This last week has been eventful.
On Monday I went back to work after an exhausting weekend – I had climbed to Emerald Lake on mount Timpanogos and not fully recovered. I wasn’t sore, just very very tired.
And on top of all this, It felt like the stitches replaced on Friday had failed again. So I called the oral surgeon and scheduled a time to meet them up in South Jordan to get it re-stitched on Tuesday morning.
Monday evening while helping feed Michael and get kids in bed, I could barely keep my eyes open, and was dozing off while sitting up. I was very glad to finally be able to close my eyes and pass out when it was finally time for bed.
Next thing I remember, I was sitting in our front room, Melody telling Josh to keep me from falling over and telling me to put on my shoes; she was taking me to the emergency room. It was 2:30 AM and she had woken up to find me lying face down in a puddle of my own spit, not breathing. It took a lot of shaking to wake me up, and I couldn’t stay awake.
At the E.R. I was admitted for being hypoxic and non-responsive. My O2 sats were at 85% after I was at the E.R and had been awake (supposedly) for 15-20 minutes.
They put me on 3 liters of oxygen and started running tests.
They drew blood and did a tox screen.
They did a carotid ultrasound.
They did a chest ct with contrast
CT ANGIO CHEST W CONTRAST
CLINICAL HISTORY: Dizziness, weakness, possible dehydration.
Diaphoretic, difficulty breathing.
TECHNIQUE: Helical multidetector CT angiography through the chest
after bolus and ministration of 100 mL of Isovue- 370 IV, timed to
optimally opacified the pulmonary arterial tree. Coronal multiplanar
reformats and maximum intensity projection views.
HEART: Normal. No pericardial effusion.
PULMONARY ARTERIAL TREE: Well-opacified. No filling defects to
suggest pulmonary emboli.
LUNGS: There is mild dependent atelectasis.
PLEURA: No pleural effusions or pneumothoraces.
CHEST WALL: Unremarkable.
1. Negative for pulmonary embolus or aortic dissection
2. Mild dependent atelectasis. Otherwise unremarkable exam..
They did a ct scan of the brain
CT BRAIN W O CONTRAST
CLINICAL HISTORY: Dizziness and weakness possible dehydration.
TECHNIQUE: Axial CT head from skull base to the vertex without
Ventricular system: Normal in size and configuration.
Basilar cisterns: Patent.
Brain parenchyma: No contusion, mass effect.
Extra-axial spaces: No hemorrhage or fluid collection.
Calvarium: No fracture.
Extracranial soft tissues: Normal.
Paranasal sinuses: Clear.
Mastoid air-cells: Clear.
1. No acute intracranial hemorrhage or skull fracture.
2. Otherwise unremarkable exam.
They did an Echo Cardiogram. This was very cool. It was like watching a running engine. I could actually see my heart valves open and close and the blood pumping through them.
Also a bubble study to check for any leaks in my heart – there were none.
They were looking for heart problems or a possible mini-stroke. All they found was the mild dependent atelectasis.
The blood tests came back with no abnormalities other than a slightly elevated CK (nothing near rhabdomyolysis, but 700 something when anything over 300 is abnormal)
I was not maintaining my oxygenation on room air, so they admitted me for observation. I spent the day in the ICU but on the next level down of care (where there is one nurse for two patients, instead of one nurse for one.)
Then I was moved to a regular room for the night but with continued full monitoring via telemetry by the ICU people.
I didn’t have any further episodes like what brought me in, but I wasn’t able to keep my sats up on room air until the next day.
The doctors figured that it was sleep apnea and breathing my own carbon dioxide for a while. I think sleep apnea played a part (I definitely have that) but that it was a perfect storm of the oral surgery, the medications I was on from that, the timp hike, and general overall exhaustion.
The anesthetic during the surgery could have caused the dependent atelectasis.
The amoxicillin and ibuprofen post surgery drugs could have contributed to the exhaustion – especially during the timp hike.
But all of this is conjecture. The doctor’s all say sleep apnea.
So after a night at home where Melody wouldn’t let me roll over because she was afraid I would stop breathing again, a haircut (Melody is great at cutting hair too – she can do *anything*!) and a second night at home where I wore a sat monitor and oxygen mask, we scheduled a sleep study.
Friday I finally went up to the oral surgeon’s office. They were very understanding about my missed appointment. It turns out only one stitch had failed. The other one was still holding.
They cut the stitch that had held (it was no longer needed) and placed one where it was missing. I was grateful to hear that the bone graft looked like it was healing well with no infection.
Then I had a follow up appointment with my general care doctor to talk over the hospital report, and he told me what to expect at the sleep study. He had schedule a more advanced version where they would monitor me for the first half, and then put on a cpap mask and get the settings dialed in for the second half. This would save me a second sleep study.
We had left at 9:00 AM to get to my appointment up in SLC and didn’t get home until after 4:00 PM after my general doctor’s appointment. I had to be back up in Provo at 9:00 PM for the sleep study.
Melody and Michael had been with me all day for the other appointments – Melody was worried that about me keeping my sats up while driving all over – and we were all very glad to get home and decompress a little bit.
At 8:30 PM I drove myself up to Advanced Sleep Solutions and checked myself in. After filling out some paperwork and questionnaires about my sleeping habits and quality, I was hooked up to many different types of wires and monitors and tried to go to sleep.
As normal, I tossed and turned for a couple of hours. I didn’t think I had slept at all but when the nurse came in at 1:00 AM to put on a cpap mask, she said I had a little bit.
The cpap mask was surprising comfortable. And immediately I was breathing easier, and not tossing and turning as much. I was ready to take it home with me!
The nurse came in several more times during the night and made some slight adjustments to the cpap mask and machine. They were continuing to monitor while the mask was on and were dialing in the settings for me.
At 5:30 they woke me up, disconnected everything, had me fill out a post-study questionnaire and I was free to leave.
I took my own sats (we had bought a sat monitor like this one http://amzn.to/1fy8fid while we were out and about and I had it in my pocket) and I was only at 90% – even after using the CPAP machine. So I may have to have oxygen at night until I get better.
But I won’t know the official findings on that until after the doctor interprets the night’s worth of data. Probably some time next week I will hear the results on that and get a CPAP machine.
All in all, quite an adventure!
(And the haircut is lots better than it looks in the sleep study picture above.)