Sunday, June 23, 2024

A health warning

For the past two or three years my husband has been having problems with his back and also some issues with arthritis, so it didn't strike us as particularly odd that he had become so tired he could barely function. As time went by he seemed to be needing more and more rest and sleep, usually going to bed around 10:45pm, wakening at around 7:15, and needing to go to bed for a nap of two to three hours on work days after work, say from 4 or 5-7pm. That seemed excessive but his back problems meant he wasn't getting a good sleep so it didn't ring any major alarm bells.

This year things have been worse. He's barely done anything in the garden, which is usually a great passion of his and we've done nothing on weekends either, no day trips, no sightseeing, no entertaining. He has stopped blogging and given up on all his usual pastimes such as language learning, and other computing tasks. When I went to visit my two older kids in London and Madrid, he stayed home. Whenever our oldest daughter needed picking up from work at 10pm, he said he couldn't do it because he was too exhausted. Any time Léon needed driven home from a party, I would have to go alone as he was unwakeable. Over the past few months I noticed he was finding it harder and harder to waken up. His alarm would go off in the morning but even though he'd sit up in bed, instead of taking in the morning news on his phone as he would have done in the past, he'd sit almost comatose for up to an hour before coming to. He tried various physiotherapists but nothing helped. 

So to be honest the only thing he actually managed over the last six months was work. Even simple things like asking him to help me with my tax return on the computer was too much. And I had to do all the distance driving as he couldn't. But both of us were convinced that the reason behind it all was his disturbed sleep due to back problems. Then, fortunately he developed a constant sore throat. He visited the GP who sent him to a throat specialist as he could feel his thyroid was enlarged. He discussed that issue with the throat specialist who has sent him for biopsies and other tests which we are still waiting for, but he pointed out that an enlarged thyroid should not be giving him the dry, sore throat he was complaining about. He asked if he had any issues with snoring or sleep apnoea.

Thomas has always had what we considered very mild sleep apnoea issues. They run in his family so he knew the signs to looks out for such as bad snoring, difficulty staying awake during activities such as reading, meetings, watching TV, or driving, morning headaches, choking sensations but he suffered none of these, well other than the snoring, but don't all guys snore a bit?! Once awake, he was awake. He never once fell asleep in front of a movie or in a meeting, so figured if he had it at all, it wasn't worth treating. He simply seemed to need more and more sleep to function. I had pointed out nearly twenty years ago that his night-time breathing wasn't even; he often paused for a moment or two but then it would correct itself, so again we both figured that once it got to the stage where he was falling asleep in front of the TV, he would look into it.

The throat specialist thought, given his family history, that he ought to take a sleep machine home one night to measure his breathing and oxygen levels just to rule that out.

I delivered it back to the clinic the next day and before I had even made it back home the specialist had phoned him in a complete panic. Not only did he have sleep apnoea, but it was so severe that he was in real and imminent danger. He stopped breathing altogether more than 50 times an hour, the highest acceptable number is apparently 5 times an hour. His blood oxygen level overnight hovered around 51%. Anything under 90% is dangerous and under 80% is critical.

He was moved on the patient list on our island to the number one spot and called in the following Monday as he was at imminent risk of death, they told him flat out. This was not to mild apnoea that causes you to fall asleep, this is the severe version that starves your brain of oxygen and kills you without warning. The doctor looked at him sternly and told him he was not to underestimate why he was called in urgently before all the other patients on their list. So, of course when we got home we read the leaflets we'd been given and checked some health pages and these are apparently the issues he faced:

  • Cardiovascular Problems: Chronic low oxygen levels can cause high blood pressure, increasing the risk of heart disease and stroke. 
  • Heart Failure: Prolonged hypoxemia can lead to heart strain and eventually heart failure​.
  • Cognitive Impairment Memory Loss: Hypoxia can damage brain cells, leading to memory problems. 
  • Dementia: Chronic low oxygen levels can increase the risk of developing dementia and other cognitive impairments​​. 
  • Stroke Increased Risk: Severe sleep apnoea significantly raises the risk of stroke due to fluctuating oxygen levels and increased blood pressure​. 
  • Diabetes Insulin Resistance: Sleep apnoea can lead to insulin resistance, increasing the risk of developing type 2 diabetes​. 
  • Arrhythmias Irregular Heartbeats: Low oxygen levels can cause abnormal heart rhythms, including atrial fibrillation, which can be life-threatening​. 
  • Pulmonary Hypertension Lung Complications: Prolonged hypoxia can cause high blood pressure in the lungs' arteries, leading to right-sided heart failure​.
  • Metabolic Syndrome Cluster of Conditions: This includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels, raising the risk of heart disease, stroke, and diabetes. 
The bottom line was that untreated severe sleep apnoea with chronic hypoxia significantly increases the risk of premature death​ by 300% and I was lucky not to have woken up one morning beside a dead husband. They insisted he go home that night with a machine to pump oxygen into him constantly and told him he shouldn't even nap without it on as oxygen levels of 50% during sleep were life threatening.

What a fright that gave us both. Life has been tough enough that last few years with my own brushes with cancer, our moving to a place where we have no friends or family close by to support us. The thought that I could have woken up one morning to find him dead is unimaginable. The kids need their daddy and I need my rock, my soulmate. We can probably get through anything life throws at us together, the last few years have shown that, but alone would have been unimaginable. I'm not sure who it would have been worse for: him dead at 52, or me entirely alone in a foreign country without a steady income and three kids to see through to their end of their education. We are truly shaken.

On the positive side, he's now had his machine six nights and I hardly recognise him. He's now only stopping breathing 3-5 times an hour and he's so refreshed in the mornings, he's jumping out of bed at 7am and reading the news before skipping out to the garden. Of course, he's still meant to take it easy as his body has been damaged by the years of oxygen deprivation but it is so nice to see him slowly reverting to the man I knew, rather than the barely conscious and exhausted one he had become. Somehow it was hard to be fully aware quite how ill he had become when it happened as gradually as it did. 

He's already so much better, I'm half scared he'll now need to trade me in for a younger wife as I am suddenly the more tired of the two. But, joking aside, if you are experiencing any of the symptoms above, go an ask your GP. It could be nothing but it could just turn out to be life threatening.