Sunday, September 26, 2004


It seems that every year I have my physical exam, then I have two or three follow-on visits to other doctors. Not because I'm ill in any noticable way, but because my doctor is thorough. The result is that my physical, which typically happens in June or July, stretches out into these other visits. I've always gotten a clean bill of health, but I end up waiting for closure.

This year, I made a trip to Dr. Rudoff, the cardiologist, to evaluate my blood pressure, and got five gold stars. No really. He said "don't stop whatever you're doing. Your LDL cholesterol is 75, and when you were born you probably had an LDL of 50." No blood pressure medication, high marks all round.

I also made a trip to see Dr. Marilyn Rudin. She is a pulmonary specialist, and I was there because I made the mistake of telling my family doctor that I sometimes started myself out of sleep just after bedtime, as if I'd forgotten to breath. He said "that could be apnea, which can be dangerous, so let's get you checked out."

Dr. Rudin asked that Jean come along, and she asked Jean questions about my sleeping behavior. Nothing I said made her want to do anything to me, but Jean told her about flailing arms, snoring and such stuff. "Classic apnea," exclaimed Dr. Rudin. So I got scheduled for a sleep study. Friday night was my night.

I didn't write this up on Saturday, because I was sort of a zombie. Sleep study is sort of a misnomer. I suppose there are folk who sleep soundly enough that they could doze through this thing, but I am not one of them. The sleep technician, a friendly young guy named Anthony, hooked up several electrodes to my scalp, behind my ears, beside my jaw and my eyes, my chest and my legs. He attached two bands around my chest to measure breathing, and most annoying, stuck a sensor consisting of two insulated wires up my nose!

Around ten, not my normal bedtime, it was lights out. First we went through a calibration drill, opening and closing eyes, flexing leg muscles, thrusting belly in and out, breathing only through the nose, breathing only through the mouth, for a few minutes. Then silence. The room was nice and dark, and most of the time quiet. I could hear doors opening and closing, and interns chatting, so of course I couldn't go to sleep until they shut up.

What's more, every time I turned around there were these wires dragging on me. I forgot to mention that I had a oxygen sensor attached to one finger, and whenever I reached to rub my nose (full of wires) the light on the sensor would shine bright red in my eye. Turning on my side drove the nose sensors deeper into my nose, precipitating a round of snorting and eye-watering.

Eventually I managed to get to sleep, I don't know when. Around 4am I woke with the need to visit the restroom. You have to speak out, and the microphone in the room picks up your request. In comes Anthony, to detach the central switchbox from my droud of wires, so I can walk to the bathroom. Afterwards, I got back into bed, hooked up and struggling to get to sleep again.

However, sometime shortly thereafter a hideous shrieking hiss filled the room. Along with other noises, I was able to figure out that another sleep study subject had arisen and was taking a shower. This went on for so long that only a half hour or so after it stopped, Anthony spoke over the loudspeaker. "Well, you haven't really gone back to sleep, but we got some good measurements. It's six am, time to get up!"

I'd optimistically say I got six hours, probably more like five, of sleep in this 'sleep study'. But of course, they don't need you to sleep for the whole night, only long enough to observe your full sleep cycle (light sleep, dreaming, deep sleep) and breathing. According to Anthony, I have a mild manifestation of apnea, but it wasn't enough that he would have entered the room to try a C-PAP on me. This is basically a breathing mask which forces air past an obstructed throat to ensure proper breathing all night. It's just as well, since I generally don't get back to sleep when someone else wakes me, much less when someone else straps a blower onto my nose with a weird yarmulka to hold it on my face.

I took a shower in the adjacent bathroom, working gingerly to remove the six larger sensor patches, which were heavy adhesive squares on my legs and chest (just where the hair is heaviest). When I left the hospital, I saw only one person as Anthony had gone home. I got to peek into the control room, sort of a mini NASA. Then I drove home, had some breakfast, and stumbled through the day.

Last night I went to bed at ten, got up once during the night, and slept in to 7:45am. I felt really rested.

Now I wait three weeks, then have a follow-up visit with Dr. Rudin. Assuming she doesn't try to burden me with one of those C-PAP machines, or otherwise meddle with my physiology, I will finally be able to pronounce my yearly physical over, in mid-October!

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