"Never awake me when you have good news to announce..."

“Never awake me when you have good news to announce, because with good news nothing presses; but when you have bad news, arouse me immediately, for then there is not an instant to be lost.” - Napoleon Bonaparte

Day 89

I have good news and bad news to report from the sleep study. The good news is that I don't have to go back for a second night's torture. The bad news is that it's because I failed so abysmally there's absolutely no question but that I have severe sleep apnea and must start using a sleep machine. Wow. It's difficult to assimilate this on so many levels. One, hard to imagine I have had such crappy sleep benefits; another that even a sleeping pill didn't make it any better, another that I'm going to have to learn to sleep with a machine that makes me feel like I am suffocating and finally that this puts my surgery at least two months out now. Wow.

The tech was great - a guy named Al which is my father's nick-name. I arrived at the sleep center about 5 minutes early and not a car was in sight. I was all-a-jitter, not looking forward to the "experience" in the least. Per my instructions I rang the ominous after-hours bell, and out walks this very jovial man saying, "Hi, you must be Gail. I'm Al. Welcome." Clearly he's done this before. Anxiety level considers minimal abatement. We walk into the center. By day it's an outpatient surgery center, by night cavernous rooms with lots of scary equipment and empty hospital beds. "Oh great, I think... I'm going to have to do this darn thing in a surgical suite in a hospital bed."

He finally stops the tour and invites me to follow him into a room that although still rather clinical turned out to be not half-bad. Similar to John's sleep study experience of a couple years past there's a queen size murphy-bed made-up with a cheery yellow blanket and two amazingly fluffy looking pillows for a sleep center. And to my great delight a large black recliner that looks fairly squishy (and yes, I was able to convince him to let me sleep there so my shoulder survived the night admirably) and a nice-sized flat screen TV mounted to the wall. Anxiety abates slightly... and then I notice the seemingly endless pile of connectors neatly lined up on the bed awaiting attachment to various body parts. Ugh.

Al was cool though. He had me fill out a pre-sleep survey (as though I hadn't already filled out 100 pieces of paper prior to the evening) and change into my jammies and then came back and started the almost 90 minute process of hooking me up to all those wires. It probably could have been done in half the time but Al was chatty and I had warned him I was anxious so he was doing all he could to help me relax. About two-thirds of the way through the process his other "guest" for the evening arrived - an 18 year old man with his parents and older brother. Boy were they rowdy! I heard Dad telling his son all about the experience and not to worry after his brother pointed out the cart that had all of the ointments and tape prepped on it in anticipation of his hook-up session.

Al had told me earlier in my hook-up that the 18 year-old was coming. I told him that I was amazed someone so young was there and he said sadly he's had a number of 10 and 11 year-olds in the center. Typically they didn't have apnea - they couldn't sleep because of stress generally related to parents getting divorced. How very sad. I heard the 18 year-old's mom asking the tech to try to do a split-study for him because they were taking him to his college on Thursday for some early training and they didn't want him to come back. So now I'm envisioning there must have been an athlete in that room - an anonymous person who may someday be famous and I could have said I'd spent the night with him - except for that anonymity thing. Oh well, I guess the Enquirer article isn't an option after all.

Before the family arrived I also pleaded for a split study. Al explained the criteria for it to me in more detail than the doc had. He said that the only way he could do a split study was if it was clear in the first 3 hours of the evening that I had sleep apnea. If unclear, or if seemingly I didn't, then they'd have to do a two night procedure. He told me about the guy he'd had the night before that had a horrible time for the first hour of his sleep but finally fell into a good REM sleep with no breathing issues for the next few hours... and then back into the "bad" sleep pattern. By then it was too late to move him to the machine. I asked him to put me on it 3 hours in if it looked possible that I had any issues. He woke me up after 2 hours and said "I just couldn't stand to see you suffer any longer. You were literally gasping for air." No doubt at all about my condition. OK then. Bring it on.

I breathe through my mouth - a lot. I have for as long as I can remember. I've always had upper respiratory junk - allergies to everything in our environment, a little asthma, blah blah blah. Because I "admitted" this he had the "special" mask holder all prepped for me. I was very light weight - that's about the only good thing I could think of to say about it. It was fitted around my head and had a chin strap so that when you tried to breathe through your mouth it wouldn't fall off - also helped remind you to keep your mouth closed. This turned out to be a very good thing because with the mask in place and the air turned on if you do open your mouth you can't breathe at all. It was all I could do to keep myself calm and out of full panic mode when I had to cough - at one point I ripped the thing off when I did need to cough because I was sure I was going to suffocate. They only had a c-pap machine. John uses a bi-pap. I'm going to have to ask the doc about the latter because his seems a lot better. The c-pap blows air in and you have to exhale on your own. The bi-pap both blows air in and helps you exhale.

When he first put it on I was OK - not loving it, but OK. He had the air flow really low. As he increased the air flow I found it difficult to breathe. I wondered how on earth I was ever going to be able to go back to sleep. The mask itself is effectively a small piece of plastic fitted over your nose with holes the size of your nostrils and a protuberance that hovers over your lips - perhaps 1/4 of an inch away - hence the inability to breathe through your mouth. As soon as you do there's this feeling of almost like reverse air pressure sucking air out of you instead of putting it in. Very odd - add very scary. One of my phobias is fear of drowning - and it made me feel like that.

So good old Al reduced the air flow for me and I thought about beaches (no doubt with those lovely visuals I mentioned yesterday from one friend and in yesterday's comments from another). The sound of waves crashing on the shore in my mind overcame the sound of this thing pushing air into my nose. But then Al turned in evil, nefarious Al! As soon as I fell asleep he cranked that air flow up. Of course I didn't know this until I woke up coughing - no doubt that's why I ripped the mask off then.

He was a cool guy though. He came into the room right away. Turned the air flow back down and repositioned the mask. I was sure I'd never be able to fall back asleep (it was around 3 AM then), but did so within a few minutes. The evil, nefarious Al kicked the air flow back up high again and for the first time in the night I actually went into REM sleep. Amazing. Maybe I do need this damn thing after all! Of course the ever-wishing-to-be-in-denial part of me wants to blame it on total exhaustion after a night in the catacombs... but...

Around 5 AM after I came out of REM the good Al came back and released me from all of the medieval torture devices. He commented that he was going to encourage future victims, I mean patients, to try sleeping in the recliner because it worked so well -- they want you on your back and most of us are side-sleepers). I refused to admit it but I did wake up amazingly awake if that makes any sense. No grogginess at all, just suddenly awake. Another clue perhaps that perhaps I do need this thing.

I was home around 5:30 (it as a lot faster detaching the multitudinous devices that it was attaching them!!). After setting off the house alarm and reassuring the alarm company that we were OK (John had set the alarm to go off immediately upon an exterior door opening instead of the away delay) we both went back to sleep. I didn't get up until around 10 - about 4 hours later than my usual weekend wake-up time.

The only residual challenge to deal with this morning was my hair. Four of the connections of the EEG to my head were on my scalp. Al used a gross gooey, waxy product to attach them. He warned me last night that it wouldn't be fun to get out but that as long as I used the hottest water I could stand and no shampoo that I'd be OK. And once again Al came though for me. After figuring out how to bypass the shower's safety thermostat (I do love the new shower tower we put in with the remodel a couple of year's ago!) I spent about 20 minutes melting the gunk away. My hair still felt icky and then I spotted the clarifier my stylist had recommended a year ago when I had some product build-up on it so decided to give it a try. After two rinses with it I feel much better -- bless you Rene Furtier!! His products are outrageously expensive, but worth every penny at a crisis time like this. :)

OK then... this has to be more than enough gory details for anyone, even me, by now! Thank you kind friend for ploughing your way through this endless blog today. Once again, it's been very therapeutic for me to write my way through the angst and into acceptance. Thanks for all your support.

One last anxious milestone to deal with now - this coming Thursday's drug-induced stress-test and PET scan. Can't wait (for it to be over). I'll let you know how it goes! Please thing good, calming thoughts for me and send your positive vibes my way around 12:30 Thursday afternoon.