Episode: 2655
Title: HPR2655: Sleep Apnea and Afib
Source: https://hub.hackerpublicradio.org/ccdn.php?filename=/eps/hpr2655/hpr2655.mp3
Transcribed: 2025-10-19 07:04:31

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This is HPR Episode 2655 entitled Sleep Up Near and a Fib and is part of the series, Health and Health Care.
It is hosted by a huker and in about 12 minutes long and carrying a clean flag.
The summer is how Sleep Up Near and that real fibrillation entered my life.
This episode of HPR is brought to you by archive.org.
Support universal access to all knowledge by heading over to archive.org forward slash donate.
Hello, this is a huker welcoming you to Hacker Public Radio in another exciting episode.
And I'm going to be continuing my series on health and taking care of yourself.
Now this will be the last of my posts regarding the health issues I've personally dealt with.
And I've done these for a reason. It's not that I am an exhibitionist.
But knowing the background helps when I get to where I am now and how I got there.
So in this case, back in 2015, my wife and I were planning a trip to Ireland.
As you might guess from my name, my ancestors came from the Emerald Isle.
And as is the case with most Irish Americans, it was during the famine of the 1840s.
Now, I'm very clear in my own mind. I am not Irish. I am American.
But most Irish Americans are proud of their heritage and a trip to Ireland is important to us.
But a couple of months before our departure, my wife said that I had developed an unsettling habit of stopping breathing when I was asleep.
I was totally unaware of this. But I talked to my doctor and as a result, got signed up for a sleep study.
Now this was done at my local hospital and it meant I had to bring my pajamas with me and spend the night.
It was not a very comfortable night because they had me wired up to instruments like an electrocardiogram
and then put a mask over my face to blow air at me.
I did manage to get some sleep, but not what I would have preferred.
In the morning I got up and the nurse told me that I did indeed have sleep apnea and then said,
did you know you have atrial fibrillation?
Now that was a surprise and I must say something of a gut punch.
With all of the test results in, I went back to my doctor. I now had two more things to deal with.
My big fear was that I was about to leave for Ireland and that he might say I shouldn't fly or something like that, which would end that trip.
Thankfully that did not happen, though he did prescribe some heart medication, a drug called Metoprolol.
This is a drug in the general category of beta blocker.
A class of drugs used to control heart rhythm, reduced blood pressure and treat angina.
In my case it was the first of these that mattered since atrial fibrillation is a problem with heart rhythm.
In any case I had my medication and went on to a wonderful trip in Ireland.
While there I did all the things I would have done anyway, including a lot of walking, particularly in Dublin, where we spent hours walking through the city.
I didn't feel any different and to this day I have had no physical symptoms of any kind.
Now with sleep apnea, the sleep study results had been fairly definitive.
So I was sent to a pulmonary specialist for treatment.
Looking at the results it was determined that my sleep apnea was moderate and the treatment would consist of wearing a CPAP mask on my face when sleeping at night.
CPAP is an acronym that stands for Continuous Positive Airway Pressure, and it is a machine that sits alongside my bed, connects to a mask via a hose, and the mask that's over my nose and mouth.
It has a water reservoir to help add humidity to the air, it pumps into the mask, and make it a little easier on you.
But there is definitely an adjustment process.
I think it took me about six months to really get used to it.
At first it seemed like the mask was always leaking air and it was loud and uncomfortable, but I was told it was the key to preventing the apnea issues and would add years to my life so I stuck it out.
Eventually I got to the point where I'm at now where I just put on the mask to turn on the machine and go right to sleep.
I use the mask every night, and my pulmonary doctor used me gold stars since a lot of her patients don't do that.
But as you might have picked up from my post so far, I consider compliance with medical orders a very important part of my health plan.
This machine has an SD card in it that records usage, and when I go in for my annual visit I bring the SD card with me for the doctor to review.
And like so many of my check-up visits, the result is always doing great, keep it up, and we'll see you again next year.
Now doing this can take a little planning.
I discovered that when I am traveling I get an exemption for bringing it on the plane as an extra item, which is great.
But I need to use distilled water for the reservoir, and since I can't bring it on the plane I need to plan on stopping at a store when I land.
And I've gotten in the habit of filling the reservoir and setting up the machine early in the evening so that when I'm ready for bed all I have to do is put the mask on and turn it on.
That helps a lot with compliance, and you do want to take it seriously. Sleep apnea is linked to other health problems, including type 2 diabetes, which as I've already discussed I have, as well as heart problems, which I am discussing now.
Then there is the atrial fibrillation.
As I discovered the sleep apnea probably had a lot to do with triggering the atrial fibrillation as well, since repeatedly stopping my breathing put strain on my heart.
Atrial fibrillation is a problem of a part of the heart not beating properly.
Your heart basically has two sides, and each side has two chambers. Blood flows into the atrium, and from the atrium into the ventricle, which pumps it out again.
And you have two sides, because the blood has to go on two trips. One is a round trip to the lungs, where it can pick up a load of oxygen, and the other is a round trip through the rest of your body to deliver that sweet, sweet oxygen to all of your cells that need it.
Atrial fibrillation, or atrial fluttering, means that the atrium does not have a strong beat, but instead vibrates weakly and chaotically.
This is not good, but need not be fatal if treated.
So I was sent to a cardiologist, who told me my aphib, as it is called, was not terribly serious, but it did increase my risk for heart problems, and more importantly for stroke.
You see, in aphib, the blood is not flowing strongly through the heart as it should, and this can cause clots to form.
If a clot forms, and it flows through your arteries to your brain, a stroke can result if the clot cuts off the flow of blood.
The answer is to reduce the chance of a clot forming.
This is done through medication that reduces the clotting factor in your blood.
In fact, the medicine they use in most cases, the brand name is Cuminin, but the generic name is Warfarin, was originally developed as a rat poison.
The idea was that in high doses, rats would simply bleed the death.
In the doses given to people like me, though, it should help to keep us alive.
Now, the first thing I heard was that I should avoid green leafy vegetables, because they are high in vitamin K, which reduces the effect of the medication.
And when I heard that, I had a problem.
As you may recall, my very successful management of my diabetes is based on eating a lot of salad.
But I discussed this with the medical folks, and we agreed that as long as I was consistent, it would not be a problem, since we would just adjust the dosage level.
So, you know, what happens is if I go to a new pharmacy to get my prescription refill, the first thing that happens, the pharmacist looks at it and says, that's a high dose, what the hell is going on here?
And then we have to have a talk, and I explain, yes, this was actually something I worked out with my doctor, and all of that.
So, yes, the dose I take is higher than normal, but that's because the amount of salad I eat is higher than normal, and it all balances out.
Now, this is something that you need to get right, as Paracelsus said, the dose makes the poison.
Too much of the warfarin could kill me, or at a minimum, cause problems with bleeding, similar to hemophilia.
Too little would raise the risk of a clot and a stroke.
So, to make sure I'm on track, I get a monthly blood test to measure something called INR, which stands for International Normalized Ratio.
Now, that's a measure of how long it takes my blood, or anyone else's for that matter, to clot.
Now, in my case, my doctor wants to see a number between two and three, as long as I'm in that range, they say, keep it up and test again in a month.
If it is out of that range, we have a talk about whether I have changed anything.
For example, one time it was low for some reason, and in discussing the possibilities, it turned out I have been taking ibuprofen for some physical pain I was having, and that reduces the effectiveness of the medication.
So, I threw out all of my ibuprofen, and now I use acetaminophen when I have pain.
Now, I can't use aspirin for the opposite reason, aspirin would add to the effect of the medication and make my numbers too high.
So, sometimes we make a small adjustment to how much I take, since it varies by the day of the week.
I bought one of those seven-day pill organizers, and every Sunday morning, dull out all of my morning pills for the week.
Now, I want to emphasize, again, that I have never experienced any physical symptoms if I'd not gone in for the sleep test, who knows when the atrial fibrillation would have been caught or how much worse it might have gotten.
So, one immediate conclusion is that how I feel is not necessarily a good guide to my state of health.
And I think this, again, emphasizes the importance of getting check-ups, and I am 67 years old.
I really should be getting check-ups fairly frequently, just to catch things.
One of the things you frequently hear with various illnesses and problems that people have is that the earlier you catch it, the better.
So, if you put off going to the doctor, all you're doing is ensuring that when something happens, it's going to end up being even worse.
And you shouldn't do that.
And this is a hookah for Hacker Public Radio signing off, and reminding you is I always do to support free software. Bye-bye.
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