Can Anyone Explain The Results Of My Study?

[hawkcrewchief]

Patient XXX XXXXXXX is a XX year old male recent overnight sleep recording showed:

-There were 22 apneas (3.3/hr sleep) of those 0 were mixed , 22 were obstructed and 0 were central apneas

-There were 77 hyponea (11.6/hr. sleep).

-The Apnea+Hyponea Index (AHI) was 15.0/hr. sleep.

-In addition, there were 33 Respiratory Related Arousals 5.0/hr. sleep.

-The respiratory Disturbances index (RDI) is 20.0events/hour.

-The subjects sleep was recorded mostly supine.

-Apneas and Hyponeas during supine sleep (back index) 18.4

-Apneas and hypopneas during REM sleep (REM index) 50.6.

- O2 saturation lowest point was 85% ;)

Assesessment:

Primary Diagnosis

moderate sleep apnea, worse in REM

caffeine dependence

chronic headaches

nasal septal deviation ( blunt force injury in army)

Plan:

-Will need pap titration to determine therapeutic measures

-ENT evaluation for nasal obstruction and snoring.

-Reduce caffeine intake may improve headaches.

-PT reports RLS sx but no PLMS noted with minimal wake before sleep. Will observe, if sx are persistent and problematic we will consider treatment.

XXXX XXXXX MD Neurology

Soooo does anyone know what this means??? Should I file a claim for SC? My nose injury is not SC but it is in my SMR along with the x-rays from the fractures when I got injured, plus several MD's say I have a deviated septum from it. Thanks in advance.

[hawkcrewchief]

My nose injury happened while in service and my x-rays and medical was done at an Army hospital. I fractured it during a collision with another soldier while playing in team sports. The caffeine is just cokes to stay awake since I am so tired during the day from not sleeping at night hopefully they do not try to stick that on me since I just said 1 or two cokes a day. I am also being screened for TBI which is also were my chronic headaches might be coming from. I have 30% for TMJ,Tinnutis, and degenetarive disk diesease 10 percent each. Now how do I file the claim for my nose? What do I say? Do I just state the fact it is bothering me now, I am a bit confused.

[jbasser]

File the claim for residuals of a Broken nose with Deviated Septum. You also need to get an ENT doctor to write a Nexus on your behalf, stating that your Sleep apnea is a result of the broken nose. If you have to, show the Doc the records.

That is your fastest way. You should be 50 percent OSA if you are using a CPAP machine.

[Stretch]

The strange part about it is that, if you are caffeine dependent and stop drinking it, you will get headaches (Migraines).

Caffeine, shrinks capillaries in the brain. When caffeine is stopped, the brain loads up with blood causing massive headaches.

Just stop all caffeine and see for yourself.

For a doctor to say "Reduce caffeine intake may improve headaches", means the doctor doesn't know anything about caffeine.

I guess that "May" means the improvement in the headache, would mean greater headaches.

[broncovet]

IMHO your o2 saturation dropping to 85% is a concern for your health. My sleep study showed 67 apnea events per hour, and, I have been using a CPAP for better than a year now. Even tho my apnea is far worse than yours (67 events/hour vs yours of 3.3) my o2 sat. was the same as yours.

Unless I am missing something I think that sleep apnea is either SC or not, and if you use a CPAP, and it is SC, then its 50%. From what I read of your study, your doc is not prescribing CPAP even tho you have been diagnosed with sleep apnea.

I recommend you go to a hospital specializing in heart ailments..and get tests done. REASON: In my case I did it the other way..my heart ailment (enlarged right side of heart) indicated sleep apnea. So I got a sleep study done, and sure enough..I had sleep apnea, just as the cardio doc had said. Prior to that, I was unaware of sleep apnea.

My cardio doc explained it this way: (he is private and not VA) When you stop breathing at nite, your heart tries to compensate for the lack of oxygen and gets larger, pumping more blood to the lungs. If untreated, the rt side of heart will continue to enlarge..and this can lead to heart arrythmeias..(irregular heart beats). Irregular heart beats can lead to Congestive heart failure and death. Long story short..sleep apnea, especailly untreated, can kill you but it does take a few years. Get it treated or more than just your sleep will suffer. Do what the cardio doc says, however, not what I say..except that I think that heart tests are indicated. If your cardiologist says no, then his opinion is obviously hundreds of more times more qualified than mine. All I am suggesting is that you shouldnt assume your sleep doc will automatically refer you to the cardiologist to get needed tests done..YOU have to ask for it. JMHO.

Edited February 20, 2009 by broncovet

[hawkcrewchief]

No he did order another thing it is a sleep study where I get to wear the mask and they figure what is the best pressure setting for my needs. He told me I would then get the machine issued to me thru the VA. I think its called the pap titration or something like that. I am worried about the O2 levels and the heart conditions you spoke about, I will make sure to bring that up when I go in for my follow-up appointment. Thanks for the heads up though. I really couldnt sleep well with all that stuff on the night of the study plus the guy in the other room was very loud. The Doc said he was going to order this pap titration thing so I can get on the CPAP asap he said once I fell into deep sleep I crashed pretty bad as far as the stats go and it was of concern to him. I think I am going to wait untill the sleep study is done and the ENT eval and then with that new info ask to file a claim for my Nose injury with the Apnea secondary to that, what do you guys think? Should I wait to finish all the eval's or get the ball rolling now as far as the claim goes...?

[mags1023]

No he did order another thing it is a sleep study where I get to wear the mask and they figure what is the best pressure setting for my needs. He told me I would then get the machine issued to me thru the VA. I think its called the pap titration or something like that. I am worried about the O2 levels and the heart conditions you spoke about, I will make sure to bring that up when I go in for my follow-up appointment. Thanks for the heads up though. I really couldnt sleep well with all that stuff on the night of the study plus the guy in the other room was very loud. The Doc said he was going to order this pap titration thing so I can get on the CPAP asap he said once I fell into deep sleep I crashed pretty bad as far as the stats go and it was of concern to him. I think I am going to wait untill the sleep study is done and the ENT eval and then with that new info ask to file a claim for my Nose injury with the Apnea secondary to that, what do you guys think? Should I wait to finish all the eval's or get the ball rolling now as far as the claim goes...?

I'll let you answer your question yourself, if you file next week and you are eventually service connected for your nose injury, the date you would start getting compensation would be the date they receive it sometime next week. If you wait for all of the results, let's say 6 months from now, and you are service connected for your nose injury, your start date will be 6 months from now. That would be 6 months of lost compensation, because you waited. Getting the date established as soon as possible is very important. In an earlier post you stated your nose injury is not SC. If it happened on active duty whether you were shot in the nose in battle or just playing basketball on base, it is SC. I don't know if you can get compensation back dated to your exit date from the serice or not. Did you not file for SC on your nose with your initial VA claim? Is that what the VSO advised?? If so, you can state in the letter that you want it dated back to your exit date, the worse they can do is say no it will start on the date we received your request for compensation.