A Dearth of Material

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Today was a very odd day. I slept in and had very disturbing dreams late in my sleep cycle. I was lost in a city that I didn’t recognize and the further and further I got from my point of origin the more I started to recognize things in the dream (the dream and the reality of the town that I thought I was in couldn’t have been more different, but my brain told me it was this real town from my past, so my subconscious ran with it). The problem was that my parents were at the point of origin, and I was really running out of juice to walk back, so my quest then became to find a phone that I could call them on and get picked up, now that I could tell them where I was. The problem was that I couldn’t find a pay phone and no one seemed to have a mobile phone. I finally found some kid who handed me what he called a phone, but what my brain recognized as a Palm Pilot V (the thinner, metal-skinned version) in white. I fumbled to try and find the phone on the device, and that’s when I was very abruptly woken up by a phone call from an automated system trying to sell me an aftermarket warranty on a car I no longer own.

I tried shaking the dream but had no luck in doing so, and I was in a fog. I managed to get out of bed and get my vitals done and my meds taken before going back to bed for another attempt at sleep. I got maybe ten minutes of shuteye before my brain kicked in and told me I had a checklist to try and accomplish, so I got up and tried to start my day. I was exceptionally drowsy and the fog persisted until my wife came home from lunch.

Today was supposed to be a day that I drove in the afternoon due to a therapist’s appointment, but we both came to the conclusion that I didn’t have any business behind the wheel of a car, so we sent a text to my therapist cancelling the appointment, I had a quick lunch, and very soon after my wife left to go back to work I went back to bed.

I was in bed for about 45 minutes this time, and don’t remember any dreaming from that period, but when I awoke again I was still in a fog from the earlier dream.

The fog eventually lifted, but the dream has stuck with me all day long. Usually I don’t remember my dreams at all, and if I do, it’s only fleeting bits here and there, so remembering this one in the detail that I do is very unusual for me.

Other than that, it’s been a completely unremarkable day. I’ll have completed my checklist again today – I think this is day nine of the new streak – but other than that there really isn’t that much to report from the day. It’s kind of like I was going through the motions all day long.

The therapist’s appointment has been rescheduled for tomorrow. Here’s hoping that I can wake up alert and ready to go tomorrow.

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A Concerning Development

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I have a recurrence of an old problem, and I’m not sure what to do about it.

Before last August, I would regularly wake up at around my regular time, do my vitals, take my meds, maybe have a coffee and breakfast, and then head back to sleep for the rest of the morning, finally rolling out of bed around noon or 1 pm. Then I got a CPAP machine, and I was keeping VERY regular sleeping hours. I felt I was getting plenty of rest, I would only occasionally nap for perhaps a half hour in the afternoons, I was doing well.

But recently I’ve gotten back into the habit of waking up, doing my vitals, taking my meds, maybe having a coffee and breakfast, and then going back to sleep for a while. This morning I managed to get as far as breakfast and about a third of my coffee plus my reading and part of my learning before the phone rang. It was my mother, who was rambling from topic to topic so quickly I couldn’t really follow her and could only occasionally get an “uh-huh” in between topics. This wore me out emotionally, so when the phone call ended I laid my head back on the pillow at the top of the couch and … the next thing I know it was just before noon.

Yesterday I finally got out of bed for good around 1 pm. The day before it was close to noon.

It looks like I’m back in the habit of sleeping far longer than is really necessary, and it’s affecting my productivity greatly.

I wish I knew what was causing this. I admit, I’m regularly staying up until 1:30 or 2 am reading things on my phone before putting on my mask and turning out the lights, but that still doesn’t explain why I need to sleep for nearly 11 hours a day these days.

Maybe I should call the folks at the sleep center to bump up my appointment from April.

Tonight’s the Night

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I’ve picked up the new CPAP machine and mask. All the parts of the machine and mask that require daily cleaning have been cleaned and are drying at this time. The machine itself has been programmed and is set up, awaiting use tonight. The tracking software that automatically tracks my compliance (which is a bigger deal than it would normally be because of Medicare regulations) has been installed on my laptop and is ready to start accumulating data. I have alarms set on my phone to remind me to do both daily and weekly cleaning cycles. I couldn’t be more ready – or excited – if I tried.
 
If things go as expected, I will be sleeping very well this evening and will likely notice an immediate difference tomorrow in the lack of need to nap during the day. More long-term benefits will hopefully follow over time, like lower blood pressure, for instance.
 
I’m really excited about tonight and I can’t wait to see how things go.

Hope on the Horizon

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Friday night was the follow-up sleep study.

They gave me the same intake form, describing my day, gave me the same technician (Carl) to wire me up, gave me mostly the same wiring configuration – everything but the nasal cannulas – and then fitted me with a mask.

It was a nose pillows type of mask, with a small piece of silicone forming the seal between the mask and my nose. The silicone part had two holes in it to correspond with my nostrils, and with the help of a few straps around and over my head secured the mask tightly to my nose. We’d also tried a nasal mask, which is similar in design to the full face mask that covers the nose and mouth, only this one covers the nose only. It had a fatal flaw once air pressure was activated: the shape of my face prevented a tight seal from happening, and the mask was leaking in such a way that the air was blowing straight into my right eye. So we switched to the pillows.

I’ve used a CPAP machine twice before, for not a long time before setting it aside due to comfort issues with the full face mask I’d used both times. The nose pillows mask is by far the most comfortable mask that I’ve ever worn. It felt natural in every way except when trying to speak – the air pressure that’s coming through the nose tends to interfere with the lungs’ ability to get enough air out to speak, and so it’s like fighting uphill to talk with the mask on. However, it’s nowhere near as bad as trying to talk with a full face mask on, where air pressure is forcing its way into both nose and mouth, fighting against the lung power needed to squeeze out words, that are then muffled by the mask itself.

I climbed into bed, lights out happened, and I was in the process of texting my wife good night when she sent over “you’ll never guess who’s on the air.”

I told her I didn’t have a clue. She responded with the name of a DJ that’s been away from the station for over a year dealing with “real life.” It was a surprise to everyone at the station except for our station manager – apparently even from her husband too, who’s also a DJ with the station.

So I spent the next twenty minutes trying desperately to give myself access to be able to talk to our returning DJ, and finally did so. I was in the channel long enough to say “hi, you were missed, how the hell are you” and get a perfunctory conversation before I felt that I really should try and shut things down and get some sleep – after all, this wasn’t a talk-on-your-mobile-until-all-hours-of-the-night study I was wired up for.

I shut things down on my phone and started my sleep sounds app and shut my eyes, trying to unwind mentally and get some rest. (The app, incidentally, is called Relax & Sleep II for Android platforms; it’s free and it’s extremely customizable with the ability to program set combinations of sounds from the library of a few dozen available, as well as the ability to adjust each individual sound’s volume and save “playlists” as favorites that can be recalled with a tap.) And it wasn’t too long afterward that, with the gentle air pressure into my nose feeling almost natural, I dozed off.

The next thing I remember was the knock at the door waking me up at 5:00 am. I had slept for five and a half hours uninterrupted. I cannot remember the last time I had gotten so much sleep in one go.

I was well rested, I was alert, I wasn’t groggy at all. I cleaned the wax off my head, changed clothes, filled in their exit survey, and after a short wait to be picked up was on my way back home, where I slept for another three hours or so.

That Saturday was a busy one – we had visitors in the middle of the afternoon and more visitors later that night for a free-for-all of a radio show. There wasn’t much opportunity for me to sleep during the day, but I noted that I didn’t need to. I wasn’t tired or lethargic at all, although saying I was full of energy might have been stretching it just a bit. I had a great time being social and was even social for a few hours on Sunday as well. It was a good weekend and I had a great time.

Either today or tomorrow, the doctor at the sleep center is going to write my prescription for a CPAP machine and I’ll likely get an in-home visit from the respiratory therapist to get it set up and fit the mask correctly. I’ll be specifically requesting the nose pillows for home use. And for the first time out of the three times I’ve tried a CPAP machine, I’m actually looking forward to it coming in and getting started with it.

And then maybe, just maybe, I can start to keep a more regular sleep schedule again.

Lethargic Despite Intentions

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I woke up this morning intending to be a spitfire, full of energy for whatever the day had in store for me.

By 10:30 I was back in bed.

I suppose that I should explain something at this point in the ongoing lethargy topic that I bring up frequently here. It’s taken a long time for me to get to the point where I would listen to what my body tells me to do. If I was hungry, I’d ignore it; if I was in pain, I wouldn’t take anything for it; if I was tired or fatigued, I’d push myself to stay awake because I might miss something. I still get like that, but those instances are fewer and further between nowadays. If I’m hungry, I’ll get up and feed myself. If I have a headache or backache, I’ll either take something for the pain (head) or pull out the heating pad (back). And if my body is telling me it’s fatigued, I’m much more apt to listen to it and go rest.

Now, a lot of time I’m in bed for maybe an hour, sometimes more, sometimes less. I catch enough of a nap to recharge me for a little while, and eventually I get past that fatigue and into the “awake for good” portion, which usually isn’t until later in the afternoon or evening.

The sleep study I did Monday night proved that I have sleep apnea, something we’ve honestly known for years, but never really put much stock into. The care of the machine is insanely complex, the mask fitting never seemed to seal well, and it was difficult for me to get used to it, which all totaled to near complete non-compliance on my part.

That was before I found out that my blood oxygen level was dropping by almost 25% during the night.

No wonder I’m tired – my heart is working overtime to try and get enough oxygen to my body, restful sleep is being interrupted about every ten minutes or so, which means that eight hours of “sleep” is likely translating to maybe four or five hours of “rest” each night.

So for now I’m going to be more accepting of my fatigue and lethargy. There’s not much I can do for it until I get a prescription for a CPAP machine and start using it – regularly.

But the good thing is that it will likely help alleviate my daytime fatigue, reduce my blood pressure to the point that I could potentially come off of some of my medications, and possibly even help me to better manage my diabetes.

I’m still not crazy about the need to sleep attached to a machine, but given the risks without it and the benefits with it, I think I’m finally going to be compliant with its use. And then we’ll see what happens.

The Tale of Darth Babar

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Yesterday I wrote about how I’ve started the ball rolling towards a sleep study. This will be my third one. My first one said that I had sleep apnea but that I had averaged six times an hour where I stopped breathing – not a particularly severe case, but one that merited a CPAP machine. The second was years after that one, and it said that the number of times I stopped breathing per hour had increased, although I never learned to what degree. They were just a lot more insistent that the CPAP become a thing. It is almost a guarantee that they will have determined my sleep apnea is getting progressively worse over time, and that the CPAP is now no longer an option – I’m going to have to have it if I want to get any sort of restful sleep at all.

I hate CPAP machines. It has always been my impression that, because I’m prone to snoring, a full face mask would be necessary. For many years, I wore a closely trimmed Van Dyke that would interfere with the seal on the mask, and so to make sure the seal was tight enough, I would have to strap the headgear holding the mask in place extra tight. This would not normally be a problem, except that in early 2000 I shaved my head, and only once since have I let it grow out, a decision that my wife immediately demanded be reversed. (She’s also insistent on the Van Dyke, otherwise I look like I’m 12, which is a bad trait in a married 47-year old.) That means that the headgear is so tightly affixed to my skull that it imprints into my skin, and those imprints take at least half the day to fade. They’re obvious on a bald head and very unsightly. I also toss and turn a lot in my sleep, from one side to the other, and as a result dragging the air hose around the bed as I squirm in my sleep becomes somewhat restrictive. Finally, I have a tendency to read in bed until my phone (thank you, Nook app) falls out of my hand and onto my face. The problem here is that full face masks go up the nose and across the bridge in order to achieve a seal, and I’ve been wearing glasses since I was three – meaning that I would have to put my phone down, take off my glasses, put on the mask, and then try to go to sleep while this device gently but insistently tries to force air into my lungs. It’s not something that I relish. But this time I think I’m going to be told that I don’t have a choice anymore, that CPAP usage is going to be mandatory.

I think I’m going to go with a nasal mask this time. This mask only covers the user’s nose or nostrils, and often doesn’t use the extension up the bridge of the nose to reinforce the seal. If I can get a nostrils mask instead of a nose mask, that would be ideal – the only point at which there needs to be a seal is on the nose itself, rather than around it, which would mean a compromised seal due to my mustache. (Do a Google images search for “cpap nasal mask” and you’ll discover what the difference is and see many examples of the kinds of masks that are available.)

Breathing with the first CPAP I had sounded a little like someone using a SCUBA regulator which, when combined with the air hose extending from my face, resulted in my nighttime look being dubbed “Darth Babar.” Fortunately the technology that goes into CPAP machines has greatly improved, making them quieter and considerably smaller. I don’t much like it, but I imagine that Darth Babar is going to be making a reappearance soon.

Dichotomy

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I haven’t written in almost a week because I’m not sure what to write about.

My lethargy has finally reached the breaking point. I had an appointment with my psych med manager that I’ve now had to postpone twice because I was just too tired to get behind the wheel. I’ve called my general practitioner’s office to get a referral for a sleep study, and at this point the referral is over in the hands of the sleep center waiting insurance approval before calling to make the appointment. I’m almost certain that sleeping with a CPAP is going to be helpful, but I don’t know how helpful it will be.

Pokémon Go has become a bigger part of my life. I’m up to level 9, I’ve caught over 100 Pokémon total, and have a few fairly high powered ‘mons to do battle with, though I still haven’t picked a team or gone to a gym. We’ve been going out to hit a series of PokéStops – these are locations that you can resupply at for free – at night and catching whatever we can along the way. (Tonight, it’s my turn to drive so my wife can play over in the passenger’s seat.) I admit that I haven’t been getting the exercise that I should be getting playing this game, but it’s getting me out of the house on a regular basis, and that’s a good thing. Last night we went to the store and I got a little exercise there. Also last night we met a couple that was out playing just as we were, and had a nice conversation with them. It’s our first social interaction with another player, and it was a good experience. It seems silly to admit that this little game is succeeding where almost nothing was before. (Although I have to admit, I very willingly left the house to go see the new Ghostbusters movie on Sunday, and was very glad I did – I enjoyed it very much.)

That parenthetical statement reminds me – apparently I helped make this past weekend very memorable for my wife. She thanked me multiple times for making her weekend so good, and I didn’t really do much except be willing to watch a few movies with her and go out hunting Pokémon. But I’m very glad that I did it because she was obviously overjoyed with how her weekend went, so there’s that.

Today’s been kinda low key. Got some housework done, got my main three daily tasks done (well, done once I hit publish, that is), and also have been taking short little naps in between. It hasn’t been a spectacular day, but it’s been good, and I’ll take that any day of the week.