Solutions

I had my appointment with the doctor at the sleep clinic.  He was a very nice man who really listened to me.  I don't know about you, but I have had times when I have gone to the doctor's office and he or she just seemed to not be hearing me.  Not every time, but enough to drive me feeling like something was wrong with me.  When he asked me how my sleep was going using the machine, I looked at him and simply said, "Horrible.  I have slept twice on the machine ... two hours last night and a half hour the night before."  I was grateful for the two hours, trust me on that one, because up to the night before that, I had not been able to string together enough will in me to even fall asleep.  Actually, it isn't my will, but just a pure inability to fall asleep on the machine.  Getting the half an hour and then the two hours felt like a freaking miracle to be honest.  After much discussion with him regarding exactly what was going on and doing a physical examination, we developed an action plan together.  I could tell he wasn't going to just let this go and check with me in six months.  He understands that I'm not sleeping now and need help now.  To be honest, I practically cried while talking to him.  I have spent so many nights in tears from the sheer frustration of not being able to fall asleep yet being so tired.  This has been going on for a solid month.  That might not seem like a long time but I can assure you that not being able to get a somewhat restful night of sleep night after night is a horrible feeling.

To begin, the doctor is changing the two sleeping pills I had to a more intense one that is solely to help with sleep (I guess the other two pills were anti-anxiety meds with a side effect of being drowsy).  My new pill is called Ambien.  You may have seen commercials for it on TV.  It's the one where the person is sleeping and a butterfly flies all around them while they're sleeping.  When I would see that commercial, it would make me jealous that that person could sleep and I couldn't.  Then I remembered that I heard something about people sleep-walking using that med.  The doctor did say that has occurred with a small number of patients.  So he told me to watch out for signs that I had done things in the middle of the night that I hadn't done before bedtime, like making a full meal and then leaving it out on the stove.  The thought of that just cracked me up.  He told me that if I do have those episodes, I am to stop immediately and then we'd go to a different med.  I was looking at the medication guide they gave with it and I had to do a double-take.  In the section where they talk about sleep-walking, it says:

"Reported activities include:

• Driving a car ("sleep-driving")
• Making and eating food
• Talking on the phone
• Having sex
• Sleep-walking"

That made me laugh even more.  I just had this image in my mind of me going to bed.  After a while, I got up to use the phone to call someone.  I then got in the car and ended up eating food at a fast-food restaurant instead of having sex with the person I called, which apparently was my original reason for using the phone in the first place. Ha ha!!  It just struck me as hilarious.   Getting that sort of image in my head is what made me laugh at that.  I'm sure it happens to people, but to think any of those things can happen while I'm dead asleep is pretty laughable.  Apparently people do have functional episodes while sleep-walking to the extent that others around them feel like they are their normal selves.  It's such an interesting phenomena to me.  Of course this is nothing to take lightly and I think you guys know me well enough by now to know I don't take things like this lightly.  On the flip side, I do have funny images that pop into my head at the most inopportune time.  I'm happy to report that none of the above happened when I took the pill last night.

I need to check in with the doctor in a week or two.  If the med doesn't work, the second thing the doctor wants to look at is having me studied more in the overnight sleep clinic so they can monitor everything going on.  He said that, according to the data from the CPAP machine, when I'm wearing the nasal pillow, I am not experiencing apnea.  In fact, I should be able to sleep in any position with that machine on.  He is thinking there is something going on in my brain that is psyching myself out in not being able to sleep on the machine.  He says I may be thinking about it too much and preventing myself from falling asleep.  He didn't say it in a dismissive way, but just that it doesn't make sense based on his experience with other patients.  He does feel that a recliner could help on a short-term basis now and when I have the surgery due to the different body positioning.

We did talk about the possibility of a device that goes in my mouth that will force my tongue forward, thereby opening up the passageway.  Unfortunately, I can't qualify for that device until at least six months after my gastric bypass surgery.  They want to see that I have lost weight first before going in that direction.  Speaking of the surgery, he did say that many patients end up no longer having sleep apnea or a very mild form of it afterwards.  I was reminded that even thin people have sleep apnea, which I know to be the case because I've had class members when I learned how to use the machine that were thin.

I'm beyond thrilled that I slept last night!  Not all night long, but a couple more hours on the machine.  I was so tired that I decided I needed to take off the nasal pillow and just sleep on my own so that I could be as functional as possible today.  The lack of sleep I have been experiencing really has taken a toll not only on my body but on my mind.  I've been slurring my words a little bit and even having to try a couple of times to say one word.  That has all been from being extremely tired.  

Speaking of which, my med is starting to kick in now.  My dad is coming for a visit tomorrow.  I am going to move forward with telling him that I'm pursuing the gastric bypass surgery.  I'm nervous and feeling a bit anxious about having this conversation with him.  I just worry that he won't approve and that he won't be supportive.  It's important for me to have his support.  In the end, I know he does back me in whatever I do, even if he doesn't agree with my choices.  Ultimately, it is my choice and I have to remember that I'm a grown-up and not that 13-year-old that's trying to get the courage to tell her daddy something important.  I'll let you all know how it goes!

Day 31:  Drank 186 of 185 ounces (I rock!)

Sleeping and body image

My mother went home after spending four days at my house.  It's nice to have my place to myself again, although I do miss her.  I know that she will be living with me in the future, probably after she retires from her job, so these little visits over are good.  She's alone and, especially as she gets older, I don't want her living by herself.  I really am more amazed each day at hour our relationship just continues to grow and flourish, especially after such an abusive childhood.  This helps me see that really all things are possible.

It looks like my APAP machine (CPAP with auto adjustment features) is in so I'm going tomorrow to get a fitting.  I told the person on the phone that the mask I was given to do the sleep study just isn't working for me and that I'd like to have the nasal pillow.  It was pretty amazing in how easy that conversation went because they told me it wouldn't be a problem.  I'm so grateful to have insurance because the machine along with everything associated is completely free to me.

My biggest problem with sleep is that the only position I can sleep in is on my tummy.  That's normally fine, but that is not going to work after I get the gastric bypass surgery done.  What happens to me is that I'll lay on my back and I'll start to fall asleep, but then I either snore or stop breathing and then I wake up.  I've tried many different positions to make it happen - bigger pillows, smaller pillows, sitting up, laying perfectly flat.  No matter what I do, I just can't get to sleep.  This is a big reason I decided to get on the machine for the sleep apnea so early when my surgery won't be for another eight months or so ... I need the time to adjust.  My dad said he has the same problem but he was able to overcome it eventually with the nasal pillow.  He said it did take time and patience, but it is doable.  Lord help me but I pray that the surgery will aid in getting rid of the sleep apnea altogether.

Speaking of the surgery, I'm feeling really antsy.  It is months away and I just want to get going with it already.  I know a big part of that is that I've been having some really major body image issues coming up lately.  This morning when I was changing my clothes and looking in the mirror, I focused on my thighs.  The excess on my upper thigh feels like a growth to me, even though I know in my head it is not.  I recently watched a program on TLC, Half Ton Killer, and I know I am comparing my body to hers.  It's the story of a woman who weighed over 1,000 pounds and was accused of killing her little nephew by accidentally rolling over on him while babysitting him.

Obviously I don't weigh 1,000 pounds.  I just sat there staring at the screen and looking at the mass of flesh surrounding her, feeling so broken-hearted for her but also feeling as though I am the same way.  There are so many physical limitations that she has that she is now bed-ridden.  I wondered how she could get to that extreme point without doing something about it, but then realized I am in the same situation.  Sure, it's not as drastic as hers, but it seems like I closed my eyes one day and wondered how all the weight piled on without me really recognizing how bad it had gotten.  Obviously I saw what was happening, but I guess it just goes to show me how much of an addiction food is to me, just like alcohol is to the alcoholic.

Whether this was before I went on Optifast or after the weight came back, the devastation is still just as strong.  I just don't want to feel the physical and emotional pain of obesity any more.  I don't want to continue putting my life at risk being this size.  I know there is a process I need to go through with the surgery and the next stage of that will happen in about three weeks with me starting the six-months of classes. I just want it now.  I want to close my eyes and fast forward to the time I can have the surgery done.  It's hard being in this body and not feeling shame when I look in the mirror.

Of course, in the meantime, I do have the opportunity to be proactive and do my best to be as healthy as I can right now.  Kaiser has set a goal for me to lose 37 pounds before the surgery, so I'm doing my best to work on that.  Obviously I have to work on the feelings I have going on.  I'm so glad that I was brave enough to seek out therapy because my head is the source of all the negative emotions around body image.  I think it is vitally important for me to continue working with the therapist throughout this entire process.  Otherwise, I am quite certain I'll repeat patterns that got me here in the first place.  I definitely don't want that to happen.