Goshes! No battle here either! RAM I am DELIGHTED to know that you are an RRT and I assume RPSGT too!!! And even MORE DELIGHTED that you are taking the time to respond to posts in the forum! Bless you!

Nope. I'm not a medical professional of any kind. Just a curious, opinionated ole broad w/a not too complimentary opinion of the medical profession as a whole but a healthy respect, admiration and appreciation for the "good uns" I've met in person, in practice and in these forums.

Karessa, the apnea and the reflux are gonna be your hubby's most pressing problems to get adequately treated. Get those under control and the two of you are gonna be two very happy people!! Good luck and God bless.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Your user name is on a handful of health-related forums, so I was thinking you were a registered nurse. :)

RAM_Sleep wrote:

Your user name is on a handful of health-related forums, so I was thinking you were a registered nurse. :)

Who me??

Oooooh, RAM honey. You MUST have small hands! I hope they are warm! If you are following me around I want you to know I INSIST on warm hands on my back. Absolutely insist.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

I didn't think u were talking to me LOL! I have absolutely NO med. knowlege or are on any boards LOL

CrohnieToo wrote:

Oooooh, RAM honey. You MUST have small hands! I hope they are warm! If you are following me around I want you to know I INSIST on warm hands on my back. Absolutely insist.

Not following so much. A 20 second google search, nothing special. Gotta love the internet. I do have warm hands though.  :)

Ok, RAM_Sleep, since you're a respiratory therapist, I've got a question.... I think.

And keep in mind, I get my terminology all screwy.   So, I forget which of the two terms I was diagnosed with when diagnosed with sleep apnea.  The doc said I had one of these - hypoventilation or hyper, gosh I forget, but I'm assuming hypo?  My oxygen levels were very low also, but it's been a few years since I looked at my sleep study report.  (me bad, my memory)  

What can you tell me about those?  I know my oxygen levels were so low that they put me on oxygen during my split study, and I was ordered supplemental oxygen at home with my bipap.  The levels did return to normal, I was told, a couple of months later or so.  But I never really understood this and I've always felt embarrassed about being ignorant on this.  Plus it didn't help that the pulmonoligist (who ran a sleep lab) was not good at explaining things, a tad intimidating, and also creepy.  

At the time he ordered my bipap and supplemental oxygen, he ordered a pulmonary function test.  I took it, but never heard about results.  I didn't do much followup after that due to personal emergencies, change of job, insurance, etc.   It was an upheaval time, but I was feeling good from the use of my bipap.  I just assumed hypoventilation meant weak lungs.  lol  Can you enlighten me on the term hypoventilation?


Linda

Linda wrote:

Ok, RAM_Sleep, since you're a respiratory therapist, I've got a question.... I think.

And keep in mind, I get my terminology all screwy.   So, I forget which of the two terms I was diagnosed with when diagnosed with sleep apnea.  The doc said I had one of these - hypoventilation or hyper, gosh I forget, but I'm assuming hypo?  My oxygen levels were very low also, but it's been a few years since I looked at my sleep study report.  (me bad, my memory)  

What can you tell me about those?  I know my oxygen levels were so low that they put me on oxygen during my split study, and I was ordered supplemental oxygen at home with my bipap.  The levels did return to normal, I was told, a couple of months later or so.  But I never really understood this and I've always felt embarrassed about being ignorant on this.  Plus it didn't help that the pulmonoligist (who ran a sleep lab) was not good at explaining things, a tad intimidating, and also creepy.  

At the time he ordered my bipap and supplemental oxygen, he ordered a pulmonary function test.  I took it, but never heard about results.  I didn't do much followup after that due to personal emergencies, change of job, insurance, etc.   It was an upheaval time, but I was feeling good from the use of my bipap.  I just assumed hypoventilation meant weak lungs.  lol  Can you enlighten me on the term hypoventilation?


Linda

Sounds like you might have Sleep HYPOventiliation syndrome.

This is associated with rapid respiratory rate, tachycardia (fast heart rate), and sustained desaturation despite no obvious apneas or hypopneas. In other words, the sleep study equipment failed to show what exactly is causing the dips in oxygen saturation. Apneas and hypopneas have clear definitions for scoring (IE clear 30% reduction in airflow or 50% reduction from baseline).

Did your hypoxemia worsen in REM sleep? That would be expected.

Did they measure End Tidal CO2 during your sleep testing? If so, then I feel that hypoventilation can properly be diagnosed. See, PaCO2 can increase to an abnormal level resulting in prolonged and severe episodes of low blood O2 content. It is commonly seen in morbid obese patients, neuromusulcar disease, and COPD (which includes 5 subsets: Chronic Bronchitis, Cystic Fibrosis, Asthma, Bronchiectasis, Emphysema).

Typically your body breathes based on receptors (which are sensitive to CO2) in your Cerebral Spinal Fluid. These can become deactivated and one must use peripheral receptors (which are sensitive to O2). Consider the peripheral as a backup system. Its also a system that relies on O2 content, so someone who is using the peripherals can stop breathing by a high oxygen content. Think about that, going to the hospital and being put on 5L (as an example) of O2 can make someone stop breathing. That last part has nothing to do with you, persay, but is a fun fact.

Here are some causes of hypoventilation:

Causes of hypoventilation (taken from a site):

   * Brainstem
          o brainstem injury due to trauma, haemorrhage, infarction, hypoxia, infection etc
          o metabolic encephalopathy
          o depressant drugs
    * Spinal cord
          o trauma, tumour, transverse myelitis
    * Nerve root injury
    * Nerve
          o trauma
          o neuropathy eg Guillain Barre
          o motor neuron disease
    * Neuromuscular junction
          o myasthenia gravis
          o neuromuscular blockers
    * Respiratory muscles
          o fatigue
          o disuse atrophy
          o myopathy
          o malnutrition
    * Respiratory system
          o airway obstruction (upper or lower)
          o decreased lung, pleural or chest wall compliance


So, if ventilation is inadequate, CO2 builds up, O2 decreases and bang...you can be diagnosed.

BiPap certainly is a treatment that works. The pressure support can be the key, which is why BiPap is sometimes chosen over Cpap.

---

Does this help at all? I typed most of this from memory, so forgive me for any errors. I copy and pasted the last section for completeness.

Wow, I'm impressed!

Yes, it helps immensely.
I can't answer those questions you asked.  (I never throw anything away, so that sleep study report has to be around here somewhere.)
But much of described makes sense.  And I'm glad to think that perhaps my bipap is helping this.  And it gives me more confidence in thinking the doc likely knew what he was saying.  I had a hunch he did, on most of what little he said, but his personality was basically icky, so I was glad to have moved.  Since I now work in the office of a sleep study center, I mentioned some of this to my boss and she offered to let me stay for an overnight to be tested with the oxyimeter (?sp), but I haven't yet taken her up on it.

I just remember during the sleep study the tech seemed to take no time getting that huge oxygen tank into my room, that kinda scared me.  As to my bipap, I definitely need it for the exhale relief.  Someone lent me an auto cpap with the cflex full out, but that was impossible for me.  I'm glad I tried it, though.  Because I'd had the bipap from the beginning, I didn't know what it was like to struggle with the exhale, so now I know.  It's an awful feeling.

Thanks so much!


Linda


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The info provided on this site is not intended as a substitute for professional medical advice. You should not use info on this website to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.

update on 02----just heard back from dr. and they said it was not neccessary!--actually knowing what i know now--I'd never would have bothered the dr. about it in the first place.
i think they were just CYA or CTA LOL! when they said that.

karessamom wrote:

update on 02----just heard back from dr. and they said it was not neccessary!--actually knowing what i know now--I'd never would have bothered the dr. about it in the first place.
i think they were just CYA or CTA LOL! when they said that.

Not necessary because he is schedule for a sleep study in a few days or not necessary period?

I wish you and your husband the best. Hopefully, he feels like a new man next week at this time!

RAM_Sleep wrote:

karessamom wrote:

update on 02----just heard back from dr. and they said it was not neccessary!--actually knowing what i know now--I'd never would have bothered the dr. about it in the first place.
i think they were just CYA or CTA LOL! when they said that.

Not necessary because he is schedule for a sleep study in a few days or not necessary period?

I wish you and your husband the best. Hopefully, he feels like a new man next week at this time!

RAM I think they basically said not neccessary because he's having sleep study on Saturday. I wasn't home when they called back so they left message--that's what it seemed to imply.  hope he feels better too next week, but i'm thinking it will probably take a while since we don't see the dr. until the 28--unless they (sleep lab) goes ahead and faxes rx to DME --i'm thinking it won't happen though until the dr. appt.?? but who knows?? i guess we'll see what they say at the lab--although i highly doubt he'll have any info until he sees dr.  Hopefully he won't have to wait until after the 28th for the 2nd study to be ordered (titration) or we might be waiting months LOL!--well maybe not that long