Horton Hears a Who

After a brief fling with Jacques, I decided it was time to move on.  He just didn't get me.  He suffocated me and I just needed room to breathe.  I have since moved on to what I think will be a long term relationship with Horton.

My new CPAP mask is just a nasal covering instead of a full mouth and nose mask.  I've been sleeping successfully for the past week.  I still wake up wanting to keep sleeping but I think I just love sleeping.  What has drastically changed is that I am peppy all day.  I no longer get tired.  More importantly I haven't drifted off while driving. 

Jacques Strap

My new boyfriend Jacques and I slept together for the first time last night.  As many first times go, it took some time to get comfortable and find the rhythm.  I took deep breaths, he took deeper ones.  He was aggressive at times and very clingy. Every time I rolled over, he was right there. I may not like Jacques very much, but I need him.  I think tonight I might need to ease up a little and settle in.  Trust that he has my best interest at heart. 

The envelope please.....

I received a call early Tuesday morning with the results of my sleep study, not even 24 hours after turning in the machine.  On my way into a sales meeting, one in which I was hosting and had to be on my A-game, I am told that I have severe sleep apnea.  I don't know why this hit me so hard, but it did.  I sent messages to all my closest friends. They knew I was scared. They knew I needed a little TLC. I shouldn't be surprised at something I have known for years, but I suppose I ignored the severity just like I ignored the weight gain.  Due to the extreme apnea, they were putting in an emergency order for a CPAP machine to be delivered to my home THAT DAY!

I've been hiding it for a few weeks, but the depression is certainly kicking in.  I am ready to have this surgery. I am not ready to kee hearing how unhealthy I have been and for so long.  I am resentful that my primary care physician NEVER suggested any referrals to other medical professionals.  Why was it me who walked in and said that I wanted gastric surgery? Why did my doctor never suggest it?  I am angry and resentful. 

After my world came crashing down a few years ago I starting getting medical treatment for depression as well as ensuring my health was in tact.   Blood word was ordered and reviewed and my doctor mentioned to lower my carbs.  That's it!  When an obese women walks into a doctors office and says I'm looking to you to ensure I'm ok, you refer them to get checked out from a cardiologist and pulmanologist. You ask them, any trouble sleeping? When they tell you yes, you suggest a sleep study.  You don't send them on their way with a clean bill of health! 

My clean bill of health made me cocky. I figured this was my life.  No need to worry.  Then I had two emergency room visits within the year. Following up with my primary care physician and again, no other tests were ordered other than labs.

I am venting, I know. I digress a lot, I know.  There is a major disconnect in the healthcare system.  Primary care physicians need to encourage wellness by all avenues. Their are specialties in medicine for a reason!  I'm fat on my own. I blame no one for my illnesses and wel being.  But I certainly do believe the the health system has a responsibility to aid someone when they raise their hand and say, "Oooo, ooooo, ooooo, I have a question, please help me!"

Appt 10: Sleep Study

Got a call Monday morning telling me that my insurance (Cigna) does not cover in hospital sleep study.  However, they do cover one at home.  I was thrilled.  Initially my sleep study was set for two Seperste nights next week where I would check into the hospital and sleep over night, two nights in a row.  Even more enticing from the call I received, I could come in right away and pick up the sleep equipment.

I went down to Penn that afternoon and met with a lovely tech who showed me the monitoring apparatus. Taught me how to put it on and what to do.  That evening, I was in for a real treat.

In true Anne Marie form, I had to share a selfie!

I can normally "sleep" through anything. I'll explain the quotes later. This night, I wasn't feeling well.  I had a small headache, my stomachs was nauseated, from what I don't know.  I attempted to fall asleep around 11.  I wad unsuccessful.  That night, I couldn't even tell you if I slept at all.  It seemed I was awake every hour, uncomfortable, aware of being monitored, and just plain ill.  By 7am the pulse monitor battery was dead and I took that as my sign to remove the rest of the equipment.  At that point, I went back to sleep for an uninterrupted, and what seemed heavenly, two hours.

I dropped off the machine back to Prnn on my way to work.  I wanted to tell the tech about my night but there wasn't anyone to speak with.  I was told they would read the monitor and be in touch.

The rest of the day I was lethargic and feeling like I was getting the flu or something.  It was brought to my attention by a friend that I seem to feel this way after every visit to the hospital.  Perhaps he is right.  I mean, I got the flu shot, but I do always feel sickly after leaving that environment.

The results of the sleep study are not surprising but severe.

Appt #9 FROM HELL!

I was scared of this test when I was 21 and it hadn't changed at 38.  When I called to make my appointment for my esophageal manometry, the woman on the phone told me I would be under anesthesia.  SHE LIED!  Luckily I had the heads up the day prior from my appointment reminder.

The lucky day was last thursday.  Couldn't eat or drink from midnight the night before.  And with the amount of water I've been consuming lately, that was a struggle! This appointment was at HUP (Hospital at University of Penn).  No disrespect to anyone I know who may work there, but the environment sucks.  I am more than certain my HIPAA rights were violated.  I had no choice but to go to that facility.  Fortunately, my nurse Robin was delightful.

When I got into the room, I told Robin very clearly that I was not happy about the procedure and my blood pressure proved it. I was sky high and worse cause I couldn't take my meds that morning.  She explained to me what the procedure was and that it should take less than 10 minutes.  I settled a little until I turn to my left and saw the elephant sized tube that was going to be inserted up my nose!

So it may not be elephant sized, but that shit is thick!  She gave me some liquid to snort up my nose to help numb the passageway.  Unfortunately, I have never been much of a snorter so it was difficult for me to injest.  After a minute she went to go in my left nostril but had difficulty because there was so much fluid that I hadn't injested.  So she went in the right one. I cannot even describe how uncomfortable it was.  I gagged the entire time and tried to regurgitate it back up. Tears streaming down my face and cheeks red of embarrassment.  Just as I begin to breathe, the computer that is monitoring the test CRASHES!

In what fer like forever for the PC to reboot, Robin allowed me to take a selfie!

See that joy in my face????

Procedure lasted another 15 minutes. Some sipping of water, some deep breathes, and the promise to not breathe in between and the test was done. Pulling that elephant out of my nose was no treat either!

The next two nights my throat hurt like a bitch.  On the plus side, I never breathed better!

Appt #8: Another place to make you feel young

I am quickly learning how unhealthy I truly am by the other patients in waiting rooms having 30 years on me!

Went to the Pulmanologist on Tuesday for a consultation regarding sleep apnea.  A consult we all knew was going to require me a sleep consult but gotta nickle and dime you by having "consults".  This doc is old school.  The charts he had on me from the computer he has to write down in a file.  Defeats the purpose of online charting but you can't teach an old dog new tricks.  He took his time writing down notes that I just happened to snap a pic of him.  #nooneissafeinthepresenceofmyiphone

Lungs are open. Heart is fine. Nasal passages are clear. Sleep patterns assessed. Questions asked and answered.  So the verdict is... I need a sleep study and my insurance doesn't cover it at home. So, I have to spend two consecutive nights at the study clinic.  This sealed my fate that I will not be having this surgery any time soon.  Looks like May is my new target date.  I am okay with it.

I think the biggest thing that I have learned is how truly unhealthy I am.  And all these procedures are going to assist me in the greater scheme.  I just wish I did all of these things sooner.  To think I am going to be able to breathe at night and that my snoring will subside is miraculous.  Do you know the last time I let a gentleman caller spend the night???? That's right, never!

Appt #7: Do you have conversations with anyone that perhaps other people can't see or hear?

Ah, the joys of a couch!  Indeed one of my favorite places of all time. However, when it come to brain shrinking, might not be the best place to be. I kid.  Going to the psychiatrist wasn't so bad.  I had been to therapy before and it was no different. Well...

So this specific appointment is required but not covered by my insurance. I had to pay $275 up front to get Psychiatric clearance.  I have to say, I felt jipped right off the bat.  I was marginally excited about seeing a real psychiatrist for the first time. I was less than thrilled that I was seeing a student intern by the name of Emily Wu.  I am in full support of teaching hospitals and welcome any and all students to learn from my medical charts, but darn it, I wanted the real thing!

I spent my morning filling out a 30 page survey on the history of my obesity.  I had to chart my weight from the age of 5 in five year increments along with full body diagrams.  I had to answer questions about my family and their weight.  I had to reflect on "reasons I could have gained weight" that made me face some things in my past that I didn't really want to reflect on.  Such as, my "break-up" with a dear friend (or two) and my historic two month battle with Chantix. Elissa reviewed all these materials just before meeting with me.  This was very much a clinical appointment.  She continued to ask me questions about me, my life with food, my diet, etc.  She was most concerned for my eating habits and how I can go all day without eating.  I used the word binge eat at night and learned that binging is something completely different and more damaging, especially in psychology. I am an over-eater.  That was easy!

Some of my favorite questions from the session...

Do you eat and find yourself unable to stop yourself?
Do you have guilt or sadness after eating?
Do you have conversations with anyone that perhaps other people can't see or hear? I laughed so hard at this question because she was so serious!

Elissa is a very text book soon-to-be doctor.  She isn't really natural at talking.  She does well, though, at telling you her clinical determinations.  I say that because she has cleared me for surgery.  My mental health is in tact. Thank you Prozac!!!  (I should mention, she seemed concerned I was on Prozac and didn't quite take my word for it in regards to taking 20 mgs daily. She asked for my Primary Doc info to verify. She did make one recommendation that will be on my chart, and that is to speak at length with my nutritionist on eating every two hours, which at this point is my biggest weakness.  I am still overeating at nighttime, just with healthier foods.