Friday, August 14, 2015

Pennsy's Night in the Sleep Lab

I won't say I was tearful, but I was pretty agitated.
"It's been five years since my cancer treatment, Doc, and I'm still so tired all the time. I can't work for four hours without going home to nap. By Thursday, I'm out of gas. I wouldn't even try to balance my checkbook on a Friday. I can run a marathon! There's got to be a way for me to work a 40 hour week again."
She nodded sympathetically and maybe a little bit wearily. "So many people come in saying they are tired. And the truth is, we really don't know why. But the best place to start is with a sleep study."

If she had said that the best place to start was by plunging needles under my fingernails and setting them on fire, I would have seriously considered it. I'm a little desperate.  I have big plans for my life. I want to act more. I want to teach more classes and do more personal training. I want to get off of disability insurance, and stand on my own feet. And most of all, I want to get a full-time job at the Y. And I can't do any of those things if I can't stay awake for a normal work day.

Ever since my treatment ended, my surgeon had been asking if I thought I might have sleep apnea: the condition that makes a person stop breathing and wake up smothering several times a night. It can have lots of causes: overweight, drinking too much, high blood pressure, bombarding the muscles in your neck with toxic doses of radiation. I was a likely candidate. So, after my last class finished at 8:00, I drove over to the sleep lab.

The building is only a sleep lab at night. During the day, it is the receiving area where you go to wait to be escorted to the big, radioactive trailer where they do the PET/CT scans. Yes, I had been here before. I sat in the parking lot for a while, waiting for my 9:00 appointment. Taking in the creepy coincidence. Preparing to sleep for science. Would I be self-conscious? Would the instruments annoy and keep me awake? Would the nurse be weird and give me strange dreams? I really didn't know what I was walking into as I approached the door and rang the buzzer.

A pleasant, apple faced young woman whose name tag said she was "Kimberly" popped into the lobby and opened the door with a smile; a little too quickly, I thought. One might be slightly more cautious about who you let into a place where people were essentially wired down to beds all night long. I told her my name, and she greeted me. Kimberly showed me to my room, a small, pleasantly dim little nook with a closet, a bathroom and shower, and a Tempur-Pedic bed. There was also a TV with a DVR player overhead. I wondered if that would help me sleep, or keep me awake all night. I decided to ignore it.

Kimberly told me she had another study start across the hall. I should relax for about 30 minutes, and try not to fall asleep. I changed into my pajamas, and tried to check Facebook, but got no signal for my phone. It occurred to me that this might be a real plus. No playing Words with Friends until 1:30 in the morning. Kimberly tapped on the door, bringing me a glass of water. I gulped down my pills, finished the drink, and started thinking about what would happen if I had to pee with electrodes and straps all over my body. I took a couple of quick trips to the bathroom while I waited for her to return.

The room was silent. the only movement was the turning of the ceiling fan over the bed. It chilled me in the air conditioned dimness as I tucked the blankets up under my chin and started to read. I'm working on a book that a friend recommended, and haven't really gotten into it, but knowing that I had half an hour to kill helped me to stay engaged. I noticed that the story was a lot better than it had seemed before. I also noticed myself becoming more calm and relaxed.

Finally, the time came to connect me. Kimberly eased back on the AC a little and the temp rose to a more comfortable level. She asked if I would be sleeping with our without my shirt, (no need for a hospital gown,) and I said I'd just as soon leave my shirt on, if that was OK. She was fine with that and we chatted softly as she placed pads on my legs, my chest and back, my scalp. There was a weird contraption like the cannula on an oxygen tank that went around my head and up my nose. She knew the surgeon who had discovered my cancer, and we discussed his reputation and bedside manner. She asked me about my cancer, and about my work at the Y. I was very much at ease in her hands, and when she was finished, I laid down on the bed, signed some papers, and she plugged me in to the wall. Kimberly explained that if I had to get out of bed during the night, I should buzz for her so she could help me get the whole rig to the bathroom. I assured her she would be hearing from me several times. Finally, she turned out the light and said she would be talking to me for a moment over the intercom, just to make sure everything was connected properly.

There in the silent darkness, I noticed a circle of red lights, near the ceiling across from the bed. It was an infra-red camera. Yes, Kimberly would be recording a video of me for the next few hours. I was glad I had decided to change clothes in the bathroom, and wondered if there was a second camera in there. After a few seconds, I heard her voice in the dark. She asked me to hold my eyes open, which I did with some effort. I was already getting pretty sleepy. She asked me to look to the left and right, up and down, blink 10 times quickly, hold my breath for ten seconds, and move my legs. Then she said good night and I was alone.

Silence. Darkness. No Netflix. No email. No texts or Facebook messages asking "Who's awake?" I closed my eyes and practiced mindful breathing, my mind's eye drifting gently from image to image. Friends I loved. People in my classes. Women I had dated or wanted to date. I don't know how long I lay there in the dark, but if it was 5 minutes, I would be shocked. Several times in the night, I remember vague awareness of having things stuck to my fact and hair. Once I felt a little warm, and kicked the blanket off of one foot. But I never tossed or turned. I never needed to use the bathroom. When Kimberly greeted me with a gentle "Good Morning," at 5:30, I was in the same position I had been when I fell asleep.

She asked me to step over to the chair so she could unplug me, then warned me that there would be lots of stickum on my skin and hair. Letting the hot water flow over me in the shower would take care of that in no time. She gave me a clipboard with two questionnaires to fill out, then left me to change. One of the forms asked how I slept and how I felt now. I slept wonderfully, but I felt pretty groggy. I had to re-read most of the simple questions several times before I understood them. Of course, I hadn't had any coffee yet. The other asked about my experience at the lab, which was stellar. There was no mistaking it for a hotel room, but it was certainly more comfortable than any hospital room I'd ever been in. I dressed, and after a lengthy search for the large, clearly marked box in the lobby, I deposited my paperwork into the slot and made my way to the car. I went directly to Starbucks, then home where I had another cup of coffee, then fell back to sleep for another two hours.

Kimberly explained before the study began that she would not be telling me anything about the data or what she saw during the night. That is the doctor's job. So I'll be waiting for a while before I know what they found out. But I do hope they learned something that will help me to have more energy and stamina during the day.

After all, I have big plans.

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