Appointment accomplished! I got to see the Clinical Fellow for the Respirologist who was doing my sleep consult yesterday. (If you don’t speak medical, a fellow is a doc who has obtained his MD and has continued his education to specialize in a particular field of medicine. Different areas have different fellowship lengths. Being seen by a fellow is as close to seeing a specialist as you can get, without seeing the actual consulting physician.) The fellow was very attentive, compassionate and thorough. He listened to everything I had to say, even when the info I was sharing was obviously not applicable (some docs just dismiss that info and interrupt you, refocusing you on the facts they need to know in order to make a diagnosis. This one actually listened and nodded and then went on to his next question – it makes for a much more compassionate bedside manner, even though it does take a little more time.) After he took my history he did a physical examination and determined that my issues with sleep are stemming from one of three things.
- Narcolepsy – somewhat mild as I do not have the symptoms of cataplexy (temporary paralysis or losing control of muscles when experiencing intense emotions).
- Sleep apnea – this is always suspected when someone has sleep issues. My airways are a bit narrow so they often think it’s a lack of oxygen getting to my system while I sleep that is causing the lack of restful, healing sleep. Sleep apnea has never been identified in any of my previous sleep studies, but, I remain open to the idea as it makes a lot of sense. I don’t wake up choking or gasping, ever, and I never struggle for breath while sleeping (confirmed by everyone I’ve ever slept in the same room with). I don’t snore either – but, as I said, it’s a possibility that I remain open to.
- The pain is waking me up and/or keeping me from getting any deep, restful sleep. This one is obvious, I know, and it seems a bit off since the excessive exhaustion and the pain levels do not seem to be related to each other. I’ve been feeling sleepy like this…shutting down in the middle of anything, for years. The pain has fluctuated through that time, sometimes almost entirely controlled. I also had episodes of excessive sleepiness years ago when I had no neck pain at all.
So – in the end I got what I wanted – a sleep study. Now we just have to wait for the appointment. That will be the thing that brings the most answers. Once that is done, I’ll see the rheumatologist again for the blood work results and then I suspect I’ll be right back where I started: Unable to obtain restful sleep, in pain all the time and exhausted. The doc told me that we might just need to elevate the Dexedrine for the daytime and then stack me up with pain killers at night and although I dislike that idea A LOT, he gave me the shrug and said “It’s a benefit/risk situation here. If your quality of life is being sacrificed because of pain and exhaustion, the increased medication and the risks that go along with it becomes worth it.”
In the end it’s up to me, I know. I will just have to wait and see what the results show.