Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
132 Doctors are Online

Suffering from Sleep apnea and COPD - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   I am status post-Hodgkins, treated with MOPP/ABDD, diagnosed with pulmonary hypertension (mild) and left ventricular diastolic dysfunction (significant) in April 2006.
User :   In December 2008, I had an episode of mental confusion and high blood pressure
Doctor :   ok
User :   Since that time I have begun nocturnal oxygen therapy.
Doctor :   ok
User :   I have been diagnosed mildly hypoxic, both daytime and nighttime.
Doctor :   ok
User :   I have these episodes where I cannot be awakened,
User :   either by noise, shaking, having water poured on me, pain stimulus applied
User :   And after the episodes I am generally ill for several days
Doctor :   what are the current medication that you are taking? when was your last complete health check up?
User :   And I have been having memory loss associated with these episodes.
User :   I take Lasix 40 mg,
User :   Lotrel 5-10mg
User :   Aspirin 325 mg
User :   Claritin 10mg
User :   Zoloft 150mg
Doctor :   the episodes that you are having where you cannot be awakened could be due to apnea.
User :   Tenormin 50mg
User :   That's all.
User :   Yes, I have been diagnosed with moderate obstructive sleep apnea
User :   My husband is a physician
Doctor :   which causes transient loss of consiousness.
User :   How transient?
Doctor :   has EEG been done after any of these episodes to look for brain function abnormality?
User :   No
Doctor :   it could vary from 5 minutes or more
User :   The last episode I had lasted a long time, they put oxygen up to 5L/min and it still took 45 minutes to awaken me
Doctor :   what treatment has been given for your moderate obstructive sleep apnea
User :   CPAP
Doctor :   has the cause for obstruction made out?
User :   But I cannot use it because I cannot breathe out with the mask on.
Doctor :   ok
User :   I am overweight, so I'm sure that's part of it. I've had pulmonary function studies several times
User :   due to treatment with Bleomycin
User :   And the last one showed very low ERV, RV, and one other one I can't remember right this minute, but an expiratory value
Doctor :   i would suggest you to get an EEG done for the apnic episodes to make sure there are no higher level functions affected since you take more than 5-10 minutes to be awakened
Doctor :   have you consulted with a pulmonologist ad neurologist for your symptoms?
User :   Would an EEG have to be done right after the episodes to have value?
Doctor :   yes, EEG should be done within 12 hours of the episode or atleast within 24 hours of last episode
User :   I have a pulmonologist, yes, and he does not know. My pulse oximetry shows on average 200+ oxygen desaturation events within a 12 hour period (awake and asleep), but never low enough to cause unconsciousness and never long enough either
User :   Okay, because I had an EEG during the sleep study, which was normal.
User :   Pulmonary doctor says pulmonary hypertension could be contributing.
Doctor :   ok. i suggest you to consult a neurologist and take EEG after you have any apnic episode
Doctor :   yes, partly it could contribute, but the duration of your last episode is worrysome
User :   I had a PET scan recently, and there was nothing abnormal in my brain area. Okay, if I am breathing during these episodes, would it simply be that I went unconscious and then started breathing?
User :   And apparently I never actually quit breathing, but I understand that a very slow respiration rate counts as apneic.
Doctor :   if you would like, you can take a second opinion from one of our panel specialists and then proced with discussion with your treating doctor about your next steps for treatment
User :   My sleep study doctor says my respiration rate goes down to 6-8 per minute.
User :   Would night sweats be linked to apneic episodes?
Doctor :   yes, that can be counted as apnic, you might be stopping the breathing, due to which you become unconscious but as a protective mechanism, body restarts breathing but not at a conscious level.
Doctor :   night sweats are more linked to pulmonary hypertension, though they could also be a symptom of apnea
Doctor :   since your PET scan came back normal for brain, there is no need to worry about the metastasis there
Doctor :   was a whole body PET scan done anytime after the treatment of hodgkins?
User :   Okay. They are not the drenching sweats like with cancer, I don't think, but they are pretty significant. I did have a whole body PET scan, 3 weeks ago. Had several lymph nodes test "hot" and I have a soft tissue mass in my left lower lobe that was too small to tell yet
User :   Nodes were on average 1cm with SUV values ranging from 4 to 8.
Doctor :   ok, then the 'hot' nodes need to be monitored
Doctor :   consult our panel neurologist
User :   Right. If they were not lymph nodes, would be easier, but since they are, could be inflammatory. Okay, I will talk to neurologist, thank you.
Doctor :   visit this link to consult our panel oncologist
User :   Is there a way to go back to the first one? I can't quite tell.
Doctor :   i am sorry i did not understand. Could tel me what you meant in your last question? where do you want to go back to?
Doctor :   are you there?
User :   Yes, sorry.
User :   I wasn't sure how that second opinion worked,
User :   I guess it's an e-mail thing?
Doctor :   ok. this works like this: you have both an e-mail and phone option
Doctor :   in both you need to write your query and send along with your reports copies
User :   Ahh, I see. Pretty cool.
User :   I have been gathering all my medical records so we can look at a start to finish picture.
Doctor :   and if you opt for e-mail answer, then specialist replies you via e-mail
User :   I didn't realize until I got my records I was diagnosed with COPD in 2006 as well.
Doctor :   if you want to opt for the phone call, then the specialist call you up at scheduled time (you dont need to spend on the call).
Doctor :   and he discusses the query and reports with you for any length of time
Doctor :   untill all your queries are answered
Doctor :   he may ask you to provide extra details or reports if required
Doctor :   have you followed what I have said?
User :   Well, it would be pretty interesting if you guys figured out what's wrong after all this time! I was scheduled to go to hospital in December, but there was a baby due in the family at the time and I had to cancel. Yes, I understand, it's very neat.
Doctor :   gathering all your records copies might help to organise in chronological order to try and figure out what has been happening to you
User :   Exactly, yes.
Doctor :   so if we have your copies of reports we can put it together as per the date
Doctor :   and then correakte whats been going on
Doctor :   *correlate
User :   Okay, I will get them scanned and get a packet together. I think my 15 minutes of questions is about up, so thank you very much. I will keep up with it.
Doctor :   and proceed with the second opinion with specialists as required be it neurologist, pulmonologist or oncologist OR all the three together as depending on your case
User :   It probably would take at least two of them. :)
Doctor :   sure you can get back to us anytime when you have gathered all reports and have them put together in a bit chronological order from start til now
Doctor :   and we will see what can be done
User :   Okay, thank you very much.
Doctor :   please get back to us if you have any further queries
User :   I will. This is a very cool service.
Doctor :   you can also contact our customer care support if you need further help technically to send the reports
User :   I can't get most of my doctors to listen to me tell my symptoms start to finish. :)
User :   Okay.
Doctor :   we are there to help you 24/7. you can discuss all your queries at length with us
Doctor :   antime
Doctor :   *anytime
User :   I will be back!
Doctor :   sure. thanks for consulting me. bye for now.
User :   I laugh because I can't get my husband to listen start to finish --
User :   Bye.
Doctor :   you can be assured that we and our doctors team will listen to all your queries and answer them to the best of their capacity and experience
Doctor :   thanks for consulting me. bye for now.
Question is related to
Diseases and Conditions
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor