The Writer is in a State

a well inlaiddeath cut down

So, ladies, gentlemen and small squirrels, I’m here to assure you that I did not forget Dark Fate, though my idea is to take a stray week in February, write it to the end, and then put it up in great big chunks.  Um… Might be in March.

You see, I didn’t forget either Alien Curse OR A Well Inlaid Death (the next Dyce mystery, for which I have a cover and everything done by the amazingly talented Jack Wylder, see above.)  I’m just running about 3 weeks late on when I intended to release things, which I feel calls for some small explanation.

You see, late last year older son was diagnosed with obstructive sleep apnea, which had probably been going on for three and a half years, judging by symptoms.  There is an unfortunate airways configuration in my husband’s family, so that men get this issue quite early, but you know, the thing about sleep apnea is that it’s a stealth issue, and you don’t notice and the person just thinks they’re depressed, or at least that was the case.  Also, since son didn’t snore as in AT ALL it never occurred to us he had an issue, since you usually can hear someone with apnea across the house.  (We used to joke when my father in law visited about sleeping as far away as possible.)

Anyway, we know Dan had it, he just for several reasons hadn’t treated it for about 10 years (long and complex story involving insurance and stuff) and he realized suddenly he was suffering severe problems and should go along with it.  Fine.  And then I thought, “Well, when it comes to dropping projects, etc, I’ve been having the same issues, including an inability to lose weight, and a massive issue with being able to concentrate on anything longer than an article.”

The doctor was doubtful (as he should be) on my needing a test, because it seemed to be (and was, to an extent) a case of “Well, since we’re at it.”

So I did the home sleep test and they found I was running oxygen in the low eighties most of the night.  This wasn’t actually a huge shock, since I was high eighties to low nineties during the day.  You see, I was born premature, and then I had a bunch of illnesses that left my lungs in screwed up shape.

So they scheduled a full sleep test.  I went to that sure they’d tell me all was normal and I wasn’t right in the head.  Um… turns out not so much.  Still down in the low eighties to sometimes high eighties for blood ox.

It’s not exactly the same issue as husband and son, since it seems to be mostly an insufficiency of oxygen.  But it’s solved more or less the same way.  I do apnea and probably have most of my adult life, but that can be fixed by an appliance that moves my lower jaw forward.  The problem is I’d still need an oxygen concentrator with that.  The other problem is that I found I had the exact same issue with the appliance as I had with the one my doctor made me years ago to prevent my grinding my teeth: I grind my teeth MORE on it  and more or less destroy my gums in the process.  OTOH just having an apap blowing an almighty jet of air into me both stops the apnea and the oxygen deficiency.

So I’ve been a week and a half on it.  I think this is called “The week of fighting the machine.”

It’s getting better, but last night one of the stupid straps that aren’t supposed to come loose came loose, and I was too sleepy to figure out what it was until 5 am.

ANYWAY there is a difference.  I resumed dreaming with just the dental appliance, which I’ve had for a couple of months (before that I was sleeping in two minute increments, so not so much.)  But the blowy air thingy has stopped the perenial congestion and in a week and a half is well on its way to clearing the chronic bronchitis. It makes me think of tons of things, since mom — she does snore.  Loud too.  Also has the symptom I was having, of getting maybe two seconds warning I needed a nap and falling asleep anywhere and everywhere — and her family all develop this chronic congestion and bronchitis starting at around 40.  I know I’ve been oxygen deficient at least that long.  The thing is if I’m oxygenated at night, I seem to remain so during the day.  Though it’s entirely possible not to say likely that in ten years or so I’ll need an oxygen concentrator during the day, at least while living at altitude.  (And yeah, on “why didn’t people get this stuff before?”  Well, they did.  I’m sure a sleep study on mom would be interesting.  My family has the charming habit of stopping sharing a bedroom when the kids move out.  Not because of not getting alone, but because of sudden onset, bizarrely loud snoring.  This tells you something.)

This is probably the cause of the demilienation events going on in my brain, and in six months or so I’ll ring up the neurologist and ask to check.  I haven’t had cases of my foot not obeying me, but that might be just coincidence, since a week and a half is not enough (probably) to recover from that, unless it was caused by sheer tiredness.

The other thing that seems to be clearing up is the incipient and permanent depression.  You guys have no idea how amusing it has been for years to be berated for being “too optimistic” when in fact my “optimism” was self administered therapy so I didn’t fall completely into the pit of despond.

There are indications that the brain is coming back on line, too.  I mean, the last two years since being treated for hypothyroidism, I have been markedly better, but not … up to my own standards.  And long works still required an enormous amount of will power.

Speaking of which, I want major props because while extremely sleep deprived and hypothyroidal, I still finished at least a novel a year and often more.  (And by the last two years have been better: well, I haven’t need to tape a list of character names to the monitor because I kept forgetting them or have the issue of forgetting where I’d left people in the last chapter.)

I am older, perhaps 5 or ten years since the problems set in, so I have no idea how far I’ll recover.

Anyway apparently one of the things that this oxygen thing and not breathing properly (Seriously, guys, how can I flunk breathing?  I’m special) has done is cause me to get sick a lot.  This January I caught what my son classified as a “Pseudo flu” (I mean, I couldn’t even have the real thing?) and was even more out than usual.  So I lost three weeks, a week of which I couldn’t even write for PJMedia, because I was out of it.

Things are better, even if last night was a mess.  And I hope they’ll get steadily better over the next few months, and that I can type in the novels I have long hand, and finish others, including but not limited to a couple of Dyce novels, and the sixth musketeer mystery.  (I might have waited too long on that and lost the fans, but it couldn’t be helped.  I wasn’t well.  I hope the sixth revives the series.  If not it will be the last.)

Lately too, I’ve stumbled on the half written 4th Shakespeare book (there were five planed in the series) but I hesitate on that, just because of the massive amount of research it will take to get back to that mode.  We’ll see.

Anyway, I should be writing.  Books, I mean.  Oh, and articles.  This weekend too I hope to finish typesetting the next short story collection and get it out next week.  There’s this velum program for typesetting I mean to try to put out paper editions of all the stuff that doesn’t have it.

I shall go.  More Grant in Portugal and other stuff next week, I promise.

 

169 responses to “The Writer is in a State

  1. Paul (Drak Bibliophile) Howard

    Writing is Good but Taking Care Of Yourself is Better! 😀

  2. If you continue to have trouble with the CPAP machine, be aware they always give you the cheapest one that will work. It’s stupid but that’s the bureaucracy. Instead of the bottom end machines that blow a constant pressure they have them that sense when you are inhaling and work with you instead of fighting you. But if you need one you will probably have to insist on it.

    • Ah. We did an end run and bought one. No, my trouble is getting used to the mask. I’ve tried three, I like this latest one, but it has a strap that slides out of the hook if you thrash around a lot, which is what I do in sleep. So…

      • Thrashing around a lot is not a bad thing (although your bed partner might not share that view.) I tend to sleep without moving – at all – during the night, so that choosing which side to lie on is equivalent to deciding which knee, which hip, which shoulder will spend the next day aching.

        I share you dislike of face masks, even though the one they first issued me is the one I still use (I’ve replaced the gasket five times, the straps twice, and the plastic bit that joins the two a couple of times, but it is still the same mask.) I doubt there is much that can be done except keep shopping about until you find a least bothersome option.

        • The mask I like has interrupted plastic loops for the straps – the gap is so you can adjust the strap and then slip it onto the loop – and they break. Not quickly, but I have a beard I’m not getting rid of and that means I need tight straps and in about 18 months they snap.

          *sigh*

          I also miss breathing fresh air when we can have the windows open. AND when I’m connected to the hose, my body declines to move in my sleep so I wake up to shift.

          It ain’t perect, but it’s better than not having the thing at all.

          • I’ve been waking up to turn over for a long time now (probably 2 decades). It’s an interesting sleep method. (Yes, I mean that word in a pejorative fashion.)
            And, yes, I used to toss and turn a LOT (Mike nails it with “rotisserie”).

        • I’m a darn rotisserie when it comes to sleeping. Tie my feet to a generator, and I could probably provide all the electricity needed in New Hampshire.

      • Not looking forward to the prelim test at home monitoring my sleep. Trying to figure out why I am so sleepy about 2 or 3 hours after eating (personally I think it is the Reactive Hypoglycemia getting worse, diagnosed last 30 years ago) & if I don’t work out, my legs hurt something fierce when I get up after siting 15/20 minutes (worse if sit longer); once I’m moving, I’m fine. All the blood draw tests come back “normal”. Since waking up more than once or twice a night is standard, & I’m over 50, & overweight, I get to do the monitoring thing. Thrash about at night, oh yea. Been that way since I was an infant (per folks) ain’t stopping anytime soon; & night hot flashes aren’t helping. If I take something so I “sleep” all night, well then I don’t move. How do I know? In the morning EVERYTHING hurts. Getting up is more of a “uhhh let me think about that a minute or two or 5, etc”.

      • I literally could not fall asleep with the CPAP mask on, and after a month of trying my left ear stopped up giving me something like tinnitus.

      • William O. B'Livion

        I sleep like a baby. Which is to say I thrash around a lot and wake up every two or so hours looking for a…umm…Family Blog, right?

  3. Speaking of which, I want major props …

    I would think an APAP is a major prop?

  4. Breathing is good. We want you to keep breathing as long as possible okay? 🙂

  5. So, ladies, gentlemen and small squirrels, …

    And what shall large squirrels wearing berets and smoking Galois do?

  6. … since a week and a half is not enough (probably) to recover from that, unless it was caused by sheer tiredness. 

    Sleep deprivation causes all sorts of problems.  Possibly the worst is the inability to think straight about the various effects of your sleep deprivation.  On top of that you suffered from oxygen deprivation.  Horrors!  I would not be surprised if the many of your health issues are diminished, if not entirely addressed going forward.  I pray so.

    I wish I was in a position to come and properly provide you with hot soup and earl gray tea.  The commute would result in cold soup and tea.  This time of year who would want that?  

    virtual HUGS!

  7. Hmm, did WordPress eat my wall-o-text?

    CPAP helps, a lot.

    • WordPress delenda est!

      Executive summary:

      1) Watch out for Atrial Fibrillation, a potential consequence of apnea. It can also trigger “clear airway” or “central apnea” events, which seem to be sort-of benign. AFIB isn’t, and warfarin would be your friend.

      2) apneaboard dot com is a good support site for new users.

      3) I found the SleepyHead program so be useful in monitoring sleep. It has a provision to integrate oximeter readings (I haven’t done this). Vendors also have programs for their machines.

      • Anybody considering making a friend of warfarin needs to review the list of who won’t be your friend if you hang with warfarin: Garlic, Kale, Spinach, Brussels sprouts, Parsley, Garlic, Collard greens, Mustard greens, Chard, Green tea and Garlic.

        Cranberry juice and Alcohol, in other than small amounts, are troublesome, so if you like warfarin forget about those Crantinis.

        • Kale is anybody’s friend? Even I find it unlikable.

          • I like kale, shredded raw and tossed with sesame asian dressing it is quite pleasant. I like most fresh vegetables (although the rude ones I would as soon pass.)

            • Random story triggered by “rude” v. “fresh”:
              W. S. Gilbert (the lyricist) once explained the difference between using the right word, and a synonym that wasn’t of the correct nuance.
              “Gilbert’s response to being told they (the words ‘ruddy’ and ‘bloody’) meant the same thing was: “Not at all, for that would mean that if I said that I admired your ruddy countenance, which I do, I would be saying that I liked your bloody cheek, which I don’t.”

          • Apparently there are substitutes,

            • Honestly, collards and kale are genetically the same plant, just mildly different varieties. As are kohlrabi, brussel sprouts, cauliflower, broccoli, and cabbage. I’ve used kohlrabi leaves as collard substitutes with zero differences noted.

              • 2500 years of domestication (i.e. artificial selection) have led to quite a few distinct varieties of Brassica oleracea.

              • That explains a lot. I look at collard it reminds me way too much of some lawn weed. And I’ve collard green, but… well, no appeal. Someone said cooked kale was alright. Perhaps. I’ve had the raw, in a salad, and well, i won’t be doing that again, I expect.

                • If you like cooked spinach, you’d probably like cooked kale. To me, it has a milder flavor. But as I said in another comment, I don’t like raw kale at all.

                • Okay… you’ve reminded me of a story. Some time ago, I was invited to visit the home of a young lady at college. Dinner! Yay! Her mother sat me down, and brought out salads. Then her mother hesitated, and asked, “Do you mind eating dandelion greens?” I bit my lip, looked at the young lady, who nodded at me, and I said, “I don’t think I’d mind at all? Why?” Her mother gestured at the salads, and said, “Well, I pick it out of the lawns. I always offer to give people some, but no one else picks any, and they don’t want it!” I picked up my fork and dug in… it was a good salad. Her mother did recommend that if I was going to pick dandelion greens, to make sure I got the young, tender ones, ’cause they get tough. So, I guess one person’s lawn week is another person’s salad…

                  • My dad picked dandelion greens every spring. He said that was a normal addition to the food on the farm when they were in the good season. That man ate every kind of greens I can think of, EXCEPT Swiss Chard. I don’t think that mom ever thought to buy it, and doubt that dad knew it existed. But he would eat spinach, kale, collard greens, turnip greens, mustard greens. dandelion greens, wild lettuce, and I think there are a few that I have forgotten.

                    • I understand that the presence of dandelions in the US is the result of early colonists liking them in salads, with no concept of the problems that they would eventually cause. No as bad as kudzu, but then what plant is.
                      JPDev

                    • When my father was on his last tour of Vietnam (technically he was in Thailand, but the B-52s he worked on were visiting Hanoi daily) my mom decided to pick some dandelion greens out of the yard for supper. Our neighbor, who knew dad was overseas, came over to tell my mom he’d done her a favor and sprayed weed killer on all the dandelions in the yard for her. That part of supper ended up in the trash.

                      She never tried making them again, so I’m guessing dad wasn’t a fan.

          • Kale sauteed in bacon grease so it wilts down is delicious.

          • Kale is anybody’s friend? Even I find it unlikable.

            Caldo verde. Scrumptius, uses loads of kale, and I bet Mrs. Hoyt has the recipe.

          • You know, I think you’re right. I’ve NEVER heard of Koreans making Kimchee with kale. They make it out of darn near everything else. I think that’s a strong tell.

        • Note that if your diet is steady, you can dial in the warfarin dosage. We have green tea every other day with no problem, and (granulated) garlic is also part of the diet. I miss chard and spinach, though. I also miss cranberry.

          I did go under my INR window by having the Costco chicken caesar salad the day before my test. Romaine is pretty high in vitamin K. Iceberg isn’t, but it’s not my favorite. OTOH, I found that I can eat their chili, so I have an alternative quick lunch when I’m over there.

          • my heart doesn’t seem to be an issue. except for being, as usual, slow

            • Not sure how long I had it (occasional mild chest pains means I had it a few years previously), but apnea is a risk factor. AFIB doesn’t always present; I was diagnosed with it the second cataract procedure. #1 was fine, #2 a couple-three weeks later, I had it bad. It’s pretty much all the time now, but rarely painful. There’s a procedure, but until it’s a real pain, nope.

              FWIW, the second eye gets the keratectomy (cornea, meet Mr Diamond Burr) next week. Not as nervous as the first time, but there’s a chance it will hurt more. I’m taking an extra day over there before coming home so I can take a bit more Vicodin if necessary. Whee.

              • Apnea correlates with insulin resistance (Type II Diabetes) which can affect weight gain/retention, and insulin resistance can exacerbate apnea creating an evil feedback loop.

                My optometrist is threatening cataract surgery in the next few years. To say I am not chipper about the prospect is a level of understatement extreme even for me. Dammitt, I use my eyes, I give them lovely things to read; how dast they repay me in such low way!

                • Yup as a being 16 years on CPAP therapy and a sufferer of Type II Diabetes(controlled) they seem to be interrelated. And of course insulin resistance plays into weight gain. In addition you had thyroid issues too which can affect weight gain too. Of course I feel like everything I do affects weight gain, but there’s worse things in life. Some day I want to have a talk with the design engineer who made that insulin loop. The edge cases were very poorly tested 🙂 . Here’s hoping things clear up for you Sarah. I know when I first
                  got my CPAP it was amazing to see how much I’d actually kind of been drowsing through life.

                  I sometimes wonder if Larry Niven had it right in Protector that theres a step in human development we’re missing. Or maybe the design standard was two score and ten and those of us over 50 are out of warranty.

                  • Yes, I gained tons of weight because of the thyroid issues. Then the sleep deprivation made me too tired to use my treadmill desk. I’m going to start on it again next week.

                • Find a good cataract surgeon, and it should go swimmingly! There are a few in the small city, and I was referred the one who is well liked by patients and staff. I’m very myopic, so getting an optimal focus was iffy; I ended up getting the left eye optimized for close work, and the right eye for distance. If I had to do it again, I’d do both eyes for distance; might actually find reading glasses off the shelf.

                  The deeds were done in a day-surgery center; show up at 7:00 or so, and it takes 30-60 minutes for the prep. I think the procedure takes 30-45 minutes to do.

                  I went out when the surgeon started to put drops in my eye. Awoke (in theory, it’s done with a conscious patient, but not for me) with a patch over my eye. Hungry as hell. (The second time, the anesthesiologist told me I had AFIB. “Oh really? What’s that?” Cue the heart checks and warfarin games.) I had to take drops (antibiotic, a steroid, and a pain killer) about 4 X per day. The eye shield came off for day use the next day, though I slept with it on. I did the second eye 2-3 weeks later, and after that eye settled (another 2 weeks or so), got new glasses.

                  A common issue is clouding of the membrane behind the lens. My left was tackled when I had the retina procedure done, but a YAG laser took care of the right eye. It feels like you’re on the wrong end of a first-person shooting game, but it was an easy procedure and painless.

                  And yes, Type II diabetes is a common precursor for cataracts, among several other things.

                  To me, it was well worth it. Driving at night was horrible due to glare before the surgery; lots better afterwards. Reading is easier, too.

                  • My mom had cataract surgery, then surgery to “lift” eyes, something that is new in the last 5 years. Went from coke bottle glasses to not being required, even to drive. She was thrilled. She’s worn glasses since she was in grade school, probably 7 or 8, she doesn’t remember; she’s 82.

                • I know right! Stupid Eyes, most exercised part. I have Glaucoma, granted that is hereditary and not anything I can avoid (so far 3 for 3 my sister’s & me diagnosed, don’t know about the other 6 cousins, skipped mom’s generation). Normally I am horrible about taking medication of any kind. I have not missed a night of drops, since diagnosed and prescription written. Do NOT want to loose my sight!

        • You can have Vitamin K, you just have to have the same amount EVERY DAY. So my mother grumbles a bit about how the veggies have gotten more than a bit monotonous since my father went on rat poison.

      • Em has AFIB. Fortunately, it’s controlled with Metropolol(?), but her doctor at one point was proposing a surgical intervention. Apparently, it involves cutting the nerve pathway in the heart with a laser.

      • > vendors also have programs

        Resmed, and maybe others, have built in cellular modems, and tattle all your data back to the Mothership, That function on mine mysteriously failed after reading a how-to on vandalizing the machine… the DME probably vacuums the SDcard and uploads all the information to Resmed’s web site anyway, but at least they’re not getting it in real time.

  8. Christopher M. Chupik

    Please keep breathing. This place just wouldn’t be the same without you.

  9. I’ll add my voice to the chorus telling the hostess to get better.

    And on a completely random note, did anyone else read Sarah’s comments on “blood ox” and for just a moment wonder if our local minotaur had been turned into a vampire?

    • That was a speedbump, yes. But having seen the abbreviated term before, it gets a bit smaller of a bump each time. Being turned into a vampire might not be a thing I would choose, but I suppose I might just be able to deal with it. being turned into umpire, however, would have… consequences.

      • MHI has minotaurs, it has vampires. But I haven’t the foggiest idea if Larry is going to ever put in vampiric minotaurs.

        • Minotaur hide impervious to vampires, perhaps? Presumably werewolves are protected against vampire bites by their “resetting” every month.

          Larry hasn’t been particularly explicit about the methodology of vampirism, although it seems to involve substitution of the original soul by a vampiric one — possession, perhaps? Which leaves the question of whether an individual could exorcise the demon and regain his human soul, possibly while retaining the vampire body.

          • He has also been explicit about monster hunter funerals, which involve a decapitation to prevent possible rise of vampires.

            • I thought that was cremation.

              Plot bunny: shifted into another world, a group of Christians develops the tradition of cremation, on the principle of reducing the body to a state where only God could raise it.

              • It is decapitation, mentioned several times in the monster hunter books; but I would assume that cremation would also work.

              • I have a religion in a RP world where death rites involve decapitation, hand and foot removal, a ritual (with precise placement of removed parts), followed by cremation. I’m thinking something very bad happened in the past to develop that ritual…………………

          • In one of the books, he seemed to tie them to the Great Old Ones. Which, when you think about “That is not dead which may eternal lie.”, may make sense….

    • LOL. Blood Oxygen. 😀 I’m becoming a little daft with medical terms from hanging out with older son. I’m picking his lingo.

    • Hmm, Orvan a vampire Minotaur. Then he’d be doubly mythical. How do you kill a vampire minotaur? Drive a steak through its heart? (ducks behind wall to avoid carp, garum and other piscine projectiles…). Pleas note no harm intended to our resident minotaur I just couldn’t help myself…

  10. “Speaking of which, I want major props …”

    I thought dragons flapped their wings, but if engines are the way a dragon wishes to go, then the only questions are:

    How many props?
    How big?
    How many blades per prop?

  11. “The Writer is in a State”

    Colorado?

  12. There’s a freeware program called “Sleepyhead” that can read the data from most common CPAP machines and graph it for you. Sleepyhead will also coordinate the CPAP data with Bluetooth-enabled pulse oximeter data; you can pick up a compatible oximeter on AMZ for $50-ish.

    There are three basic types of mask: the thing with cones that go up your nostrils, the nose cup, and the larger cup that covers your mouth too. Most people find the latter to be my far the most convenient since you don’t have to lock your throat shut while you’re asleep. Subtypes are masks with fairly stiff edge seals and masks with very soft double seals. The doubles seal better, but if you don’t have a head shaped like a ferret you might have problems with fit. Most of the mask designs are German, but their “standard human head” seems to be Sicilian…

    The critical dimension for mask fit is from your eyes to your upper or lower lip, depending on the mask type. The “small, medium, large” fits don’t seem to take that into account; sometimes a “not correcft size” mask will seal better than the one they think you’re supposed to use.

    The Sleepyhead forum has a bunch of posts about “adjusting” masks for better fit.

    You wake up tired after a night of low oxygen level because your heart works in overdrive trying to keep the tissues oxygenated, and that sets off all kinds of stress alarms to the rest of the body. In extreme cases your heart will just ragequit for a while, which is how I discovered I had severe sleep apnea.

  13. Stopped reading half way through to write this (but I’ll go back & read the rest), regarding the dental appliance: So Sarah, some folks, myself included, have found a cheap hockey mouth guard, that you put in hot water and shape exactly to your mouth/teeth configuration, works better and is far more comfortable than the expensive appliance.

  14. I’ve been using a CPAP for almost 18 years, so I’ll presume to inflict upon your some things that I’ve learned, in no particular order.

    One thing that can help those of us who thrash around is a longer hose. [Pause for all of the guffaws and for someone to tell the fireman’s wife joke.] Just about everybody will give you a six-foot hose to start. For many people, including me, that feels like barely enough to reach from the nightstand to the edge of your side of the bed, especially if you are facing away. Even a couple of feet more will help. And for real freedom, a ten-foot hose combined with a cheap towel ring. The towel ring is mounted (depending on your bed either on or just above the headboard above where you sleep. If you run the hose through the towel ring then instead of dragging across the bed (and across you if you sleep facing away from the nightstand) the mask now comes down from above. This allows you greater freedom of movement.

    Face oils are death on the seal of the mask against your face, and also tend to cause the nasal cushion (the soft gasket part that rests against your face) to deteriorate faster. Take a wipe and clean the nasal cushion each morning when you get up. The nasal cushion will still deteriorate over time, so replace it every few months. If your insurance doesn’t cover this they can be ordered online for $30-$50, depending on the mask.

    If too much facial oil causes leaking the human reaction to the leak is to tighten the straps. Tighter straps make the mask less comfortable. In extreme cases, straps that are too tight can cause the mask to chafe. Then you end up with raw spots on your face and it hurts to put on the mask, so you don’t. (Been there, done that.) Straps that are too tight, for whatever reason, seem to be one of the most common reasons for people not being able to tolerate a CPAP.

    Don’t spend the money on the specialized CPAP wipes. Generic baby wipes will do fine. I actually use a store generic for “Wet Ones” hand wipes rather than baby wipes, which removes the oils better than either.

    If you have allergies then your CPAP can force the allergens into your lungs under pressure. The filter on your CPAP will catch most dust, but not the smallest dust particles or stuff like pollen or smoke particles from a fireplace. l An inline bacterial filter will last 2-6 weeks, depending on how much crud is in your air. (Actually dragging your CPAP out to the living room so you can sleep in a recliner in front of the fireplace while your spouse is out of town will reduce filter life to one week due to smoke particles.) In general, this means your hose ends up being in two sections, and also requires a small gender changing adapter. (If you have a small-diameter hose you will need adapters to change to and from the regular diameter.) My hose is an 18-inch hose, the gender changer, the inline filter, then an eight-foot hose. (I found having the filter close to the CPAP is a lot more comfortable than having it dangling from your mask.)

    The dedicated antibacterial cleaners for your CPAP, tank, and hose are overkill for the regular cleaning. Four parts water and one part white vinegar will discourage most little things that want to grow in your system. Rinse well after. Do use the fancy stuff from time to time, but picking up a couple of gallon jugs of white vinegar at Costco is good for ordinary use and a lot cheaper.

    I shop for filters, mask parts, and replacement hoses at CPAP dot com. They’ve been around for years and have always given me good service.

  15. Once upon a time I had an 8:30 am physical. Resident pokes at my shins and says “Hmm. Did you work all night?” No….

    Turned out I had managed to develop pulmonary hypertension from untreated sleep apnea. I wasn’t aware of any sleep problems, other then the awful rumors people spread about how I snored. After a few years on a CPAP the CT and cardiac echo showed normal again, which they most definitely did not when I was diagnosed.

    So yeah, sleep apnea sucks, CPAPs suck, but are better then the alternative. Which in my case was dying of heart failure.

  16. Though the common phrase is “obstructive sleep apnea”, there’s also “central sleep apnea”, where your body simply doesn’t bother to breathe. CO2 buildup in the lungs is supposed to trigger the breathing reflex, but sometimes it doesn’t work right.

    Theoretically the CPAP will only help with obstructive apnea; in practice, most people have a mix of central and obstructive, and it can still help… and it’s also why it might not be a complete solution on its own.

    Years ago when I got my first machine, the masks of the day did an almost complete air seal; it turns out I’m sensitive to CO2 buildup, and they made me feel like I was smothering. I’d wake up with the mask neatly hung on the pulled-out textbook on the shelf by the bed. After eventually figuring out what the problem was, I drilled extra vent holes in the mask to let some CO2 get flushed out.

    Modern masks have not only recognized the problem, but the cure has swung to far that hurricane of air whistles through the mask, drying out my sinuses and mouth even with the humidifier turned up to maximum. I found that a piece of tape or a dab of modeling clay, depending on the brand of mask, would block enough of the overly-generous vent holes to let the humidifier keep up.

    • I have a lot of central apnea (AKA “clear airway”) that usually shows up around 3 or 4 in the morning. From what I’ve found, it’s related to AFIB, and this seems to match my experience.

      There are CPAP-like machines that will work with centrals; they’re called Adaptive-Servo machines. Not sure now, but they’ve been pretty expensive.

      What’s not clear to me, is whether central apnea events are actually dangerous. My reading (I’m an engineer, not a doctor, Jim!) shows a lot of handwavium around the issue. I get the impression that it’s nice, but not essential to control it.

      The gale of exhaust air went away when I did two things: 1) auto-CPAP (was 15 cm-H2O originally, now running 6 to 10 with rare forays to 15), and 2) a new mask. The ResMed has a diffuser on the exhaust port.

  17. Speaking of which, I want major props because while extremely sleep deprived and hypothyroidal, I still finished at least a novel a year and often more.

    And raised two sons who, by all indications, are well on their way to being productive and useful citizens. Consider this virtual “Brava! Brava!” for both.

  18. Be sure you’re getting plenty of natural cholesterol to eat, as well. Eggs are great for this.

    Tasty high-protein egg recipe:

    hard boiled eggs
    cream cheese
    basalmic vinigar
    spices: onion powder, garlic salt, smoked paprika, black pepper. Mix ingredients until you find the ratio that tastes good to you, then use those proportions, to taste in the mix:

    Use the above to make devilled eggs. You can eat them while working at your computer, and they’re a good lunch or snack.

  19. 11B-Mailclerk

    If O2 shortage is the problem, is a tent a better idea than a mask?

  20. Mrs Hoyt, your machine likely has a nasal prong application setting, and a face mask setting. The former is very annoying w the mask. A switch inside the housing will change to the desired pressure and impulse.
    Philip Gattey

  21. Say …

    Learning to play the didgeridoo supposedly can help with sleep apnea. See:
    http://www.bmj.com/content/332/7536/266

    You can even make the instrument out of PVC:

    http://www.subatomicglue.com/didjl0g/index.php

    • Is that because your family becomes determined to make you suffer badly for playing the didgeridoo? Once you’re no longer required to breathe or sleep, then sleep apnea is no longer a problem. The last time I was tempted to play one (a cheap injection molded plastic one), my wife decided that it made a good tool to club me over the head with. Given that I’m faster than she is and a foot taller, she needed the extra reach. 😀

      • It’s all in how you sell it. You don’t start out by telling them you want to play the didgeridoo. Oh, no, no, no. You start out by telling them you want to play the bag pipes. Then you “settle” for the didgeridoo, and they won’t complain at all.

        • Back during the first Bush administration there was a jazz band called Outback, laying down their bass line on didgeridoo …


          Per Wiki:
          Outback were a world music group founded in the late 1980s by multi-instrumentalists Graham Wiggins and Martin Cradick. The group fused traditional Australian tribal music, represented primarily through Wiggins’s didgeridoo, with modern Western music, mostly Cradick’s steel-string guitar. Before the band dissolved in 1992, it had been joined by Senegalese percussionist Sagar N’Gom, French violinist Paddy Le Mercier and drummer Ian Campbell.

          Discography
          1988: Didgeridoo and Guitar
          1990: Baka
          1991: Dance the Devil Away

          Don’t diss the didg!

    • William O. B'Livion

      A friend of mine got divorced. His wife was a…not a nice person.

      She got custody of their son.

      I bought him a Didgeridoo.

  22. Awful lot of people seem to be having breathing problems, especially while attempting to sleep.

    • I honestly think what sent me over the edge was the fires in our neighborhood 7? years ago. I SHOULD have taken John Ringo’s sugge– command, and stuck husband, sons and cats in the expedition and driven to TN for a month or two.

      • I’m not allergic to anything (well when the Scotch Broom is super, super bad, which is everywhere now, sometimes I sneeze a lot, but don’t get stuffy), yet the smoke in the Willamette Valley from all the fires up North, Down South, and East in Cascades (Detroit, Oak Ridge, & Roseburg), really got to me, both inside & out; worse than when I grew up & field burning was allowed w/o a lot of restrictions. I don’t know how people with compromised breathing could stand it. Inside we probably had troubles because none of us do have breathing problems & we didn’t lock down the house fast enough, but then we had to buy air conditioners so we could lock down the house.

      • It is quite possible. My apnea was largely controlled until I had a [redacted] of a upper respiratory infection a few years back and that left permanent scars on my health.

        Although that suggests that had not the fires happened to exacerbate your problem, something else would have.

  23. I’m in a state because .. well.. i read The Memo.

    two years ago i woulda called you a freeper if you told me that was happening…

    • Right? The stunning thing is to find our most paranoid suspicions were true.

      • Exactly… and how the dems are still crowing about it needing to stay classified and the FBI worried about how we won’t trust them anymore…
        … ehhh, my distrust of the federal DoJ was solidified when they didn’t charge Shrillary.

        • There is a certain amusement about the Dems, the party which spent the last fifty plus years denouncing the FBI suddenly defending it. Almost as entertaining as the FBI hiding behind its erstwhile honorable reputation — commonly a sign of somebody having besmirched their honor.

          • Transcript of Andrew Klavan appearance on Tucker Carlson:

            The Fox News host asked him, “What do you make of the press coverage of this? Do you think it has been designed to serve the public interest or something else?”

            Klavan replied, “I think it’s a scandal within a scandal almost as bad as the scandal within the FBI.”

            He pointed out the fact that Hollywood just praised The Washington Post in the Steven Spielberg film “The Post” for releasing the Pentagon Papers in defiance of the Nixon Administration’s claims it would affect national security.

            Klavan said, “Now suddenly national security is sacrosanct and more important than information. I remember decades of the Left squealing about J. Edgar Hoover and his unjustified wiretaps and now suddenly we’re told that unjustified wiretapping is a nothing-burger.”

            He added, “The press has done nothing for this past year but whine about how Donald Trump has slapped them back and forth.”

            “But now, when it comes to releasing information, this information that in no way damaged the public good and in no way damaged our national security, the press, the people who are supposed to speak truth to power and about power, are trying to cover it and suppress it and spin it to make it less important.”

            • It endangers the security of leftists in their positions, and they are, after all, the important part of the nation.

        • Meh, for me, at the latest, it was when they didn’t charge Lerner.

      • You know, if they want to be the Secret Cabal or shadow government, at least they could *try* to do a decent job of it.

        How idiots like that even get those jobs in the first place is a mystery to me. Yes, convergence, and slime fast-tracking slime, but… even that seems to be more organized than these people are capable of.

        • The overall trend on the quality of such officeholders will always be down. There may be temporary rises, but overall the trend will be down.

          The reason being: Such officeholders will not want to be supplanted by the people they have lifted up, usually to offices beneath themselves, so they choose people who are not as competent as they are, in the main. So the new crop is less capable than the previous one, and the next and the next and the next, until they are the incompetent losers we see today.

  24. My husband has dealt with low oxygenation for much of his life (asthmatic) and he got a new med a year or so back. He said he started waking up in the middle of the night because it felt so weird to get that much air.

    I’ve seen the difference with the new med. Oxygenation is good.

    • asthmatic and allergic to everything here. I understand I should have had some kind of breathing aid 20 years ago, at least, and would have, if I were 20 years younger.

      • I have yet to live in a place where I’m not allergic to every piece of plant sex that makes it into the air. Even in Tucson, which is, or so I’ve been told, a place where people go to escape their pollen allergies.

        Maybe if the Air Force hadn’t changed it’s mind and had sent us to Guam instead of Omaha when I was 4…

        • Heh. I would go outside on Guam to get my breathing right. Turns out the building I worked in was not cleaned well after Supertyphoon Paka, and the a/c system was FULL of mold and such. I would literally ride my bike home, and nap in a chair on the back lawn for a half hour to restore my sinuses.

  25. ” (And yeah, on “why didn’t people get this stuff before?” Well, they did.”

    Sleep apnea is like a lot of issues that you don’t here about in history, they were there, just not noted for a huge number of reasons. The biggest of course being they didn’t know what it was. But you also have the fact that many of them are age related, and people tend on average to live longer today. Also many of them are either related or exascerbated by being overweight, and again there are more sedentary and/or overweight people today. There are also people who always have to suffer from the latest fad disease, and sleep apnea fits that category. Mild cases were probably never even noticed throughout history, while today doctors diagnosis perfectly healthy people with diseases that don’t affect them.

    • And it’s not like snoring is a new discovery. Recognizing that it might be associated with deteriorations that were previously just attributed to getting older, or just something to live with, and that something can be done….

    • as my mom told me when I was small “Old people don’t sleep much.”

  26. I usually bookmark Sarah’s posts in “political” or even “things to be seriously pondered.”
    This is a first for my “medical and wellness” folder.
    It does make me consider taking a sleep test, since I wake up sometimes more tired than when I went to bed.
    But that could be because I stay up past midnight here at the ball…

    • > sleep test

      There’s a whole industry of that now, dedicated to extracting as much money as possible from insurance carriers. I could tell you some sleep lab stories…

      If your insurance or deductible./copay are high, you might be able to buy a machine off eBay for less, get some data, and fire up Sleepyhead.. Despite the medical-industry voodoo, it’s not rocket surgery.

      • YOu can buy one from Amazon for co-pay money, which is what we did.

      • SleepyHead works with Windows and Macs, and there’s a pre-compiled version for Ubuntu Linux. I had to compile from source to get it to work with my Slackware Linux. I did a post on Apneaboard about the procedure: (Warning, this is pretty involved. You should be comfortable working under the hood on your system.)

        Here’s the link, with my instructions at the top of the page.
        http://www.apneaboard.com/forums/Thread-SleepyHead-and-Linux–15841?page=2

        • I was never able to get an install on openSUSE. It installed into a Windows VM and works fine, except it can’t find the SDcard. Well, it did *once*, but never again. If I copy the SDcard to a shared directory, it won’t use it, because it wants the SDcard. I played with VirtualBox’s USB sharing, no dice. After a while I gave up and I use the laptop, which has a copy of Windows 7 on it.

          • It took longer to find the card than I liked, until I learned to mount the card before running SleepyHead. One computer uses the SD card directly, while my desktop machine uses the card in a USB adapter (the card slot in the desktop is tough to work with; needs help getting the frippin’ card back out).

  27. Totally totally off topic, but here is something to give you all a good laugh tomorrow (today?).

    https://thefederalist.com/2018/02/02/football-101-the-downton-abbey-guide-to-the-super-bowl/

  28. Glad to hear you’re improving!

  29. Better to be in a state than lying in state.

  30. I’ve been dealing with sleep apnea for a few years now.

    try a bunch of different masks, I have found that I’m a mouth breather so the ones that just cover my nose don’t help.

    If insurance isn’t paying for all of the machine, look around and see if you can get one of the auto-adjusting machines, that way you don’t have to keep going through the expensive sleep studies as you change (weight gain/loss is a common factor, but there are just so many others…)

    I get my equipment through http://www.cpap-supply.com and find that full price through them is sometimes cheaper than copay through the insurance folks.

    the mask I have found I prefer is http://www.cpap-supply.com/Amara-View-Full-Face-Mask-with-Headgear-p/109062x.htm