lifesucks vs Liam 1965

Jeff seems to have a bit of a cross to bare and I thought Liam may be able to cheer him up a little.

Anyway, Jeff - you've got me beat. Only have aortic valve replacement, high blood pressure, glasses since the 5th grade (although I do have an implant, detached retina, thick lens one one side slim on the other and the damn screw falls out now and again so the lens ends up wherever), no appendix or gall bladder, Barrett's syndrome and now OSA.

You're probably overweight like me, BUT - do you have a comb? Not me!

I saw your first post and really enjoyed it, you have had health problems but are still obviously able to make a great contribution - well for the next six years anyway. Just kidding about that and do hope you get to enjoy better days.

Noticed you are considering xPAP as a second alternative. My first blush is that you should go for the xPAP first. Just think, you are a pro when it comes to dealing with the medical system but this could be something of a challenge for you - would love to see your posts regarding this. The other thing is it will really give you something to do. You know a leak here a rainout there and all round tweaking to get the thing just right!

Enough of all that, my real motive for this post is to ask you how you deal with all those pills. I only have five scripts ( yeah, there's an anti-depressant in there too) but it seems I'm always at the pharmacy. I think I may have finally trained my family MD to give me one script for all the meds every 3 months. I see six MD's not including my family MD or Dentist (thats another story I forgot about -I have two of them). I do work for a living and it's a real pain in the ass fitting everything in time wise.

Anyway - stay on the forum, we do have this fellow who can do wonders with his quips that do cheer everyone up!

OK Liam that's your Q. I think I'll just toddle off for my weekend R & diet P.

Wishing you all well!

Bob F

Wow, you don't set much of a challenge, do you. I know among standup comedians (of which I am not one), they say you should never follow a BETTER comedian, and that's probably good advice, but it's also kind of hard to find something to laugh at when the room has been completely bummed out as well.

However, there is some good news: Lack of sleep can do REALLY nasty things to your body, according to everything I've read.

("Good news? This is GOOD news?" I hear you cry.)

Yes, it's good news, because you know, now, that you suffer from lack of sleep, and you have plenty of opportunity to combat the problem.

You can get on an xPAP machine and see if you can clear up the apnea.

You can start taking sleeping pills.

You can get a huge, cartoon style mallet, and say to your wife, "Wilma, would you mind putting on this Wile E. Coyote outfit and giving me a good whack over the head at bed time?"

(I don't suggest this last one. At least, not unless your wife's name is Wilma.)

But seriously, there are reports on here and elsewhere of everything from Depression to acid reflux to even diabetes getting better when the apnea is treated. It's not at all beyond the realm of possibility that you might find, once you're getting better sleep, that some of your other ailments get better. Maybe you can cut down the number of pills. Maybe you can give up the anti-depressants entirely!

I would not, of course, suggest cutting anything out without consulting your doctor first, and certainly there is no GUARANTEE that xPAP will solve all of these problems. But there's enough reason to think that they might, that if you look at it from just the right viewpoint (I suggest with one eye closed, the head cocked, and after consuming about 3 beers), being diagnosed with apnea may actually be a GOOD thing.

Liam, maybe not funny, here, but at least maybe I can cheer you up a bit. You want funny, you can always try my blog (click on my name, it's linked).

Actually logged in successfully this time; yeah!

Warning: Long post ahead; read just after putting on your masks, it might help get you to sleep. However, if you make it through, you might be able to give me some advice, too.

As for prescriptions, I think I am actually in a drug-induced death spiral. Started with my GI assuming that my nausea and headaches (after CT scans of my brain were negative) were histimic and Crohn's related. Whacked me up with ever increasing levels of antihistimines (e.g. 100mg Atarax every night and now good doses of Tigan on top of that). Add to that blood pressure, cholesterol, base Crohn's drugs, now Osteoporosis drugs because of all the steroids to treat Crohn's flareups, antidepressents, and even synthetic bear bile to offload my liver so that it can metabolize all these chemicals without exploding. Oh, and still on corticosteroids albeit at a low dose.

I'm down to keeping three drawers in the bathroom. One for morning drugs, one for mid-day, one for bedtime. Duplicate bottles for those that I take more than once a day; only way my feeble brain can keep straight what to take when. Made the mistake one time of taking bedtime drugs in the morning; what a day that was.

So, PCP had an epiphany when prescribing 400mg/day of Provigil to deal with fatigue. Realized that a bunch of my symptoms could also be due to OSA.

Even with the promise of getting rid of some meds, the OSA diagnosis (10 days ago) has hit me like a ton of bricks. CPAP titration study done 5 days ago, no results to me yet. Already begun the conversations with my insurance carrier; going to be a rough road to get reimbursement for anything but basic CPAP. Currently looking at just buying direct what I feel is right from cpap.com and then fight the insurance fight. My PCP is actually great, and my sister is a family practice doctor and makes a solid sounding board. However, we all missed the possibility of OSA in the mix when we began what I now believe was a path that has me as over-medicated as Ozzie Osbourne.

My reasons for this relate to my sleep study. Results show that I got a whopping 5 minutes of REM during the 6.5 hours in the study. Now, I know that REM during a study can vary widely due to the stresses of the study itself. Thing is, I actually dreamed that night for the first time in forever. My OSA is mild (11-12 events per hour), so it has me really wondering what is going on. O2 sat never dropped below 84% for the night either. Personal feeling after lots of web research is that I have been taking so many drugs with sedative effects/side-effects that my brain flat-out doesn't know how to sleep anymore.

There is no question that I have the OSA; wife says "finally" as she has been panicked more than once in our 22 years together by my long pauses in breathing on the occassions that I stop snoring and then the gagging, gasping, etc. I personally have no recollection of these events, guess I am lucky there. Only times I haven't snored in past 10 years is on our 5 trips to Russia to adopt our three kids; maybe something about sleeping on floors, sofas, etc.

So, my plan -- time for opinions please -- is that I need to unload all the drugs I take to combat nausea, fatigue, and pump seratonin to act as headache prevention and then get another sleep study. gonna stick with the blood pressure duo, cholesterol, osteoporosis, and pure Crohn's meds (been on Asacol since I was in the stage two trial for the drug back in '89). I'm afraid that any pressure number that comes from the titration study won't be worth a grain of salt if I change the drug mix. Since the cumulative sedative effect of the meds could also be relaxing the throat muscles and compounding the OSA issues. I have already gone cold-turkey this week from the pure antihistimines in my diet; next to go is the Tigan and titrate off of the Urso (bear bile). And, I have already begun to dream again -- albeit in limited doses each night.

Next, while I work on getting out from under my drug haze, I figured I would take the time to get an evaluation from a qualified dentist that deals with mouthpieces. Dr. Thornton (TAP device) is local for me, so maybe I can even get in to see him. Then, regardless of the results of that exercise, get a new sleep study even if I have to pay for it myself to see what has changed. I will be down to a "reasonable" dose of only 7 meds, although I will probably have so much nausea and fatigue that I'm not sure what daily life will be like.

So, let me have it... Am I all wet here? Or should I just go with the current diagnosis and the pending pressure setting for a CPAP? I'm pretty sure my PCP will write for an auto machine; he doesn't bring any DME in house and as such gets no kickbacks or revenue regardless of what device I end up buying. Alternative is to go straight for the auto device (sounds like the c-flex capable device and I could be a good couple) and try to get some real sleep that way while simultaneously reducing Atarax, Tigan, etc.

I'm really confused on which way to proceed at this point. My only real hope from the treatment of the OSA is to regain enough energy to actually make it to an evening soccer game for my 8 year old's team, and to not have to take a nap every morning when I get back home from taking my kids to school and my youngest to her special-ed preschool. I don't have the expectation that xPAP devices can completely rid me of my nausea, headaches, etc. but it would be a nice bonus if it can provide some relief.

There, I've unloaded my gut on how I got to this place in life and in need of CPAP. I have also gone waaaay off-topic for a CPAP bulletin board, but.... Anybody got any experience with prescription meds affecting their OSA or eventual pressure requirements for CPAP? Any suggestions for alternatives that I have missed?

Cheers to all,

-Jeff

Jeff,

Nothing you said was off topic. I'm going to provide a short response to your long and thorough post. I have no experience with heavy meds, but I do know many of them can affect sleep, apnea and other factors that can affect both. An auto machine will adjust for you as your circumstances change. The C-flex will give you an added level of comfort. It sounds like you could use it.

Good luck! I sincerely hope you are able to continue to improve your health and are able to enjoy spending time with your kids. They can have a huge positive affect on your well being. Mine do for me.

OK, this time I really need to stress that I'm *NOT A DOCTOR*. Because you are very much asking for medical advice, and I am not qualified to give it. Since you asked, I'll take a shot, but PLEASE get a medical opinion before you try anything I have to say here.

That said... With regard to the xPAP, I'd start right out with the Auto. You said you'd pay for another sleep study if you had to do it out of pocket... You'll pay a lot less just buying an Auto and all the bells and whistles from cpap.com, and *IF* apnea is really your problem, it's going to change your titrated pressure as needed, so if you have nights where you need more, it'll give you more. If you have nights where you need less, it'll give you less.

From everything folks have said on here, I'd get the software as well, and monitor your results, to see what's going on. If you start finding that the machine is never giving you any real pressure and you're not having any events (doubtful, but...), then maybe it'd be time for another sleep study, to determine if something ELSE is disturbing your sleep.

Now, something you said rang pretty true for me: My O2 saturation level never dropped much either. That doesn't really matter. Yes, O2 levels dropping have a really bad effect on your organs over time, but so does the lack of sleep that comes from apnea that constantly rouses you, preventing you from getting your nights REM sleep. Just because you're not damaging your organs doesn't mean you're not hurting yourself.

As to reducing your meds, I wouldn't even begin to counsel you there. I have absolutely no idea what effect that will have. I do think you may be right in thinking that at this point, you're on so many meds, there's no way to know what's really a systemic problem, and what is just a side effect of one drug or another. But I'd do it VERY carefully, and with full knowledge and advice of your doctor!

All of that said, good luck to you. I really hope you can manage to solve (by treating the apnea) what you've been unable to solve by the various meds!

Liam, who can't stress it enough, is NOT a doctor!

I was basically in the same boat with asthma this time last year. I was taking 10 meds daily just to TRY to avoid asthma attacks (wasn't working) The best suggestion I can make is become VERY educated about your conditions. Find out if side effects of one drug are being treated with another. (very common to find when you are on over 5 or 6 drugs)

AND talk to your doctor!! Tell him your concerns, and your goals. If he doesn't want to try to work with you, find one that will.

I used to work in pharmacy years ago, and saw MANY people taking drugs to counteract other drugs that they were taking. With that many meds, I would be very suprised if that were not the case for you. You can find out what each drug is for from your pharmacist.

GET PROACTIVE!!!

Thanks to all who have responded with input. Believe me, I don't take stock-tips from the guy sitting next to me on a plane and I don't look at you guys as if you are trying to speak for the medical profession. Your experience with the issues is what I value.

From your responses here as well as all the message threads I have been reading it appears that the vast majority of users who have migrated to an auto machine wish the current designs had been available a long time ago. This makes my choice of machine very obvious. And, it is also obvious that you guys favor going straight to the auto CPAP instead of waiting while I try other things. My PCP admits he has no experience with them, but when I showed him some literature, his immediate response was that "heck, sounds like the one I would want". He is also going to consult with an ENT who handles sleep disorders to see if I should transfer to the ENT or if he still feels comfortable working with me. Can't ask for too much more than that. I will have him write me two prescriptions (good ol' Texas) and route one through the insurance-approved DME I have been assigned to work with. If they don't handle the device that I want, I will go out of plan to cpap.com and then fight with insurance myself. At least whatever they end up not reimbursing can come out of my medical-spending account pre-tax.

As for my GI who has prescribed a good chunk of my meds, it is also clear that I either need to find a way to trust him again, or find one that I can trust. I wish my original GI were still practicing; Malcolm Robinson, universally considered one of the world's best for Crohn's. Sigh. Anyhow, stuffing my body with this many chemicals cannot be good for it. Even reading every chunk of literature I have access to, there is no way for anyone to fully know how a particular mix of chemicals is going to interact in a specific person. Studies uses statistics to "prove" the efficacy of drugs in a mostly isolated environment. I have anecdotal evidence that suggests there is some harmful cumulative effect to what I am doing; time to do a study of one to be sure the cure is not worse than the condition being treated. And, with doctor's consent of course. I even consulted the same GI before I went cold-turkey off of the Atarax. And since several of the ones I want to back off of require careful reverse-titration, docs will definitely be involved in the process.

One thing there were no comments on was my option of consulting a relevant dentist. Going straight to auto CPAP, assuming PCP and ENT agree, do any of you see any value at all at simultaneously getting an evaluation to see if an oral appliance could help? Or, is that whole concept just snake-oil? I read on the web that I can go to India and get some great remedies made with cow urine, too. Wait, not that desperate yet.

Thanks again guys; I hope to hang around this place for a while. And, I also hope to be able to lighten up a bit, too.

Cheers,

-Jeff