Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Saturday, 13 May 2017

Story Time : "Younger Man" with Sleep Apnoea

Not dissimilar to the description J K Rowling gives to the character of Uncle Vernon in the Harry Potter series, I am a "Big Beefy Man" with "not much neck".

As a result last year it became blindingly obvious that my waist was expanding, I also personally noticed a drop in my day-time alertness.  Initially I would like to point out that I have always been a night owl, and it was not uncommon for me to stay up late and get stuff done (especially programming things) and then sleep later.

This fit well with my employment offering flexible start hours too, and so happily for very many years, I got slowly fatter and fatter, sitting down and eating too much, and I slept later and all was merry.

Except, it wasn't... I suddenly noticed I had become extremely moody, irritable, bad tempered, my concentration was dropping and I found it nearly impossible to remember new things.  Initially I bit back my bad temper, and to compensate I started to use a series of physical notebooks and then scheduling apps to help abate my failing memory.

This crooked self-dillusion carried on for about four weeks, the wife later told me I was a nightmare to live with, however at the time I could not explain the reasons for the change, I could think I didn't want to act that way, I didn't want to forget my lunch, or eat junk, or be a bastard.  But I was being, and there was nothing I could seemingly do about it.

So, I took a few days to think about what I was doing, what had changed, I was very tired, I had to admit.  I kept going though... Kept going, caffeine, pushing black coffee down me, and sugar, lots of sugar.  I never felt I was eating well, but I needed the energy, without it I faltered, stumbled and one day I said "no caffeine today, lets see how I get along".

Driving home one moment I was at red lights, a blaze of other tail lights a head of me, the next blink, I was alone... Sat at the lights still, no-one around me... I had fallen asleep at the wheel.

I literally pulled over and slept there and then.

I contacted my GP, and said "I think I have sleep apnoea", this notified the DVLA, I suspended driving and got one with treatment... Unfortunately this took sometime, so my coping mechanism in the meantime was to sit up in bed more, and to fit a black-out blind to the window.

This alleviated symptoms, but I knew I wasn't sleeping deeply, a short time later and a night of sleep monitoring it was confirmed, I have obstructive sleep apnoea.

I thought this was because I was fat, because I was getting older.  But it seems thats not just it, I am large, and all my family are.  However, the tiredness makes you want to eat more, the BBC has recently covered this phenomenon more than once, and I have to admit it was nice to hear.

I was issued with a CPAP machine, was immediately sleeping so much better.  It was like night and day.  And for the last year I have enjoyed this machine immensely.

However, the straps for the masks go slack over time, as they go slack your sleep falters again, as a man if you have too much facial hair air escapes the mask (have a beard but very short trimmed it's not a problem), far more of a problem is how the mask  seal skirt wear and then the straps go slowly slack.

I would have to argue that the company making these (Phillips) could be held somewhat to account for the latter, as it seems to happen at a predictable, almost designed rate, however I have to concede that the material used has certain requirements and the felt like vencro fastening straps with their slight elasticity are pretty good, but the continual re-stressing of the product does result in quite quick deterioration in performance, even before you take into account the biological factor (sweat & skin cells, and having to then wash the straps).

However a year on, I'm not wondering whether the machine is enough for my condition, I've noticed more than just slack straps, more than wearing seal skirts, more than just a bad nights sleep that more days than not I am quite tired of a day.

This is not everyday, but perhaps two days every fortnight or so, there's no obvious reason for this biologically, environmentally there's no changes either.  I have to admit to slightly more stress in my life at present, however pressure or stress have never stopped me sleeping before (a side effect of studying the martial arts - if a bloke bigger than me can hit me, a bit of code not working in the office is nothing to sweat over).

I will have to discuss this with my consultant in early June.

Being an every inquisitive soul I have started to look at other factors into why I might have apnoea whilst my brother (a close body match to me) does not, and as far as I know no-one else in my family - despite our having a string of heavy snorers - doesn't have apnoea.

One thing I mulled over, before doing some reading, is that during my mid to late teens I had orthodontic treatment, I had four healty pre-molar teeth removed and the two following molars behind these pulled forward.

I've just read, in two sources, that these molars play a role in strengthening the stiffening the sides of the soft pallet, and they also provide a framework onto which the throat muscles structure, then of course the net result is that your jaw is shrunk, leaving less room for the tongue.

I have to be completely honest here, if I let my tongue rest in as natural a position as it can, as easy feeling as it can be, it sticks out over the end of my lower front teeth.  But sits slightly behind my upper bite.

I have the distinct feeling that if I had not had this procedure, yes I would have slightly wonky front teeth, and yes there may not have been space for my wisdom teeth to fill in but my tongue would fit inside my teeth.

As a consequence of this poor fit I have to draw my tongue slightly backwards, with a kink mid-way, to let it sit behind my lower teeth, add the very nature of the action of the flesh being slack in my apnoea and this is a recipe for real trouble.

Having made mention of my weight problem, I did grow whilst without my CPAP machine, I went up to 21 stones around July 2016, by December I was 19 stones, and now today at posting, I am 17 stones and 9 pounds, you can go convert that yourself.

I'm still big, but I feel so much better, even with a few crappy days sleep I feel so much better.

Coming up in June, lets see if my consultant agrees with my orthodontic question, and if I need anything corrected or improved with my CPAP machine.

Tuesday, 23 February 2016

My Surgery - True Experience of an Epidural & Arthoscopy

I'm back, I've had my surgery, and I'm feeling fine...


I had an arthroscopic investigation, which is key-hole surgery, to go into my right ankle joint and remove a load of gunk and file the bone away.

It has left me, absolutely elated, I can walk again!

The above is an image of my bed in recovery, I was the only guy in there that day whom didn't have a general anesthetic, I had a spinal block, or epidural.  And I thought I'd come to these pages and let anyone out there having to have an epidural how I got along.

First of all, I was very squeamish of their working on my spine, I told them so, but really, I was panicking over nothing, if I had to have any work done on my legs or feet again, a spinal block would be my first choice, having a baby?... Get a spinal block!

The injections into the spine start with skin numbing, I had to have alcohol sterilization of the skin too, but you may get iodine (yellow) sterilization.  You then get a plastic cover taped into place and they work on the skin, numbing with a ice cold freeze spray... these are perhaps the most immediately shocking things, they're cold, they're on wide aware skin, and you're heightened by anxiety, but really they are the worst bits!  Which is fab, because the rest is so easy compared to being prepared.

Next you get the injection into the spine, you have to hold very still, let your shoulders be very slack, this is very important, you will be on a heart monitor, so listen to it beeping and try to breath slowly and deeply to slow that beep, you will feel strong pressure, just them pressing on you... It doesn't hurt, but they're pressing you... Get someone to press their finger as hard as they can into the palm of your hand, same thing, but in the bottom of your back... it's uncomfortable.  And this pressure will leave a nice bruise later.

The needle going in, you should not feel, if you do, just say and they freeze spray again, but generally you can't feel a thing, if you're lucky they go in once and you start to not feel anything.

The key feeling is your bum going warm, a hot flushing feeling going down your body, it's very peaceful, and they remove the sticky wrapper on your back and lay you down quickly, because your legs are about to be paralyzed... but it feels nothing but warm and fine.

You get to wait now a moment or two, and they will check you again by spraying more of that freeze spray; I had three stages with the spray, I felt it and it was cold, I could feel it but had no idea if it was cold, and I couldn't feel it at all... At this last stage you can not move your legs, which is a really strange feeling... 

You don't feel anything, you don't know you have legs, there's no feeling of phantom limbs, nothing no weight, nothing... You can reach down and touch your legs, they're warm soft yours, but immovable, but you cant' even feel your own touch.

I couldn't feel my privates, nothing... 

They did the surgery with my awake, I could watch, but felt nothing.

Recovery, well that took longer, nearly 2 hours... As you sit to recover, you start to feel the reverse, the warm feeling starts to wash down out of your bum into your legs, you can feel your buttocks again, make sure you clench them a bit to make sure you can feel them...

About an hour later you can pull your knees up and down, but not lift your foot up at all.

Next you can flex your knee and lift your foot of the mattress.... and finally you can wiggle your toes.

Plenty of fluids is key, hence in the image above, unlike the other patients, I got a saline drip.

Friday, 31 July 2015

NHS Typo

I've had a mystery appointment text'd to me today from the NHS, nice to see them using some good technology, my GP surgery uses an SMS based reminder system and I think it's a fabulous addition to the NHS armoury to reduce wasted appointment times.

Unfortunately, I didn't recognise this appointment, so checked it out and came to this page...


I was so sad to read the paragraph:

"If you believe the hospital has incorrect phone numbers recorded you will need to ask them to change their systems as we are note allowed to make changes to that data."

They are 'note allowed' to make changes to the data?... NOTE!.. NOT... It's a mistake, a typo, a small one, but the thing that bugged me was there was no way to tell them.

This site is powered by ZenDesk, so that page is just an entry in their knowledge base, but there's no way to give feedback.