CompSA, Hypoventilation, PLMs, Bradycardia and Hypotension?

[SleepingUgly]

bb, I'm listening to your complaints and it's sounding all too familiar. I have carpal tunnel, my knees have started hurting recently (sporadically, mostly if I do any working out, even very mild stuff), my feet have hurt for years, and at least every other month I pull a muscle in my back... I had rheumatology workups in the past because intermittently I've had positive ANAs, but nothing else was positive. I didn't have some of this pain at the time of my last rheumatology workup, such as my knee pain, but I remember the rheumatologist specifically asked me about my knees. I have Hashimoto's Thyroiditis, but I've remained euthyroid to date. I get my TSH checked every 4-6 months. It's really a drag to have all these issues because I need to work out for a variety of reasons, including that I have osteopenia. It's really hard to work out without exacerbating these issues, so it's a vicious cycle.

Was your ANA positive?

[blizzardboy]

bb, I'm listening to your complaints and it's sounding all too familiar...I have Hashimoto's Thyroiditis, but I've remained euthyroid to date. I get my TSH checked every 4-6 months

Hi SU, Did/do you get heightened indicators for inflammation e.g. monocytes, C-reactive proteins, etc? Was/is your rheumatoid factor and CCP Ab higher than the norm? Do you take some sort of thyroid hormone replacement?

Was your ANA positive?

I can't see that number in any of my test results. Cheers,

[Rebecca R]

No GP I have seen has thought that I have a thyroid issue based on blood results (http://users.adam.com.au/sixsome/bloods ... 410_01.JPG), although my free T3 and T4 are on the low side of the normal range.

I don't recall you mentioning that you are a centaur earlier in the thread, but then again, I am very tired. I'm not so sure that a TSH level of 1.2 is within the acceptable range for an "Architect/Centaur." I suppose that is the reason you had your blood drawn at the Institute of Medical and "Veterinary" Sciences then...



r

[blizzardboy]

I don't recall you mentioning that you are a centaur earlier in the thread, but then again...I suppose that is the reason you had your blood drawn at the Institute of...Veterinary...Sciences then...

Hi r, Aaah, that would explain the four nurses that held me down in the stall and the 18g needle they stuck in my neck.
(feeling flighty, BB bolts back to complete his latest a-maze-ing building design: "The EDS Labyrinth")

[Muffy]

Nothing stands out as far as average SPO2 goes, staying in the 94->95% band according to the pulse ox. software.

Actually, I was looking at heart rate trends to see if there was some sort of overall autonomic increase, or clues that the prednisone made your sleep quality even worse, which, despite the decrease in EDS, still might be (but the gain realized by pain relief could far outweigh the loss in sleep quality). Eventual PSG would be necessary to really define that, but OTOH, you might just take "feeling better" and leave it at that. However, I think you still have to figure out the role PLMs play, if D/C'ing the fluoxetine made a difference, and perhaps whether or not you really need ASV (I think you'd probably be fine on low-level CPAP, but in the big scheme of things, it probably doesn't really make a difference).

Muffy

[Rebecca R]

"Feeling better" sounds pretty good.

BB, if you look into the PLMs as Muffy suggested, you could feel even better than you do now. No wonder you had so many PLMs on your PSG, having four legs and all. I'm glad to hear that you feel better.
r

P.S. Don't make that EDS Labyrinth too hard--some of us may be lost in there forever.

[blizzardboy]

Actually, I was looking at heart rate trends to see if there was some sort of overall autonomic increase, or clues that the prednisone made your sleep quality even worse, which, despite the decrease in EDS, still might be, but the gain realized by pain relief could far outweigh the loss in sleep quality. Eventual PSG would be necessary to really define that, but OTOH, you might just take "feeling better" and leave it at that. But I think you still have to figure out the role PLMs play, if D/C'ing the fluoxetine made a difference, and perhaps whether or not you really need ASV (I think you'd probably be fine on low-level CPAP, but in the big scheme of things, it probably doesn't really make a difference).

Hi Muffy, Subjectively, I feel like I am sleeper deeper and my daytime energy is better since prednisone consumption commenced, certainly now not waking with pulsating pain or having longer/memorable awakenings during the night. Yeah, PLMs...now that (new) sleep doctor is two-weeks overdue to ring me about his take on my PSGs - might try a gentle nudge next week. Since commencing on the oral steroid with the ensuing increase in MV, I have been considering reverting to fixed CPAP to see how stable my respiration is according to the VPAP Adapt SV. If I were to proceed with a fixed CPAP trial, what do you think would be a good first choice for fixed CPAP (e.g. current EEP value; mean ASV pressure; 95th percential ASV pressure)? Cheers,

[Muffy]

OK, that July oximetry D/L gave you 3 days on prednisone?

In a comparative overlay of HR:



I don't see nuthin'.

The change in MV could also simply be a change in the way it's calculating stuff. VT is estimated (it has to figure out what the leak is), so maybe a change in breathing pattern is giving you different numbers, but your breathing really hasn't changed.

Muffy

[Muffy]

Hi r, Aaah, that would explain the four nurses that held me down in the stall...

Man, you get all the luck!

Perhaps you can join us in the "How To Get Boinked" thread and offer up some tips.

Muffy

[blizzardboy]

Well, for now, watch what (and how much) you eat. Weight gain can sneak right up on you while you're taking steroids.

Yea, 'tis panning out as you spake. In particular, uncomfortable fluid retention in the midriff has come to me, I believe due to sodium retention and potassium expulsion (oh how Goog-orac-le makes one seem so clever). Now to try to drink more water, consume less sodium and eat more bananas...

[Muffy]

Well, for now, watch what (and how much) you eat. Weight gain can sneak right up on you while you're taking steroids.

Yea, 'tis panning out as you spake. In particular, uncomfortable fluid retention in the midriff has come to me, I believe due to sodium retention and potassium expulsion (oh how Goog-orac-le makes one seem so clever). Now to try to drink more water, consume less sodium and eat more bananas...

Moonface too, I'll bet.

Muffy

[Rebecca R]

Hi r, Aaah, that would explain the four nurses that held me down in the stall...

Man, you get all the luck!

Perhaps you can join us in the "How To Get Boinked" thread and offer up some tips.

Muffy

I must be extra sleep deprived, 'cause I can't see a HTGB thread.

[Muffy]

Hi r, Aaah, that would explain the four nurses that held me down in the stall...

Man, you get all the luck!

Perhaps you can join us in the "How To Get Boinked" thread and offer up some tips.

Muffy

I must be extra sleep deprived, 'cause I can't see a HTGB thread.

Goodness, Becko, take one step forward and you'll trip over it.

viewtopic/p500381/Looking-for-single-ma ... ml#p500381

Muffy

[blizzardboy]

OK, that July oximetry D/L gave you 3 days on prednisone?

Affirmative.

In a comparative overlay of HR...I don't see nuthin'...but your breathing really hasn't changed.

So with SPO2 and HR as the clinical indicators (bottom line) focus for me is on arousals and PLMs, not desats/ventilation or autonomic reactions. FWIW, the ASV is also reporting a reduction in my AHI (which is negligible anyway) since starting on prednisone: Cheers,

[Rebecca R]

Hi r, Aaah, that would explain the four nurses that held me down in the stall...

Man, you get all the luck!

Perhaps you can join us in the "How To Get Boinked" thread and offer up some tips.

Muffy

I must be extra sleep deprived, 'cause I can't see a HTGB thread.

Goodness, Becko, take one step forward and you'll trip over it.

viewtopic/p500381/Looking-for-single-ma ... ml#p500381

Muffy

Oh. Missed it, since I'm not a single man in my 30s-or-40s...I see it could be in contention to be The Big Thread. It's almost halfway there.