The saga continues....

More drama! My flu symptoms got worse today. I took a nap and about 8 p.m. I wake up and can't breathe, like I am having an asthma attack. So after a little preparation (and I was already thinking of going in anyway, even before the "asthma attack"), I head to the ER.

Of course, when I am finally seen, everything is fine. I tell the whole story to the ER doc. He says the problem is that he can't even order oxygen for me, because he can only prescribe what he sees and diagnoses based on my current symptoms..my awake symptoms. He takes a chest x-ray to make sure it's not pneumonia, which it wasn't. His thought is that the flu symptoms made a desaturation caused by my sleep apnea being out of control worse than usual,and this caused respiratory distress or an anxiety attack of not having enough oxygen.

Basically, he says that I need to camp out at the primary care's practice tomorrow, as they are the only ones that can legally treat me. The ER doc called, and they are open with one of the partners tomorrow (Friday). The doc available tomorrow happens to be the only doctor that doesn't take my insurance. But I will scream my lungs out if I am sent a bill.

I'd better try to sleep again, so I can camp out at the primary care office in the morning. When will this end???? Lovey

correct me if I am wrong but

you have an overnight pulse ox at home while on bipap with low O2 sats a good part of the night

you then have an "emergency sleep study" that was triggered by this oximetry. It could be that the device you had used that night was faulty. A second trial would have been cheaper, as a full PSG costs several thousand dollars for the test and interpretation. During that night there were no problems with the O2 sats. However you felt that the test wasn't run in the best manner to be consistent with your sleeping patterns (pressure and position). I believe you didn't care for the results of this PSG and tried to talk to the sleep doc or staff about your concerns.

I hope that after this test you were given a change in pressures (if needed), your machine was reset, and you were instructed on what positions to try to sleep in and suggestions on how to maintain these.

However, your low O2 sat oximetry was followed through on with this Emergency PSG and it was the opinion of the interpreting physician that supplemental Oxygen was not needed. This test was done after the overnight oximetry so it is the most recent study.

If this latest test shows there is not a need for supplemental O2, then there isn't a need. Even if there had been O2 issued after the overnight oximetry, after this test, the O2 probably would have been canceled and taken back to the DME.

You don't want O2 in the house unless you absolutely have to have it. I have been there and was very glad to get rid of it. When I moved here I had a propane fireplace taken out because of the O2 I was on; it might not have been required but it was the safer way to go.

Also in rural America family doctors are disappearing. The local clinics here both are losing patients because of cut back in hours the doctors are there. There is concern even if there will be doctors staffing them in the near future. We have 2 clinics, one staffed by one doctor (number of days he is there varies - several weeks this summer it was 0 and he also moonlights weekends across the state to pay the bills), and the other clinic staffed by who knows what any more? The last I knew it was a doc there for a few weeks and there was not information about what would happen after that.

Do you work for the sleep doc?? my primary doc. I'm sorry, but I am taking a little offense to your interpretation.

Yes, it has been brought up that the initital oximetry test was faulty. The general thought though my a few respiratory therapists who have looked at the results felt it was not because of the patterns it showed. Yes, the "emergency" sleep study was costly. The sleep doc, had all of my other symptoms filtered out to him, so all he saw was the oximetry results and that I had lost weight. Yes, my pressures were slightly adjusted after the sleep study.
The sleep study showed zero REM, and something like 2% stage 3 and 4.which is a contradiction to my usual sleep. The oximetry pattern showed that I only destated after long periods of sleep. I have long, complicated dreams each night, so I must be having a good amount of REM easily. My other sleep studies all showed 15-20% REM. This is why I don't consider the sleep study valid.

It has been suggested to redo the oximetry to make sure I am destating still. It is a possibility that I am not, but my other symptoms are more suggestive that I still am. And I had been on pap therapy for 2 years with no problems, and had a bunch of symptoms show up in September with an unknown cause. There are other symptoms, suggesting a low oxygen level. Yes, I have anxiety, and that might be triggering some things, but there are too many signs that something is going on.

I also don't see the point of the rural primary doctor shortage of your post. So, I am supposed to accept sub-standard care because I live in a semi-rural area?? Actually, I live 8 miles from South Bend, IN. It's not that rural.
They have done nothing more to treat me. I have asked for another oximetry to no response. The sleep doc now after knowing all my symptoms, not those "filtered" to him, that something underlying is going on. The cardiologist thinks something is going on. But the only qualifying test is the oximetry results, and that is why the primary care doctor has to handle it.

Just because oxygen didn't work for you, doesn't mean it won't for me, and it would help safe-guard me from harm if I am destating, until they can determine a more definitive cause of what is going on.

I don't mean to be "snippy", I woke up with a headache (one of the symptoms). I never had headaches before September. Please understand why I am pursing oxygen in the short term. Lovey

It's been a fricking unbelievable morning. I called the primary care office this morning. Yes, there is a doctor in today. No, I can't see him, because he doesn't take my insurance. I asked if they could just use my Medicaid--no. The receptionist said "you cannot see a doctor here today". I had explained everything, how the ER doctor said that legally on their practice could do anything because they are the ones who ordered the reports. I explained what the ER doc said and that he had told me to camp out in their waiting room.

I said what am I supposed to do? She said she will have the nurse call me. It's been 3 hours now and no nurse call. I'm calling back now. Fricking unbelievable.

Laurie

Last (hopefully) update... The nurse didn't do anything, even when I told her I have a bacterial infection and no antibiotics for two days. I decided to go to the walk in clinic. I feel like I am living there. It turns out I have a severe sinus infection. The doctor there thinks the bacteria from the sinus went into my lungs a bit, and caused a asthma like attack that sent me to the ER. Plus that I might have been already deoxygenated while I was taking the nap. So more antibiotics. My absentee primary doctor is back on Monday, and there is a pile of notes ready for him on me. Tired of doctors, Lovey