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Legal Action? Lawyers Here? Missed Diagnosis
#1
Legal Action? Lawyers Here? Missed Diagnosis
Hi all,

26 years ago:
I was having an increasing number of incidents where I'd abruptly awaken gasping for air, usually 1) as I was falling asleep, 2) soon after falling asleep, or 3) within a few hours of falling asleep. I'd always had these incidents every now and then, but they'd been getting more frequent and I blamed anxiety, but nevertheless...

...I contacted my HMO and said, "I think I might have sleep apnea." They sent a man to my home who set up a little box and told me to wear a finger oximeter overnight. Next day I brought the box to the clinic. Later they called and said everything was normal. Immediately after that the incidents pretty much disappeared.

But over the years they returned every so often. I always blamed gravity pressing down on my stomach and stopping my breathing and thought that the only incidents I had were the ones I was awakening to; maybe five or so a month.

Never any daytime symptoms. Always very physically fit, gym rat, runner, etc. Fast forward to the present. I'm 53. Had same dentist for years. But only in the past few years has she asked if I had SA due to my small airway. I'd always say, "No, I don't have any symptoms (headaches, sleepiness, fatigue), and years ago I had a sleep test that was normal."

However, recently I began researching OSA because I'm a journalist. And damn, I now realize that my nocturnal gasps are AI's instead of laryngospasms or gravity. I've also learned that a small airway and receding chin (which I also have) are very predictive of OSA.

But what really has freaked me out is the nocturia! For years I've been awakened at least once overnight, sometimes twice, to urinate. Every single night even if I stop drinking fluids four hours prior to bedtime. Over past few years it's usually twice a night, sometimes three.

All along I thought this was normal but I was awakening because I've always been a light sleeper. I now know that the bladder is NOT SUPPOSED TO FILL UP AT ALL during sleep. My chronic nocturia is obviously not from a UTI. It's also not menopause because I've had the problem long before menopause.

So that's 1) nocturnal gasps, 2) small airway, receding chin, and 3) chronic nocturia.

I've also learned that a pulse oximeter by itself is not reliable for detecting SA. I am now fuming that my HMO set me up with only a finger unit instead of an actual bona fide home sleep study. I am LIVID, because that's 25 years I COULD HAVE BEEN USING CPAP.

Even though to this day I still have absolutely no daytime symptoms and in fact, am so fit that I compare myself to people half my age, I still can't help wonder if there's subclinical irreversible cardiovascular damage. My BP is consistently on the low side. I've actually gone for extended periods on 4-6 hours of sleep while caretaking for sick relatives -- never felt exhausted or drained and still managed to fit in workouts, running, etc. 

I'm now in process of getting referral for a home sleep study from my doctor (same HMO, but apparently they've caught up with the times). If I have OSA, do I have a legal case for the shoddy response to my concern 26 years ago? I am SO LIVID over this.
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#2
RE: Legal Action? Lawyers Here? Missed Diagnosis
If I read your post correctly, you are allowing the past to affect the present, and possibly the future. One, you need to give up the anger and not continue to re-live that which you cannot change or control. Two, you must become proactive in your own treatment. Might I suggest that, due to your past and the complexity of your situation, a home sleep study may not be adequate for your needs and you should press your HMO for an in-lab sleep study where you are continually observed and where the technicians may spot something of interest that could lead to a better diagnosis and subsequent therapy.

As for the legal issues, you may find that: one, you would need to prove professional negligence; two, you would need to prove cognizable harm; and three, there needs to be a remedy that could compensate you for your loss, if any. Doesn't sound too promising -- even if you could find an expert to evaluate your past medical records and produce a finding of negligence, the statute of limitations is most likely to have passed.

I wish you luck in resolving your issues and further suggest you post your progress and request advice on this forum.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#3
RE: Legal Action? Lawyers Here? Missed Diagnosis
Hi K.L.,

Welcome to Apnea Board!

There are many of us here that have had similar experiences.  

I know now looking back over the years and thinking about my symptoms that I’ve had Sleep Apnea many years before being diagnosed.  Do I wonder why doctors couldn’t recognize it?  Yes, of course.

The thing is, there is no point in dwelling on something you can’t change.  Let go of the past, and start to take charge of your health.  You are now aware of your Apnea, so take action.  

Talk to your doctor and schedule a Sleep Study.  You need to start receiving the proper therapy.

You’ve stumbled upon us, and we’re good at helping folk.  Smile

Here is some information to help get you started.

http://www.apneaboard.com/forums/Thread-...re-success
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Legal Action? Lawyers Here? Missed Diagnosis
(10-22-2017, 11:29 PM)K.L. Wrote: Even though to this day I still have absolutely no daytime symptoms and in fact, am so fit that I compare myself to people half my age, I still can't help wonder if there's subclinical irreversible cardiovascular damage. My BP is consistently on the low side. I've actually gone for extended periods on 4-6 hours of sleep while caretaking for sick relatives -- never felt exhausted or drained and still managed to fit in workouts, running, etc.

OK, I've got this. You are livid because you absolutely have no symptoms of sleep apnea, are in excellent shape and can function on 4-6 hours of sleep, yeah, I'd be P*ssed too. Especially since you may have a disease that is not severe enough to show any observable symptoms.

Comment removed.  Moderator Action

Ian
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#5
RE: Legal Action? Lawyers Here? Missed Diagnosis
"If I have OSA, do I have a legal case for the shoddy response to my concern 26 years ago? I am SO LIVID over this."

Very unlikely that you would have a successful suit over over this.
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#6
RE: Legal Action? Lawyers Here? Missed Diagnosis
I don't think pursuing legal action is worth it. Like others here say, let go of the past. 

A lot has changed in this field with more research and time passing since you were first tested. 

Back then OSA was considered to be fairly rare, especially in young women, and unfortunately it has taken many years for some of these stereotypes to be "debunked".

Also, tests back then were not nearly as sensitive as those that are being done now. Some of the definitions have changed, much like diabetes. What was considered normal blood glucose 25 years ago is now considered prediabetic. 

Slowly but surely doctors are beginning to discover that sleep disordered breathing is highly prevalent and affects an alarmingly high number of people, of all ages.  They just didn't know it back then, and the tests were different. 

Focus on the positive.

You are fit, have no cardiovascular issues that you are aware of, low blood pressure and a very astute dentist. 

If you are diagnosed with OSA and do need to use CPAP, you also have great online resources and forums like this one.
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#7
RE: Legal Action? Lawyers Here? Missed Diagnosis
You’ve got your appointment with the sleep specialist, correct? That’s more important than anything else you could do right now, and you’ll need your energy and drive to press on through the adaptive stages of treatment.

Fact is, most women and many men were (and are still) deemed unlikely to have OSA because they don’t fit the classical (male) physical stereotype for OSA. It just wasn’t on the radar to guess that a woman—let alone a fit, healthy, one—might be struggling with apneas at night. So, the treatment you received was unlikely to have been malpractice; it might even have been state of the art for the context and date.

My recommendation is to start reading around voraciously in this forum and ask questions. Make up for lost time by being exceptionally prepared going forward. Check in here with your progress so you get well-informed support as you go along.
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#8
RE: Legal Action? Lawyers Here? Missed Diagnosis
You can have apneas and not have OSA, you might be below the limit (5 per hour) and be considered "normal".

26 years ago you got tested, were normal then, you say you don't have symptoms now, but get up a couple times a night to pee.

What if your new test doesn't result in an OSA diagnosis either?
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#9
RE: Legal Action? Lawyers Here? Missed Diagnosis
KSMatthew is correct about the possibility that you might not qualify for treatment. However.....this is why I recommended that you read read read and get prepared. Understand, too, that women can suffer from the hazards of apnea at much lower AHI than men, per NIH.

I’m giving you this advice because at first I was denied treatment although my AHI was 18, diagnosis moderate sleep apnea. That’s because a much lower proportion of my events had a 4%+ oxygen desat. All the others were 3-4% O2 desat. This gave me a 5 AHI for insurance purposes.

I read my insurance company’s (Medicare) specs word for word. It seemed I qualified. I wrote to the sleep doc, and it appeared that the Medicare specs I had landed on had a .1 threshold lower than the ones she was using. She prescribed CPAP; in fact, she prescribed me exactly everything this board told me to ask for.

Moral? Focus, commitment, and homework. And supportive folks. Instead of waging an old war, go to bat for yourself 100% on this one. Don’t be daunted.


PS This board is superbly moderated, but don’t be daunted if you see an unkind comment or two. People interpret things different ways.
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#10
RE: Legal Action? Lawyers Here? Missed Diagnosis
K.L.

First things first;  Welcome

Now on to the situation. I sincerely understand all too well where you are coming from; I've dealt with similar feelings for my own medical situation. My own sleep apnea diagnosis may have been discovered many years before it developed into a bigger and a much worse situation. Unfortunate for me it wasn't. My apnea status got my attention in a VERY big way in August 2014; I had to decide if dwelling on it or moving on from it, and getting medical help, was the better choice. I decided not to pick the battle of fixing the past as I determined it was one I could not win. I chose to focus on a battle that I could win, and that was to get medical help in focusing on what I can help myself as in getting a CPAP and the other medical treatment I needed to not only survive but to get better.

My opinion: I would focus on what I can control and that is get CPAP therapy for what is NOW a medical issue. I would feel personally a bit manipulated if I dwelt on "what could have been" in my past. And in no way am I talking down to you or being belligerently dismissive. I'm posting this info to you on the thoughts I had to face for myself and for my own well-being.

Here's to hoping all turns out for your best,

Dave B.

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Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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