Doctor

As reported in my last post – back in the early part of winter my doctor referred me to a sleep specialist and sent me for a head CT (without contrast). If you want to know why – read that last post.

Now – we are most fortunate to live within five minutes drive of the Saanich Peninsula Hospital – which is where I get all of my lab work done. I paid them another visit for my head CT – which took all of about two minutes. I was in and out so fast that it hardly seemed worth going at all – but when the results came back they confirmed that I do still have a brain and that it looks pretty much the way that 68 year old male brains should.

This is all good news.

The sleep study was considerably more of a pain. Having had a phone consult with the specialist I was booked in for a night at the clinic – the which is up in Nanaimo, about an hour and a half’s drive up island from here. I had to be at the clinic by 9:00pm on a Friday evening and was told that I would be booted out at 6:00 the next morning.

Things have, of course, been disrupted by the COVID pandemic. My instructions were to arrive at the clinic and to park outside, awaiting a phone call to tell me when they were ready to admit me. This I duly did, in company with the other poor souls undergoing the same ritual. One by one we were summoned, taken inside to our rooms and, eventually, wired up to a huge harness and loads of sensors, which were stuck to our bodies with some sort of unpleasant goop. We were then invited to go to sleep whilst the technicians monitored our vital signs.

I cannot say that I had a good night’s sleep – so I have some doubts as to the value of the data recorded. Sleep was difficult because:

• the bed was uncomfortable
• the pillow was uncomfortable
• I was obliged to wear pajamas (which I never do!)
• the room was far too hot
• I was wearing a cumbersome harness of cables
• the technician woke me up a number of times during the night, over the intercom, to request that I sleep on my back (which I rarely do!)

All in all then – a rough night. At the end of it I was woken abruptly and sent packing (no showers for COVID reasons). 6:00am on a winter Saturday morning, with snow falling and unpleasant goop in my hair… I had to drive back down the island to catch the first ferry of the morning from Mill Bay over to the peninsula. The photo at the top of this post was from that ferry crossing. Not too much traffic at that time of day, you’ll note.

“But what of the sleep study?” – I hear you cry. What indeed? The follow-ups with both the sleep specialist and my doctor revealed nothing conclusive. The sleep specialist is convinced that I do have a bit of sleep apnea – when I lie on my back (which I rarely do!) – but couldn’t say anything else definitive. He suggested we wait for a few months and then go around the circuit again.

Joy!!

The one definite thing that he did observe was what looked like a heart arrythmia. Concerned about a heart block he flagged this up with my doctor who in short order sent me back to Saanich Peninsula Hospital to get set up with a Holter Monitor to wear for 24 hours. This monitor revealed that I do not have anything like a heart block – but what I do have is Premature Atrial Contractions (PAC). This is where one gets additional contractions in front of the actual heartbeat. During the 24 period that I was monitored I apparently had some 15,000 additional early contractions.

“Did I ever have heart flutters or palpitations?” – asked my physician. ‘”No!” – said I – truthfully. “Probably nothing to worry about then” – quoth he. Even Dr Google agrees with this diagnosis!

I reassured my doctor that he was not the first to have noticed this slight irregularity – and none of the other doctors who did so knew what to do about it either.

Still – gives them something to ponder on, I suppose…

So – here’s the thing… (this is – should you be wondering- a continuation of my last post, ‘Ask your doctor – 1‘).

Over the last year or so I have experienced a few random instances of an odd phenomenon connected to sleep and to dreaming.  I have always dreamed vividly, but on these occasions I have woken abruptly from the dream to find myself ‘acting’ it out. In other words – if in the dream I was being attacked and tried to retaliate – I would awake and find myself doing just that.

This is, of course, somewhat worrying because of the potential to cause injury to myself or to The Girl. Clearly something needed to be done about it and – naturally –  I did what I should not have done; I consulted Dr Google!

Dr Google knows a lot about parasomnias and in this instance he directed me to some literature on the subject of REM Behavioural Disorder (RBD). It seems that this is a dysfunction of the muscle atonia that the body utilises during REM sleep to prevent one from physically engaging whilst dreaming. This sort of thing can, sadly, occur as one gets older.

The worry lies less in the immediate behavioural issue – the symptoms of which may be ameliorated by such treatments as taking a nightly dose of Melatonin – but in that RBD is thought to be a long-term precursor to other neurodegenerative diseases such as Parkinsons or dementia with Lewy bodies. These are a considerably less pleasant prospect – even if years in the future.

Dr G also offers the sop that that not everyone with RBD goes on to develop Parkinsons and indeed that there are other sleep disorders that mimic RBD. One should not, of course, in any case rely on the good(?) doctor for diagnosis and I took notice of this. Clearly the thing to do was to actually talk to my own doctor – which I duly did (talk only – of course – because one doesn’t actually get to see one’s doctor these days – only to chat over the phone!).

With a new scent to pursue my doctor was immediately off and running. He quickly arranged for me to have a head CT (scan) at our local hospital – and he further referred me to a sleep specialist (that’s not someone who just sleeps a lot!). This all took place back in the autumn (Fall) and I promise that I will shortly finish this saga in a third and final post – to let gentle readers know where that all went.

Bet you can’t wait!