tomgreen

Many thanks to all who found the time to comment and offer advice on my sleep apnea . That is much appreciated .

 

So this is today's update 

So last night for the second time in a row I took 1 mg of Lorazepam before going to bed and slept continually all through the night until to day where I awoke at 5.30 am. On waking up the feeling of having an unbroken good nights sleep felt absolutely wonderful ???? .  The general feeling I am now experiencing to day is one of over all calmness and relaxation but all my physical actions and movements seem to feel like they are being carried out in slow motion. 

 

Its a strange new feeling for me  ????, when I earlier walked around our local out doors market this morning it felt like I was in a wonderful happy dream , smiling and not a care in the world ( which is not normally the way I feel ) but as time went on that euphoric feeling slowly changed to a feeling of being slightly un well . So I returned back home and generally zonked out and I then slept for several hours. 

 

As suggested by another forum member Ive tried to not Google my symptoms , as I’m sure the vast range of results would only add to my all ready mounting stress level. 

 

I’m now going through all the suggestions and advice that other posters here have kindly offered and trying to get to the bottom of my symptoms and what course of action I should eventually take .

 

I am a non smoker and not really that overweight and have no other medical conditions ( apart from stress / anxiety )  I exercise on my home treadmill most days,  and until I was diagnosed with this sleep apnea , I liked the odd bottle of red wine ( which I now really miss ???? ) .

 

My symptoms which originally commenced on the 23rd of last month have over time slowly changed to these current symptoms .....

 

The current feelings I experience once I have woken up range from having light heart palpitations / I feel the need to breath in more air / a funny feeling that what I’m experiencing is really a dream / and always a strong thought going through my mind that I’m about to die. These feelings generally continue for around 30 – 60 seconds and then slowly fade away . I normally then get out of bed and have a drink of water and then go back to sleep . My symptoms when being woken up do not include any sweating / headaches / difficulty returning back to sleep / and I do not snore while sleeping . One other intermittent symptom I some times experience when being woken up is a feeling that I have some thing stuck in my throat ( a small lump ) 

 

So tonight ive decided not to take any Lorazepam before going to bed and I will post tomorrow how things work out .

 

Again , thanks to every one 

 

Tom

 

 

 

Ok this is going to sound like I'm rambling on , but I hope you will stick with me and tell me if I'm missing some thing or just getting unnecessary too worked up ☹️

 

As suggested by the doctor at the first government hospital I visited .

 

 

The cause of my symptoms were possibly due to Prinzmetal's heart variant angina (PVA) or known as Coronary Artery Spasm ( CAS ) . That condition was ruled out after undergoing several tests by the private hospital cardiologists doctor.

 

Another medical condition that my symptoms may be due to was Nocturnal anxiety attacks ? 

And finally the last medical condition that could be causing my symptoms was Obstructive sleep apnea (OSA) . After my in hospital sleep test the results were available they seemed to confirm that my symptoms were in fact due to that condition.

 

Now below are a few things that I’m still a bit fuzzy about ????

 

When I told the private hospital cardiologists about my anxiety and stress issues , he then prescribed me a small amount of Lorazepam tablets ( 0.5mg ) and told me to take one tablet before bed time . ( Lorazepam is used for the treatment of anxiety and insomnia )

 

I took one Lorazepam at bed time and experienced no symptoms and was never woken up all night . I did the same over several of the following nights and the results were the same. 

 

While listening to the private hospitals Pulmonologist doctor explaining the results of my recent over night sleep test results , the doctor ( who spoke reasonable English ) made the comment that during the sleep test period my oxygen levels indicated that generally they were acceptable and not really of concern  ,but the test also indicated that I awoke at numerous times over the sleep test period ( which I did not remember doing ) . 

 

Then I happened to mention to the Pulmonologist doctor about my ongoing anxiety and stress issues and I then asked the Pulmonologist doctor if having those current symptoms may in any way relate to / effect / contribute to the final results of my recent sleep apnea test .

 

The Pulmonologist doctor seemed surprised to hear me describe my current anxiety and stress issues . ( which I think they did not know about ) .  It was at this point I also mentioned that when I previously had described my anxiety and stress issues to the cardiologists who had conducted the past treadmill stress test /heart scan etc , that cardiologists then prescribed to me a small amount of the drug …  Lorazepam ( 0.5mg ) .

 

 I then told the Pulmonologist doctor that in fact I had followed the cardiologists suggestion and had taken over several nights 1 tablet of Lorazepam and that after taking those tablets over a period of several nights the end results were all the same ( experienced no symptoms and was never woken up all night ).

 

The pulmonologist doctor on hearing that I had all ready been prescribed Lorazepam by the cardiologists and my results after taking the drug seemed to lessen / eliminate my sleep apnea symptoms , I think made the pulmonologist doctor started wonder. 

 

So if my oxygen levels during the sleep test were generally showing a normal state and the brain did not need to send an alarm signal to wake me up because the oxygen was not being restricted ( like sleep apnea symptoms ) ,what was it that kept waking me up ( possible night time anxiety panic attacks ???? ) .

 

Then the pulmonologist doctor suggested that I carry on taking the Lorazepam drug , but increase the dose to 1 mg before going to bed , just to see how I felt and what would be my symptoms . So I have now followed the pulmonologist doctor advice and last night I took 1 mg of  Lorazepam at bedtime , and again I slept all throught the night , but when I woke up this morning I could feel a mood change in me, I some how felt a bit disoriented , but I certinally felt less stressed out than normal. To night I am planning to take only 0.5mg of Lorazepam before I go to bed .

 

The pulmonologist doctor did comment that use of a CAPA mask and machine was in their mind still the best option for my symptoms , were the CPAP considered the gold standard in treating sleep apnea.  If I wanted there was a technician on site that could advise me on which CPAP mask and machine would be the best to treat my condition , after hearing that statement I asked if that technician was employed by the hospital , the answer was no the  technician was a Representative from a local CPAP machine seller.

 

I declined the invitation to see the technician , but on the way out of the  pulmonologist doctors office I did question them about the cost of  CPAP machine in Thailand being very expensive , the pulmonologist doctors answer with a smile was, try and buy the CPAP machine from out side Thailand.

 

The cost of the seeing 2 cardiologists + the treadmill stress test + the ultra heart scan + drugs in a private hospital came to 16,200.00  Baht 

The cost of the private overnight sleep test came to 7,900.00 Baht ( including a double room and food ) .

 

Ive just remember some thing that made me smile ???? when the hospital nurse was attaching endless wires and tubes to my body while preparing for the over night sleep test , the nurse said that if I could not sleep while the sleep test was being conducted , she could give me some sleeping sedative drugs . 

 

 

So in some way I'm still feeling a little bit confused about a few things and would appreciate any thoughts or advice on the above. 

 

 

 

Tom 

4 hours ago, NightSky said:

My dad had sleep apnea for decades. It didnt cause any issues other than maybe the occasional startled wake up in the night although he did have heart conditions. There are things that you can do to manage sleep apnea though and its only a risk factor. 

 

You can not suffocate since your body will wake you up.

 

I suggest not Googling anything to do with medical conditions because Dr Google will have you thinking all sorts of untrue things with your anxiety on level 10.

 

Instead follow your doctors advice and try to relax. Stress is another risk facor that is likely worse than sleep apnea in my personal opinion.

 

Millions and millions of people have sleep apnea, its only one risk factor for general health. If you lead a healthy lifestyle you can offset certain risk factors. 

 

best of luck with it Tom.

 

PS  -by the way if motivation is lacking try a steady brisk 20 minute daily walk for a bit of excersize maybe?

 

Your suggestion to stop Googling my symptoms is going to be hard to try and do , but deep down I know your exactly right and me sitting in front of my computer hour after hour , searching for answers to my symptoms I'm sure is only adding to my all ready stressful state.  

4 hours ago, ThaiBunny said:

I've lost 20 kilos in the last six months simply by eating less. No additional exercising required. My sleep apnea has gone away. I'm 74

The loosing weight subject does seem to play some importance and its some thing I'm going to once more think about

3 hours ago, cmarshall said:

It may be that you do need a CPAP machine, but on the other hand doctors seldom offer recommendations that they believe it is unlikely that the patient will follow.  Losing weight for example, which can help with some cases of sleep apnea.  Also, it's worth trying Breathe Right strips (not the cheap Chinese knockoffs, which are useless) at night.  It's like a small, stiff band-aid that you stick on your nose to hold your nostrils open.  Don't know how likely it is to help you, but it might be worth a try.

 

But losing weight could make a significant difference.

Thanks for the information and comment 

9 hours ago, Curt1591 said:

After about with AF, I had a sleep test.

Although the result wasn't too clear, the doctor recommended a CPAP. I really got the feeling he was just trying to sell me one. 

Fairly recently, I took the results to Phayathai 2 and saw Dr Viratch Tangsujaritvijit for a second opinion. He confirmed a negative result and saw nothing that would contribute to AF.

He did, however, mention that some people do find more restful sleep with aCPAP, and that I could rent one for a couple weeks to try it out. In my case, I couldn't sleep at all with the thing. I tried a "nose only" mask and it would either keep blocking my nose, or would blow open my mouth. If I ever tried again, I would go for  the nose/mouth mask.

It only cost 700 baht for the two weeks, at Ramathibodi Hospital. You will need to get a referral from Dr. Viratch.

https://www.phyathai.com/doctor_detail/40326/นพ.วิรัช_ตั้งสุจริตวิจิตร

Their machines are quite expensive. But it will give you a "feel" for what you might like.

Several things are now running through my mind , which I'm about to post 

15 hours ago, scoutman360 said:

ResMed machines are #1 globally. I know because I work in the business. Respironics and Fisher & Paykel are second in the business, but personally, I think they will all work good for you. All of them work very well. Good luck.

Thanks , the Brand  ResMed I keep seeing as being highly recommended .

15 hours ago, uhuh said:

Lose weight if you are overweight. 

I know it is not easy.  

People have gotten rid of sleep apnea after losing 10 or 20% of their bodyweight. 

Before these current symptoms I was attempting to loose weight and exerciser, but some how now I have found out that suffering from Sleep Apnea can have serious side effects and could be life threatening , at 70 years old my enthusiasm for loosing weight and exercising has suddenly hit rock bottom. ☹️

16 hours ago, NightSky said:

I was reading your previous thread about angina symptoms, its good to see the diagnosis is nothing as serious Tom, best of luck with everything.

Thanks for your kind thoughts , I’m hoping that other forum members will be able to put my mind at rest .

16 hours ago, madmen said:

You make no mention of a CPAP machine ?

Yes sorry my mistake , I should have said a CPAP mask and machine .

First a big thanks you to every one who offered advice and suggestions .

 

 

Well after following other forum members advice here I now seem to have found out what my symptoms were being caused by , but as to not confuse a now different medical issue I have started a brand new topic that outlines my current situation . 

The new topic can be found here.

 

 

So again thanks every one for you input .

 

Following on from my original past topic ( Angina – Any one have or had my symptoms ) I have now finally discovered what my symptoms are due to. 

 

Well after suffering a range of symptoms after I went to sleep at night time with regularly being awoken with a feeling that I could not breathe properly / a sensation like some one was sitting on my chest / the sensation of light tingling down the left hand side of my arm and leg but no where else on my body,  I took Sheryl's advice and went to see a cardiologist at a local private hospital.

The cardiologist recommended carrying out several tests including a treadmill stress test and an ultra scan of the heart ( before the treadmill stress test and after ) . The tests were then carried out later that day by a second different cardiologist . The results from those tests showed no issues or heart problems other than some slight thickening of the hearts left ventricle wall due to my age ( 70 ).

 

I explained to the second cardiologist that I have had an anxiety and ongoing stress issues over the past few years and I wondered if those anxiety and ongoing stress situation may have some thing to do with my current after going to sleep symptoms. 

 

The second cardiologist agreed that my anxiety and ongoing stress issues could have some thing to do with my current night time symptoms , but first they wanted to rule out the possibility that Sleep Apnea could be the cause of my night time symptoms.  So an appointment was made for me to undergo an over night sleep test at the same private hospital.  

 

I have just received the results of that over night sleep test and the hospitals Pulmonologist confirmed that indeed I am suffering from Sleep Apnea and they recommended that I now obtain and start to use a CPAP mask .

 

 So I would be most grateful for any thoughts or suggestions or experiences about purchasing / using a CPAP mask and if you too have had experience of Sleep Apnea

 

 

Tom

 

A big thank you to every one for your thoughts advice and suggestions its very much appreciated and I am going to check out each option and I will post the results back here.

 

The local vet who we have taken Star to on numerous occasions carried out several ( scrape the dogs skin ) biopsy's and blood tests and prescribed a drug called APOQUEL.

 

APOQUEL (oclacitinib tablet) works differently than other treatments for allergic dog itch.

 

 I researched that drug and came across many articles like this one …

 

https://www.dogsnaturallymagazine.com/wouldnt-give-dog-new-allergy-drug/

 

The cost of APOQUEL is around 6,000 Baht for 100 3.6 mg tablets.

 

I thought that drug cost seemed to be excessive so I would search for an alternative vet’s opinion and at the same time seek out a possible answer that I could try my self at home.  In the mean time I have purchased several items mentioned here by members and plan to give them a try . I know that seeking a vets advice is the correct thing to do , but my faith in my local vets has been severely dented by past outcomes and visits. 

I have now managed to find the nearest vet that only specializes in skin disorders on animals ( Dermatology ) and they are located at the khon kaen university veterinary hospital which is approximately a full day's 140 km round trip from where I live and they are only available one day a week . I have already prepared a written history of Star’s past visits and treatment at the local vets. 

So before I book an appointment at khon kaen university veterinary hospital , and make the long trip to there I am going to try out the suggestions posted here by other members . 

 

It at first glance seem that Star’s skin problem may be due to .....

 

1.     Malassezia Dermatitis

2.     Sarcoptic Mange

( see photographs ) 

 

Again many thanks every one , your input is really appreciated by my self and Star 

 

 

 

This looks very much like what Star is suffering from

 

 

19 minutes ago, Kenny202 said:

Yes can buy it anywhere Big C and Tesco. It's just called Dettol original. Comes in small and large pump packs.

 

Thanks , it was the eucalyptus bit that I was looking for , so just normal ( Original will do ) .

34 minutes ago, Kenny202 said:

I had similar problems with my French bulldog. I started washing her with dettol eucalyptus hand soap. Problem stopped immediately

Thanks , did you buy that soap in Thailand , I can't seem to find it for sale ?

5 hours ago, faraday said:

Try Sudocrem

 

 

 

 

 

 

Thanks for the suggestion , another thing the wife has on her to days shopping  list 

11 hours ago, BestB said:

Ok, disregard previous post, found the name of pills, it’s called buzole tabs, works every time 

Many thanks , The wife is on her way out of the house to see if she can find the same thing as shown in the photo , I will post back on how things progress . 

 

 

 

11 hours ago, amykat said:

She could have low thyroid, that can cause skin/ hair issues.  Especially older dogs.  Also, you might want to try only antifungal products, like the one for human hair shampoo sold in pharmacies ....I forget the name now.  You don’t need to use antibacterial and antifungal at the same time, that might be making things worse.  If you go to pharmacy ask for human hair product for fungal hair problems, it is little grey bottle.  Don’t wash too much.  Your dog needs her natural oils back and some bacteria.  You have probably stripped everything away and the cause might be thyroid???  Does your dog have smelly ear problems too, or did she once??  Get black stuff inside?

Thanks for the suggestions , its certainly some thing I'm going to check out .  

Just now, BestB said:

Has vet taken some skin biopsy for testing? Have you tried washing her with Malaseb? if not try every 2-3 days, rub it in and leave it on for 10-15mins

 

Her food now, what is it? local brand biscuits or proven brands like Royal Canine or Hills Diet? also any chicken? Chicken can be a problem.

 

 

Hi and thanks , over time the vet took several skin biopsy's and had them tested ( not sure if the tests were conducted in house or sent out ) We constantly wash Star ever two days using Malaseb shamopp leaving the suds on her for 15 mins , the hypoallergenic dog food was the Royal Canine Brand ( expensive ) . Currently Star after months of the hypoallergenic dog food with no improvement  is back on cooked chicken and veg .

We have an 8 year old shih tzu bitch ( called - Star ) that has a skin problem for the around 8 Months

 

We have taken star to several local vet’s to try and resolve her on going skin issue , our current female vet has carried out a range tests on Star including several blood tests and skin biopsy's and has determined that the cause of Stars on going skin problem ‘’ may ‘’ be due to one of the following.

 

1. An out side allergenic ( some thing that Star comes into contact while roaming outside the house walled garden area )

 

2. An in side allergenic ( some thing in side our house that is causing Stars skin problem )

 

3. A food allergy reaction ( some thing in the type of food we are feeding Star )

 

4. A reaction to the shampoo used on Star .

 

5. A problem relating to Dog Ticks & Fleas

 

 

To try and narrow down the cause of Stars skin problem we have done over many months duration the following .

 

1. An out side allergenic - we have restricted Stars time out of the house to a new area we prepared which is totally clean of any thing that Star may come into contact with which could cause a skin problem ( no plants or other foliage just bare earth ).

 

2. An in side allergenic – We stopped altogether using any chemicals in the house like floor cleaners or furniture polish , mosquito sprays , air fresheners etc.

 

3. A food allergy reaction – As recommended by the current vet Stars food was totally change to a brand of hypoallergenic dog food.

 

4. A reaction to the shampoo used on Star – As recommended by the current vet we changed to a different brand of shampoo ( Dermcare Malaseb Medicated Shampoo ).

 

5. A problem relating to Dog Ticks , Fleas – As recommended by the current vet Star was put on a course of – Frontline and is clear of any skin parasite issues .

 

We constantly wash Stars bedding and soft toys

 

After months of trying the above ideas Stars skin problem is still the same and has not improved at all . The skin issue is generally on a few areas and not over Stars whole body

 

I’m wondering if I have missed any out thing in out attempt to cure Stars skin problem . Our vet only wants to prescribe more drugs to stop Star from scratching her self. If we cannot find a solution then our last hope seems to be to try and find a veterinary dermatologist , as far as I can see there are no veterinary dermatologist in our area ( Korat ) so it may involve a long trip to Bangkok .

 

Any thoughts - suggestions or advice welcome

 

1 hour ago, dddave said:

Not trying to distress the OP any further but if an angioplasty (stent insertion) is indicated and you proceed, make sure you have a financial and personal plan in place before surgery.  I went into a VA hospital 3 years ago for angioplasty and ended up with a triple by-pass instead.  Doctors never 100% know what they are going to find.  In my case (I was 73) I had a severe heart "event" during the procedure and was immediately wheeled into the surgical ward for the by-pass.   Recovery time and costs for a by-pass are significantly more than for an angioplasty.  Hopefully this will not be the case for the OP but do discuss the possibility with your cardiologist.

I had walked around Bangkok with angina for 2 years not realizing what it was.  I never identified the sensation as "pain", just "pressure" and I had always heard that angina was severely painful.

I was lucky to have survived my ignorance.

I think "ThaiPauly's" advice to check in to a good hospital sooner rather than later is good advice.  Your body is telling you that there is a problem. Heart attacks don't always give a second chance.

One suggestion that may be helpful when sleeping.  Put some blocks under the foot of your bed, raining that end up by 8" to 12".  That position will take a bit of stress off your heart at night.

 

Thanks dave for the comment and advice , yes ThaiPauly's idea is some thing I’m now pursuing. 

 

Currently my Thai wife is on the telephone to the hospital , my appointment with the heart doctor is for next Monday and the wife is asking if I can move that appointment forward to tomorrow.

 

My symptoms also do not include any feeling of pain , just a sensation like some one was sitting on my chest.

 

 

 

 

 

 

 

 

Well early this morning around 2.30 am I was awoken again with the feeling of pressure on my stomach area and could not breathe properly . But this time un like the past I had no feeling of the sensation of light tingling down the left hand side of my arm and leg , this feeling lasted for about 30 seconds and it suddenly stopped . So this is now the forth continuous day that the same symptom occurred and around the same time ( 2 – 3 am ) . The emergency ward doctor prescribed some small pills that I should place under my tongue should I experience any symptoms like above. Unfortunately I have not yet managed to take any of the pills at the time when experiencing the symptom outlined above as its difficult to concentrate on trying to keep breathing .

 

Now Ive had four episodes over four continuous days all with the same symptoms and all occurring at approximately the same time ( 2 – 3 am ) It does seem that my symptoms are the same as Prinzmetal's or Prinzmetal Angina, Variant Angina.

 

https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/prinzmetals-or-prinzmetal-angina-variant-angina-and-angina-inversa

 

 

My heart doctors appointment is in 5 days time .

 

 

 

 

2 hours ago, Puchaiyank said:

Do not add unnecessary stress to your medical condition...

Yes your right , I must try harder

48 minutes ago, Sheryl said:

Angina is a symptom, it is pain resulting from reduced blood flow to heart muscle.

 

Actual heart attack has been ruled out by the blood tests and EKG but if the pain was angina then you may be at risk of one in future.

 

A stress test would be a sensible next step and will show it if there is any blockage about 85% of the time (i.e. there are 15% false negatives).

 

If the stress test shows ischemic changes next step after that would usually be an angiogram and during that they may place one or more stents, won't know until it is done.

 

 

 

After finally sitting in the emergency ward doctors office and being told that the 2 ECG tests I had done on me both showed normal readings and that my blood test also showed nothing to be concerned about and my blood pressure was within the normal range I felt some what relieved, but after getting home and doing more internet research on my symptoms I’m now not so happy . I’m going to add your suggestions of the stress test and possible angiogram to my list of questions I want to talk to the heart doctor about .

 

Can you think of any other relevant questions I could add to my list of questions to ask the heart doctor?