Going to the bathroom With Titration Update

[Greg6657]

This is going to be a long post and I apoligize for it but here goes:
I have been on Bipap for almost 4 years. I had a heart attack 2 years ago. My wife and son kept telling me "Your different since your heart attack" and not in a good way. When I first had my heart attack I slept like a baby with a full belly, but that slowly has changed and I hadnt noticed it. Well recently the last couple of months my sleep has gone from bad to worse. I now go to sleep like always within 2-3 minutes of putting on my mask. But I can only sleep for maybe 2-2 1/2 hours before I wake up feeling like my kidneys are about to burst. I go to the bathroom put my mask back on and fall right back to sleep. 2-2 1/2 hours later guess who's knocking? Yep its another kidney call. This goes on all night till I finally have to get up to go to work. In the last 2 weeks I have noticed I dream constantly in the 2 hours I'm asleep. I feel so tired that I have actually fallen asleep at work a few times. This is totally not like me even though I work nites.
I will have to load my equipment list tomorrow but I do know I have a 15 minute ramp which I hate I feel like I'm suffocating, so I just turn on my machine and let the ramp expire before I put on my mask. My in is 15 and out is 12, I use a full face mask.
I think I know my own answers but I have a Doctors appointment next week and I kinda want to have my ducks in a row when I talk to him.
First, if I remember right your body produces more liquid when you arent sleeping right?
Next, I dont think I'm hitting REM sleep even though I'm dreaming like crazy.
And lastly something else that is driving me crazy is I feel like I'm just plain out and out LAZY, because I don't want to do anything. And to do it I have to literally make myself do it.
This may be just thinking out loud but I was thinking that a AUTO BiPap may be worth looking into. My reasoning is one to actually get a good nights sleep, and to also get a hard copy read out of my max and min breathing pressures events etc.
If you have any question like do you have this or that I may have forgotten PLEASE ask so I can wright all my answers down to take to the Doctor...

[zoocrewphoto]

Have any medications changed? That might be causing the bathroom issue. Or it could be that your pressure settings are no longer doing the job for you. If your machine has data, you can check that and print it for your doctor. If not, I would ask for a new machine that does data. Then you can find out if you are still having too many apneas, or longer ones, or what. It will really help to look at your data and see what was going on before you wake up each time.

[purple]

IF your body feels stress, as in the heart feels stress, then it reacts by trying to get rid of liquids. Time to see the Cardiologist.

Personally, I can reduce the times/amounts I need to wake up for a kidney call by making sure I drink enough water during the day. Body does not like dehydration either.

[Greg6657]

So far there hasn't been any new or changed Meds. Ask anyone that has had a Heart Attack we have enough meds As for dehydration I'm not thinking that is a problem because I have quit drinking coffee and just drink water (like a buffalo). But I'm not drinking any more or any less then 6 months or a year ago.
Yes that is what my thinking is on getting a Auto BiPap with telemtry, The unit I have only records useage compliance not events or anything else.
I appreciate your replies though.
I guess thats one advantage to working nights... people with apnea are always up and there is someone to listen and or talk too.

[markk]

Hi, I experienced this about a year to a year and a half ago. It slowly got worse and worse, to the point where I was driving my wife crazy, as I was getting up to empty my bladder every 90 to 120 minutes ALL night.

I had moved from one town to the next, and the WATER was different. In addition to that, I started taking BP meds, one of which was to relax your blood vessels (didn't help my bp, btw) supposedly to improve blood flow. Between the water and the meds (I got worse after meds), I was bloating up big time, my feet swelling so big that my loose boots couldn't be put on. Legs, arms, face.. everything was swelling.

My "solution"? Well, I started drinking distilled or "drinking" water. Not spring, not artesian, just purified water or, water with small amounts of specific minerals added. And a little more exercise, AND I began sitting with my feet up in an easy chair for at least an hour during the day. When I first started the distilled water, I thought I was going to die. My bladder filled so much every night it was painful, sometimes in less than an HOUR, I would have a painfully full bladder.

Your body has a water balance system, and that system is affected by your position. When you lie down, your body can think ( or discovers) that you have too much water in you and releases a hormone to correct it. It overrides your natural "kidneys go real slow when you sleep" mode, and instead, they're in hyperdrive. The effects took quite some time to build up after moving, and it took a few weeks after changing my drinking water to subside.

Some of the meds they give you can have a side effect of letting water push into your cells and bloat you. And, when you lie down, the process tends to reverse, and your body has to get rid of it. So, your endless battle every night. Sometimes I spend a couiple hours in the chair with my feet way up and rest of me down, and if it causes me to fill the bladder in an hour, I start looking at what I'm doing and what i'm eating and drinking. If I drink too much of my city's water, I can tell.

I can't say this is your problem, but you don't need a doctor's prescription to switch drinking water, or anything else I did, either. Try reducing your salt a little and increasing your potassium intake. And, of course, please, get checked out to make sure you don't have some other issue.

[SleepyToo2]

Some beta-blockers are well known for causing "tiredness," which might actually be what is happening with your "laziness." Many medications can cause changes in sleep patterns - if that only happened after you started a medication (or several of them), there is another clue. Another sleep study may well be called for since your body has changed since the heart attack, or at least a trial with a fully efficacy data-capable machine. Without such data you are taking stabs in the dark as to what may be wrong. However, a full sleep study will give the docs the most information to work with. I think I would want my sleep doc and my cardiologist to be working together on my case, if I were you. It sounds far too complex to be diagnosed on this forum!

[RandyJ]

Have you seen a urologist for a digital exam to check size of your prostate gland? Assuming that your bipap is working, the prostate would be next on my list of things to check.

[deltadave]

http://www.asn-online.org/education_and ... pter19.pdf

[Afterhours]

You might want to have your doctor check you for diabetes. The "Drinking water like a buffalo" and constantly getting up for bathroom breaks makes me think that. I have been type 2 diabetic for a few years now. Just my $.02 worth.

[SMenasco]

I have heard that more water is processed by the kidneys when you are horizontal. I also had a similar problem and found I was suffering from an enlarged prostate. After a roto-rooter job, (turp) I now sleep 10 hours and have the pressure I had at 20 years old, One of the best things I have had done.

[chris-p1]

I agree with Afterhours regarding checking also for diabetes, as I also have type 2. Those sound a lot like the symptoms I once had prior to my diagnosis. I don't know about where you live, but your bood sugar level can easily be checked out any any drugstore by a pharmacist at a very measly cost ( I paid someting like a dollar). This will at least give you a clue if your sugars are high.

Hope this helps

[chunkyfrog]

GO TO THE DOCTOR---NOW!

[Greg6657]

Follow Up:
Well I went to my doctor today, and I have to say I LOVE MY PCP I was in his office for an hour and 20 minutes dicussusing my care.
Here is the letter I gave him because I new I wouldn't be able to remember it, we discussed each one in detail.

1.Tired throughout the day
Actually fell asleep at work twice in 1 week

2. I have to force myself to do anything
Feel like I'm just lazy don't want to do anything

3.Trouble concentrating
Problems doing reports at work, making mistakes

4. Headache
Occasionally when I first get up lasts about an hour

5. Memory loss
If asked to do something I have to do it immediately or won’t remember to

6. Mood swings / Irritability
Kim (my wife) says I haven’t been right since my heart attack

7. Waking up frequently to urinate
2-4 X per day last couple of weeks average every 2-2 ½ hours

8. DREAMS
Constantly dreaming during my 2 hours sleep, wake up and usually remember them

9. Insomnia
Occasionally wake up after 2 hours and can’t get back to sleep for 4 or 5 hours then have problem getting to sleep toss and turn

10. Sweat
Wake up sometimes sweating on the head and neck

Hypertension
Depression
Weight gain
Heart failure
Heart palpitations
Diabetes

Statin Drugs?

Blood Test Vitamin D, B, & Magnesium

Well my heart and lungs sound great, EKG looked excellent, PB was 126/84, prostate was normal (OH HELLO in a high pitched voice )
I am being scheduled for a Split Sleep Study, since I work nights it takes a little extra to get setup.
He is running labs from A to Z literally, Vitamin A,B,D, calcium, magnesium, thyroid, liver panel (we discussed simvastatin and the pro's out way the cons for my situation) chem 12, CBC, NBP?, zinc, PSA, Sugar and a few others. His quote when he was done wrighting the order was WOW I just ordered a $10000.00 worth of labs . Oh well they wont like it but I dont care. I'll order another $10000.00 if I need to, to find out whats happening. See why I Love him! His overall thoughts are for some reason I have had a sudden and drastic change in pressure needs. But lets wait for the studys before we make any decisions or changes.
Well thats it for now a further follow up once we get some results, Thanks everyone for your thought and advice.

G

[Greg6657]

I almost forgot he is also checking my testestaron levels, and I've also lost 12 lbs since my last visit only 70 more to go .

[Xney]

It's good to check out that stuff because missing something at this point could be really bad.