Active Duty Marine needing input/help/advice

[MarineCorpsNerd1]

Good Afternoon all!

So the story is a long one. I am a 31 year old current Marine with 4 years of service so far who has suddenly come up with a series of pretty horrible health issues after 4 years of being in pretty awesome and flawless shape. High blood pressure, pretty severe heart palpitations, etc etc...Episode started almost a year ago now with a seizure and I experienced no issues again until 4 months ago when I lost all of the feeling in my arms and legs and sight in one eye(It's all back now, but took months to get my strength back and I am still pretty shaky). It was at that time I noticed that my heart was horribly off rhythm and I am SURE that is what caused the first seizure and the aforementioned episode. The first thing we found in the hospital was that my blood pressure was just far to high despite a very good diet, about 170/120 being a resting blood pressure before being medicated and after medications I run 190/110-120 during a brief run(Whereas I used to be able to pull 8-10 miles as a warmup before work!). After way to many tests regarding bloodwork, echos, the whole shabang came back saying I was in perfect health I had to try to figure out what was going on, they kept pumping me full of meds to regulate my BP and heart but I don't want to attack symptoms, I want to actually be fixed. Our medical coverage being what it is you will definitely be crippled or die if you just kind of let them do what they want with a big issue. 

I meditated on things for a while and finally came to my current conclusion, I frequently wakeup during the night(always did but never thought anything of it) and feel delirious and wore out all the time. I had always choked it up to the hours and stress of the job until now. Sometimes I wakeup and it is plain as day that I am not breathing, tingling lips and bloodshot eyes, even to the extent that my hands and feet are cold and numb.  My eyesight has quickly deteriorated(I am convinced it is due to the blood pressure) as well which has really set me for a downhill roll seeing as how I start college soon(online). I was sent to a one night sleep study and all came back "good" except for a ton of PVCs(Think heart palpitation) which are always very bad at night, sometimes even waking me up. I wasn't taking that, one good night doesn't mean anything because I had already noticed that some nights I wakeup feeling ok and alot of nights I feel like a band of midgets busted into my room in my sleep and beat me near to death. So I went out and bought my own Sp02 monitor...

Commercial link removed. Search for Wellue Tracker.

And things started to surface that I had suspected. Ill go sometimes for 3 or 4 days with good oxygen levels and heartrate then get slammed with a few days(Without doing anything different that day) where it says I had several drops. Those are the days I feel like crap. They don't give a crap about us and never did. I have been ripping medicals teeth out to try to get a good study done, they always go for the lowest bidder and cheapest solution, even threw heart surgery onto the dang table before a longer sleep study, that is Military healthcare for you...I just want to get fixed, there are alot of guys here fighting the same battle.

This is a link to images of my Spo2 levels and heartrate at night I saved. The ring talks to my phone via bluetooth, we tested it against the hospitals equipment and it is dead on. I have to prove I have something going on ASAP. Any help, advice, or input is a literal lifesaver.

https://drive.google.com/open?id=1Qhz_Em...1rPc36mZPe

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[Sleeprider]

The oxygen and pulse data point to inconsistent problems with desaturation and a physiological reaction of arousal, high adrenaline and heart rate. The records I reviewed look pretty good for SpO2 and while there are some low spikes of oxygen, it rarely reaches 90% and tends to be in the upper 90s, however lower SpO2 is associated with spikes in heart rate.

Since you are currently in the Marines and young, we must assume you are in excellent physical condition other than this problem. Without recording the incident with a polysomongraph, it is impossible to know what is happening, so a sleep study seems to be in order, however as you know this is a condition that does not occur every night, or it may be infrequent on nights where you are not "slammed". The possibilities for sleep disordered breathing include obstructive apnea episodes caused by poor alignment of the airway (chin tucking), or possibly idiopathic central apnea episodes (unknown causes). The chronic high blood pressure is an important warning sign that this has been going on for some time. In addition, you have indicated you are affected by fatigue and other symptoms of apnea. Has anyone ever complained about you snoring?

[MarineCorpsNerd1]

Thank you for the reply! No I never snore actually as far as I am told, and I never move when I sleep also(The ring picks that up and so does another thing I have). Whatever position I fall asleep in is exactly the same one I wakeup in and I think that is part of the problem. I did notice that if something is poking me in the neck(I sleep with a body pillow) I instantly stop breathing and I definitely cannot under any circumstances sleep on my back.

There are alot of episodes I have noticed where my SpO2 is perfect but that heartrate hits about 120 over and over again throughout the night and I think that is just as murderous as the low SpO2(it has been in the mid 80s several times, 83 being the lowest so far but always picks right back up). So there is definitely not a 100% correlation between heartrate and SpO2 but there is a 100% correlation with my constant waking up at night and either heartrate being ridiculously high or SpO2 being low.

The worst night I have had so far was the 28th of December. It has gone on consistently for 4 months now and over the past 3 weeks I have started to feel ALOT better, even able to do my CFT(difficult fitness test) whereas when this started I could hardly stand without excruciating chestpain. Suddenly on the 28th it intensified, I wokeup at night with my heart off rhythm beating faster than if I was at a dead sprint. I would breath but it was like there was no air, I sprung out of bed and started walking around to try to stop myself from feinting and was about to call 911 when I started to regain my breath. It was very strange. The PVCs/Palpitations only really happen to me at night anymore and yes I am extremely fatigued and mentally everything is extremely foggy. I think it may hearken back to my very early 20s when I hurt my back, the curve of my neck/spine is a bit off and I wonder if that isn't causing some issues.

[Crimson Nape]

Several questions come to mind.  Here are my top three.

1. Have you had a any blood work preformed lately?  If so, did it contain any thyroid profile tests?
   
2. You indicated that you're active duty.  How long, if at all, since your last deployment?
   
3. Are your CFT/PFT scores getting worse, same, or better?
   

[MarineCorpsNerd1]

1. Yes alot actually, thyroid was one of the first things we checked and we did so twice. Came back perfect both times.

2. Never deployed, never will, kind of how things go now.

3. Definitely getting worse, I am alot weaker than I was before the episode started even after all of this time. Just very little energy and cant seem to gain weight back that I lost(about 20lbs of muscle really fast). Its been grueling!

[Amdx64]

I would suggest doing some research into migraines. The last couple of years I started having some of the same symptoms you have described. After being diagnosed with severe complex sleep apnea we discovered that I had chronic migraines as well. Once we started getting the migraines under control I noticed that a lot of the symptoms that I had complained about to the doctor started to go away. I never had the normal signs for sleep apnea or migraines so it took awhile to finally figure out my issues. I hope you find a solution soon. Thanks for your service.

[Sleeprider]

You’re not alone apparently https://journals.lww.com/jhypertension/A...ary.26.asp

You don’t fit the profile for sleep apnea but I am not able to reply tonight Let’s pick this up tomorrow.

[MarineCorpsNerd1]

Should be interesting. The only fault I can find in myself after all of these tests is that something happens in my sleep. Sporadic sleep apnea is the only thing that makes sense. O2 drops down to the mid 80s for one of the fittest people in the Corps is not ok and has probably gone on for years. If I hadn't joined the service I am sure it wouldn't have surfaced until my mid 40s to early 50s, but the things we deal with and the hours and strain behind it all caused it to hit a deadly breaking point in the 30s. That is my diagnosis with a bit of help. We need proof though, that is where things hit the redzone. Until then it is a disgusting amount of bloodwork and failed avenues that I have ZERO confidence in now. I am planning to get more equipment to prove it is a sleep thing soon but I really just don't get paid enough for it. Ill make it happen, but good lord. I need help, alot of us need help, and alot of us cant serve in the capacity we want to and dont live as long as we would like because of the exact same garbage.

[srlevine1]

Might I suggest that you ask your physician to recommend a good cardiologist and have a nuclear heart scan to see if the source of the PVCs are related to heart muscle defects which are not always detectible on cardiograms or echo-cardiograms?

The basic issue is that PVCs can combine into a life-threatening arrhythmia (ventricular tachycardia and fibrillation) and result in sudden cardiac death. Not a good thing.

If your resting heart rate is above 100, you are by some definitions, experiencing ventricular tachycardia. The symptoms can include dizziness, lightheadedness, palpitations. And your blood pressure may spike to compensate for the lower oxygen saturation as the chambers of the heart beat irregularly.

You may also want to check your Magnesium level to ensure against a particularly malevolent arrhythmia known as Torsades de pointes .

Work the problem. I wish you the best of luck.

[Sleeprider]

Sorry it took so long to get back here. When we talk about "sporatic" sleep apnea, that takes us into a realm that the sleep specialists do not cope with well. It is not conventional obstructive sleep apnea that occurs anytime you sleep and is easily documented, diagnosed and treated. Intermittent respiratory distress could be central or obstructive and may arise from positional apnea, idiopathic central events where you just stop breathing without obstruction, or even plain old obstructive apnea. Your problem in being diagnosed is compounded in that you are physically fit and don't fit the profile of someone normally diagnosed with OSA and you're a Jarhead for heaven's sake! So that just doesn't happen to super-human beings.

Inexpensive and unobtrusive things you can do on your own include documenting the symptoms by keeping a journal. Get a small recording oximeter and use the data. Buy a CPAP off Craigslist, Offerup, Facebook Market etc and see if it makes a difference. Get a Resmed Airsense 10 Autoset or similar and it will also provide data. I don't know all the limitations you have in self-treatment or diagnosis or the use of these approaches, but documentation makes it very hard for physicians to ignore a problem. The workup that SRlevine suggests sounds like a very good idea, but obtaining this within an active duty environment is understandably difficult, however you guys should get the same or better care as any other working man or woman in this world where bad things happen to good and even fit people.