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My ENT appointment 
3rd-May-2007 07:49 am
Misc: brain side view on black
I don’t really have time or energy to go into detail about my ENT appointment yesterday, but the short version is that while I liked the guy and he was clearly skilled and attentive and knowledgeable, it wasn’t the watershed event I had hoped it would be.

Evidently, I have “lots” of small anatomical abnormalities in my nose (news to me) and throat (not news at all), no one of which would be a big deal by itself, but which all together add up to a big problem. It’s not clear yet what if anything he wants to do about any of them; he’s waiting for my sleep study report.

I also have mild acid reflux (which I didn’t think I had), and he told me to take something for that.

I need to lose weight, but honestly I don’t think that’s going to happen until/unless I can get my energy level up. (And all the time I have to put in dealing with the CPAP machine and the light box doesn’t help, either, for finding time to exercise.)

I have had the intuitive (i.e., made-up :-) sense all along that my breathing problems are the root cause of my low energy and cognitive problems, but the ENT suspected that was probably not the case, and that there’s something else underlying. Maybe the bloodwork I had at the hematologist’s office on Monday will help with that. The bloodwork I’ve already got results from shows oddness which I may discuss in a filtered post if I get a chance.

While I’m moping and grumping, the light box doesn’t seem so far to be actually making my life better. It does get me to sleep earlier, at least occasionally — but I also often wake up much earlier on those nights, and feel really groggy and crummy and sleepy the next day no matter how long I’ve slept. (Admittedly, I’m not extrapolating from very many data points here.) As with the CPAP machine, I have the problem of not having a control group — I don’t know if I’m just getting worse independently of the light box and would be much worse if I weren’t using it, or if the light box is actually making things worse in some way (although the latter doesn’t sound very plausible). It’s certainly chewing a chunk out of my productive day (although I can do things like post to LJ as I’m doing while I use it).

And worry about my health is probably messing with my sleep at this point (although I feel like I’m sleeping a lot). I may ask my PCP about anti-anxiety meds to see if they improve my sleep.
3rd-May-2007 01:10 pm (UTC)
some anti anxiety meds may help you sleep...some may not.
i take alprazolam (generic xanax) and it knocks me out. atavan on the other hand, did not help me sleep...also did nothing for my anxiety attacks.

wish you luck with your health issues...

have to get cassandra to see you sometime...now that she is a cranky teen instead of cranky baby i wonder if your magic would still work on her? :)
3rd-May-2007 02:30 pm (UTC)
If you are, indeed, having reflux problems, you may find that they were far more disruptive of your sleep than you realized, and treating it may do wonders for you.

Here's hoping for restful slumber.
3rd-May-2007 02:33 pm (UTC)
Sorry you're having these ongoing issues. If you want to talk about reflux things I've been dealing with mine for years and have it pretty well under non-drug control
3rd-May-2007 02:36 pm (UTC)
I know from what you speak here. I had my first good night of sleep in about a year last night (and for no very good reason) and I *know* the difference in my cognitive abilities today.

Keep persevering. Keep talking to doctors. You are young now and have plenty of time to fix this. Keep a journal and write your symptoms down so you have a clear memory of them.

Good luck!
3rd-May-2007 02:56 pm (UTC)
Running type stuff does wonders for my energy level. And I really did start out "running" at a slow walking pace. I really think it would be all kinds of worth it to you. From my experience I would expect it to be best for everybody to start out on an elliptical machine, then go to a treadmill, then actual running. But if you can't get to machines, I'd say just go run. Right now. 5 minutes, 10 minutes, anything, 3 times a week. Run till you can't, walk till you can run again. Go easy.

A far more complicated but frequently recommended plan: http://www.coolrunning.com/engine/2/2_3/181.shtml
3rd-May-2007 03:33 pm (UTC)
Agreed, without a control group it's so difficult to guage changes and responses (or lack thereof). I'll be glad when you get the results of your bloodwork back. There could be big chunks of information in there.

Love you, including your anatomically abnormal nose and throat...
3rd-May-2007 03:42 pm (UTC)
*hug* I'm sorry to hear that the ENT didn't have a single problem with a single simple solution for you -- I know that would have been far preferable! But I'm glad that you're finally getting treatment for your nose/throat troubles.

If you get time for that post about your bloodwork, I'd love to hear more about what's going on with your health.

Norman has both trouble sleeping and acid reflux, and the trouble sleeping is much worse when the reflux is active! So I'd suggest that you try some over-the-counter treatment for that, and if it helps, great, and if it doesn't, you can always stop taking it.

*hug* Good luck wending your way through the medical system!
3rd-May-2007 04:29 pm (UTC)
You really should do something about the acid reflux. For one thing, it feels a little like anxiety, and can make you feel more anxious than you really are. It may be contributing to your emotional state more than you realize.

Also, I find a nice little dose of valium helps take the edge off things. It's like I try to worry, and I just can't. Do ask your PCP about that; there's no reason to fester in worry when you have better things to think about.
3rd-May-2007 06:06 pm (UTC)
Oof. :\ I hope for some more clarification and good action soon.

Also, re: the light box. I'll see if I can dig up the link, but I found one source (when I move back to Boston, I will probably have to use one of them gadgets in the winter, all 6 months of it) that had some sorta online calculator-type thing that asked you a bunch of questions about sleep habits and when you crash during the day, and based on all that, told what time of day and for how long the thing ought to be in use. Maybe you already have done all this, but it sounded to me like if a person was using the light box at the wrong time/for the wrong duration, it could be ineffective or even disruptive.
5th-May-2007 02:30 pm (UTC)
Maybe you already have done all this, [...]
I haven’t, but my sleep specialist gave me a schedule to follow. I’d love the link, though, since I’d like to confirm her suggestion.
5th-May-2007 02:44 pm (UTC)
Here is the assessment widget. This is done by a particular manufacturer of light boxes, but I imagine there'd be some interoperability.
3rd-May-2007 08:20 pm (UTC)
On the weight loss thing, there's something simple you might be able to try. Maybe not, but I figure I'll just mention it.

I've been losing a kilo a week (about 2 lbs) since I stopped eating meat back in October. It started out as an experiment to see if I could go two weeks without meat, and I just haven't gone back to eating meat since. Part of the weight loss may be attributed to the change in the types of foods I'm eating. My whole diet has been re-jiggered towards legumes and veggies (even more so since I arrived in Israel, but that's a different story).

This, and I'm actually getting *less* physical exercise than I was back in the US where I went ice skating at least few times a week compared to here where I've had a couple of injuries and haven't been able to do much of anything but write computer code.

Good luck with ALL the health stuff! :)
3rd-May-2007 09:07 pm (UTC)
Thanks for the suggestion, but, um, no earthly way. I actually did try cutting out red meat in college (not even all meat, just red meat). I got weaker and weaker and eventually started fainting. (Come to think of it, it felt kind of how I feel now.)

Plus, meat is yummy! I could cut out fruits, veggies, carbohydrates, and stuff like that with no problem, though. :-)
‘[T]he food was good solid stuff for a cold morning, all calories and fat and protein and maybe a vitamin crying softly because it was all alone.’
—Terry Pratchett, Guards! Guards!
PS — your userpic looks familiar, but I can’t place you. Can you remind me how I know you? Email to beowabbit@livejournal.com works fine.
3rd-May-2007 11:02 pm (UTC)
Almost 1 1/2 years ago I was diagnosed with a borderline sleep apnea, and the CPAC machine was recommended, and I hated it at the trial sleep study.

Around this same time my MD prescribed sleeping pills in a low dose (I think I tried Restoril, Lunestra and Ambien.) Restoril didn't work for me. Lunestra worked the best for me, but I hated the ka ka taste in the mouth/water tasting disgusting side effect, so opted for ambien, which I took in a tiny dose. It was enough to improve my sleep, then I was able to exercise, and embarked on a weight loss program, eventually losing 65 pounds, which I've maintained for about 9 months so far. (Still trying to lose a little more! :) )

I agree, when you're exhausted it's really hard to lose weight, yet the weight loss is the key to feeling better. Catch 22 huh? For me, the solution was sleeping pills, which improved my sleep good enough (not perfect, but good enough..) to get off my butt. Since I'm a stress eater, the exercise helped me control stress eating as well.

Only about a fifteen pound weight loss was enough to dramatically improve the quality of my sleep, and now I no longer have sleep apnea. I do realize we are all different, but for me, a lose dose sleeping pill was the first of many beneficial dominoes.
5th-May-2007 02:34 pm (UTC)
I agree, when you're exhausted it's really hard to lose weight, yet the weight loss is the key to feeling better. Catch 22 huh?
Yeah. In my case there are other factors besides sleep apnea in both the fatigue and the weight gain. (It’s sort of a vicious cycle, though, since everything contributes to everything else.) It seems extremely likely at this point that some sort of hormone therapy (exact kind yet to be determined) is going to make a big difference in my energy level and (perhaps smaller and less striking) my weight.
4th-May-2007 04:35 am (UTC)
I also use a CPAP machine every night.

But I also had an operation I dubbed the "snorectomy." Basically I had surgery that removed my tonsils and other throat tissue including my uvula. (Yes, men have a uvula...) I also had my nasal passages straightened out.

The surgery helped a great deal. On top of the CPAP, my sleep is even better.

However, I do still need to lose 40 pounds...
5th-May-2007 02:37 pm (UTC)
I think my ENT is considering fixing my deviated septum; not sure what he wants to do with the rest of my throat.

I don’t actually snore much; I just stop breathing. :-) I have a restriction at the soft palate and uvula, but I’ve only noticed that fairly recently. The restriction I’ve had for a long time, and which most frequently cuts off my breathing, is at the root of my tongue.
4th-May-2007 04:36 am (UTC)
I have steered clear of sleeping pills.
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