07-22-2024, 08:21 PM
Advice request. How do I talk to my doctor?
I was diagnosed with sleep apnea and was put on CPAP about 12-15 years ago. At the time I weighed 350+ lbs. I lost 205 lbs, no longer had sleep apnea and stopped therapy.
About five years ago I moved to high elevation. About a year after moving I began talking to my doctor about constant fatigue, depression and weight gain. During the course of several blood tests to figure out what might be going on, he put me on antidepressants, added supplements where blood tests indicated, but nothing was helping. We also learned that apparently my body didn't like the lower oxygen and responded by increasing red blood cells. While this is a normal reaction when one moves to high elevation, my body wasn't leveling out like it should and when I reached erythrocyotic levels, my doctor became concerned, suspected sleep apnea and ordered an at-home sleep study. The results boiled down to negative for sleep apnea, but possible UARS. I asked my doctor about looking further into sleep/nighttime oxygenation because it makes the most sense when you factor in the OSA history, move to elevation, fatigue, depression, weight gain, etc., but he declined and instead referred me to a hematologist. I begrudgingly made the appointment for a month in the future and in the meantime put myself back on CPAP without prescription and consulted with you fine folks for appropriate settings. (which have made a huge difference! Thank you!)
As of today, I have been on self-prescribed CPAP for a total of about 2-1/2 weeks. I met with the hematologist this afternoon. I explained the CPAP and my most recent CBC from this morning shows both my hemoglobin and hematocrit down to almost within normal range. My hematologist agrees that this doesn't appear to be a hematology issue and has referred me to pulmonology.
I'm worried that the pulmonologist will put too much weight on the one-night sleep study and not enough on the weeks worth of data I will be able to provide with blood tests and CPAP data via OSCAR. Is there any way to use the CPAP to record events without therapy so I can give a more rounded picture with and without therapy? Does anyone have any advice about how to talk to the pulmonologist to present my case so I can get prescription for therapy that is both subjectively and objectively helping, so insurance covers it?
Thank you for your help!!
About five years ago I moved to high elevation. About a year after moving I began talking to my doctor about constant fatigue, depression and weight gain. During the course of several blood tests to figure out what might be going on, he put me on antidepressants, added supplements where blood tests indicated, but nothing was helping. We also learned that apparently my body didn't like the lower oxygen and responded by increasing red blood cells. While this is a normal reaction when one moves to high elevation, my body wasn't leveling out like it should and when I reached erythrocyotic levels, my doctor became concerned, suspected sleep apnea and ordered an at-home sleep study. The results boiled down to negative for sleep apnea, but possible UARS. I asked my doctor about looking further into sleep/nighttime oxygenation because it makes the most sense when you factor in the OSA history, move to elevation, fatigue, depression, weight gain, etc., but he declined and instead referred me to a hematologist. I begrudgingly made the appointment for a month in the future and in the meantime put myself back on CPAP without prescription and consulted with you fine folks for appropriate settings. (which have made a huge difference! Thank you!)
As of today, I have been on self-prescribed CPAP for a total of about 2-1/2 weeks. I met with the hematologist this afternoon. I explained the CPAP and my most recent CBC from this morning shows both my hemoglobin and hematocrit down to almost within normal range. My hematologist agrees that this doesn't appear to be a hematology issue and has referred me to pulmonology.
I'm worried that the pulmonologist will put too much weight on the one-night sleep study and not enough on the weeks worth of data I will be able to provide with blood tests and CPAP data via OSCAR. Is there any way to use the CPAP to record events without therapy so I can give a more rounded picture with and without therapy? Does anyone have any advice about how to talk to the pulmonologist to present my case so I can get prescription for therapy that is both subjectively and objectively helping, so insurance covers it?
Thank you for your help!!
