Healthy Obsessions The Adventures of a Mild Obsessive Compulsive

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Meeting a New Doc Today

Seeing a new doc today. Feeling a bit stressed about it.

For years, when I told my doctors I thought something was wrong, they told me I was wrong. That I was perfectly healthy and maybe I was just depressed.

Fast forward to this past September and the double diagnostic whammy of Sleep Apnea and PCOS. Nothing wrong, my ass. (Actually, there’s nothing wrong with my ass – it’s one of the few body parts with which I’m completely happy).

Any rate, even though I’m going in to see this new doc with those two diagnoses in hand, with a referral from my primary care doc, and with an unquestionably positive Celiac screening test… I’m bracing for getting brushed off. Bah.

So, I’ve been reorganizing my Medical Info Binder. It seems like one of the few productive (and at least not destructive) things I can do with the excess worry-energy. Wanna see pics? I’m so ridiculously proud.

Medical Binder of Massiveness

Interior - With Tabs

Page one is a list of current diagnoses and medications (mostly blurred out for practicality reasons).

The tabs are for the different years. Thanks to the combination of my OCD and my Dad’s OCD, I have medical records going back to 1986. They aren’t all in here, and there are a few years that I didn’t keep track of. But it’s still pretty thorough.

And… it functions kinda like a safety blanket. Or magical armor. Or at least something to occupy my hands.

Sleep Apnea, A Family History (and Rant)

Technically, no one else in my family has ever been diagnosed with Sleep Apnea, but I’m pretty sure I’m not the first to have it.

What I’m about to say will no doubt provoke my father into an argument (one we’ve had before). But.

In 1990, one of my uncles mysteriously died. He was 38, seemingly hale and healthy. No one, at the time, could figure out the cause. All we knew was that during his sleep, he cried out and accidentally struck his wife. By the time she was fully awake and realized something was wrong, it was too late. She called for help, but the ambulance arrived far too late to do anything. The only theory the coroner had was that it was some sort of heart failure.

Sixteen years later another uncle cried out in his sleep, waking his wife. Her cry for help reached their son, who performed CPR while she called for an ambulance. This time, the ambulance arrived in time. It was cardiac arrest, in an otherwise hale and healthy man.

In the hospital, right after the attack but never again repeatable, my uncle evinced a heart arrhythmia. A prolonged QT, somewhat rare and unusual in that it strikes only during sleep. Very simply, that means that his heart took too long between beats.

My father may be right, and Sleep Apnea may have nothing to do with it. But. Sleep Apnea is known to cause cardiac arrest. Sleep Apnea is even known to cause not just heart arrhythmias, but also a prolonged QT.

“After adjustment for age and body mass index, the odds ratios were diminished but still remained significant: Sleep clinic OSA patients had a 2.6-fold greater risk of long QT syndrome than controls, while OSA patients from the general population were at 2.3-fold increased risk.”  – Jancin, Clinical Psychiatry News.

Then let us look at the other comorbid conditions:

Comorbid Conditions for Sleep Apnea

Each condition listed on that graph has enough supporting evidence to be included in the general sleep literature (although “pacemaker” is really more a treatment than it is a condition). But that graph, while lovely and useful (snagged from ResMed) is not absolutely comprehensive.  It can’t be, because 1) it only addresses men, and 2) there are new developments that haven’t yet been accepted into the cannon. We also have evidence of links to Ischemic Stroke, GERD, PCOS, and Metabolic Syndrome.

Let’s be clear here. Correlation does not necessitate causation. Just because two conditions often show up together does not mean that one causes the other. Many of those correlations are still under study, although some (like the one with PCOS) have enough substantiation to be widely accepted.

Then there are the other standard signs (not conclusive on their own, but alarming when taken in conjunction) like snoring, trouble sleeping, frequent wakings, and fatigue (though don’t ever tell a doctor you have fatigue, they seem to think that translates directly to “depression” or “hypochondria”). To my mind, the presence of any of those serious conditions is good enough reason for someone to get a sleep study. Combine them with each other or any of the other signs… yeah. Get thee to a sleep doc.

Back to my family. All on my mother’s side of the family we have: sudden death during sleep, cardiac arrest, heart arrhythmia (specifically prolonged QT), GERD, ischemic strokes, frequent wakings, trouble sleeping, snoring, fatigue, and –if we’re counting me– PCOS and… wait for it… wait for it… SLEEP APNEA.

Sounds like a party, no?

I may be emotional about this issue (all right, I’m definitely emotional about it). But that doesn’t change the fact that within that one branch of the family we have  10 of the conditions known to be linked to sleep apnea — in addition to Sleep Apnea itself. My mom alone has six of those conditions. Six.

There is no way I am the only one.

Edited to add: Oh, ya. And one of my maternal cousins has a Sleep Apnea diagnosis, too. There are at least two of us in my generation.

(Continually Updated List of References)