(Phaysis)

So the good news is that the doctor found something wrong with me. The bad news is that the treatment is lifelong.

According to the polysomnogram I got last week, I apparently stop breathing when I sleep. Not all through the night, mind you, but only during REM sleep. As soon as REM is over, I’m back to mostly normal. “REM-dependent sleep apnea“, the doctor called it, which means I just don’t sleep very well. How awesome is that?

See, when you’re in REM sleep, your brain is firing most of your neurons in a random fashion; this is necessary for memory, cognition, and sanity. Any interruption of this has negative consequences. During REM, you’re dreaming, and what you experience in your dreams is nothing more than an interpretation of this randomness. We act out in our dreams, but are prevented from actually acting on them. For instance, if the neurons responsible for remembering a childhood fear are triggered, the neurons that enable you to feel fear are triggered in response, and you may get the strong motivation to run away from the imagined threat. So you start running, firing the neurons that tell your legs to pump back and forth. What happens instead is that the nerves at the top of your spinal cord block these running signals and redirect some of them to the muscles in your eyes, effectively paralysing you and preventing you from accidentally killing yourself in your sleep by knocking yourself out of the tree or running off a cliff.

With the exception of your autonomic nervous system (which controls heartrate, breathing, digestion, etc.), every part of you is shut down during REM sleep. Even if your brain wanted to, you would be unable to move until this paralysis wore off. That’s why some people report suddenly waking up and being frozen stiff, unable to move. Stories like this are sometimes accompanied by a vision of a ghost or some other paranormal activity present in the room — an expected after-effect of the suggestibility of dreaming, but propped up by the dreamer as a convenient, though incorrect, explanation. The person is awake, but their nerves from the neck down haven’t caught on.

This paralysis varies with each individual. Some people are able to talk in their sleep, some walk in their sleep, others eat or have sex in their sleep. At this end of the pool, the paralysis isn’t deep enough. On the other end, you have people like me, whose paralysis is so deep that breathing stops frequently throughout the night. There are two sets of muscles that control breathing: the main set is the diaphragm underneath your ribcage for “belly breathing”, and the second is around the ribcage, used for “chest breathing”. During REM, the chest muscles are shut off, since they’re not part of the autonomic nervous system, so your only way to breathe is your automatic diaphragm motions.

With me, the diaphragm isn’t enough, so it either struggles to pull in air or just doesn’t move at all. The extra weight I carry on my belly is a contributing factor, as is my sleeping position (worse when I’m on my back). And so what happens if I’m not breathing? My blood-oxygen level drops. According to my sleep study, during these REM episodes it drops to as low as 60% O2 saturation. And so my adrenal system goes into panic mode, makes my heart pump more to keep O2 levels up, and my dream gets really intense and panicked, causing me to wake up just enough to start breathing again. The immediate result is disruption of necessary REM sleep. The intermediate result is a really bad night of sleep. The long-term result ranges from loss of concentration, bad memory, weight gain, all the way up to increased risk of diabetes and early-onset heart disease. All the stuff that comes from lack of sleep and a high-stress lifestyle.

No wonder I feel crappy in the morning, can’t focus, and can’t remember important stuff ever. FML.

So what’s the treatment? Sleeping with a CPAP machine. How cool is that? I get to sleep with an air hose jockstrapped to my face for the rest of my life. Fucking awesome.

The doc is having me come in next week to do another sleep study to determine just how much air pressure I actually need. “Titration”, it’s called. Then I’ll come back again to get set up with a machine of my very own (joy joy), and then a final checkup a month later to gauge my improvement. I feel my youth slipping away as I type.

So, it feels like my days of going to the submarine races are drawing to an end. I’ll be snorkeling in the shallows for the rest of my life.

So the holidays were crappy. That’s par for the course. I hate the holidays, but I try to power through them the best I can. At least I’m getting paid holiday pay this time around; thank the stars for not being a contractor anymore. Still, this xmas sucked ass because the only thing I got in my stocking was a head cold. I would’ve settled for a lump of coal instead.

No idea where the germs came from; most likely the coffeeshop I hang out at with all its weirdos and sickos shaking hands and whatnot. But I think what precipitated the collapse of my immunity against it was my mother’s visit for the holiday. See, she brought her two dogs, which I don’t mind as long as I take an allergy pill. But she smokes like a train, and apparently I lack the backbone to tell my own mother that she can’t smoke in my apartment. Others have smoked in here, but it was one smoke here or there; not an entire pack of really, really cheap tobacco. So after a day of exposure, I woke up xmas morning with a heavy knot of crud at the back of my throat. Happy effing holidays.

Two days and two rolls of tissue later, the fever broke and I was able to breathe through my nose again. Finally. I’ve got to take control of my passive-aggressive ways before they ruin my life further. It’s my life, it’s my house, it’s my health.

I was out sick for two days last week; came down with some sinus respiratory thing that’d been plaguing me for the past month. Remnants of the girl cooties I picked up. It settled down two weeks ago, but then a few shots of alcohol threw the bacterial balance off and it got worse over the next few days. Saw the doc Tuesday, got the amoxycillin. Doc recommended something non-antihistamine to help with the symptoms. I was like, “what, you mean like one of those Neti pots?” “Exactly.” So tonight, I bought one.

Now I hate my doctor.

Sure, I can breathe through my nose now. Mostly. I could do that before. But now there’s a slightly burning sensation…and the permanent taste of salt, baking soda, and snot in my mouth and throat. Gag. I think it would’ve been better had I shaken up a carbonated water bottle and jammed it up my nose. Sure, I know it’s my first time to the dance and with practice I can develop the technique, but I had absolutely no grace about it. The stuff that ran down the back of my throat collected in my mouth and came out as salty drool. It’s like I devolved back to my infant form. Absolutely no grace, absolutely no class.

Given that I paid twelve bucks for this damn thing, I may as well finish out the 30 packets of “dry solution mix” provided with it. I can’t believe they’re selling this, but people are buying it…and swearing by it. My coworker got one when he was out sick; swears by it. Doc swears by it. It seems to be the In Thing now. And all the white people go “it’s from Finland/Holland/Scandanavia, so it’s got to be good! Let’s dose up, blow out, and then go to Ikea!”

Me? I can’t swear by it. I’ll just stand next to it…and swear.

I am finally getting over my cold. We broke up a few days ago. She tried to hook me up with her sister Bronchitis, but I said “NO! I’m not interested. Let’s just pretend to be friends and never call each other ever again.” I’m also getting over my angry cough; for two nights it’s been getting me up at 3am in a fit of dream-coughing that gets so bad I wake up and have to do something about it. Disrupts my sleep. But I take some robo, double up my pillows to elevate my head, and make another pass at sleep. Maybe tonight will prove successful.

Work is hectic. My department is in the middle of a move to the new campus, so my coworkers and I have been pulling crap out of the corners, piling papers, sorting them into stacks, and then throwing away all the stacks. Every wire, cable, heat sink, component, processor, screw, server, everything has to be sorted, returned to its place and packed up by 5pm next wednesday. So far, it’s all a clusterfuck: trying to motivate and organize a department of ~75 people to get their stuff straight, and trying to get the movers to understand what we need moved, and trying to have all parties communicate what actually has to happen (versus what people think needs to happen) is a herculean effort. AND my coworker and I have to keep producing numbers. So, when all our equipment is over in the new campus across town, we’ll be with our test servers and offline test equipment in the old campus trying to do our work for two days, and then we’ll pack it all up and carry it all across town.

Predicting a huge pain in the ass.

While writing this, I remembered that I needed to update my timesheet, so I tabbed over to my Google Notes page to note the time I left today. What the hell…when I clicked on the note that contained all my clock-in/clock-out times for this week, the note disappeared. Deleted. So I clicked “Undo”, and the note came back, then I clicked on the note again to select it for editing…it deleted again. So I clicked “Undo”. It didn’t come back. It wasn’t in the deleted bin. It just…vanished. What the hell. All my timepoints lost, and I hadn’t had the chance to enter it all into my real timesheet app. So, I tried to remember and re-entered everything.

Maybe I should not be so trusting. Maybe if I say “Google sucks!” they’ll find this entry in their results for the search “Google sucks” (companies have departments that do this) and they’ll contact me to see what they can do to help make it right. Maybe I should file a bug report. Maybe I should just get over it.

I hate computers.

To the concerned, I am bruised but not broken. My heart is ok, but you should see the veins on my left arm. Yesterday’s trip to the ER was humbling but yielded a potentially positive outcome.

It started with a sip of soda; some went down my windpipe and caused me to cough forcefully. This is a bad thing — with me, coughs almost always end in hiccups (after smoking for 9 years, I can’t cough anymore – I have to hack). So, the hiccups inevitably began and I could not silence them soon enough. The unfortunate chain of events ended in tachycardia: the sudden, sustained doubling of my heartrate.

I’ve had this before, too many times. Went to the ER for it on one extremely long case. Usually lasts five to thirty seconds until my heart finally settles down. But yesterday morning, after I tried all my doctor-recommended tricks to end it, I knew it was going to last, so I called to my roomate to take me to the ER.

All the signs, cars, stop lights, people, activity – you notice the absurdity of it all when you’re sitting in a passenger seat and your vehicle is going in slow motion, your pulse is 180bpm and your heart feels like it wants to die. You feel completely unimportant; the world goes on regardless of your emergent health.

Tachycardia is not fatal; there’s a 1% to 3% chance of death from cardiac arrest. It feels like it’s eminent, though; the heart is on a freewheeling feedback where it still pumps blood but does so incredibly inefficiently. When your pulse returns to normal, you almost can’t feel it anymore, but you’re still alive. It’s otherworldly to not feel your own pulse, but you’re glad it’s settled down. You can relax.

I went to the ER hoping that they could get the ECG leads on me before it settled; sadly, my heart once again returned to normal before I could see a triage nurse. For a proper diagnosis, they need to see it happening. I considered trying to induce it, a potentially dangerous proposition, but it’d be the best place to try that kind of thing.

The doctor on staff mentioned that it might be a condition known as WPW, or Wolff-Parkinson-White Syndrome; the cardiologist on call suggested it, and the staff doctor seemed to agree. Basically, the heart has a nerve bundle between the upper and lower chambers which is responsible for transmitting the heartbeat impulse between halves while in the process delaying the beat of the lower chambers.

People with WPW also have a rogue nerve elsewhere between the halves that causes the impulse to be sent too soon and on rare occasion will cause a circular impulse loop, resulting in tachycardia. WPW is treatable with medication and in most cases (I’m assuming) curable with a procedure called radio-frequency ablation where heart surgeons run a catheter to the site of the rogue nerve and burn it with radio energy.

This errant nerve is formed at gestation but its effects are generally not seen until the person is between 11 and 40 years of age. I’ve had this problem for at least since 25. I had always associated it with smoking or too much caffiene; although that exacerbates the situation, it is not the cause.

The ER doctor recommended I see the cardiologist for a follow-up. Gave me his pager and office numbers. Since I have new insurance, I need to check with my provider to ensure I can see this specialist without referral from my primary physician. Politics and money first, health second. As much as I hate using the phone, I will start making some calls tomorrow morning. Even if the ER trip was a wash, this important lead makes it worth the effort.