Deemed untreatable

49er wrote:

woodworkerjunkie wrote:

naturalisbest wrote:I don't want to be flying with a pilot in an airline who's been up for 20 hours and living with untreated sleep apnea. Just saying what I feel. Get the truckers treated and make them prove they comply and do the same for pilots. Common sense demands it.

Consider this... why would you consider a car, pickup, motorcycle, van or SUV on the highways any safer? If that is the way you feel toward pilots and truck drivers on the highway, then anyone with a drivers license and sleep apnea ought to be monitored! That would include most everyone on this forum, having to comply with regular reporting of compliance in order to retain a drivers license. Common sense would demand it.

And if we're going to go this route, sleep apnea isn't the only condition that should be monitored since many untreated medical conditions can affect driving, Epilepsy, high blood pressure, diabetes, traumatic brain injury are ones that come to mind. And the meds you take for various conditions can also affect driving.

If they can't get the drunks off the road now, there ain't a snowball's chance they can get any of the other people off, either.

Sludge wrote:

49er wrote:

woodworkerjunkie wrote:

naturalisbest wrote:I don't want to be flying with a pilot in an airline who's been up for 20 hours and living with untreated sleep apnea. Just saying what I feel. Get the truckers treated and make them prove they comply and do the same for pilots. Common sense demands it.

Consider this... why would you consider a car, pickup, motorcycle, van or SUV on the highways any safer? If that is the way you feel toward pilots and truck drivers on the highway, then anyone with a drivers license and sleep apnea ought to be monitored! That would include most everyone on this forum, having to comply with regular reporting of compliance in order to retain a drivers license. Common sense would demand it.

And if we're going to go this route, sleep apnea isn't the only condition that should be monitored since many untreated medical conditions can affect driving, Epilepsy, high blood pressure, diabetes, traumatic brain injury are ones that come to mind. And the meds you take for various conditions can also affect driving.

If they can't get the drunks off the road now, there ain't a snowball's chance they can get any of the other people off, either.

Great point Sludge.

49er

Sludge wrote:

49er wrote:

woodworkerjunkie wrote:

naturalisbest wrote:I don't want to be flying with a pilot in an airline who's been up for 20 hours and living with untreated sleep apnea. Just saying what I feel. Get the truckers treated and make them prove they comply and do the same for pilots. Common sense demands it.

Consider this... why would you consider a car, pickup, motorcycle, van or SUV on the highways any safer? If that is the way you feel toward pilots and truck drivers on the highway, then anyone with a drivers license and sleep apnea ought to be monitored! That would include most everyone on this forum, having to comply with regular reporting of compliance in order to retain a drivers license. Common sense would demand it.

And if we're going to go this route, sleep apnea isn't the only condition that should be monitored since many untreated medical conditions can affect driving, Epilepsy, high blood pressure, diabetes, traumatic brain injury are ones that come to mind. And the meds you take for various conditions can also affect driving.

If they can't get the drunks off the road now, there ain't a snowball's chance they can get any of the other people off, either.

Kind of to my point. DOT-Department of Transportation is no better or worse than any other government agency. They are to enforce laws of all transportation, including personal vehicles. Laws aimed at specific groups of people are discriminatory! You have people in personal vehicles on the interstates traveling that won't stop and sleep when they should. You have business people traveling on the interstates that have to travel from town to town in a short amount of time, to get their job completed, driving fatigued and without sleep. Just because these people are not in commercial vehicles, doesn't make them any safer to be with on the highway. A personal vehicle can cross the median and hit a bus full of people head on and kill just as many people as a truck or bus! But, people only seem to demand laws against the truck and bus drivers...people that have to perform their job on the highways.
I agree these laws are there to help keep our highways safer. All I'm saying is they don't go far enough! Until they monitor all drivers driving on our roads across this country, then they are not being serious about their jobs! Of course that will never happen, cause people would be in a major uproar if they had to comply with these laws! Yes, I agree that there are many health conditions besides SA that should be monitored.

The thread is named “Deemed Untreatable”.

adjective: untreatable (of a patient, a disease or other condition) for whom or which no medical care is available or possible.

So Gfm had a lot of trouble with his first experience with CPAP. I know from looking into the usability literature that those who have problems “off the bat” so to speak are the least likely to be using CPAP for more than four hours a day at the end of one year.

Of course if the medical care is “well above average” his chances improve but the VA he uses is not likely to be known for “well above average” care.

From my first few years with CPAP I know that stress changes the effectiveness of the therapy. Specifically when I had a job that was “several weeks on” often followed by “several weeks off” my daytime performance would be great during the weeks off but became increasingly less and less as a several week assignment progressed. My AHI numbers would go up. My daytime performance would go down. If several days in a row were particularly stressful this would be particularly noticeable.

Indeed stress became an even more noticeable variable after a traumatic assault. That brought the issues of CPAP exacerbated ventilatory instability to the forefront. If I had not learned of EERS I might not have made it.

From what I read of trucking it is challenging in terms of stamina, stress, and circadian rhythm challenge.

The body will change, life will be life, but they do not monitor CPAP therapy (unless “well above average” care is in play) so the therapy can become ineffective. The driver is unlikely to notice due to the affect of sleep apena which tends to disable the self monitoring abilities (an executive function) and due to the fact that to talk about it with anyone might well threaten his job. So we are back to untreated sleep apnea and danger on the road.

So perhaps the doctor understood the usability issues with CPAP and understood that initial problems are not a good sign. Perhaps he knows the kind of care his group can offer and understands that over time the treatment is very likely to lack and danger on the road would become a reality. And so perhaps the doctor made the right call in a truthful effort to make his patient and the rest of us safe.

If Gfm does go back on the road I hope he monitors his therapy with the data from the machine several times a week and more so under stress. I also hope he uses vigilance monitoring. For his sake and for ours.

Todzo,

Just so you know the over-the-road truckers have electronic logs that force them to comply with hours driven. Meaning if a driver is close to his 12 hr limit (note: I'm not sure if OTR is 12 or 11.5) then he must find a spot to pull off the road for his 'sleep period' and cannot log back in until that sleep time is up. I don't know actual time for driving/sleeping for OTR, since my hubby drives local.

Local depends on days a company has drivers on the road locally. For a 6 day a week company, this is called the 60 hour rule & is broken up into 12 hours each day to add up to no more than 60 hours per week. Effective July 2013 that was amended to add lunches, meaning a driver must take his lunch within that 12 hours, so he drives only 11.5 hours per day or 57.5 hours per week. Each classification of company has a similar set of hours per day/week they must comply with.

If you are still with me, the purpose of this illustration is to point out that adequate sleep/eat time is supposed to be built into a drivers requirements for work. With electronic logs it is hard for a driver to circumvent these rules. In the old days it was common for a driver to keep 2 sets of log books. One for DOT in case they pull you over, for use at weight stations, etc. The second set was actual time for your employer to use to help determine payment.

This brief look at a minescule portion of the many, many regulations the DOT enforces daily should tell you that the DOT tries its best to keep commercial vehicles safely driven by safe, well rested drivers. These regs are complex and sometimes not as well enforced as you would think. Companies try to get their CDL holders to break/bend rules on time driven. For instance my hubby's company would like him to stay out 'a little over' to make 'an extra stop or two' but to do so, he has to file an exception log. If the company is audited by the DOT & a driver has a lot of exception logs, the DOT can fine that driver $500/hour for every hour he is over. Needless to say my hubby & other long term drivers don't take that chance. The young drivers, hungry for that OT do take chances & they hope they won't get caught. They are playing russian roulette with their CDL's (and wallets) AND the safety of the public on the roads with them.

Perhaps this illustration gives you some insight as to how hard the DOT is trying to make the roads safer. Is the system perfect? No it isn't, but its much better than 25 years ago before any of these rules were in place. Before the CDL was required to drive semi & delivery trucks.

The rules the DOT has established regarding the use of CPAP for the treatment of OSA are fairly new and while not perfect at least a step in the right direction. At least they set a standard based on acceptable medical practice. My hubby recently had to choose to keep his CDL (& job) by stopping his sleeping meds. He chose his job & is dealing with his insomnia thru various other methods, many recommended by forum members.

Now why did I respond, its so that you can see you alone cannot get your congressional representative to 'talk to the DOT'. Its not that simple. While you are certainly welcome to let them know your opinion, this is a huge system of rules & regulations, not a small rule book.

I also hope that Gfm gets help effectively using his CPAP therapy & stays compliant on the road. Although you don't think CPAP will 'help him' I do believe if he is compliant he deserves that medical card back so he can use his CDL. If he follows the rules & he is already trying by posting here, he deserves his job back, assuming his company hasn't already fired him for the loss of his med card.

Gfm:
I hope you read this. This forum has a lot of great folks here who will help you thru this. Just post your questions & you will get some help.

Jen