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Forum Name: Miscellaneous Cardiology Topics
|angelforever34 - Thu Jan 26, 2006 3:04 am|
I recently had surgery and during recovery, was woke up about 6 times because they said I wasn't wanting to breath. I have been waking up in my sleep the past few weeks with a very forceful breath through my nose. I do this repeadedly in my sleep, about 15 times or so an hour. My doctor sent me home with an oximeter but the results was negative though I have about every symptom there is of sleep apnea. Now it seems he isn't wanting to do anything else but I'm really worried about this. Could the fact that I quit breathing like that prove it's apnea? They just wouldn't return my call about it. But there's no way that can be normal, can it? I also develop a rapid pulse following these breathing spells.
|Dr. A. Madia - Thu Jan 26, 2006 3:37 am|
You need to provide information on your age, body weight and sstatus of your blood pressure-whether hypertensive or not- as well as diabetes. Because all these factirs are inportant for the diagnosis of sleep apnea.
Even then what you describe does fit into the diagnosis of sleep apnea. But 15 times an hour is a bit too much. You need to see a pulmonologist at the earliest who will administer some tests and then may be you need a bi pap.
|angelforever34 - Thu Jan 26, 2006 4:05 am|
I'm 35 years old, 146 lbs, 5'4. My symptoms related to this are excessive daytime sleepiness, unrefreshed sleep - feeling like I haven't even had 5 minutes of sleep, chronic fatigue for 9 years, fibromyalgia, loud snoring at times, morning headaches, irritability, recent change in personality (mood swings), depression,
insomnia (have had to use sleeping pills for 5 years), rapid/pounding pulse, recurring upper respiratory infections with otitis media & sore throat, sinus type pain, and pressure & pain in nose. But I do not have the high blood pressure or diabetes. Though it's high risk in my family. My grandfather had apnea and my brother had a severe case of it from a deviated septum, he quit breathing over 100 times a night before his surgery. He told me that all of his physical symptoms were exactly like mine. This recently has started happening to me during the day too while awake and he also had that problem. Could it be apnea? I would really like to know if it is normal to quit breathing during recovery after being sedated for surgery. I cannot go see a specialist about this as that would be up to my primary care physician and he won't even respond to this. I called the office about it while I was still in the hospital but they didn't even bother to call me back. Should I be concerned and demand that they do something about this? I really don't understand why he's ignoring this anyways. I know my oximeter reading was okay, but I also know that's not 100% accurate. And something is wrong with me causing this. I have gotten so horribly moody from being so tired from this that I had thoughts of taking a bottle of sleeping pills just so I'd get some sleep. It's just a stupid thought, not that I was going to do it, that's just how bad it's been.
|Dr. A. Madia - Thu Jan 26, 2006 8:13 am|
Thanks for providing the data and a detailed history. Things have become much clearer now.
In my view, you are unnecessarily worried about your breathing. All you are sufferring from is a complex syndrome of anxiety depression. Following are the positive points in your history:
1. You are only 35. Sleep apnea not too common at this age.
2. You have no hypertension.
3. You have no diabetes.
4. You are not obese.
5. Pulse oxymetry readings are normal. And let me state that in contrast to Glucometer and digital BP machines, pulse oxymeters are remarkably accurate.
Just don't be so hyper about the whole thing. Cool down, Take a capsule of fluoxetine 20 mg daily after breakfast for at least 4-6 months, the positive effects will be seen only after 2 weeks. I hope you can get this there over the counter. Otherwise ask your primary care physician to prescribe this. In addition also take some tranquiliser like Ativan or Xanax at bedtime.
You will be much better in 2 weeks time. Stop thinking about sleep apnea.
Wish you all the best.
Get back to me whenever necessary.
Dr. A. Madia
|angelforever34 - Thu Jan 26, 2006 12:09 pm|
I've had anxiety problems since I was 17. I take Buspar for it and that extremely helps. I also have taken 10 mg of Sonata when I go to bed for sometime now, it doesn't stop the breathing episodes as strong as that medication is. These started happening to me within days following a flare up of sinus type trouble, otitis media & a sore throat. I repeadedly have this problem while asleep, most of the time, not waking me up. It is a problem for me because it is causing me to just overall feel bad, have bouts of extreme fatigue and have some really bad mood swings. But I should not let myself get concerned? I didn't ask for this to start happening to me. If I sedate myself too much while I'm asleep, I'd say there'd be a big chance that I would stop breathing as I did in the hospital. That is not an option for me. Nor is this depression/anxiety related. Though I apprieciate your thoughts on it. I know that I have the right to be able to find out what is wrong. And my doctors shouldn't treat me like it's nothing just because I have depression issues. I went over a year up until I met my new GYN months ago not knowing why I had so much pain and pressure in my urinary tract including hydronephrosis. They absolutely treated me like there wasn't a thing wrong. It just took having a doctor that could actually believe me when I told him all of the problems that I was having. An IVP showed my uterus impinging and pressing on the upper part of my bladder causing a parcel blockage. After the surgury, I found out that all my organs was prolapsed including my bladder, uterus and cervix. My uterus was inflammed as my bladder is and my cervix was inches from coming out of me. Both organs had to be removed as both was really messing up my bladder function. I also had a sling put in my bladder. I had to go to the bathroom sometimes over 100 times a day and was diagnosed as having a very severe case of intersistial cystitis. This surgery took away all of that pressure and pain and has extremely helped me. What was so severe is not so bad anymore. I had several doctors acting like this was nothing, and being told I'd just have to learn to deal with the severity of my problems. My gyn told me that he was definitey sure that my uterus was causing problems to my bladder and another doctor told me it was an obstruction as on the IVP, my bladder filled very slow, and said it could get so bad, without treatment, that my kidneys could shut down and quit working. I was treated like this was nothing for over a year and it seems as if history is going to just repeat itself. And quite frankly, I am tired of it. I do not or would not manifest health problems just because I get depressed. And it just really bothers me knowing that people treat me that way. The past bleeding from my nose, repeaded upper respiratory problems, and the continuous pain/pressure & numbness in my nose may even be signaling the problem here. A health clinic that's been treating these problems for me wants me going to a ENT doctor because of this but my doctor needs to give me the referral. And I have reason to think he's just not going to do anything else. I don't think my age is a factor here as my brother is only 37 with a severe form of apnea. But he does have high blood pressure unlike me. I have however developed a rapid and pounding pulse that even skips beats at times. Not really sure as to why. The only question I really need answered though is whether it is normal or not to stop breathing while under sedation and what type of condition may actually cause such a thing if it's not apnea (or depression related). I think my doctor should at least do a sleep study before ruling out apnea, especially since the symptoms are there. Am I really so wrong in thinking that?
|Dr. A. Madia - Fri Jan 27, 2006 2:31 am|
I am not saying that its all in your mind and that you have nothing wrong. As a first line of action I did advise you to see a pulmonologist and RULE OUT apnea. However since you expressed technical difficulties doing so I offered my clinical judgement.
Secondly when the levels of serotonin and dopamin are low in the brain, for any reason whatsoever, a person tends to be sad, melacholic and even small bodily problems appear magnified in intensity and one cannot divert the mind into some constructive activities. This is why I advised you to get on to a course of fluoxetine which increases the level of dopamin in the brain.
Even so the best course of action is to rule out any organic pathology before starting fluoxtine.
|angelforever34 - Fri Jan 27, 2006 8:54 pm|
Thank you Dr Madia. I really do apprieciate your opinion even if I strongly disagree. I was really upset that day and scared. It had nothing to do with you but was over my doctor, knowing that he wasn't going to do anything further for me than that oximeter reading. It's just the one person I thought would never treat me that way and it really hurt that he did. I have taken Cymbalta for the depression and the mood swings since it got so bad. I've tried to stay away from such meds because I have side effects of suicidal thoughts but realized I really needed something. I have clinical depression but I extremely recovered from the severity of it after I quit taking antidepressants. I was mentally and sexually abused by my ex-husband and that's what caused me to get so depressed the begin with and after I finally got away from him, my children decided they wanted to live with him instead of me. That was so hard to go through. And I am under the care of both a therapist and a psychiatrist now. I have heard that people who have depression manifest physical symptoms that are not real but seem real to them but that someone is just not me. But I have been getting treated that way by some of my doctors. Back to the sleeping problem. I taped myself sleeping on my video camera and very shortly after I take this forceful breath, I stop moving completely, am completely silent and obviously I've stopped breathing, and when I finally resume breathing again, all I do is take a deep breath upon doing so, which is nothing like the forceful breath. I have heard myself on a cassette tape during some of these episodes go to moaning like I had been sufficating to death. I know with apnea, you quit breathing and then take the forceful breath or gasp but it appears that I am still breathing during that part. So do you think that could be apnea or something else similar to it? With the frequent sinus problems, sore throat and otitis media, if I was gonna take a guess at this, I'd say I got a deviated septum like my brother did. Or a tumor or something considering the blood that came out of my nose for a month straight. How abnormal of a shape will your nose take with a deviated septum? Mine is actually somewhat larger on one side but nothing extreme. If I infact do have apnea, why did the oximeter reading not show it? Could the fact that I smoke and have gas stoves for heat cause the oxygen level to stay higher than it might have actually been? A health clinic I've been going to is sending me to an ENT specialist due to the frequency with my upper respiratory problems. That should help. If this is apnea, am I unsafe by taking sonata, amitriptyline and any other medications that promote or cause drowsiness? I really don't feel like I could make it from one day to the next without taking sonota to help me sleep.
|angelforever34 - Mon Jan 30, 2006 10:16 am|
I made an appt with my psychiatrist tomorrow so I can ask about getting a higher dose of my anxiety medication and getting on a new anti-depressant. I couldn't really see how much I needed to do that until I discussed my heath issues with you. I worry way too much over my physical problems. But I think my anxiety would be extremely less if my doctors would help me more and just quit assuming it's just depression related when it's not. The anxiety that puts on me knowing I'm not gonna get the help I need from them is just unbelievable. This is just as big of a problem as it is having sleep apnea. And it does need to be resolved. Surely, I will feel better getting these anxiety issues under control regardless of what problems I'm having in my life. Thank you for the help as it has certaintly been alot of help to me. Even though I couldn't see that the begin with when you mentioned depression being a problem. Sincerely, thanks so much..
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