In the Hospital

So, I spent the night in the hospital last night. Not for me, for my wife.

She had shoulder surgery yesterday. The surgery went well, but she has a difficult time coming out of anesthesia. She told her doctor, she told her anesthesiologist, she told the nurses, she told the mailman (he was concerned), but it doesn’t matter. When she can’t wake up, people are amazed – because they are never the people she’s told.

In their defense, when a normal person, say me, has any day surgery that ends at 3:30pm, I will be coherent at 4:00pm, and out the door by 4:30pm – at the latest.

She will be out of surgery at 3:30pm, cranky by 4:30pm and barely awake at 7pm, assuming a good tailwind.

Here’s the issue: with more and more day surgery “hospitals”, they really want you out by six because they’re closing for the evening.

To get her out by six, surgery should have started last Tuesday.

So, her shoulder surgery started at 3pm, she was admitted to the hospital by 7pm and at 9pm, she was ordering Dominos because the cafeteria was closed. (Yes, they deliver to the hospital.)

I’m waiting to see the diagnosis for her admittance because I think it will be “couldn’t wake up.” Usually, “couldn’t wake up” in a hospital means people with paddles yelling “Clear!” and pressing on your chest and blowing in your mouth.

In this case, it was a nurse who had a bus to catch, and said, “If you can’t get up, we have to admit you.”

This is a stupid threat to make to someone who likes being waited on, and spends a lot of her spare time with various doctors.

It is a doubly stupid threat to make when the other person in the room is trying to postpone being the caregiver as long as possible.

So, she was admitted for “sleepiness”, and then she sent me off home to gather the four tons of supplies she doesn’t carry in her purse – which is probably what weakened her shoulder in the first place.

By the time I ate dinner, got home, walked the dogs, medicated the dogs, corralled the dogs, gathered up the four ton laundry list from the four corners of the house and got back to the hospital, it was after midnight, so I decided to just stay.

This gets many good husband points, and a crick in the neck.

I almost never sleep in a chair, except on Thanksgiving or in meetings, but the recliner was like a business class seat without the annoying person blocking the aisle.

I never use blankets on a plane, but when I woke up at four with my teeth chattering, I decided to make an exception.

(It turned out it was in the 60s in the room, so either the A/C works or the heat doesn’t.)

I slept like a baby, which is to say I woke up every couple of hours to pee and spent the rest of the time sobbing quietly, wrapped in my blankie.

So, it’s morning and we’re waiting for discharge papers. After that, we have to get the four tons of equipment I retrieved plus all of her new medical equipment home and unpacked.

Then, we set her up in a chair and teach the dogs, “No! Not on Mommy’s shoulder!”

Then, I’m taking a nap.

Sleep Study

I’m tired this morning. This is probably because I spent last night having my sleep studied. This was my first sleep study in ten years or so, and that was just long enough to forget how non-sleep-inducing a sleep study really is.

A sleep study is a classic case of the observer effect – if you’re measuring something, there’s a high likelihood you will change it. (This is similar to (but not the same as) the Heisenberg Uncertainty Principle, which is a much cooler name.)

First of all, you’re in a strange bed. This is not too challenging for somebody who travels, but it’s still a strange bed in a strange place, without your wife’s Nook glowing quietly next to you and a PBGV pressed to your butt. It’s also dark – no nightlights, no clock (!), and you’re wired to the bed, so you can’t just get up to pee without calling for help.

Then, there are the wires. Ah, the wires. Now, there’s a challenge. You have fourteen probes on your head, two on your chest, four on your legs, a snore microphone on your neck and a pulse oximeter on your finger.  That, my friends, is a rather large collection of wires. They are all connected to a box that has a serial port (haven’t seen one of those in years – don’t they use USB by now?) that is connected to a port on the wall that is connected to a computer somewhere in the facility.

ApniaMan

Then, there’s the timing. I was scheduled to arrive at 7:30pm. My usual bedtime is about midnight – I shoot for 11:30pm or so, but it never happens. So, we’re four and a half hours before my bedtime. By the time I changed into shorts and a t-shirt (I’m too old and too young for pajamas), had my blood pressure checked (it was high – go figure), had a CPAP mask tryout (I still don’t like the nose pillows that stick in your nostrils, just give me a mask) and filled out the pre-sleep questionnaire, it was 8:15pm or so. (I guess. Who knows? There’s no clock in the room.)

The sleep clinic wants everyone in bed by 10:45pm at the latest – but really, they want you in bed much earlier so they have enough time to monitor the quality of your sleep, which will certainly be high, given you’re in a strange room with wires all over you.

After a short break, one of the technicians came to “wire me up.” This is the slow procedure of hooking up the fourteen sensors on the head (positions marked on the scalp with grease pencil after measuring with a tape measure), four taped to my legs (two per leg), two on my chest, plus a snoring microphone on my neck and the pulse oximeter (glowing red) taped closed on my finger.

Then, all of the wires are hooked to the main controller box, and it is looped over your chest with a lanyard. At that point, you’re “mobile.” Hahahahahahahaha! For those of us with glasses, you can’t wear them at this point, so I couldn’t read. I did manage to use the bathroom without calling for help, so that was an accomplishment.

Wired

I had just sat down on the bed to determine my next move when the speaker crackled on, and someone said “Just let us know when you’re ready to go to sleep.”

It’s ten to freakin’ nine. I’m pretty sure my grandchildren don’t go to bed this early.

Still, what else was there to do? I couldn’t get my glasses on, so reading was out. I desperately feared discovering what channels are available on sleep clinic TV. (Although, if they want people to “sleep normally” in a strange bed in a strange room, there might have been pay-per-view. Just sayin’.)

Just after nine (according to the text I sent home), I gave in. It was bedtime.

This was a “split study” (I did not know that until after I arrived), so the first part was to observe me sleeping “naturally” (I’ve had a CPAP for ten years). I can’t sleep without a CPAP. So, “naturally”, was going to be painful.

A CPAP is “continuous positive airway pressure.” Basically, it’s a little machine that blows air through your nose (through a mask) with enough pressure to keep your airway open, so you can actually breathe while you sleep. In my case, my throat would close while I was sleeping, blocking my air. I would choke, wake up briefly, fall asleep, and the cycle would start again. This made me snore (really, I would just breathe through my mouth), which the Spousal Unit noticed was getting worse, which is how my sleep apnia was discovered. That, and I was falling asleep at my desk in the afternoons – even without meetings.

So, if I don’t have a CPAP, I don’t breathe very well during sleep, which means I don’t sleep.

Here’s a challenge – I can’t really sleep without a CPAP, I’m wired for study, I have sensors in my nostrils, I’m in a strange bed and it’s 9pm. Why isn’t this conducive to a good night’s sleep?

I lay still. I turned over (which is stressful and a slow process, since I was worried about pulling a sensor loose.) I turned back.  I tried to figure out why the left leg cable was much shorter than the right (I was lying on it.) I adjusted the pillows and accidentally hit the main controller box.

Main Controller Box

Nobody called, so it must have been alright.

After a long time of no sleep (I thought – we’ll see what the sensors say), I heard the speaker crackle on. Jesus (Hay-sus, not Gee-sus) was coming in. Whew. Time to put on the CPAP.

I asked him what time it was. It was 12:30am. Just over three hours of no sleep. On the bright side, at this point, it’s just after my “real” bedtime.

Off go the sensors, on goes the mask. Ahhh. I really hate things sticking in my nose.

Now, I could sleep. Maybe.

Jesus said, “Could you try sleeping on your back? If you can’t go to sleep after a while, just roll over, but we’d like to try to have you sleep on your back.”

I had been warned about this while getting wired up. Apparently, sleeping on your back is more likely to cause distress in sleep apnia patients. This is why I don’t sleep on my back. However, since this is a study, distress is good. (I was told this morning when I got home that I do in fact sleep on my back. A lot. Who knew?)

So, on my back, off to Dreamland.

Nothing.

After about  a half-hour (which will turn out to be five minutes), I turned on my side and went to sleep.

After about four hours, I woke up – I was having a dream that my family was leaving the house and I was supposed to drive, but my truck was in the shop. (It was the truck I had just after I graduated from college – so I haven’t seen it in over twenty-five years. Whatever.)

I rolled over and heard something snap. Oops. I think I popped a leg sensor off.

Jesus came in to re-attach the sensor. Since he was there, I asked to get unhooked to visit the facilities. He disconnected the main controller box, looped it around my neck, and wandered out.

Peeing around wires attached to your legs when sleep deprived with a heavy controller on your chest is not as easy as it sounds.

I asked what time it was. He said, “It’s about one-thirty.”

Four hours? Not so much.

Flushed with success, and re-wired, I went back to sleep.

The next thing I remember is Jesus on the speaker, telling me the study was concluded. He came in to unwire me and I asked what time it was. He said it was 6:15am.

Ouch.

I changed, did the post-study survey, and headed out. I stopped at Whataburger, since I was pretty sure that someone with goop in his hair, looking disheveled and half-asleep would not cause concern. (I was correct.)

I would go back to bed, but I have meetings this morning. This could be a challenge.

Next week, I find out if I passed.