Question:
Should I fight the request for a sleep study or just do it - and deal with it?
I would just like everyone's advice about what I should do regarding a sleep study. My surgeon told me that I needed heart clearance and lung clearance (for him, not my insurance company) because my BMI is over 60. Yesterday I went to the "lung" doctor that my surgeon's nurse set up the appt with. First of all, he is a sleep specialist (as in, that is his primary field of expertise). I thought it was funny that I was filling out this paperwork with all these questions about my sleeping patterns and even questioned my surgeon's nurse about it before I went. She said that was his specialty but he also checks lungs for my surgeon's patients. Okay. I get into the "lung" doctor's office and he asks me about something I had marked on the paperwork indicating that I don't usually feel well rested when I wake up in the morning. Based on that (and my weight, of course) he deduced that he thinks I have sleep apnea and wants me to do a sleep study. Well, that just makes me mad! I feel like he just ordered that big expensive test to make money off of me and not because I truly need it. This guy didn't even hold a freakin' stethoscope to my chest! He did not check my lungs *AT ALL*. I would not have gone to him on my own volition because I do not feel like I have sleep apnea or a problem with my sleeping patterns. I mean yeah, I don't usually feel well rested but I'm OVERWEIGHT. I am always tired. That's one of the reasons I'm trying to get this surgery done. My surgeon's nurse said she didn't think the surgeon would perform the surgery if I didn't cooperate fully with the doctors he sent me to. I'm *not* trying to be difficult, I just don't want to do this thing because I don't feel like I need it and I don't feel like it has anything to do with checking my lungs for surgery. Should I try to fight it or just grin and bear it and have the study done? — Christina Z. (posted on March 25, 2003)
March 25, 2003
Ah they are trying to save your life. Sleep apnea kills! I nearly died
after minor knee surgery, I quit breathing. I had a panic attack got narcam
the anti narcotic, had tons of uncontrolled pain from the narcam, they had
no choice because I quit breathing repeatedly/ It was TERRIBLE. Several
memorial page members died from undiagnosed apnea. Now when I had WLS I had
no problems thanks to all the pre op tests. Unknown problems can kill,
known controlled ones arent generally a problem. Sleep studies are a
necessary pain. Congrats to your thorough docs. I know you look at this as
a big delay but its for your own safety
— bob-haller
March 25, 2003
Christina.. listening to your lungs would not tell a doctor, lung
specialist or not, if you have sleep apnea.
Sleep apnea is called the 'silent killer'.. chiefly because it can and does
affect people while giving none of the 'classic' symptoms. OSA
(Obstructive Sleep Apnea)causes your airway to close off while you sleep,
even for milliseconds at a time. This closure prevents the deep levels of
sleep that the human body needs to recharge itself, and you slowly begin to
build up carbon monoxide in your body. The only way to truly test for this
disease is the sleep study. Also, statistically, OSA is increased in those
of us who are morbidly obese, because the weight helps in the closure of
our airways when we lay flat.
None of us like to feel we are being put through meaningless paces, or
being charged for things we don't nee.. but in this instance, I personally
would prefer the peace of mind of a negative test rather than have OSA and
have it cause complications during or after surgery. There was a lovely
lady on this site who died because of her sleep apnea, her name was Ginger
Brewster, her story is told here at Obesityhelp in her profile.
As a sufferer of Severe OSA for 8 years now, believe me, I know from which
I speak. Many surgeons require a sleep study if you are not already
diagnosed and being treated for OSA, and I firmly beleived it's saved a few
lives.
I hope and pray that your test comes up negative, but do yourself and your
loved ones the favor of being tested.
~Peace
— Joscelin
March 25, 2003
It is better to know and treat than not and something horrible go wrong.
Not to mention, it could be another reason for approval from the insurance
company.:)
— harleigh2002
March 25, 2003
You absolutely need the sleep study. Sleep apnea kills...my mother-in-law
died at age 52 from cardiomyopathy, just one of the nasty side effects
apnea can cause. Apnea must be accounted for if you are under anesthesia or
you could DIE during the surgery. Not feeling well rested is a number one
sign of apnea. Your surgeon and the pulmonologist both want you to live
through the surgery!
— Maria N.
March 25, 2003
hi, I have sleep apnea, or should I say maybe HAD. I am 2.5 months post op
and have another study scheduled. The importance of knowing if you do or
don't have apnea, is very important to your WLS. If you stop breathing
when you are asleep, the same thing will happen when your under anesthesia.
If they put you out and your airway clothes, a lot of things could happen.
They may not be able to get the breathing tube in and the necessity to do
an emergency trach is not a pretty experience. You wake up with cuts on
the inside of your throat and you have a cut in your neck and can't talk.
To me, it is better to have 1 unrestful night and have the docs know for
sure if you have apnea then for them not too. I have lost 60 lbs and my
pressure on my c-pap has dropped so I am hopping to be off the c-pap
machine by summer. Good luck and have the sleep study done. $500 is
nothing compared to your life!
Sincerely, Brooke
— Brooke B.
March 25, 2003
I agree with everyone else! If you have undiagnosed sleep apnea and have
this surgery you could the most serious complications. It is an important
piece of info for your surgeon to have and for the anesthesiologist! The
reason that we all go to the pulmonologist before surgery is to make sure
that we don't have sleep apnea! Please be safe and careful and do the test!
Good Luck!
— Carol S.
March 25, 2003
Been There - Said That! I had a sleep study in 1997 because I was so tired
all day long. Everyone assumed I would have sleep apnea - not! Instead I
turn up with a really rare daytime sleep disorder, along the lines of
narcolepsy but I don't go into REM sleep. So when my surgeon wanted a new
sleep study I was quite unhappy and felt it was a waste of money and time.
Well the time issue I was able to deal with and insurance covered the money
issue and lo and behold I had moderatley severe sleep apnea. It's amazing
what that last 100 lbs did to my body. I ended up on a BiPAP machine with
quite high settings, 22/18. Believe you me I was shocked as I was sure I
didn't have it.
<p>When I thought back I had the symptoms for probably 102 years but
because of my daytime disorder I wrote the tiredness to not taking my meds
quite like I should and may body hurting and making me toss and turn all
night etc. I also had taken to sleeping the majority of the last 2 years
in my recliner. In my mind it was because I didn't wake up hurting like I
did if I slept in bed, but in reality it probably was that my sleep apnea
wasn't as bad and therefore I did sleep better which allowed me to get
restorative sleep, hence not hurting so bad. Quite a viscious circle. The
other shocking thing I found out when researching machines is that one of
the symptoms of sleep apnea is sever head sweating. Well my pillow had
been soaked every night for probably 2 years, but I had no idea that was a
symptom. I started with the machine and the head sweating was gone
instantly. It's quite nice to wake up with a dry pillow and head.
<p>I have only used my machine 4 nights since surgery and I am 7
weeks out. My surgeon did not want me using it the first 4 weeks to not
put pressure on the healing pouch. After that I tried it only to have my
muscles/ribs get severely flared up due to the pressures being too high.
The pressures have been lowered twice already and are down to 10/7. If
this is still too much then I'm going to just send it back. I am sleeping
quite good, but still in my recliner because I still hurt too much in bed,
but not from the sleep apnea. I no longer am a mouth breather and no head
sweating even though I'm not using the machine. So I suspect it's out of
my life soon. I actually do sleep just fine on it and I was one of the
people that never had a problem adjusting to it. It does help strengthen
your lungs and keep your body oxygenated better before surgery, so it does
provide some important benefits.
<p>Like everyone said, they are just trying to keep you alive and
undiagnosed sleep apnea can definitely be a killer during surgery. I know
someone who just had surgery with very bad uncontrolled sleep apnea, and
they were aware of it, but they could not get it totally controlled with a
machine. However, because they knew this going in they brought her through
with flying colors. At first her surgeon was refusing to do her surgery
because of the uncontrolled apneas but after consulting with some other
bariatric surgeons he work with the pulmonologist and anesthesiologist to
devise a plan to bring her through this alive - and it worked.
<p>So don't fight it and pick up the phone and call the sleep center
yourself and ask to be put on a cancellation list. I ended up having 2
studies before surgery because we did not assume I would end up with sleep
apnea, he did not order the 1st one with machine fitting. So then I had to
have a 2nd one. Both times I got in within 2 days because I explained I
was having surgery etc. They keep holes for emergency type things so it's
worth talking to them yourself. Good Luck!
— zoedogcbr
March 25, 2003
Hi, Christina;
I've had OSA for quite a number of years, been treated for it for the past
11, My husband died from undiagnosed Sleep Apnea because the
doctor/hospital where he was getting his medical/phyche treatment from
couldn't get him in for a Sleep Study quick enough. It was no fun the
morning he choked to death along side of me. Still have trouble getting to
sleep at night sometimes. Only way we knew what it was, was because I put
my CPAP mask on his nose and cranked the oxygen concentrator up and he
turned pink again. unfortunately, it was too late to do him any good. I
agree with the others, GET THAT SLEEP STUDY!! and get it as quickly as you
can, after all, the life you save will be your own. Good luck to you.
Sue-Ellen
— Sue-Ellen J.
March 25, 2003
If you do have sleep ap. and you don't have it diagnosed, things could go
very wrong after surgery. Read the Memorial Site. You'll see why these
tests are very important.
— cinchouli
March 25, 2003
Christina...DO THE SLEEP STUDY!!! You sound like me as far as thinking
your tiredness is because of being overweight. BOY was I shocked to find
out that I have moderate sleep apnea. It is something that many people
have..thin and heavy. So many times the general public has self-diagnosed
their situations only to find out it isn't what they thought at all.
Now... my surgeon demands a pregnancy test. I refused. I have had a
complete hysterectomy 2+ years ago. Yes, it's a minor cost..but a cost to
insurance nonetheless.
Best wishes!
— Diane S.
March 25, 2003
I was just diagnosed with sleep apnea in Dec./2002. I did not want to go
for the study and also did not feel I had sleep apnea. Now that I have went
for it and am on my cpap I'm glad I did it. I feel tired sometimes still,
but no where near as tired as I used to. Please go for the study. It is
painless and well worth it. From what I understand on this site, if you
have undiagnosed sleep apnea it can cause complications with your breathing
during and after the surgery. With all the risks from this surgery I would
rather take care of as many as I could before hand so there are less
complications or chances for them after the surgery.
— Nancy S.
March 25, 2003
Christina, PLEASE, please do get the sleep study done. Your life is worth
it! I wrote the memorial on Ginger Brewster, my best friend, who died
because of untreated sleep apnea after she had WLS. She would have been 43
years old today, March 26. Her death could have been so easily prevented.
Even if you don't think you have sleep apnea its very important to know for
sure because your anesthesia monitoring and post op care should be more
vigilant if you do have sleep apnea. Please be safe.
— Hackett
March 25, 2003
One of the many health problems that we deal with, is sleep apnea. I never
thought I had this problem and when the first psych (whom I didnt like at
all) suggested that I have the sleep study done and to be honest, I only
told him I would do it just to shut him up and had no intentions on doing
it but when I thought more about it, I realized that he was right and it
was a good idea. I scheduled my appt for the sleep study and I found out
that I wake up over 80 times and hour and after they put the CPAP on I felt
refreshed and alert that morning. I have severe sleep apnea. My surgeon
will be requiring his future patients to have this done because the
antheseologist (Sp?)needs to be able to monitor your breathing during the
surgery and also the recovery room staff will be alerted to your sleep
apnea and they will be able to monitor you and know what to do in case
something goes wrong. When you are moved to your room, the nurses are
notified of your condition and will know how to better take care of you.
So, please don't be upset that you need to take this test, try to think it
thru more clearly and be happy that they are looking out for your health
and over all success. Also, I learned from my surgeon that the other
reason why they need to know if you have sleep apnea, because if it goes
untreated, it will ruin/damage your heart and lungs and lead to death. Take
Care and Good Luck
— Jena C.
March 26, 2003
I can only reiterate what everyone else said. Putting a stethoscope to
your chest or listening to your lungs is not an indicator of sleep apnea.
Not being well rested after waking up is. Not only should you not be mad,
but you should demand that the test be done. Sleep apnea can kill.
— Lisa N M.
March 26, 2003
I also didn't think I had sleep apnea nor did I want the test to find out.
It was a pain in the ass to get done, but I am so grateful I did! I found
out that I had severe sleep apnea (BMI 72) and now wake up feeling so good
and I am able to keep going all day. Also, my it helped a bunch when my
surgeon submitted my letter to insurance stating the sleep apnea part. It
helped me get approved quicker. On my approval letter that is one of the
main reasons they approved me. Sleep apnea is not something to be ignored.
I never thought in a million years I had it. But you would be surprised.
You may only have a minor case of it, but if you do, you need to get it
checked. You'll be glad when you do. Please go ahead and get it done, once
it is done, you are done with that. Good luck in your journey.
— tpalmer
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