I mentioned the results of my sleep study in Friday’s post. Sleep specialists use the apnea-hypopnea index (AHI), a scale that tells whether you have sleep apnea and how serious it is. When I was given the results by the doctor who read the sleep study, she gave me the score based on the criteria set by the American Academy of Sleep Medicine (AASM).

Late Friday afternoon, my sleep medicine provider called me to discuss my results. She explained to me that there are actually two scales used. The one the doctor had sent me a message about was the one determined by the AASM, which is accepted by most insurance companies, and according to that scale, I am above the limit for the Inspire therapy implant. However, there is a second scale used by the U.S. Centers for Medicare & Medicaid Services (CMS). This is the scale used by Medicare and Medicaid to determine AHI.

I know all of this may sound technical, God knows it does for me. But the important thing my sleep medicine provider told me was that according to the AHI scale used by CMS, I qualify for the Inspire therapy implant. In other words, if I had Medicare or Medicaid, I’d qualify, but most other insurances don’t recognize the CMS AHI as a valid criteria.

Now, just because my insurance Cigna doesn’t normally recognize the CMS AHI score doesn’t mean they can’t be convinced otherwise. So, because I meet all of the other criteria, especially intolerance for the CPAP, she is referring me to the ENT specialist that does consultations for the Inspire therapy at Dartmouth-Hitchcock Hospital. She believes there may still be some hope.

The ENT would still have to do an endoscopy to see if my throat is round enough to meet the last criteria. I will have to consult with the ENT though before she will agree to go forward with qualifications for the procedure and getting it approved by Cigna. I suspect, I will not be able to see the ENT until the new year, but I’m hoping to hear from her office at some point this week.

Fingers crossed!

Quick Update: The ENT doctor’s office called and I have a consultation on Jan. 10.

Wednesday night, I had a new sleep study done. This time, instead of a home sleep study, I had to go down to New Hampshire for an in-clinic sleep study. The in-clinic sleep studies are more accurate. When I did the home sleep study, my sleep apnea was pretty severe, but with weight loss, I was hoping to improve enough to qualify for the Inspire implant that treats sleep apnea instead of wearing a CPAP every night. Because of the nerve damage that resulted in me having trigeminal neuralgia, it is very difficult and painful to wear the CPAP at night.

To qualify for the Inspire therapy, you have to prove that the you cannot use the CPAP, which was difficult to convince the Sleep Clinic of in the first place. I had to get my neurologist from the Headache Clinic to contact them. Finally, the Sleep Clinic understood the pain the CPAP caused and ordered a new sleep study to see if my sleep apnea had improved enough to qualify for the Inspire therapy. It had to improve enough to be considered moderate sleep apnea not severe.

Have any of you ever had a sleep study? The home sleep study was bad enough. It involved straps around my abdomen and chest, an oxygen tube in my nose, and a small machine strapped to me. However, at least I was able to sleep in my own bed. The in-clinic sleep study was much more elaborate. I was hooked up to about a dozen electrodes from my calves to the top of my head, tight straps around my abdomen and chest, and a censor in my nose that was taped to my face. In addition, the bed was very firm, which I hate, I had a camera on me all night long with people watching me, and only two flat pillows under my head.

I was able to sleep fitfully through the night, but it was not a restful night of sleep, not because of the sleep apnea as much as the very uncomfortable situation and bed. The woman administering the test was very nice. We chatted for quite a bit as she hooked me up to the equipment and then as she unhooked me in the morning. When I looked in the mirror I had red marks and goo all over my face and in my hair. The sleep study is now over, and I have to wait a week to see what the results will be. The whole thing is very anxiety inducing.

I asked the woman who administered the test if she could tell me anything about the results, but she couldn’t. She knows the answer but can’t tell me because only a doctor is allowed to do that because it would be giving a diagnosis. All she could tell me was that my test went pretty flawlessly. I slept on my back and side like they wanted, I reached REM sleep, and I slept the required length of time. I suspect by the way she discussed things with me (her tone and actions), my sleep apnea is still too severe to qualify for Inspire, but I won’t know for sure until I hear from the doctor about the results. Wish me luck, but I refuse to be optimistic. I don’t want to get my hopes up, just in case they are dashed after the results.

Combine stress, rain, and that it’s nearly time for another Botox treatment and you have the perfect storm for intense bouts of pain from my trigeminal neuralgia and migraines. I had to leave work early the past two days. I’d consider calling in sick today, but I’m the only one available to work. However, I’m hoping today will be better. I’m supposed to go to dinner with friends tonight, and I really don’t want to miss that. I haven’t been able to spend time with these two ladies in months, and I’ve really missed them. Here’s to praying that my headache is better today.

When I went to write this last night, I still had a headache. This one has lasted since I had my COVID booster around 1 pm on Sunday. I’m hoping it will end soon. It looks like all of the other side effects have subsided. Anyway, I didn’t feel like writing much for today.

This Pfizer COVID vaccine booster has kicked my ass for the past two days. I developed a headache that continued to worsen from the time I got the shot. I had hoped all I’d have was a bad headache, but roughly 24 hours after I received my booster shot, I developed body aches, joint pain, fatigue, chills, and a fever. The fever only lasted a few hours, but I was miserable Monday afternoon. The side effects lasted for roughly 24 hours and then began to subside, all except the headache. I still had the headache when I went to bed last night, although it could have had as much to do with the nor’easter over the Northeast as the booster shot.

When I had my first dose of the Pfizer vaccine, I only had a sore arm. With the second dose, I had pretty bad body aches that lasted roughly 24 hours. This booster was a doozy. I say all of this because I’ve been out of commission and out of work for the past two days. Also, this was my experience and does not represent what most people seem to be experiencing. My friend Susan had no effects at all. Her arm wasn’t even sore. My arm has been sore and there is a dime sized bruise around the injection site (when I received the shot I barely felt it). I was also told by one of my healthcare providers that she had not heard of anyone having an adverse reaction to the booster shot. I only know of one person who’s had a reaction besides me.

If you’re eligible, I’d say to please get your booster. If you have not received a vaccine at all, please do so. We need this pandemic to end, and it will only end if we all get vaccinated.

Yesterday, I got my Pfizer booster for the COVID vaccine. I was eligible because of my diabetes but also because universities are considered high risk work places. As of last night, I only had a sore arm. I barely felt the shot itself, but it was definitely painful afterwards. I basically did very little over the weekend. I ran some errands yesterday and watched the Alabama vs. Tennessee game Saturday night.

I roasted a chicken for dinner. Besides that, I watched the new Dune movie staring Timothée Chalamet that was just released in the U.S.; it’s streaming on HBO Max. I’ve been looking forward to its release for over a year when first saw the trailer. I have to say, it was far superior to the original 1984 film. What I did not realize was that this was Part One. So now, I have to wait God knows how long for the sequel, which doesn’t even have a script yet.

I am sure I have mentioned before that I have sleep apnea and I wear a CPAP to sleep. I have always hated wearing that thing, but I’ve gotten so used to getting a great night of sleep, that I really can’t go without it. However, I’ve also mentioned my trigeminal neuralgia. The straps on the CPAP mask aggravate my already damaged trigeminal nerve. Therefore, I go to sleep in pain, and I wake up with pain. I have spoken to the Sleep Clinic about the issue and have discussed with them a surgery that would implant a device, much like a pacemaker, that would have the same effect as the sleep mask, but not be as intrusive. However, the Sleep Clinic wants me to prove that the CPAP failed before they will let me be considered for the other device. Partly, this is because of insurance. I went to the medical equipment specialist that handle my CPAP supplies for a fitting for a new mask a few months ago. The mask they gave me is just as bad, plus I can’t breathe well enough through it, so I had to go down to the Sleep Clinic yesterday for them to try and fit me with a new mask.

That was an ordeal and a waste of time. First of all, the clinic is at Dartmouth-Hitchcock Hospital in the same building as the Headache Clinic, so it’s about an hour’s drive. Second, I don’t have the same confidence in the Sleep Clinic as I do in the Headache Clinic. When I first got the CPAP, they were supposed to follow up with me every three months, yet they forgot about me. It was only because I was having trouble with the CPAP mask and trigeminal neuralgia that they took notice of me again. That had me annoyed when they told me this three months ago. I got a call a few weeks ago wanting me to do a mask fitting before my appointment with the Sleep Clinic’s nurse practitioner on October 26. So I made the appointment and went down.

After trying on several masks, I told the respiratory therapist (RT) how much they hurt. All of which caused me to be in quite a bit of pain for the rest of the day. The RT I met with sent me home with a new mask to try, but I don’t hold out much hope it will work any better. It hurt to wear it for a few minutes down there, just like the others. I don’t know what she thinks it will do to sleep in it that’s different? What really aggravated me was that I had to pay $55 for basically the “pleasure” of visiting a showroom with a hospital bed in it. What bullshit! The lady was nice, but I really don’t think they should have charged me for this. The supply place didn’t charge me for their mask fitting, but because this was done in a clinic, they charged me, even though they did the exact same thing, I had to pay the higher copay to see a “specialist.” I’m also sure they will charge me for the mask they sent me home with.

I have told the Sleep Clinic people that my neurologist has already said that as long as I am wearing a CPAP at night, it will continue to prevent my trigeminal nerve from healing. It told the RT the same thing yesterday, to which she replied that maybe I should ask my neurologist if she has another solution to my sleep apnea. She said it in a very nice and “concerned” way, but I still felt like she was being somewhat dismissive of the advice I’d received from my neurologist. By the way, if I do qualify for the surgical implant, Dartmouth can’t do it (they have no one trained for it), and I’d have to go to the University of Vermont (UVM) instead. At this point, I wish I’d been referred to the UVM in the first place for my sleep apnea. I wasn’t originally sent to them because my doctor, who works for UVM, knows what a pain in the ass they can be. I see my neurologist Tuesday, so will talk to her, and then on the 26th, I’ll see what the Sleep Clinic has to say.

Yesterday, I replied to a comment by uvdp about my headaches in which I said, “I have moments when I only have a little pain, uvdp. Other times, it can be quite intense. Basically, the intensity come in waves, and on occasion, like when I woke up this morning, the wave is a tidal wave, other times it’s more like a tidal pool.” By the time I was able to write this post, my headache wasn’t a tidal wave, but the size of the wave would have made any surfer happy. Needless to say, I was not feeling very well as I wrote this. I went to bed shortly afterwards in hopes that I could fall asleep before it could get any worse.