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Very confused about apnea
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Shastzi Offline

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Post: #41
RE: Very confused about apnea
Oooh? Thats new to me Arch! Thanks! Smile

Lets see, about the opiates. (pain killers, muscle relaxants, etc)
I don't think thats a good idea myself.
Since your breathing is regulated by your central nervous system, anything you take that depresses central nervous system activity can cause you to "forget you need to breathe"
They often suppress REM sleep as well. (It's not sleep, it's anesthesia then. )
Anything that is strong enough to relieve pain by 'putting you out' comes under that as well.

I am biased against opiates anyway. They were directly responsible for the deaths of some people I know and ruining the lives of others though addiction that WAS ENCOURAGED by sloppy administration of these powerful drugs in my local area.

ie: They are the nuclear weapons of pain relief and need to be used much more sparingly.
Sometimes they are required but doctors hand them out for tootaches in this country.

Misuse is the key word here.
When someone *does* get addicted the patient is mishandled even further by being locked into 'cold turkey'
clinics until they ride it out.
Don't take my word for it.
Check the death statisics.
I think 60 Minutes even did a report on the subject.

Sorry msmcintosh. I really am.
Not what you want to hear but there must be a better solution for you than
just to keep taking opiates. Sad
I hope you find a better path.

*****************
02-10-2013 10:45 AM
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PaulaO2 Offline
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Post: #42
RE: Very confused about apnea
There are studies that have repeatedly shown that for many patients whose body uses the narcotic for pain relief, they do not get the usual "addiction" like folks who use narcotics for recreational purposes. Many also do not experience the stereotypical high. This is because in therapeutic doses, it's not enough to form a true addiction. It is, however, enough to cause a dependence, meaning the dose has to be slowly increased as the body gets used to the medication and requires more to take care of the pain. This is why good pain docs will regularly rotate the medications and methods used to treat the pain. Even then, this dependence is not the same as folks who use it for recreational purposes. Yes, there are still withdrawal symptoms because the body still has to get it out.

Many folks with chronic pain will tell you it is not the medication that they are addicted to. It is the lack of pain they are addicted to. We will do almost anything to make that pain go away. And only someone who has chronic pain would understand that concept. Sure, there's folks whose treatment goes further than that. And they are the ones that get noticed by the media and by statistics.

If I had to choose between CPAP and pain relief, pain relief wins. Without pain relief, I won't sleep anyway.

Far too many docs, when they think of pain relief, think only of narcotics. There's a plethora of medication out there to help with chronic pain. It's a long process to find the right one or the right combination that will treat the pain. And there's more than just medication. For me, my biggest pain reliever is my wheelchair. When I decided enough was enough and I started using one, I got my life back. Too many people see it as giving up. To them I say go to heck. Walk fifty feet in my shoes then a mile with my wheels and they'll understand.

Rolling off my soap box now.

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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.
02-10-2013 12:01 PM
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msmcintosh Offline

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Post: #43
RE: Very confused about apnea
It's hard for me to say too much. It's been 4 days since I've taken the last 15mg Morphine SR and I feel really bad. I was tapered down slowly, but I guess there is never slow enough.
I am taking meds based on cervical and lumbar MRIs. Never did the opioids make me feel drowsy, high, or put me to sleep, they simply relieved pain.The muscle relaxer I am taking is not an opioid. It's called Methocarbamol. This also does not make me drowsy, high, or put me to sleep. I have never abused my pain meds. When I had my sleep study, I was not on a high dosage.

For my sleep study, I checked into the VA hospital and went up to the floor where they had two rooms for the study. The technician hooked me up with wires and I eventually went to sleep. I was afraid to move with all the wires, so I stayed on my back the whole time. I remember when he woke me up to put on the CPAP and then oxygen. He woke me up at 5:00 AM and said I could go. That's the last I heard of anything until 2 months later when my PM doctor saw the report. I wanted to know exactly what was on the report, so I finally got a copy from my PCP. There were other recommendations, like Auto PAP, oxygen while weaning off of opioids. When I saw my PM doctor a month later, I mentioned the recommendations and that no one contacted me. My PM doctor emailed a message to the head doctor at the sleep clinic asking about the other recommendations. He got a reply back saying it's probably the opioids. So that was it for me, no opioids. I don't see my PM doctor until the end of March. Once the withdrawals are gone and the pain is still overwhelming, I'll have to go to the VA ER.

So, I've never talked to a doctor at the sleep clinic. I have no one to work with. Since I go to the VA, all the doctors, my records, everything is in the same place. Appointments take months.
(This post was last modified: 02-10-2013 01:42 PM by msmcintosh.)
02-10-2013 01:40 PM
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PaulaO2 Offline
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Post: #44
RE: Very confused about apnea
Once you are off of them, ask for another sleep study.

I'm sorry you gotta go through all this crap. Most Americans have no clue how little the military is treated, or not treated, by the VA.

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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.
02-10-2013 02:15 PM
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msmcintosh Offline

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Post: #45
RE: Very confused about apnea
I went to the ER at the VA hospital this morning, because I just couldn't take the pain anymore. I explained how I got in that situation, on account of the sleep apnea. The ER doc said that it's obvious I need the opioids and no one has died from sleep apnea. So now I have to figure out how I can see my PM doctor. I don't have an unlimited supply of meds. But I do have enough to take and use the oximeter. Maybe, I might be able to sleep again.
02-11-2013 09:34 AM
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msmcintosh Offline

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Post: #46
RE: Very confused about apnea
I managed to talk to my PM doctor's nurse today. I explained what happened and she could look up my records any ways. She was going to give the doctor a message to reconsider reinstating my opioids pain meds and I insisted she tell him to ask the sleep clinic about an ASV PAP machine.

To my surprise, the doctor called me later in the afternoon. I'm impressed that he took the time to actually call me and I can tell he's concerned. However, I don't think he completely understands the situation. I don't even understand everything. All I know is that I took all the other/extra meds he prescribed and weaned off the opioids, tried to hold out for 5 days to hopefully, get over any withdrawals, and the pain became more than I could handle. He still does not want me to take any long acting opioids, like the Morphine SR, which worked the best. He reluctantly said he would allow my to take hydrocodone during the day only. That's pretty weak and short acting. I'm not going to be able to survive on that and since I get nothing at night, I guess I won't get much sleep. I tried to explain how much I hurt, I pleaded with him, but that sleep study always got in the way. I really think he thinks I'm going to die in my sleep. I tried to bring up the ASV PAP, but he has never been good at listening to me. He usually just gives information, rather than receive it. I told him I get a home oxygen machine on March 5th. He said, Oh good that should help. I have to call back and give an update by the end of the week. I don't think I'd make a good doctor, because I'd hate to see someone suffer.

I see a nurse practitioner at the Mental Health Clinic who has helped me quite a bit. I spoke to her today and she has a friend in the sleep clinic that she's going to talk to on my behalf. She's the one that told me about the sleep study in the first place and requested it. She knows I'm pretty desperate for some kind of relief.

I've decided for now, I'm not going to suffer the way I did in the last several days and continue to take the Morphine SR. It's time released and taken every 8 hours. I'll use the oximeter and see if the readings vary from taking nothing.
02-11-2013 11:01 PM
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msmcintosh Offline

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Post: #47
RE: Very confused about apnea
This the report I got after taking Morphine SR and Oxycodone. I'm not sure what to make of it. Is it better, worse or did I not take the opioids long enough to make a difference?
02-12-2013 10:22 AM
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Shastzi Offline

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Post: #48
RE: Very confused about apnea
"The ER doc said that it's obvious I need the opioids and no one has died from sleep apnea."

Sorry, msmc. Your ER doc is misinformed. Many have perished from apnea and/or complications caused by it.
John Candy comes to mind among many others.
With opiates being a central nervous system depressant, it's way to easy to forget to breathe during some sleep stages.
Not good!
The other problem I have noted in passing, with opiates for chronic pain, is in the withdrawel.
A relative of mine experienced it first hand when the clinic was working on getting him off the stuff.
There was a significant magnification of pain levels, over and above, the onset levels
( more pain coming off the meds than the patient started out with! ) than during withdrawel.
So it's no wonder folks want to stay on it, like Paula said, to stop/diminish the pain.
02-13-2013 10:06 AM
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Sleepster Offline
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Post: #49
RE: Very confused about apnea
(02-13-2013 10:06 AM)Shastzi Wrote:  "The ER doc said that it's obvious I need the opioids and no one has died from sleep apnea."

Sorry, msmc. Your ER doc is misinformed. Many have perished from apnea and/or complications caused by it.

From complications, yes. But I believe the doctor is talking about dying from apnea itself, not from complications.

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02-13-2013 09:08 PM
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Shastzi Offline

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Post: #50
RE: Very confused about apnea
I plead guilty of oversimplification. Smile
So...Just to be accurate.
Here is a somewhat recent NIH report:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147220/

This marks sleep apnea (OSA) as a symptom / stressor.
When your soft tissues collapse the Obstructive Apnea event occurs.
Your body, under stress now from lack of oxygen, reacts as you would expect but this also is putting undue stress on multiple
major organ systems. (brain cells start dying, heart rate goes up because brain in yelling for more O2, the lungs cant comply until the obstruction is
cleared though.. ) Finally the brain declares an emergency, "WAKE UP DAMMIT, YOU'RE SUFFOCATING!! TAKE A BREATH AT ALL COSTS!!"
Over the years of repeating this cycle hundreds of times each night, the affected organs start falling down on the job.
The heart can't take it anymore and it fails abruptly one night or the cranial blood supply bursts a vessel from the blood pressure going over the limits one too many times.

The good news, as the report states: "Keep up your CPAP compliance and you can hang in there a LOT longer than otherwise"

Conclusion:
Until someone comes up with a magic bullet for this thing, keep using the CPAP.

Peace, Love & Carrots,

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
(This post was last modified: 02-14-2013 01:39 PM by Shastzi.)
02-14-2013 01:37 PM
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