rarely lay down during the day, which I'm sure helps.
If you need a bipap, get a bipap. They are the easiest machines to breathe with I have heard, but I haven't experienced anything else. On a regular machine, during my sleep study, I experienced central apnea, so for me it was a necessity from the beginning. So, they are a little more expensive--you are worth it!
I hope that helps. This is a good reminder to me that my experience could help others.
Jen
First of all, there is a surgery that can tighten the Lower Esophogeal Sphincter, but that surgery is only marginally effective from what I've read about it. Many people find it only causes temporary relief. However, that has been only a small amount of research--because I have had three surgeries in three years and am not up for any more any time soon (hoping my pregnancy won't end in c-section, but my first son was a very big baby, over 10 lbs so we will see!)
The congestion you mention could very well be acid related. It is well documented that the acid can get all the way up into the sinuses and cause inflammation and mucous production. Just bending over when you have bad acid problems can squirt some acid up into the upper airway from what I have read.
The idea for me with the Zantac is that it is a short term acid reducer (and safe for pregnancy--prior to it I took prilosec). Zantac only lasts 8-12 hours. Being pregnant, I need the acid to digest my food during the day--I need to get every nutrient out of the food for me and the baby. And I actually don't get much heartburn during the day--gravity actually seems to take care of that for the most part. I might chew an occasional tums, but only a few times a week, not every day.
My real problem is at night or if I bend over a lot or take a nap during the day. Lying down takes away the help of gravity. This is why lying on the left side is critical because in that position your organs are situated in such a way to make acid coming up less likely. Also, sleeping on a wedge gives back a little help from gravity. Be careful about the ones that only support the head and shoulders--they can put a "crimp" in the tummy and may make acid worse. The Medislant (and I'm sure there must be others out there like it) is LONG enough to reach to the hips. That helps with back issues and keeps the stomach from getting pinched. I've had mine for about a year and it is still great. I don't like sleeping without it on trips etc.
I completely understand about being overwhelmed. Apnea is not a simple disorder. It is complicated. There are so many factors that can contribute to it--GERD, tonsils and adenoids, tongue size, mouth size, palate conformation, airway size and structure, fitness and weight, prescription drugs, even alcohol. All can play a roll in varying degrees for each person. And there are probably other considerations I haven't thought of or don't know about.
I have actually been pleasantly surprised that for me anyway, the Zantac, used only when I need it is actually more effective for me than Prilosec OTC was even though it is my understanding that Prilosec is the more powerful drug of the two. Maybe it IS the fact that I'm only using it at the time of day that it is most needed that is bringing the relief. I don't know.
Also, I should really mention that if you feel your food gets stuck in your esophogus when you eat sometimes--you should really see a gastroenterologist or ear nose throat doctor to talk about this. This could be more serious than you think. There is a condition called Barrett's esophagus that has this symptom--although with testing it seems to get ruled out often enough. And acid damage is nothing to play with.
The truth is acid reflux and apnea are a viscious cycle. The acid could have been a contributer or cause of the apnea--but it is the apnea that keeps it going. Every time you gasp for breath during an apnea event you create suction which can bring a TON of acid up your throat to continue the cycle of swelling/damage that can worsen the apnea. It is a terrible thing.
Since being pregnant and having to switch to Zantac at night only I have noticed another interesting thing. My AHI has gone down. I used to have an average AHI of 1-2 with about half apnea, half hypopnea. Now my obstructive apnea index is consistently zero and my hypopnea index is usually less than 1.
The changes I have made that could have contributed to this are: eating more frequent, smaller meals, not eating for 2-3 hours before bedtime, the zantac at night and being pregnant (which I would not advise for this purpose, lol!). I rarely lay down during the day, which I'm sure helps.
If you need a bipap, get a bipap. They are the easiest machines to breathe with I have heard, but I haven't experienced anything else. On a regular machine, during my sleep study, I experienced central apnea, so for me it was a necessity from the beginning. So, they are a little more expensive--you are worth it!
I hope that helps. This is a good reminder to me that my experience could help others.
Jen
_________________
| Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
| Mask: ResMed AirFit™ F30 Full Face CPAP Mask with Headgear |
Jen, that is very useful information, and I so appreciate you taking the time to share it!! I know I should probably investigate into this, especially since I've already well surpassed my deductible and 20% this year!
Gosh, I can't imagine having to deal with all this and being pregnant, too! You must be an amazing woman!!
Take care!
Peggy
Gosh, I can't imagine having to deal with all this and being pregnant, too! You must be an amazing woman!!
Take care!
Peggy
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Brenda8859
Re: Swallowing Air
I feel much worse since starting CPAP therapy 4 weeks ago. Dizzy, fatigue, stomachache, nausea, lots of bloating and my belly has increased in size by about 3 inches. Is this normal, abnormal, or do I need some adjustments in my therapy?
Re: Swallowing Air
I was going through past posts trying to find info for my relative and came across your post. How are you? Has CPAP therapy evened out for you?Brenda8859 wrote:I feel much worse since starting CPAP therapy 4 weeks ago. Dizzy, fatigue, stomachache, nausea, lots of bloating and my belly has increased in size by about 3 inches. Is this normal, abnormal, or do I need some adjustments in my therapy?
_________________
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