Have you ever had a week that just went from weird to surreal? I’m in one of those now.
It started out with my foot hurting and ended with me being diagnosed with severe sleep apnea. In between there were x-rays, blood tests, a sleep study and finally a class in how to use a CPAP machine.
After all that, I sent an email to my doctor saying, “So now that we know I have sleep apnea, can we get back to figuring out why my foot hurts?” It’s been one of those kind of rides. I show up, limping, complaining about a foot and the medical community naturally wants to check how I sleep at night.
Back to my foot. It was hurting, but only after walking or sometimes after sitting. It was just one of those weird things that one week it hurt badly for a couple of days and then went away. Sharp pain and then fine. I’ve had trouble with my feet before as a long time sufferer of gout. On the assumption it was gout, I took my gout pills. On the assumption that I need new shoes I switch to wearing my good sturdy walking shoes.
Seemed to work and then, my foot started to hurt again, so I did what I do best – I started writing. In this case an email to my doctor. She wrote back, “go get the gout blood test and make an appointment.”
When you go to the doctor’s office there is this little dance you have to do no matter why you’ve come in: pulse, blood pressure, temperature, weight, “Do you smoke?”, “Why are you here?”, etc. I’ll admit that I looked at the number on the scale will a little disbelief. I knew I ate a “little” more during the holidays, but not that much.
So the doc checks out my foot. Agrees with me that it’s likely not gout and orders x-rays. Then tells me of what could be wrong with my foot: Stress fracture, tendon problem, pinched nerves, still could be gout and your BP is great.
I should have just replied, “Thank you.” and left. Did I, no. The exchange starts with:
Doctor: “Well, your blood pressure is fine, you’re doing great on that.”
Me: “Yes, but I was a little shocked by my weight. It shouldn’t be up that much.”
Doctor: “When did we last test your thyroid and blood sugar? Have we checked your testosterone since your radiation treatment?”
I kind of lost control of the conversation after that as the doctor started listing all the medical problems that could cause weight gain and ended with the words, “sleep apnea.”
Again, I missed an opportunity to keep my mouth shut, but instead said, “Oh yeah, I remember when I had gallbladder surgery, the nurses kept asking if I’d ever been tested for sleep apnea, and my wife has said she’s heard me do that stop breathing thing at night.”
Something I should point out about a good doctor, they listen to everything you say. I have a great doctor.
So I left her office with a long list of new blood tests to get and an appointment for a sleep study.
One of things I love about my health provider is that they’ve got a great on-line system with a website I can log into. I can email my doctor and test results are emailed to me at the same time the doc gets them. By the end of the day I knew that the x-ray was normal, no stress fracture, and that my uric acid was normal so no gout.
But the sleep thing loomed on the horizon.
The sleep study turned out to be the home version. They give you this thing to wear on your wrist. It’s got an oxygen sensor that goes on your finger and a single lead you have to tape to your chest. It’s kind of like a FitBit on steroids and all you do is put it on, go to sleep and drop it off at the clinic the next day.
The blood lab was a little extra scary as the technician had a “trainee” badge on and took out three vials to fill. I thought of asking if she was going to leave any blood for me, but after the doctor’s office I decide it best to zip it and endure.
On the sleep study they don’t email you the results. You have to go in to this group clinic with 20 strangers to get your paper with the test results. Kind of like high school on the day after an exam. The high-tech thing they do is to email you a link to a video on sleep apnea to watch at home. I am thinking that after 20 years the doctor got tired of doing the same lecture for patients so he just recorded it.
It was a nice video and laid out the basic facts along with a list of life style changes you can make to reduce or even eliminate sleep apnea. Diet, exercise, sinus rinse … yeah I could do those, even though the sinus rinse video was a bit disgusting.
The faithful day came only two days after I turned in my wrist worn tricorder. There were a bunch of people in line waiting to check in and I noticed the staff were separating us into two groups. At this point I got to thinking about Bible stories and was wondering if I was going to be a sheep or a goat.
The lady at the check in desk looked at her list and told me, “You’re in room A5,” which turned out to be the room furthest from the desk and I limped my way down. Yes, my foot was hurting again and I was on my way to see how I breath at night.
At the door of the conference room was a nice man with a stack of papers asking,
“Name?”
“Reynolds,” I said.
“Here’s your results, let me get you a mask and a machine,” he replied.
“Great, I am a goat.”
“Sir?”
“Never mind, large mask please.”
Then this nice RN shows up and starts with, “You’re all here because each of you has severe sleep apnea. How many of you watched that video? Good almost everyone. You know those life style changes the doctor talked about? Great! Yes. They won’t work for you, you have severe sleep apnea and need the CPAP machine.”
Great, this guy was going to be fun to listen to. Turns out he does the machine demos because he also has severe sleep apnea. Those words got tossed around a lot that afternoon, “severe sleep apnea,” along with “Constant positive airway pressure,” and “CPAP.” And a fair amount of, “Really?” and “Seriously?” from us sitting in front of our toys.
So sitting with 20 of my new friends, wearing our masks, the nice man showed us how to plug the machine in and adjust the mask along with sage advice like, “You only need to use this machine on nights you want to breathe.”
As soon as I got home, I took some ibuprofen for my foot and sent my doctor an email with the subject, “So back to my foot.”
That email resulted in a referral to podiatry and two days later I am sitting in this exam chair, shoeless, and looking at a guy who looks like he could have been a line-backer. I gave him the quick version of my foot pain. He then took my foot in his hand and squeezed a little.
I screamed, a little.
He then described what my condition was, something about inflamed tendons and pinched nerves – I wasn’t really listing that close as I was mostly watching where his hands were in relation to my feet. He had two solutions, shoe inserts to provide better arch support, and he’d be happy to give me a nice cortisone right into the affected joint right now.
I think I went a little catatonic at that point as I remembered my last painful shot of cortisone. There was a bit of time where the room was blurry and I think the doctor was trying to get my attention. Clearly, I was expected to speak so I used the only part of my brain that was functioning at the moment, my engineering brain.
So, my engineering brain takes over and says, “Sorry, I was just doing a calculation in my mind trying to determine which would be worse, continuing with my foot pain as it is and buying the inserts, or letting you stick needles in me.”
He smiled, “Good calculation to make. And the result is?”
“I’ll try the inserts and if they don’t work, cortisone will still be an option?”
He then gave me info on the inserts, where to buy them and opened the door to set me free. I didn’t run from his office. Well, mostly because I couldn’t.
This week I go in for a followup with my new friend the CPAP machine. Frankly, I am just hoping that this week moves away from surreal and back to merely weird.
Till next week,
Andrew
Andrew's View of the Week 