Trying CPAP

 Sleep Center recommended trying the CPAP first for I've been trying it since 11.1.2023.  At firs I had the nose mask, but the puddles inside the mask kept waking me up.   And it was weird that I can't open my mouth cuz the air comes out the mouth while on the CPAP for I can't really breathe in.  Which was also awkward when I had to cough.  The forced air down the nose then throat made me want to cough until it settled down about 15min later.  (hindsight, I probably should of increased the humidity and temperature.)  The times I was able to sleep, I felt like I was sleeping better.  And I enjoyed being able to sleep on my back.  Sleeping on my side tires my back and shoulders and I don't feel rested.   

There was a mention that I can't use the nose mask when my nose is stuffy. Winter is coming so I know I'll have stuffy nose days.  So I opted to get the full face mask also, except this one doesn't completely cover the nose so it's a little less bulky.  I think I'm on 4 nights, last night probably went the best with waking up just two times.  The mask moves and leaks air.  The air is also cold so the first couple times with the face mask, I felt cold and slept poorly.  

Learning to heat up the CPAP prior to using it.  Having the Climate Control at AUTO (80 degrees, humidity lever 3) has been keeping most of the moisture out of the mask.  I may try this setting with the nose mask one of these days.   Couple nights ago I didn't use the CPAP, it was nice being "free" while I slept.  The next day I went down to the desert to grocery shop.  Dunno if I was tired from the shopping but on the drive home I experienced the sudden tiredness I used to get.  The intensity of the tiredness wasn't as strong but it was definitely there.

Some bad side effects I've read about the CPAP...  Something called a CPAP cough.  For now it doesn't seem to last all day, just when  I first put on the mask and in the morning, (tho I didn't have any this morning).  Need to be careful to keep everything clean, mold growth can mess with my lungs.  

Seems like I've developed Central Sleep Apnea from using the CPAP.  Some people with obstructive sleep apnea develop central sleep apnea while using continuous positive airway pressure (CPAP) for treatment. This condition is known as treatment-emergent central sleep apnea. It is a combination of obstructive and central sleep apneas. Medical condition-induced central sleep apnea.

I have my three week equipment check coming up on Nov 28.  Hopefully they can explain this.  And the next appt after that is at 8-weeks.  They say I should know at that point if CPAP is for me or not.  

My events per hour is less than two on the CPAP so it's working.  But now I have central sleep apnea as well.  Having difficulty finding why this happened.  ChatGPT says:  "CPAP therapy my reveal underlying central apneas that were not initially apparent.  This can happen when the continuous positive airway pressure from the CPAP influences the respiratory control system, leading to changes in breathing patterns."  Central apnea is when the brain stops telling the body to breathe.  Central sleep apnea occurs because the brain doesn't send proper signals to the muscles that control breathing.

One reason CPAP was first line of treatment was they say insurance will only pay for one.  CPAP I can return, night guard I can't (since its custom made.)   So better to try the one I can return first.  

Finding more information.  1) There are mouth exercises that may help strengthen the throat and reverse sleep apnea.  2) May have been caused by my stroke.  3) Cervical spine not being straight may contribute to OSA.  Neck brace may help.  4) Singing or playing wind instrument may help.  5) Upping my antioxidants (Vit C, E, D) might help.  6) Taking care of blocked nasal airway may help.  7) Exercise may help as the hard breathing may strengthen throat muscles  8) Less alcohol before bedtime will relax muscles less.

Since the CPAP... 1) I sleep alot more.  At least 9 hours if allowed.  Even 10.  I feel I can just sleep forever.  Going to bed earlier.  By 11pm, but sometimes around 10p.  2) I fall asleep within 15 min of wearing mask unless I'm staying up and reading.  3) Less daytime tiredness, noticebly when sitting.  4) BP has gone UP.  150/100.  Back to taking amlodipine when I remember.  5) Pulse seems lower.  Upper 60s.  6)  Lungs hurt the first week.  I feel like I take deeper breaths when hooked up.  7) "Natural" breathing seemed to resume when on machine.  Don't feel like I have to give an effort to breath like I used to have to.  Mainly at night in bed.  Often in sitting up/recline position.  Tho sometimes when lying down too.  

Update 8.13.23

 Been a month now since Baba passed.  The few couple weeks after getting back home I felt mildly depressed.  Just tired, no motivation, sleeping more, apathy, moving slow.  Turns out (and I think) it was grief.  I've been feeling more normal these past several days.

With the UTI still not gone, started to wonder if it was a kidney infection.  Especially since the UTI didn't completely cure it.  Will need to see what needs to be done for a healthy kidney.  Also, Michael Chang's IG post talked about tapping, and I noticed when I tap my face, my left cheek is tender.  Seems odd so I looked into it.  According to Chinese medicine, it could be a weak liver.   Guess I've been drinking a lot since the Belgium trip, then Baba passing, Mitsu coming over, then Emi coming over.  Plus having a lot going on and being tired.  Making notes for the future...

Decided to get something for my sleep apnea. I prefer a night guard but we'll see.  They might insist on a CPAP.  So I need to establish care with the Eisenhower Sleep Center.  Next available appt for a consultation is October 19.  Trying to get my medical stuff this year since we've met the deductible.  

Bloating got a little better for a few days, found an acupressure point to massage and it seemed to work a little.  But depending on what I eat/drink, it puffs up pretty bad.  Need to make an appt with a GI as well.   And maybe get tested for SIBO. 

BP seems to be doing alright.  Not really taking the amlodipine at night unless my BP is high.  Last reading on Aug 9 was 113/84 (81).  Just now was 120/94 (77)

UTI for a long time

After our trip to Belgium, we missed our flight and got stuck in Boston for two nights.  Started noticing symptoms of UTI, mainly burning pee.  After getting home, start a cranberry supplement along with peppermint capsules.  Symptoms seem to ease a little.   Head down to SD to visit Baba, she's not doing well.  End up staying in SD, and she passes a week later.  UTI symptoms come back so finally decide to do the GoodRx and get antibiotics prescribed on July 13 (first symptoms June 29).  They give me Nitrofuranton MONO-MCR 100 mg (generic for Macrobid).  Every 12 hours for 5 days.  5 days later, no improvement.  By then, Emi is here and she recently had a UTI also and had leftover pills.  So I take Furadantine MC 100mg for 5 days.  Seems somewhat better but it's not gone.  By then I'm back home and start taking the cranberry and peppermint again.  It's now Aug 13, it's gone for the most part but I get the funky feeling inside my vagina when I get the urge to pee and also the first second I start peeing.  Kinda like a mild burn still.  I hope it goes away, will keep an eye on it for now. 

Diagnosed with Sleep Apnea - Finally a cause of BP known?

 Sleep study showed I have severe sleep apnea.  Said I have about 34 events per hour, which jumped to about 68 in REM sleep.  So I think this may be the cause of my high BP.  Been trying to sleep on my side more, seems to help.  Been having days where I wake up before the alarm and am not too tired, not like I had been.   BP has also been almost "normal" low, the top number even drops to 108!  So I don't take the amlodipine at night all the time.  For example, just now it was 109/83 (83)  Pulse has not been as low as it used to tho.   Since we've met our deductible, I think I'll see if I can get a night guard prescribed after our Belgium trip is paid off.   I'm a bit hopeful this will solve my BP issue and I will feel more energized.  Overall been feeling less tired, not sure if it's the warmer weather or I'm sleeping better.  Also been try to practice "mewing" whenever I think of it.  Been eating more veggies and way less meat.  David broke his collarbone on April 21 so he's been not eating so I've been just cooking for myself.  Been eating lighter asian food, which also might be helping make a difference.  

Last labwork taken at Dr. Bagheri's showed I have high triglycerides.  It was 500, very high.  Normal is below 150.  It was around 300 last time, Dec 2022.  Seems like it is caused by eating more than what I'm burning.  Been trying to control intake a little.  Less carbs and sugar.  And alcohol when I can, or limit to one drink.  

The other day I noticed my faced looked slimmer so I weighed myself.  Had lost 3 lbs and was at 115.   Dunno if it was a fluke, but would like to keep it off.  Maybe I can work on my tummy. :)

Did sleep study, ECHO, and feeling lightheaded and BP Monthly average

 Went in for my ECHO last week.  The tech asks "do you have high blood pressure?"  Yes, why?  I can see that your left ventricle muscles are thick.  Common for those who have high BP.  But its on the low/med side, not too bad.  Even if BP lowers, muscles will always be thick once it got thick. Dunno if this is a concern...  But my heart doesn't seem enlarged.  That's good.  They haven't called back so I assume no bad news, or whatever it is can wait till my next appt on March 30.  Still having left upper chest pain. Damn rib? 

Picked up a sleep study kit and slept one night with it.  Tech asked some ques, do I fall asleep at the wheel when stopped at red light? No.  But then I was at a red light and got real sleepy, like I could of slept if I wasn't driving.  So I'm not sure if I asked this right.   I do get random sudden moments of tiredness which I thought I was just fatigued, but usually they go away after I don't go to sleep.  I wonder if sleep apnea patients just fall asleep.  I just resist the urge to do so but is something happening?  Results will take about 4 weeks. 

During Roscoe's morning walk today, he started making the motion to poo but the next house over had people standing outside so I yanked to make him stop when I suddenly got lightheaded and maybe a second of whiteness.  I was able to stay standing but took me about a minute to feel normal again.  I wonder if my arm being yanked touched a nerve.  Kinda like when I turn my head to drive in reverse, I get a 'head rush' and vision goes white. 

So it's been a little over a month with my meds adjustment. Overall it's been pretty good, the average for the last month is 126/89.  Dunno if its the meds or me eating better plus trying to get in 7000 steps daily (tho doesn't always happen).  

Cardiologist visit Jan. 13, 2023 - New Med added (amlodipine)

Finally decided to go see a cardiologist, Brigette and Dr. Woods had been saying I should go as my BP is not under control.  Been having chest, front of shoulder, and shoulder blade (all left side) has been having a dull ache so I've been concerned.  Dr. Bagheri says its not the heart, most likely the popped rib.  But it's been hurting more lately, and occasionally I get a sharp pain (2-3 seconds).  They run an EKG, all looks normal.  HCTZ can caused triglycerides and A1C to rise so lowering dose by half.  But adding back a low-dose Amlodipine to take at night which should prevent some of the side effects, the other two meds take in the morning.  Returning on Feb 16 do to a ECHO.  

• An echocardiogram may be done for further evaluation of signs or symptoms that may suggest:

• Atherosclerosis. A gradual clogging of the arteries by fatty materials and other substances in the blood stream. It can lead to problems in the wall motion or pumping function of your heart.

• Cardiomyopathy. An enlargement of the heart due to thick or weak heart muscle

• Congenital heart disease. Defects in one or more heart structures that occur during formation of the fetus, such as a ventricular septal defect (hole in the wall between the 2 lower chambers of the heart).

• Heart failure. A condition in which the heart muscle has become weakened or stiff during heart relaxation and blood can't be pumped efficiently. This can cause fluid buildup (congestion) in the blood vessels and lungs, and edema (swelling) in the feet, ankles, and other parts of the body.

• Aneurysm. A widening and weakening of a part of the heart muscle or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body). The aneurysm may be at risk for rupture. .

• Heart valve disease. Malfunction of one or more of the heart valves that may cause an abnormality of the blood flow within the heart. The valves can become narrowed and prevent blood from flowing through the heart or out to the lungs and body. The valves can also become leaky with blood flow leaking backwards. An echocardiogram can also check for infection of the heart valve tissue.

• Cardiac tumor. A tumor of the heart that may occur on the outside surface of the heart, within one or more chambers of the heart , or within the muscle tissue (myocardium) of the heart.

• Pericarditis. An inflammation or infection of the sac that surrounds the heart.

• Pericardial effusion or tamponade. The sac around the heart can become filled with fluid, blood, or infection. This can compress the heart muscle and prevent it from beating and pumping blood normally. This can cause symptoms of feeling dizzy, lightheaded, or a dangerous drop in blood pressure.

• Atrial or septal wall defects. Irregular channels between the right and left sides of the heart may be present at birth, or may occur form trauma, or after a heart attack. These defects occur in the upper filling chambers (atria) or the lower pumping chambers (ventricles). This may cause heart failure or poor blood flow, or increase your risk for stroke.

• Shunts. Shunts can be seen in atrial and ventricular septal defects but also when irregular blood flow is pushed through the circulation from the lungs and liver.

An echocardiogram may also be done to assess the heart’s overall function and general structure.

Follow-up on March 30 to see how the meds are doing, going in for labwork about 2 weeks prior.  Also at this appointment will be a carotid ultrasound. 

A carotid ultrasound is performed to test for narrowed carotid arteries, which increase the risk of stroke. Carotid arteries are usually narrowed by a buildup of plaque — made up of fat, cholesterol, calcium and other substances that circulate in the bloodstream.

Mammogram - January 2023

  Went into for a routine mammogram.  Results show my tissue is dense (nothing new) but they noticed some calcifications so recommended I get a diagnostic mammogram and ultrasound.  Scheduled for March 16, 2023.  We'll see what it is.  If it is suspicious, then I guess biopsy would be next step after this.   If ends up being a tumor, most likely is Stage 0, if it's only in the milk duct and not in the tissue.  In which case surgery and radiation should take care of it.  Let's hope it's nothing serious. 

EXAM: TOMOSYNTHESIS DIGITAL SCREENING BILATERAL MAMMOGRAPHY

HISTORY: 50-year-old female, routine screening evaluation.

TECHNIQUE: Using a digital tomosynthesis system, tomosynthesis (3-D imaging) bilateral CC and MLO mammograms were performed.

COMPARISON: None available.

FINDINGS:

Tissue Density: The breasts are heterogeneously dense, which may obscure small masses.

Indeterminate asymmetry with associated calcifications is identified in the superior left breast on MLO image 8. No suspicious mass, distortion or calcifications are otherwise identified within either breast.

IMPRESSION: Indeterminate findings in the left breast.

ASSESSMENT: BI-RADS Category 0: Incomplete. Need additional imaging evaluation.

RECOMMENDATION: Additional imaging.