Wednesday, January 22, 2014

The Sleep Issue

The Sleep Issue

One of the major challenges I experienced after hitting goal in November 2010 was a horrible return of my sleep apnea.  It was something I honestly thought was gone forever because after the first 100 pounds lost, it virtually disappeared. Suddenly I could sleep, breathe and feel fully rested without a cpap machine and I rejoiced! But then it came back somewhere around the 200 pounds lost mark.  I've since discussed this with sleep lab technicians and a doctor who all confirmed this was a common occurrence.  I quickly reinstated the use of my cpap when the symptoms started happening again. But this time it wasn't working like it did before.  I was still exhausted everyday.  A month after hitting 230 pounds, I underwent the first of two sleep studies over a two month period. The final diagnosis was sleep apnea and central apnea.  Things had changed dramatically. I had never heard of central apnea.

So I quickly googled it: "Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. Central sleep apnea is less common than obstructive sleep apnea. Central sleep apnea may occur as a result of other conditions, such as heart failure and stroke. Sleeping at a high altitude also may cause central sleep apnea." 

I had both. Obstructive and this less common, brain doesn't work central version. The treatment involved a different type of machine. I started using this new machine and I was still tired. It wasn't easy to get comfortable with this bipap at all. My body would fight it most of the time and most nights the mask would end up off by morning. Sleeping without it seemed the better alternative.  I stayed active during this time, continued eating within a reasonable budget and exercising. I successfully maintained the 275 pound loss for a year and a half. And I rarely made it through a full night on the bipap. I made it a habit to nap almost everyday in an effort to make up for the lost sleep.  Honestly, it didn't make too much sense trying to make up for bad sleep with more bad sleep, but as it became worse, I became desperate.  

Eventually I forced myself to use the bipap machine and soon I was making it through the night. It wasn't ever effective, at least not to the "night and day" degree of my previous cpap experience.  As my sleep became worse, I became more and more depressed, less inclined to exercise and basically lethargic. This wasn't how being at a healthy weight was supposed to feel!  Instead of being proactive and speaking up, I took a negative approach--citing the expense and trouble of possibly needing another sleep lab to help fix whatever was wrong this time. Instead of figuring out a way to do what was medically necessary for me to take better care of myself, I fell into a pattern of bad sleep, nap in the middle of the day, followed by bad sleep again the next night.  During this time I started regaining at a steady rate.


I'm not offering this as an excuse of any sort. It was/is a circumstance and my attitude and reaction to it wasn't the best course for me.  And this wasn't the only circumstance contributing, there were relationship issues and a few other things contributing to this depressive cycle.  Depression breeds things to be depressed about, you know what I mean?


But this post isn't about the why of where I am. This post is about me being proactive and taking better care of myself now, today.  


The apnea has worsened recently.  At the same time I've declared to take better care by maintaining a balance with food and exercise, writing more and getting a handle once again, I've been exhausted worse than ever. Despite this, I'm thrilled to report that reclaiming this balance has brought me tremendous support and strength and I'm doing wonderfully with food. Exercise has been another story. But in the name of compassion for me, I'm okay with a lighter exercise schedule for now. I clearly must get this sleep issue treated immediately because untreated, it's making everything ten times harder, not to mention what it's doing to my metabolism. Tuesday morning I drove to work feeling unfit to drive. I somehow made it through my radio show but not without a few slurred words here and there and what might have sounded like a slight intoxication. I was sent home immediately after a 9:30am meeting and told to get some sleep. But isn't that the most frustrating thing? That's all I want to do! But I can't. I called the doctor as soon as I got home and I must have impressed an urgency on the nurse because the doctor called me directly a short time later. I expressed to him how horrible things had become and asked for an emergency sleep study or a fast track appointment, something---anything...I just need relief.


Yesterday afternoon the nurse called back and had me an appointment for a sleep study that night in Stillwater. Talk about an answer to a prayer!


I was asked about my previous sleep lab studies during my intake. I mentioned the sleep apnea and central apnea diagnosis.  The technician stopped me and asked, "Did you have some kind of brain trauma?" No, I haven't had any kind of brain trauma that I know of in my past...and she said "Usually central starts as a result of trauma."  Hmmmm. Okay.  She continued hooking me up to all kinds of sensors and the sleep study started.


It was purely diagnostic, meaning I slept without a machine of any kind. And when I woke, I found out something very interesting.


The sleep technician monitoring me all night said she couldn't say too much, because the official reading would come from the doctor, but she wanted me to know that there wasn't any occurrence of central apnea. Not one. All night.


Which leads me to believe I was possibly misdiagnosed during the sleep labs from three years ago. This would explain why I never adapted to or benefited from the medical device prescribed to correct the issue. This explains so much!  Perhaps now I can get back to a regular cpap machine and finally find some rest. 


This is all a part of taking better care of me. This is what it's all about. 


As far as what I'm doing with food and exercise: I'm staying within a 1700 calorie budget. I've only walked a few times in the last week and a half.  When I say "My food has been good," what I mean is, I've been within my budget and I haven't binged.  I look forward to increasing my exercise and getting back some stamina. My goodness how quickly it goes! One mile and I'm hurting and out of breath!! I was doing 5 and 10 K's without too much difficulty--and now a mile is tough! But that's OKAY! :) Really--it is. And I know how quickly it returns with consistency.  


Given the circumstances, I'm proud of where I am.  I'm back and it feels good. And I'm doing a fabulous job of being compassionate toward me... And considering I didn't really know what that meant at one point, I'm figuring it out and it's a much better way of being.


I found some Joseph's 60 calorie pita's during my most recent shopping trip so needless to say it's been a regular feature of breakfast for me and even lunch as you'll see in the photo below.  I've also included a picture of Noah and me playing with the camera phone. Noah is my 6 month old grandson! I'm a 42 year old gramps, can you believe it?


Looking forward to the road ahead! Thank you for reading,

Strength,
Sean

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Recent lunch: Chicken and Cheese Pita Pizzas with a side of watermelon! It was a little too much actually, checking in at 574 calories. I was full 3/4 of the way.

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The highlight of 2013, for sure: My grandson Noah Riley was born July 6th, 2013 to my daughter Courtney.  In this photo, Noah is constantly fascinated by the phone.  He really wants to drool all over my phone! Total accident that the inspirational message on the wall behind was "photo bombing" us. It reads: "It's never too late to live happily ever after." Very nice.

13 comments:

  1. I'm so glad you're getting something done about your sleep problems. As a mother, I have some idea of what it's like to go a long period without enough sleep, but yours sounds much worse and for much longer. Keep going until you get answers.

    And hi Noah!

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  2. Hey bud, glad you got that figured...i am slowly building back as well...compassion for yourself is a fantastic step, and shows how far you have come...the old , fat brained us would seek punishment. Keep on keepin on.

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  3. Grandpappy! In the news business, that's called "burying the lead", old timer. Congrats on the family addition and best wishes to your daughter.

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  4. Sean, I am so grateful you were able to have this sleep study and are on the way to feeling better. I have read so many studies about disrupted sleep and weight gain recently. I offer that not as an excuse but do think it probably added difficulty to this issue. I hope you are able to sleep better and better as you lose and that you will be encouraged more each day. Your grandbaby is so precious... another good reason to be thin and healthy. I'm so thankful for all your posts Sean. Thank you. Shirley

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  5. My daughter suffers from insomnia and it is a terrible thing. No matter what reason you lose sleep over, it can upset your life. I hope that you are finally getting a correct diagnosis so that you can move on.

    Your grand-baby is adorable. Enjoy! :)

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  6. Let me preface this comment by stating that I have no idea what I'm talking about. You know, so you can consider the source.

    That disclaimer, claimed--I have always been concerned about two things with your weight loss plan. 1. the amount of calories you eat being too low for your height/lean body mass needs, and 2. The amount of protein you eat compared to what you need to consume to sustain your muscles...you know like your heart muscle.

    When you redeveloped sleep apnea, I wondered if the low cals/low protein may have damaged your heart. I now wonder if that rapid weight loss along with the low cal/low protein diet caused your body to send off the signals that led to the misdiagnosis.

    Just a thought, and since your current plan is only 17000 cals a day (Is that enought for aman of your height and frame?) and the pictured meal is pretty low in protein, I felt like I had to mention it. (You know, because I'm helpful like that.)

    Has any MD commented on your eating plan being a possible actor with the sleep apnea return or what your ideal cal/protein intake should be?

    Again, what do I know?

    Best wishes,

    Deb

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  7. How incredible is it that being misdiagnosed could possible be the reason you have had such a bumpy ride. Please answers are coming your way. Noah is gorgeous !! Wish we had the 60 calorie pita's here ! Keep up the awesome hard work xx

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  8. You are right to cut yourself slack on the exercise until you get the sleep issue resolved. We all need sleep,it is no wonder things got hard. It is not about falling off the wagon, but about getting back on. You are an inspiration!

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  9. Hi Sean, I used to sleep very poorly, and I do believe it was a big part of me being heavy for many years.

    I hope the doctors have some solutions for your condition. We had a client who had surgery to remove nasal polyps because he had obstructive sleep apnea, and that helped him quite a bit. I'm sure your situation is different but I hope for just as good for you. :D

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  10. So glad to hear you are feeling better and things are improving for you. I feel like I can indentify with being misdiagnosed, although I have not been through any kind of sleep study, I have been how ever dealing with illness that cause me to be less active for several years and yes for the first time I was starting to feel depression symptoms. It's not a good mix I agree. After the loss of my Mother this past June and family drama too sleep began to be really difficult. I had my days and nights mixed up and it doesn't help one's metabolism that is for sure. The good news is we can always come back after difficult circumstances. It's never too late to start over and learn from the past. You are important to many who love you, like that cute little guy in you photo with you. Grandkids are amazing and great medicine for a hurting heart. You are on your way back, thank you for sharing your story. Best wishes to you always~Jules

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  11. Oh my word!! A grandbaby?!? Congratulations, Sean!! What a blessing. He's beautiful.

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  12. Oh, wow, a grandbaby is such a good reason to get to your healthy weight!!!!

    Thanks for coming back and sharing "the number" because I'm pretty sure I gain and was considering not posting my "Serious Saturday Stats" on my FB group page tomorrow, but your action has encouraged me to suck it up a and post it anyway!

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