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At War With Obstructive Sleep Apnea

I was having trouble concentrating at work. I was tired all the time, falling asleep at stop lights in the middle of the day, and my wife said my loud snoring was keeping her awake. My wife suggested I visit the flight surgeon to see if I had a deviated septum and find out if he had any advice on how to stop the intolerable snoring. I agreed to go, even though I didn’t think there was anything he could do. Sure enough, the flight surgeon confirmed a deviated septum and told me the only way to fix it was with surgery. I told the flight surgeon to go ahead and refer me to a specialist, hoping that my snoring problem would be fixed.

The specialist know as a Otolaryngology or ENT also confirmed my deviated septum and said he could do a Septoturbinoplasty,  the surgery that fixes a deviated septum and removes some of the fleshy part of the nasal passage called the turbinate. He also told me that, although he is very experienced doing this surgery, there is a pretty good chance that it would not totally fix my snoring. I told him to go ahead and schedule me for the surgery anyway because if I didn’t my wife might move permanently to the couch. Image

The surgery went well but the recovery was pretty rough. My nose bled for about a week straight and it got so bad at one point that I had to go to the emergency room to see if they could stop the bleeding, they did. I went back for my follow-up with the surgeon and he said that everything looked great but I should go and have a sleep study done to see if I had sleep apnea. I had no idea what sleep apnea was but I knew it involved breathing. I agreed to have the sleep study done and the surgeon referred me to a sleep center in Austin, TX.

Sleep studies are not as fun as they sound. They hook you up to about twenty different wires and tubes that monitor your every body function and then they expect you to fall asleep. The results of my sleep study confirmed moderate Obstructive Sleep Apnea or OSA. There is a difference between sleep apnea and obstructive sleep apnea. Regular old fashion snoring is considered sleep apnea but obstructive sleep apnea is when you completely stop breathing in your sleep. Once you stop breathing your body goes into a fight or flight response that floods your blood stream with a massive dose of adrenaline that causes your airway to flex open. In my case I was having an obstructive episode about 11 times every hour. This is the reason I was tired all the time and having trouble concentrating. I read a pamphlet on the symptoms and health concerns for OSA. I will not go into details but it is pretty serious stuff to include heart disease and early death. Read more about OSA here: OSA

They gave me a machine to help me breath called a CPAP for continuous positive airway pressure. Everything was going to be okay because I caught it early and now had a machine to fix it….right? Wrong. The machine was extremely difficult to get accustom to and to be considered compliant I had to wear it for 4 hours a night 5 nights a week. Then came my annual flight physical and more bad news. Apparently sleep apnea of any sort that is not properly treated is a flight medical disqualifying condition. I could not fly until I got this problem under control and was able to tolerate the CPAP machine. I tried for 6 months to get used to the CPAP but it was a constant struggle and I was still snoring without it.

There was one last thing I could do to fix the problem without the CPAP. Two more surgeries that would be performed simultaneously called a Tonsillectomy and a Uvulopalatopharyngoplasty (they remove the little dangly thing in the back of your throat along with some of the soft pallet on the roof of your mouth that it attaches to). Anything must better than trying to sleep with a CPAP so I got the surgery even though the rate of effectiveness for curing sleep apnea is less than 50%. Misery! That is the only way to describe the recovery from this surgery. I could not eat anything for a week and could not eat solid food for about two weeks. I lost 20 pounds in two weeks which was a nice side effect. If you want to lose 20 pounds fast just eat one or two servings of yogurt a day and drink water for two weeks. Thrust me it works.

So there I was two surgeries into the adventure and waiting to heal so I could get another sleep study to see if my apnea was cured. It was not. I was registering as a level 7 and needed a 5 or below to be considered cured. Everyone acted amazed at how far down my index had gone since the surgery but it still was not good enough to get me back into the air. My only choice was to get used to the CPAP and apply for a waiver.

I had to learn to tolerate the CPAP so I went to the pulmonologist and asked to try every mask they could order for me. I found one I thought would work. It is a nasal pillow style mask that just goes against your nostrils with little, soft, silicon pieces that the air flows through. You must also wear a chin strap to keep your mouth closed so the air doesn’t leak out. I still could not get used to wearing all this junk on my head while sleeping. After a very stern talking to by the pulmonologist because of my non-compliance, I decided to take the CPAP with me to the National Training Center in Fort Irwin for a month and give it one more try. It worked! Within one week I was sleeping through the night while using my CPAP. The sleeping conditions in the tents sucked and the army green cot was very uncomfortable. Compared to how uncomfortable I already was I did not even notice the CPAP machine.

I was cured! Well I was treated anyway and I was able to bring the good news back to the flight surgeon. He gave me a temporary medical up-slip for flight while I wait for my permanent wavier from Fort Rucker aero-medical department. After more than a year of not flying I am finally back at it just in time for one more deployment. I do not regret having the sleep study done. OSA is a serious problem that can cause destructive side effects on the other organs of the body to include the brain. If you think you might have sleep apnea or if your spouse or partner says you snore loudly or stop breathing in your sleep you should tell your doctor about it and see if he or she will refer you to a sleep clinic to get a sleep study.

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