Had UPPP, Do I Have To Get A New Doc, To Get Help With This?

[Muffy]

Where's my (your) graphs?

Edward is my new data clerk - blame all errors on him.

Oh, OK, no problem. I'll take care of it right away.

EDWARD YOU IDIOT!! I SENT YOU OUT FOR GRAPHS AND YOU COME BACK WITH NUMBERS?!! I DON'T WANT NUMBERS!! IF I WANTED NUMBERS, I WOULD HAVE SAID, "EDWARD, GET ME NUMBERS!!" DID I SAY, "EDWARD, GET ME NUMBERS!!"? NO!? THEN WHY ARE YOU GIVING ME !*#%ING NUMBERS? IF I WANTED !*#%ING NUMBERS THEN I WOULD HAVE SAID "EDWARD, GET ME SOME !*#%ING NUMBERS!" BUT I DIDN'T, DID I? SO STOP WITH THE !*#%ING NUMBERS AND GET ME THE !*#%ING GRAPHS!!

BTW Jan, did you have a pleasant Mother's Day? I sure did, it was a beautiful day here, spent a lot of time outside, planted a few flowers, did a little light pruning and ripped out two tree stumps. Well, that was really all the same project. I planted the flowers in the early morning, but wouldn't you know it, by 10 AM they were covered by the shade from two big cedar trees! OK, no problem, a little pruning, and there! My new little children were back in the warm sunshine!!

Then about 2 PM, I went back out, and my poor children were again cloaked in darkness! Fine I said, and proceeded to take off a couple of branches. Great. See? Muffy can deal with adversity! No problem! Things are much better with the new medication!

But then at 5 o'clock THOSE !*#%ING TREES WERE KILLING MY PLANTS AGAIN! "OH YEAH?" I SAID AND WITH THAT I GRABBED THE OL' HUSQVARNA CHAIN SAW AND SAID "JUST WHAT THE !*#% IS YOUR PROBLEM THAT YOU CAN'T PUT A 'U' AFTER THE 'Q'" SO INSTEAD I SMASHED THE CHAINSAW TO BITS WITH A SLEDGEHAMMER AND RAMMED THE SILVERADO AT ABOUT 50 MILES AN HOUR INTO THOSE !*#%ING TREES 42 TIMES UNTIL THEY UNROOTED...

...and now my little babies are back in the sunlight again!

So what did you do?

Muffy

[SaltLakeJan]

To Apnea SCI Agents.
In the end of last post, I gave details of stopping Ritalin. When I took my six pm Mirapex, I recalled that on the Dec 2008 Sleep Study, I was taking the prescribed dose of two, 1.5 mg. Mirapex pills. I have been taking Mirapex for RLS. or PLM . I had read articles warning about compulsive behaviors and Mirapex. I had just finished Christmas Shopping, had I been compulsive, or did I have a large number of presents to buy? Either way I decided to cut back to one 1.5 Mirapex. One was as effective as two has been.
2.2009 Cut 3mg. Lunesta sleeping pill in half. 5-10-09 Continue to use 1.5 mg Lunesta

I don't know if I have all the pages of Sleep Titration 4-25-00
INTERPRETATION OF POLYSOMNOGRAPHY 4-25-00
Findings\Respiratory events & oxygenation:
During this study, the patient's oxygen saturation was above 90% for the majority of time. The most striking finding in this study compared to her previous, is the difference in the nature of the apneas. During the previous study, she had a predominance of obstructive apneas, but in this study, she had central apneas predominately, including central apneas or hypopneas up to 84 events per hour. There were occasional obstructive apneas, up to 16 per hour. The respiratory distress index calculates out to 81 events per hour.

Sleep Architecture:
She had 419 minutes of recorded sleep. Her sleep Latency was 67.5 minutes. The sleep period was 346 minutes. She did not experience REM sleep during the study.

EKG Findings: No significant abnormalities.

Interventions:
Nasal CPAP was applied & titrated up to 13 cm H20. There was a significant reduction in the number of obstructive apneas using CPAP, but with the overwhelming majority of events being central apneas, there was little change in her condition.

Summary:
In previous study, this patient demonstrated severe obstructive sleep apnea with hypoxemia. Nevertheless, she has a low Epworth scale score, indicating a low degree of dayting somnolence. During the CPAP trial, there was a slight improvement in hypoxemia, but there was not a significant improvement in sleep architecture. Further, frequent central apneas were noted during CPAP trial.

Sleep Statistics
Report time from 22:07:56 to 5:06:55--------419.0
Time available for sleep (lights out)-----------419.0
Sleep Latency--------------------------------------67.5
REM Latency----------------------------------------min
Sleep Period from 23:15:26 to 05:01:55------346.5
Total time awake during sleep period----------34.5

Stage 1..34.5 min,--111.1%-------------Total Sleep-------312.0 min
Stage 2. .227.5 min,..88.9%------------NREM Sleep-------312.0 min--100.0%
Stage 3. .0.0 min, 0.0%----------------- REM Sleep---------0.0 min 0.0%
Stage 4. .0.0 min, 0.0%-----------------Movement Time--0.0 min

Ave Sa02 Report time 91%---------Ave. Sa02 wake 94%------Ave. Sa02 sleep time 92%
Number of Desaturations >=3 in sleep time-----419 events
Arousal per hour of sleep 29.4-----------Sleep Efficiency 74%

RESPIRATORY STATISTICS---------NREM-------------- REM-----------------Combined
-------------------------------Back----Other---All----Back----Other----All------all
Sa02-------------------------92-------93-------92-----0---------0---------0-------92
Sa02-------------------------84-------90-------84-----0---------0---------0-------84
TOTAL DURATION (Minutes)
Central Apne +Hypopne-82.3-----1.7-----84.0----0--------0----------0------84
Obstructive Apnea------15.9------0-------15.9----0--------0----------0-----15.9
*Sub-Obstructive---0's all the way across
Obstructive Hypopnea-8.7-------0---------8.7--------------------------------8.7
Apnea + Hypopnea------106.9-----1.7-----108.6-----------------------------108.6
RDI
Central Apnea+ Hypop--62.1-----120.0----62.7------------------------------62.7
Obstructive Apnea------11.7------0.0------11.5------------------------------11.5
*Sub-Obstructive----------------------------------------------------------------------
Obstructive Hypopnea--6.6------0.0--------6.5-------------------------------6.5
Apnea=Hypopnea--------80.4-----120-------80.8------------------------------80.8

Total RDI-------------------------80.8
Sa02 Awake Average-----------94%
Average Sa02 desaturation---3%
Mean Apnea/Hypopnea duration 15.5

Heart Rate (BPM)-------------------54
Max. Heart Rate (during sleep---107
Min. Heart Rate (during sleep-----18

PLM STATISTICS
# of PLM"S during sleep--------------73
# of PLM"S during NREM sleep-------0
# of PLM's during REM sleep---------73 (In the event this should be in NREM sleep, this is how it is listed on Sleep Study
# of PLM's per hour of sleep---------14.0
# of PLM's per hour of NREM sleep-14.0
Number of PLM's per hour of REM sleep 0.0

AUTO CPAP STATISTICS
Median Pressure--------08.8 cm H20
Pressure 95th Centile--09.8 cm H20
Maxium pressure--------10.8 cm H20

Median leak---------------0.00 liters/sec
Leak 95th centile--------0.32 liters/sec
Maximum leak------------1.36 liters/sec Supplemental 02 / Time administered: N.A.

Recommendations:
1. Initiate noctural oxygen at 2 liter per minute. This should improve the nocturnal hypoxemia
2. Consider nasal CPAP if there is no improvement of symptoms after use of oxygen BCNU Jan

[SaltLakeJan]

Muffy,

Edward is nervous since he read the post addressed to him. He likes people to call him Eddie, and he gets scared easily. Please be gentle with him.

MAM,Muffie I mean, Mam, will you please describe what you want - earlier you said you wanted all the REM.? I included every REM fact I could find, Mam. most of it was connected to numbers. I've only been here one day. I get really upset, when I make a mistake. I stayed late tonight to send you all the numbers, sob. because I thought that what was you wanted.

Plus they went, & said to close-up when I left, but it sounds like a zoo outside. There are cars going in and out, & lots of noise.And the woman who raises Peacocks to guard her house, has put them out, I heard they were really mean.
Just tell me what you WANT, SO i CAN GO HOME, WHERE IT IS QUIET. That is ,If you please, Mam.

Edward MI. Lktoast

Muffy, Did you mean the pretty litle drawings with the lines on them? The ones I have been using for scrap paper. Ecks jan

[SaltLakeJan]

Ok. Ok Muffy

tell me how to send them, do you want all the graphs from all 3 sleep tests? Ssssssssssssssorry

Jan

[Muffy]

Did you mean the pretty litle drawings with the lines on them? The ones I have been using for scrap paper.

Right. Those graphs. You'll need to scan and upload them to a third party server, like Photobucket.

I think you need to drag the XM-214 over to the guy's house who suggested you needed Ritalin.

does the stylish model come with the VM 214?

No, that's Muffy.

OK, let me try to get the Mirapex story straight:

My sleep tests were in May 2000,I have a list of the prescriptions I took for FMS/CF 3-2000 to 9-2000

Clonazapam 0.5 mg For Insomnia
Neurontin 300 mg Ambien 5 mg
Prilosec 20 mg Trazadone 100 mg
Effexor 75 mg

but the

LEG MOVEMENTS: Patient was noted to have 62 leg movements per hr of sleep. Most were associated with respiratory arousals.

And based on that you went on 3.0 mg of Mirapex? What was the rationale for starting Mirapex and when did you start it?

Muffy

[-SWS]

SWS/SAG/Muffy and...

Jan and newcomers, it's worth making the distinction that SAG/Muffy is one very sharp and well-qualified clinician---whereas -SWS is an altogether different person, who is connected with the health field only as a patient. There are some similarities between us: zany humor, a love of sleep science, and a compulsion to help others (the happy norm around here).

Because SAG/Muffy is such a well-qualified clinician, I like to "sit tight" and simply follow along as he offers his typically sharp clinical analysis. Please bear in mind when reading my own posts, that you are reading the posts of a layperson.

Anyway, back to the typically scintillating Muffy/SAGanalysis...

[SaltLakeJan]

Good Morning.

Thanks SWS, so many interested players.

And good morning to you too Muffy.
Help. I uploaded a sample graph to photobucket, under properties, brought up internet address. Came to CPAP, entered to post, hit image, dragged photobucket address, inserted inbetween images, got error.

[robertmarilyn]

Help. I uploaded a sample graph to photobucket, under properties, brought up internet address. Came to CPAP, entered to post, hit image, dragged photobucket address, inserted inbetween images, got error.

Hi Jan,

When I upload an image to Photobucket, once it is there, I will click once on the image and a box with several codes will show up. The last code is the code for an image. If you click once on that last code, so it is highlighted, then you can right click on it and copy that code. Then you can paste that code into your reply message. Hope that helps
mar

[SaltLakeJan]

[jnk]

I just want to say that I have always found SAG very entertaining. But this post by Muffy made me laugh so hard that I very nearly hurt myself!

Where's my (your) graphs?

Edward is my new data clerk - blame all errors on him.

Oh, OK, no problem. I'll take care of it right away.

EDWARD YOU IDIOT!! I SENT YOU OUT FOR GRAPHS AND YOU COME BACK WITH NUMBERS?!! I DON'T WANT NUMBERS!! IF I WANTED NUMBERS, I WOULD HAVE SAID, "EDWARD, GET ME NUMBERS!!" DID I SAY, "EDWARD, GET ME NUMBERS!!"? NO!? THEN WHY ARE YOU GIVING ME !*#%ING NUMBERS? IF I WANTED !*#%ING NUMBERS THEN I WOULD HAVE SAID "EDWARD, GET ME SOME !*#%ING NUMBERS!" BUT I DIDN'T, DID I? SO STOP WITH THE !*#%ING NUMBERS AND GET ME THE !*#%ING GRAPHS!!

BTW Jan, did you have a pleasant Mother's Day? I sure did, it was a beautiful day here, spent a lot of time outside, planted a few flowers, did a little light pruning and ripped out two tree stumps. Well, that was really all the same project. I planted the flowers in the early morning, but wouldn't you know it, by 10 AM they were covered by the shade from two big cedar trees! OK, no problem, a little pruning, and there! My new little children were back in the warm sunshine!!

Then about 2 PM, I went back out, and my poor children were again cloaked in darkness! Fine I said, and proceeded to take off a couple of branches. Great. See? Muffy can deal with adversity! No problem! Things are much better with the new medication!

But then at 5 o'clock THOSE !*#%ING TREES WERE KILLING MY PLANTS AGAIN! "OH YEAH?" I SAID AND WITH THAT I GRABBED THE OL' HUSQVARNA CHAIN SAW AND SAID "JUST WHAT THE !*#% IS YOUR PROBLEM THAT YOU CAN'T PUT A 'U' AFTER THE 'Q'" SO INSTEAD I SMASHED THE CHAINSAW TO BITS WITH A SLEDGEHAMMER AND RAMMED THE SILVERADO AT ABOUT 50 MILES AN HOUR INTO THOSE !*#%ING TREES 42 TIMES UNTIL THEY UNROOTED...

...and now my little babies are back in the sunlight again!

So what did you do?

Muffy

[SaltLakeJan]

[SaltLakeJan]

[imghttp://s565.photobucket.com/albums/ss94/SaltLakeJan/?action=view&current=scan0006-2.jpg&newest=1][/img]

[SaltLakeJan]

this is sleep study 12-2008

[SaltLakeJan]

[SaltLakeJan]