Urgent advice needed - In hospital - Lots of CA's and respiratory feels depressed

[MyronH]

I have 3 heavy hitters for you.

1. Blood markers for Hypoxia

HIF1 (HIF-1α and HIF-1β) and HIF-2 proteins are a more reliable blood hypoxia markers that will be present for up to 24h(HIF1) and 2-3 days(HIF-2) after cell hypoxia. Ask them to do it. If the levels are in range, you can rest assured those initial dips are harmless.

Link removed, instead search Novusbio website for hypoxia information.

2. Brain (brainstem) perfusion SPECT scan.

https://www.ncbi.nlm.nih.gov/pubmed/8931538

Sudden rise in continuous(during the whole night) Central Apnea would suggest a worsening of an existing Heart Failure or hypoperfusion of the Brainstem, which is responsible for autonomic breathing. In your case with your history of clots, it might indicate a clot in one of the supplying basilar arteries or the vertebral arteries. If that were the case an addon to the heparin would be an tPA IV (tissue plasminogen activator)

3. If the hypoxia markers are fine tell the nurses to turn off the alarm so you can fall asleep.

On the light note. My sat% sometimes dips to 70 for a few seconds when I fall asleep. How much it drops is a marker of tiredness that day for me.

1. I mentioned blood markers for Hypoxia. Nurse said they don't normally do that unless someone is completely "out of it" and not aware of their surroundings.
She also said they use a big needle in your arm to do this.

2. She will run the SPECT Scan suggestion by the doctor but more then likely won't hear back from doctor until tomorrow.

They set up an O2 sensor monitored 24/7 by tech's here. This one doesnt beep.

[MyronH]

what do you think about this breathing pattern? This seems a little odd.
And see how my HR is all over the place now since being on blood thinners? It is messed up.

The third screenshot of my HR is from before all this happened. Very normal and more aligned,



[attachment=6060]



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A couple days before all this happened. More normal graph....
[attachment=6063]

[mdhampton]

About the only thing I can add is I've had much difficulty getting sleep in the hospital because of all the alarms (some time mine) and noise. The only time I slept well was after non-surgical stuff where they give you drugs to know you out (which never work during the procedure), when exhausted, or just plain out of it.

I've never had my machine with me, and always had to use hospital equipment.

[MyronH]

He claimed the CA's were normal transitions into sleep.

That can often be the case, but looking at your chart you don't experience any CAs until an hour after you lie down. There are a couple of mask-off events in that time so you may not have been sleeping deeply if at all, but these don't look like transition CAs to me. Docs need to learn to look at the details.

That is the problem with both sleep doctors i've been too. They read the summary and never the details. If AHI is good, they dont look into the detailed graphs, which include breathing patterns, etc.

[MyronH]

Well after adjusting pressure support to PS2 and MinEPAP 5,4 that helped for tonight, I got a few hours of sleep with no O2 drops, and instead of usually a 93-94% O2, I got between 95-97%.

I think they may release me today from the hospital. I'm ready to go home. I just wish I could figure out what causes those days where i feel unwell and then at night i have a lot of CA's and can't sleep. I asked the doctor for some tests but it doesnt look like they are too concerned, since this only happens occassionally.