neicy57

Hi all, Just a quick note on this thread since my surgery has finally been scheduled. Insurance (Tricare) came through. It's been over four months since I attended the first seminar. My surgery will be on 25 Sep. My surgeon is Dr J. Wright, South Texas Surgeons, San Antonio, Texas, at Nix Hospital. I've been using the C-PAP machine (the fatigue from lack of sleep is one of the primary reasons I considered the L-B surgery). Unfortunately, I'm finding it hard to wear the contraption throughout the entire night. I will wake up during the night and, without knowing it, pull the mask off. I wake up later (probably because I start snoring) and find it laying on the floor beside my bed. When I do manage to wear it for a few hours, I believe it does make me feel better the next day. Lord, I hope a little weight loss and more sleep will help me to feel like a normal person again. I know my husband loves the fact that I don't snore when I'm wearing the thing. My goal is to lose weight and hopefully that will help with snoring (plus I've quit smoking for 10 months now). Anyway, I have my pre-op work on 22 Sep. I must start the dreaded Atkins diet before the surgery in order to shrink my liver, but Lord I do hate that diet... been there, done that, gained all the weight and more back. Anyway, doctor recommends Atkins two weeks before surgery, so looks like I'll start that around the 11th (or maybe the weekend after that). I can't say that I'm looking forward to the LB because of how hard it has been for my sister after the procedure, AND because of my concern about missing too much work. I don't get paid unless I work so every day I'm out of work has a significant impact to our family income. I do believe, based on my conversations with the nutritionist and psychologist, that the Lapband may be the right tool to help me begin to lower my portions, drop weight, sleep better, lower my cholesterol, get active, and begin to live again. Now, that makes me excited!!:tongue2: Best wishes to all of y'all! Take care and God bless! Neicy

Any thoughts on the findings below would be greatly appreciated. I've inserted my thoughts on the recommendations at bottom. Thanks! Position: The patient spent most of the night in the lateral position. sleep Latency: The patient’s sleep onset latency after lights out was 27.5 minutes. The REM sleep latency from sleep onset was 178.0 minutes. Total Sleep Time: The total time in bed was 363.0 minutes with a total sleep time of 219.0 minutes. Sleep efficiency was 60.3 %. Sleep Architecture: The patient had 30.0 minutes of REM for 13.7% of TST, 55.0 minutes of Stage 1 for 25.1% of TST, 103.5 minutes of Stage 2 for 47.3% of TST, and 30.5 minutes of Stage 3 for 13.9% of TST. The arousal index was 51.2 per hour of sleep. Respiratory: The patient was observed to have had a total number of 16 respiratory events with an AHI index of 4.4 per hour during total sleep time. The REM AHI index was 0.0. The normal AHI index is less than 5 per hour. There were 0 obstructive apneas, 0 mixed apneas, 0 central apneas, 16 hypopneas, and 108 RERA’s. The total RDI (A/H + RERA’s) was 33.97. Moderate to loud snoring was noted for 91.2% of TST. Oxygenation: The patient had an average oxygen saturation of 95%. The minimum oxygen level was 86%. Cardiac: The average heart rate was 65.3 beats per minute. The patient had a normal sinus rhythm with PAC’s noted. Other/EMG: Patient had no evidence of periodic leg movements during sleep. Diagnosis and Impressions: This patient has evidence of mild obstructive sleep apnea syndrome independent of sleep stage. Although her total AHI was 4.4, her respiratory disturbance index was considered moderately elevated at 33.97. This indicates significantly elevated respiratory effort related arousals which contributes to significant daytime fatigue as a result of upper airway resistance. The patient was also noted to be snoring for 92% of the total study time. In addition she had evidence of oxygen desaturation events as low as 86%. The patient remained in sinus rhythm and had evidence of frequent atrial premature contractions. She did not have evidence of periodic limb movements. Sleep architecture was markedly abnormal with extremely poor sleep efficiency of only 60.3%. She had difficulty falling asleep with a sleep latency of 27.5 minutes, delayed REM latency of 178 minutes, and decreased total REM of 13.7% of the study night. The total arousal index of 51.2/hour indicates severe sleep fragmentation in general. Recommendation: 1) Based on the patient's history of daytime fatigue and evidence of significant respiratory effort related arousals, persistent snoring, and oxygen desaturation events, a CPAP trial is certainly warranted. (Scheduled) 2) weight loss efforts can help reduce the severity of sleep disordered breathing events. (evaluating lap-band procedure) 3) avoidance of alcohol and sedating medication is indicated as these can worsen sleep disordered breathing events. (rarely use alcohol; never use sedatives) 4) suggest avoidance of driving while sleepy. (rarely drive while sleepy) 5) would check TSH to rule out hypothyroidism if not already performed. (this is Greek to me):confused2: 6) if there is evidence of nasopharyngeal crowding, consider surgical evaluation.(this is Greek to me):confused2: 7) suggest improvements in sleep hygiene.(this is Greek to me):confused2: 8) if the patient continues to have significant daytime fatigue despite appropriate treatment of OSA syndrome, consider referral to a sleep specialist. (not sure what sleep specialists do but will get referral from my primary care physician). 9) consider cardiac evalution. (will get referral from my primary care physician)

Thanks for the encouragement, Gone4Ever and Susan. Nice to meet y'all! :rolleyes2:

Just a quick note to say hi! I am currently being evaluated for lap-band surgery. Have had a sleep study and going back for another one on 28 June to try out the CPAP machine. My sister turned me on to this site and it looks like a good place to get info and support on this topic. My sister (bluefish62) had the lap-band procedure on Monday (she posted five days out post in the post-op forum). She's doing well for five days out and I'm behind her 100%. I still have to get the procedure okayed by my insurance company and should know something in the next few weeks. My appointments for the nutritionist and psychologist are on 30 June. I've almost convinced myself that I need to do this, but am scared to death that I will fail. But I recently quit smoking (now over six months ago) and figure if I can get through that that maybe I can get through this. Anyway, just wanted to say hello and look forward to getting to know you all. Take care and God bless you and yours!:rolleyes2: Neicy Pipe Creek, TX