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-   -   Ever been bitten by a "Sleep Test" ? (https://vansairforce.net/community/showthread.php?t=164218)

Alex Caldwell 09-18-2018 12:04 AM

Quote:

Originally Posted by cdeerinck (Post 1288731)
I recently went to a doctor because when I made the appointment, I had wheezing coming from my lungs after I got done with my open water ocean swims for a few weeks. When I heavily exhaled, I could also hear some bubbling in my lungs, which had happened many years ago when I had some type of lung infection which antibiotics cleared up. By the time of my appointment, it was already gone, but I kept the appointment anyway.

For some reason the doc prescribed asthma medicine even though I have never had asthma.

I mentioned that when I did have the wheezing, that a few times I got extremely sleepy, and had shortness of breath while laying down. For this, she suggested I get a) blood work, b) a chest x-ray, and c) a sleep diagnostic.

After leaving, I began to feel like the doc completely missed the mark, regarding what had occurred, and was overcompensating with tests after the symptoms were gone.

But one thing really concerned me, and that was that if the sleep test somehow showed anything like sleep apnea (which I have never suffered from), that this could somehow make its way into my medical records, and possibly interfere with getting a Class III medical, which I have due in a few months.

I am inclined to not do any of what the doc suggested, given that my symptoms actually were gone before I even went in.

Have any of you ever done a sleep diagnostic test, and later had issues with your Medical based on having done it?

Assuming you're generally healthy, not old like me, and don't have any other underlying medical problems, the history you give suggests the symptoms are tied in somehow to the open water swimming sessions you were doing. I'd be wondering about something like "Exercise induced Asthma" or "Swimming Induced Pulmonary Edema". You might be one of the 1-2% of otherwise healthy, (even robustly healthy) athletes who are subject to SIPE. The factors contributing to it are not well understood. Certain people in the tiathelete, breathholding diving, competitive swimming and military communities have been noted to be subject to it. Treatment and prevention has been "empirical" meaning it's based more on theories of what might be going on, but not on hard data from well designed scientific studies. It's a bit akin to some healthy people who are subject to altitude sickness, which may strike the most robust appearing person on a climb and leave other less hardy appearing individuals untouched. Just some food for thought. I am a family doctor, but retired now.

OkieDave 09-18-2018 01:35 AM

Just as an aside, this thread is a great example of why the FAA Medical process needs to be changed: it inherently has chilling effects. By being required to report every visit to a doctor, the FAA actually discourages people from going, particularly to specialists. I understand the FAA's interest, but it's poorly implemented and arguably results in a less healthy pilot population. I personally know people who have avoided seeking help for conditions, and the multiple suggestions in this thread to avoid even checking for fear of a questionable diagnosis, because they were afraid of losing their medicals. This is compounded by the strictness of some conditions being disqualifying, or at least requiring rigorous monitoring and sharing scads of sensitive data.


FAA, take a note from this thread and fix your process.

snopercod 09-18-2018 04:34 AM

^^^This^^^
 
^^^This^^^ Dave is exactly right.

DaleB 09-18-2018 07:23 AM

Quote:

Originally Posted by snopercod (Post 1289329)
^^^This^^^ Dave is exactly right.

Amen, brother. I'd have probably ended up with a routine procedure instead of an MI if I had not hesitated to go to the doctor with some odd, non-specific symptoms... simply because I didn't want the hassle and expense of explaining it on my next medical. None were the classic "Hey, dummy, you're about to have a heart attack" symptoms, but if I hadn't had a medical to worry about I'd have called the doc 2 or 3 days before ending up in the ER.

kaweeka 09-18-2018 07:41 AM

As a practicing Otolaryngologist, I read the prior thread with some concern. There seems to be a level of suspicion regarding the patient physician relationship and the process of medical diagnosis. It always concerns me, the propagation of misinformed and biased opinions which, if not discussed with someone that actually has knowledge, can lead to medical decisions that will have real and, sometimes, severe consequences. There are so many holes and wrong assumptions in the previous thread that it would take a prolonged face to face meeting to dispel the "expert" opinions listed and lead you to real understanding of the possible causes of your symptoms. Please return to your physician and discuss your misgivings and concerns. Let he or she inform and teach you so you're an informed patient, better able to make decisions that will help you.
Respectfully,
David

Paul Thomas 09-18-2018 08:19 AM

Quote:

Originally Posted by cdeerinck (Post 1289044)
* I have never had asthma either, but the doc prescribed an inhaler. On the label it says "Take 2 puffs every 4 to 6 hours as needed". The "problem" is that it has never been needed, so it just sits there unused. The "shortness of breath" that I described to the doctor only occurred while I had the lung issue. Even though I told her that, she prescribed it anyway.

Depending on what is in the inhaler, it could cause issue with future medicals. I've seen advice from AME to return potential problematic to the Dr. office and get a letter that it was in-used to avoid problem. I'm not sure how you do that with an inhaler (vs. pills) but the trip to the Dr. seems worth it.

rocketman1988 09-18-2018 08:22 AM

and...
 
Quote:

Originally Posted by kaweeka (Post 1289355)
As a practicing Otolaryngologist, I read the prior thread with some concern. There seems to be a level of suspicion regarding the patient physician relationship and the process of medical diagnosis. It always concerns me, the propagation of misinformed and biased opinions which, if not discussed with someone that actually has knowledge, can lead to medical decisions that will have real and, sometimes, severe consequences. There are so many holes and wrong assumptions in the previous thread that it would take a prolonged face to face meeting to dispel the "expert" opinions listed and lead you to real understanding of the possible causes of your symptoms. Please return to your physician and discuss your misgivings and concerns. Let he or she inform and teach you so you're an informed patient, better able to make decisions that will help you.
Respectfully,
David

...and don't forget to include that visit on your next medical...:rolleyes:

jwilbur 09-18-2018 09:15 AM

Quote:

Originally Posted by dwranda (Post 1288904)
My wife says I snore and stop breathing for a while at a time while sleeping. I had a sleep study and couldn't sleep during it. At about 4 in the morning I asked to leave because I was wide awake. They told me I couldn't because I was being charged for it so I might as well stay the whole time. I finally fell asleep for maybe less than an hour. I personally didn't think that was enough time to classify me as having apnea but they did.
I'm 6'1 and 195 lbs so not overweight. I can drive for over 8 hours without falling sleep. I really don't believe the faa issue with apnea is realistic. Not many pilots are flying for 6 or 8 hours without stopping. If you're flying for 2 hours and falling asleep then yeah you might have an issue.
I'm with the guy who said just buy a machine and see if it helps if you're having an issue. They try to tell you that only the doctor can adjust your machine but that's not true.
Good luck. If you take the test just be prepared to be wearing a mask every night.

I was around 30 and my wife convinced me to get a sleep study because I snored a lot and she was worried about me. Not overweight. Not tired during the day at all. No health issues. I just snored.

I went for the study. They diagnosed me with apnea. I got the cpap machine. I went for a follow up appointment and they asked me if I was still tired during the day. I said I wasn't tired during the day to begin with. But I am now because that stupid machine wakes me up all night long.

Took me a very long year to get used to that machine. In my case the sleep study was a bad mistake. My wife sleeps better, though, because I don't snore anymore so that is a positive (I mean that sincerely). But I still think it was a mistake for me to do the sleep study. There were probably other ways to deal with snoring.

I'm sure there are cases where an OSA diagnosis is vital. But I'm equally convinced that a minor apnea episode probably happens to everybody on occasion. And when you're wired up like that for a sleep study it's probably a near guarantee: a form of expectation bias. I'd love to see the stats for the number of sleep studies where they DON'T find apnea.

Like many things there's certainly some truth to the seriousness of OSA, but I think also like many things it's a severely over-diagnosed condition. Regarding the OP, I would save the sleep study as a last resort only if the issues are not answered by the other tests. Doctors (in my opinion) should be viewed as trustworthy advisors, not authority figures.

For those who do use a machine, try one of the on-line sources like cpap.com. You'll get the machine you want at a fraction of the cost (including accounting for insurance). And you can most definitely make all the adjustments to pressure, etc, yourself.

Every year I jump through hoops with the FAA. But I think this next time I'm going to try the basic med route. I hope that will make things a little easier.

flyboy1963 09-18-2018 11:12 AM

^^^same as JOE ^^^^
 
...in addition to the above, which was pretty much my exact experience....

I now have to fill out a half-dozen pages of paper every time I apply for anything, explaining why I am nearly dead and/or asleep from my extremely serious sleep apnea.
yep. snored, but had no other symptoms. Normal weight.
Now I am treated like a leper when applying for life insurance, all the new hassle licensing....etc.etc.

ah, yeah, and I think the 'system', which I keep very clean, may have caused a chronic sinus infection. which is really great for pilots.

so take all that with a grain of salt. If you are NOT breathing well in your sleep, that's very hard on your heart, and wife.
Address that problem!....but beware of 'the system' ....as many have noted.

rv7boy 09-18-2018 11:13 AM

Separate bedrooms
 
Quote:

Originally Posted by jwilbur (Post 1289382)
...My wife sleeps better, though, because I don't snore anymore so that is a positive (I mean that sincerely). But I still think it was a mistake for me to do the sleep study. There were probably other ways to deal with snoring...

I know a pilot who got fed up with the CPAP machine, and he and his wife agreed the solution was for them to sleep in separate bedrooms! He sleeps better, she sleeps better...problem solved!

Disclaimer: I am unaware of any other problems this may have created! :eek:

9GT 09-18-2018 02:08 PM

Sleep Apnea,,,,,,,,The disease de jour. :) I remember it wasn't so long ago when everyone was running around wearing wrist braces for Carpal Tunnel Syndrome. Even cartoonists were putting their characters in them! With 28 years on the job in LE in a major metropolitan city that investigated all deaths that occurred outside of a hospital, not once did anyone I know of die from sleep apnea. Not saying it does not happen, but none during my 28 years. They were all a result of another form of medical condition. We had one infant SID death and one auto accident where an older gentleman died while driving his car due to a heart attack. I figure the odds of something like this killing me to be pretty remote. Sleep study testing/treatment is very expensive and profitable for the medical profession and if insurance did not cover it, the medical profession would move on to something else. There are alternate solutions to those that DO suffer from a legitimate SA diagnosis instead of the CPAP machine and that is a specially designed mouth appliance you wear at night. My building/aviation buddy is a retired dentist who had the training and equipment necessary to treat SA with an appliance he would make for the patient, very similar to a nighttime bite guard. A local sleep clinic would refer patients to him who would not, or could not, bear wearing the CPAP contraption at night. He had good success with most his patients.

Icarus 09-18-2018 05:11 PM

It's like I always like to say... It's not the OSAS that gets ya; it's the pulmonary and secondary hypertension, nocturnal cardiac dysrhythmias, MI, and ischemic stroke!

I jest...sort of.

I'll agree the system needs to be changed. It discourages reporting, always has. It's even worse in the military. But we aren't entitled to our own facts because they don't fit in with our passion(s). Go find a primary care you trust, and hopefully we will all fly on forever.

rocketman1988 09-18-2018 05:41 PM

and...
 
...and don't forget to list that visit on your next medical.:rolleyes:

NewbRVator 09-18-2018 06:39 PM

Sleep apnea is a tough problem.

It does cause health problems other than being more tired after a regular sleep cycle.

Additionally the way health insurance, life insurance, disability insurance, FAA medical examiners, occupational health examiners, etc view the problem is troublesome.

The best solutions are related to non-CPAP machine solutions. Reason being is most people don't wear or can't wear the device.

The dentist prescribing and making mouth appliances is a good example as are weight loss, avoiding alcohol, etc.

In summary it's a problem and everyone needs to improve the issue and that includes taking responsibility for personal solutions whcih can improve or eradicate the problem. Having said that I do understand pilots aversion to "going medical." Kind of like the comedian who said "Never go full retard."

"Never go full medical" is probably good advice most of the time the problem is it can kill you if you are unable to figure out when the proper time is to go "full medical."

Long read, I apologize if you had the tenacity to read it all.

Flying Canuck 09-18-2018 09:44 PM

CPAP fan
 
I've been using a CPAP for 7-1/2 years - haven't missed a night. Life beforehand was day after day of waking feeling as if I'd run a marathon and fighting to stay awake during the day. All of these are classic sleep apnea symptoms. The CPAP has made a huge difference for me in many different aspects of my health. I didn't start flight training until after this and it's been disclosed for all of my medicals - AME didn't even bat an eye. I can't imagine trusting myself to fly (and stay awake) without the CPAP.

I would hope that being treated successfully for a sleep disorder would be looked upon in a much better light than having it not be diagnosed and affecting every flight. Obviously I can't speak for anything other than my own experience and that is also in Canada


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