OK I Will Try One More Time

[howdidthemovieend?]

I really need some info. I have been dealing with illness since February. Started with what I and my MD both thought was a bad case of the flu. I gave up on that idea long before she was willing to, but after 8 weeks of fevers 102 -103 and night sweats, changing PJ's and even bed linens 4-5 times a night, weakness, loss of appetite. I was finally hospitalized with FUO,"Fever Of Unknown Origin".
By that time my lab results showed there was definitely a problem that needed to be identified. I was at a VA Hospital that is affiliated with a University, so I had a very good, thorough work-up, by several teams of doctors, the Infectious disease team, the Cardiology team, the Oncology team, the Rheumatology team. I had every blood test known to man, a CAT scan from the neck down, a Cardio sonogram, a bilateral bone marrow biopsy, a temporal artery biopsy, even a panorex of my teeth. I continued the fevers and night sweats for the 7 days I was hospitalized. The day I was discharged I was started on prednisone for the diagnosis of Polymyagia Rheumatic, and within 24 hours the fevers were gone. I am still on the prednisone, and eventually also had to be started on medication for GERD and B/P meds. One morning I woke up with a headache, got up and went to work, thinking the headache would go away once I started my day. When I got to work I checked my B/P It was 210/120. My co workers called the EMT's who started an IV and gave me OXYGEN. By the time I got to the hospital I was feeling somewhat better from that nice O2. The ER doc was not helpful, told me he "didn't belive the numbers" did not belive my B/P was that high, even though it was still 190/100 when I was admitted to the ER. He told me I had a VIRUS, and I got out of there as soon as I could, not wanting to deal with an idiot any longer than I had to. As I have always been a healthy person, I have been having a great deal of difficulty dealing with all this. I started thinking about what my daughter had said to me maybe a year and a half ago when I spent the night at her house,...."Mom, you have sleep apnea"! I didn't give that much thought at the time, but after this awful year I decided to ask my doctor to order a sleep study, and she obliged, even though neither she nor I really believed the test would be positive.although the pre study questioner indicated extreme day time drossiness. Like "If you were driving a car, how likely is it you would fall asleep waiting at a red light?" Well, of course for me it's very likely, and so over the years I just always put my car in PARK while waiting for the light to turn green. AND just how many people are mad at me cause I never stay awake to see the end of a movie.... it's been a family joke forever. " Let's put on a movie so Mom can get some sleep.", my kids would say. So the results ARE positive and now I just want to be proactive and get myself the best care that I can. And even though I am an RN, I do not know anything about all this. I think that the 4 channel sleep study is just a screening tool to save money, rather than do the full 12 channel study, but since I have not yet had the opportunity to see the results of the study, I do not know if the 4 channel study provides enough information to categorize the severity of the apnea. The plan is for me to pick up a CPAP machine from the RT at the VA, take it home for a week and return it, so they can determine the proper settings.... then I will be "trying" the CPAP for about 6 weeks, and if I do not get good results , I will be scheduled for the 12 channel sleep study at a different VA. But when I read all of your posts, it sounds as if your studies and tx. were handled differently. I would so like to be armed with good information and the right questions when I go to see the RT.
Please i, if you have the time to answer this post, and walk me through what I need to know, I would be soooooooooooo grateful to you. A BIG THANK YOU JUST FOR READING THIS

[amos]

I tried to read your post several times but got lost each time. As best as I can understand, it sounds as if the VA is giving you the old government run around business.

Ordinarily you would would go first to a sleep lab for a complete sleep study with 20 or more leads attached to legs, chest, and head and a breathing tester in your nose.

If sleep apnea is then diagnosed, you would go for a titration study to determine what cpap pressure you will need - more leads plus a nasal mask.

Then you would be referred to a DME for the equipment.

I think they have sent you home with an automatic positive airway pressure machine (apap). These machines automatically set you pressure as it feels that you need - not a determined or set pressure on a cpap.

The apap (if that is what it is) will determine what pressure you need to keep you airways open and will be recorded on a computer (smart card) card which the Drs. will read and determine what machine you need.

I have no idea why they would they say that they would send you for another sleep study.

Since you are a RN, I would recommend that you go to all the med books and computer sites that you can find and educate yourself.

Amos

[linda b]

It is not unusual for an APAP to be used to determine an appropriate pressure range for a specific patient instead of a full fledged sleep study, but the general consensus is that a sleep study will provide more accurate and more thorough information. For example, it will tell if there are any heart beat abnormalities and/or if your oxygen level drops too much during an apnea or hypopnea.

I've been very happy with the positive results of my 6 months (so far) on APAP therapy. The daytime sleepiness is totally gone, my memory is better, and I just generally feel better. Having said that, though, in all the reading I've done on sleep apnea I have never read anything to suggest that sleep apnea would be a cause of your persistent fever. It may be that a generally run-down condition from prolonged lack of sleep might make you more susceptible to whatever caused the fever.

Even if sleep apnea didn't cause the fever, it is definitely a good idea to treat it if you do have it. Untreated sleep apnea can lead to major heart problems, high blood pressure, strokes, even death.

Good luck getting the fever issue solved. I really don't have any suggestions for that problem. Keep us posted on your progress.

[Snoredog]

You should request a full blown PSG with 12-channel monitoring.

Ask for a Split-Night Study. If you are diagnosed with OSA in the first 2hrs, they will try to titrate you during the second half of the study. It is very important that they have proper EEG monitoring during the titration portion to see how you respond to the cpap pressure.

[Bamalady]

From what I have heard and read, the VA is moving to sleep studies done in the home due to costs and a backlog of folks needing testing. Here is a bit more information:

http://www.sleep-solutions.com/press_ro ... _Final.htm

Although good results have been reported, I have no idea how it will work out. Whatever happens, try to keep some equipment so that you will have some treatment while it is determined what you really need.

I have never heard or read of Apnea causing a fever, unless you are just so run down and stressed that you have some underlying infection, I couldn't even hazard a guess about that.

Keep us updated.

[howdidthemovieend?]

Thank-you all for your replys. I didn't mean to imply that my sleep apnea was a direct cause of the fever....and infection was ruled out by all the tests I had. Polymyalgia is a type of auto-immune disease, so maybe the sleep apnea did play a role with my body not being very happy with itself. There were other things going on in my life prior to the onset of my illness, including lots of stress, my son on his way to Iraq, my job as a nurse in a prison, da, duh, da duh......and as a result I stopped taking proper care of myself related to diet and exercise: even quit socializing. So, along with the depriving myself of oxygen every night, it.is no wonder my body rebelled.
Fast forward to the present. yes one of you mentioned the VA using the take home study, my understanding is that the 4 channel study I had overnight at the VA is the same as is used for patients to do at home. I wish I had had the 12 channel instead, and I did ask for one, but I would have had towait additional time for that study and also be waiting to start any kind of treatment. I envy those of you who had the split night study..... this knowing of my diagnosis, but having to WAIT to begin treatment is disconcerting when it's time to lie my head down at night. But at least now that I know, I am a bit kinder to myself, not thinking of myself as a loser, or as just plain lazy. I was able to laugh at myself last week when I took a nap after the Packers game.... when I woke up at 6:30, I thought it was morning... got up made oatmeal, and my one cup of coffee for the day. Good thing I was working from home that day, or I would have been in my car on my way to work.... took me an hour and 1/2 to figure out that it was it was NOT morning.
Your responses have been very helpful, mostly just because you did respond, so now I don't feel so alone and afraid. Thank-you, Bamalady, Snoredog, linda b and amos. and anyone else who gave information to try to help.

[howdidthemovieend?]

Just one more thing. Someone was kind enough to send me a private message. Somehow I lost the message, but thank-you so much for responding, and trying to help me. You were the first to respond and made me feel someone out there cared. THANK-YOU. Hope you see this.

[amos]

Atta girl! You can do it - whatever the method the VA uses!