Wednesday, January 30, 2008

Semi-weekly post (!)

Well, I am given the Daily Dose Award by MightyMom and then I go and rest on my laurels for several days. Rather smug, huh?

Not really. I’ve just worked the weekend, and as I am now precepting a new employee, and rather young nurse, I have been trying to stay ahead of, I mean challenge my orientee—no small feat as she is a regular little sponge and I have gotten a little complacent in my skills. Then the little snot has started 3 IV’s that I couldn’t. I told her she is not to outshine the preceptor until the orientation is officially OVER.

She’s a sweetheart, just 4 months younger than my daughter, and I am just a few months younger than her mother. As her mother is still in the Philippines, she calls me “Mommy” for laughs. I asked if this meant I now have a son-in-law and a 4-year-old grandson, and she nodded. “It’s automatic,” she informed me. Then she caught a patient who was falling, and lowered him to the floor—and strained her back in the process. Just like her preceptor. I took advantage of the situation and educated her in the dos and don’ts of Workers’ Compensation. She’ll be okay, and should be back at work on our next shift, tomorrow night.

So, to refrain from that old adage, “Do as I say, not as I do”, I have not been able to read many blogs nor post on my worknights. I’m getting behind, but I'm making rounds, I promise.

Also, last week was my appointment with the pulmonologist about the sleep apnea. I filled out his long questionnaire, marveling at the number of questions I answered in the affirmative. Based on those alone, he suspected I fall in the moderate to severe range. To prove a point, he reached down and pressed two fingers into my shin. Holy Cow! I have major swelling in my legs. I didn’t know. Some observation skills, huh? I mean, my shoes are always tight when I get home from work, but hey, I’m up on my feet half the night and sitting at the computer station teaching and charting the other half. And since I have short legs, the seat of the chair does tend to press into the back of my legs. But I had never checked my own legs, though one of my complaints at my PA’s appointment in Dec. was that they always felt so heavy, and I was just too tired to try and exercise to strengthen them.

He says I’m showing the early signs of right-sided heart failure as a result of my up and down oxygen levels at night, making my heart work harder and fluid back up due to a little pulmonary hypertension. And despite doubling the dosage of my blood pressure meds, my BP was 155/87 at the appointment. Sleep apnea also causes frequent night-time urination, and aching in joints and muscles—which is why I walk like an old lady for the first 5 minutes I am up. It’s amazing the effects this has on the body. Dr. P said correcting this could add 10 years to my life.

I felt kind of dumb after meeting with Julie, my PA. Sometimes it seems like this is the “trendy” diagnosis, a yuppie thing, the mark of the Baby Boom generation. Heck 20 years ago the term hadn’t even been coined. But Dr. P, (who by some odd coincidence has the EXACT same birthday, to the year, as I) said Cardiologists and Pulmonologists began questioning why there were so many deaths during sleep—a time when all should be peaceful and relaxing. Why so many heart attacks, strokes, and sudden deaths? That’s what led them to begin researching it all. Did you know there are 88 different sleep disorders? Restless leg syndrome is considered a sleep disorder. Amazing. I never knew there were so many.

So last night was my sleep study. I showed up at 10pm, filled out consent forms, got ready for bed, and then had more wires connected to me than Carter has Little Liver Pills (okay, anyone else out there dating themselves?) I was to try and sleep on my back. Right. Folks, I sport cantaloupes on my chest. Sleeping on my back without benefit of a recliner is a joke. Turning over with wires on (or in) my nose, temples, chin, head, shoulders, finger and shins, and two belts around my chest and waist is just as ludicrous.

I took half a sleeping pill. Within an undetermined amount of time (I wasn’t allowed to know the time), I was wide awake again and needing to go to the bathroom. Of course. I tried to ignore it, but you all know what good THAT does. So I spoke to the room, as instructed. “Hello, this is Stephanie and I need to get up.” And the Voice From the Darkness said, “I’ll be right there.” You know, it’s kind of creepy to be watched and listened to while you sleep—especially when it’s by a stranger. Like being in some grade B Sci-Fi movie.

Since I have done this in the past and stayed awake for 2-3 hours afterwards, and since they need 6 hours of sleep for the monitoring, I took the other half of the pill. Eventually I went back to sleep, but I remember waking several more times before hearing a commode flush and muffled voices. I thought of trying to turn over for a few more Zzzzs, but the Voice said “Since you’re awake, I’m going to come on in and unhook you.” Drats. The Voice sees all and knows all.

I opted not to schedule an extra appointment to meet with the doc to discuss the numbers, just scheduled the second study for the night of 2/15 to sleep with a C-PAP. So Robert, my technician, measured my face and will order me a mask. If I could have worked it out with my schedule, I could have come back in the next several days. No matter. The test confirmed it—Robert said based on what he saw, he would place me in the moderate to severe range.

Coincidentally, my new manager and I have been comparing notes. When I told her of all the symptoms I’d been having, and what I’d researched on the internet, she confessed to having the same symptoms, and also feeling she was going nuts. In fact, no one had picked up on this and they were trying several different medications, including mood meds, in an effort to help her. She scheduled an appointment with her family physician last week armed with this new information, and was to check out a pulse oximeter from the same respiratory care company to see if her oxygen levels are dropping also.

Well, I have babbled on long enough and you have had your health education for the day. I need to finish my 4 Seasons Quilt and mail it off, and I really want a nap. Preferably without wires. I will keep you updated, but if you or anyone you know has some of these symptoms, I urge you to get it checked out. It's more serious than most of us think.


MightyMom said...

I have a dear friend who I would like to tattoo this post to her forearm....wanna help??

I asked her about a month ago (I think) if she'd considered sleep apnea but I don't think it registered...........

I'll try again this weekend to convince her to go for a sleep study.

and I cram my fat butt into support hose b/c even at home my feet and shins were swollen by the end of the day, I wasn't gonna guess what they'd look like after 12 hours on the unit!

get that cpap and feel better!!

Stephanie said...

Here are some sites for her to check out:

She might just need to convince herself, and there are some quizzes there that could help.

And I haven't worn support hose for years! Too uncomfortable under pants and too hard to manipulate when you have about 30 sec to pee and get back!

Anonymous said...

RLS is a very real condition and can SEVERELY affect sleep. People's legs need to move so much that they are unable to sleep at all. Visit more information.

MightyMom said...

come see my worker saftey post and weigh in with your opinion.

Anonymous said...

Stephanie, I'm so glad you're taking care of this. My dad has sleep apnea and has suffered with it for years. I hope you're sleeping better soon.