Senescence sucks: My wife now sleeps with Darth Vader (Part 7)

(This man has just been told that he will have to wear this device for the rest of his life.)

As we pick up the exciting action after my last night in the Sleep Clinic, we find DrTom with a new device prescribed by the doctor to wear while sleeping.  It is called a CPAP unit, and it looks like the apparatus one would use to breathe hostile air on a foreign planet (see photo).  The electrical unit pumps air at a predetermined pressure into the mask, which keeps your airway from collapsing during sleep.  DrTom suffers from a common ailment known as Obstructive Sleep Apnea Syndrome.  It involves a closure of the airway due to relaxed muscles that causes you to snore and to wake up gasping for air (although you seldom remember this), which prevents you from hitting the REM stage of sleep.  It is during REM that the body obtains the restorative benefits of sleep.  Prolonged periods of REM deprivation may be associated with hypertension and heart problems, and a lowered sexual drive, according to a major Harvard study.  And, when you awake in the morning, you do not feel rested.

I've now worn the darn thing for three nights, and some changes are already apparent.  My wife won't look at me when I'm sleeping now, and she won't kiss me on the cheek when she comes to bed for fear of getting her lips caught in the clips that hold the mask on my head.  The dog no longer sleeps on the bed, but he stares at me a lot, even in the dark.  I think he is afraid to come near me when I have it on.  I was always fascinated with Star Wars and Star Trek and the idea of visiting other planets with strange creatures, like Pandora in Avatar.  Already, my dreams are now focusing on that kind of adventure.  I am sure this is because of the mind-set I have after donning my space mask as I climb into bed.  When I breathe, I sound a bit like Darth Vader, so the ambiance in the dark bedroom is perfect for fantastical hallucination.  Last night I dreamed I was Luke Skywalker's father.

When I travel with the CPAP unit, which fits in a case about the size of a shoe box, it has to be carried on an airplane.  It is too sensitive to be checked.  I have a letter from the sleep doctor that I show TSA when checking in that this is a medical device, and that it should not count as one of my carry-ons. 

I can see it all now, because I had a similar situation years ago when traveling with my daughter and my infant granddaughter to California.  Amy needed to take one of those mechanical breast pumps with her so that she could bottle milk for me to feed her daughter when I babysat on the trip.  The device was about the size of a small sewing machine and it was fairly heavy; Amy carried her baby and I carried the thing.  We were traveling soon after 9/11.  When I tried to go through security, they called me aside, opened the machine and examined it with special swabs for evidence of explosives.  After all, it did resemble a small atomic device that you see in the movies.  When the test came back negative, I whispered to the young girl what the device was.  She immediately turned to her colleague who was many yards away and yelled while laughing hysterically, "Mabel, it's a breast pump."  At that instant, about 40 passengers about to board my flight turned and looked at the white-haired guy, standing there alone, holding what was obviously the object of everyone's attention.  I don't embarrass easily, but that one made my ears glow.  My daughter was one of those smiling broadly from across the hallway, but her mouth did not utter a word of explanation.

My wife, the former ER nurse, insists that I take care of myself and that I have all medical issues checked out by a physician.  I am trying to be a good patient.  So I will continue to wear the Vader mask, to dream of faraway places and adventures, to frighten the dog, and to deal with security issues at the airport.  What worries me most is that I know from listening to them sleep at night that both my wife and my black lab also suffer from sleep apnea.  It is just that when they are both fitted with their CPAP masks, there will not be enough electrical outlets near the bed to go around.

Senescence sucks: The final chapter (part 6)

(An elderly Eskimo on an ice floe in the final days of his life.  I would do this now, but I hate the cold.)

Yesterday, I had my follow-up visit with the doc who did the upper GI endoscopy procedure a few weeks ago.  With his scope he looked around in there and took some biopsies.  Turns out I have eosinophilic esophagitis, a disease only discovered in 1978 at the Mayo Clinic.  Not as bad as it sounds.  It is an accumulation of white blood cells in the esophagus, where they should not be, caused by allergens of some type.  It results in food sticking in that pipe for a few minutes on occasion, which is not pleasant.  Treatment is to shoot a steroid inhalant into the mouth twice a day, and then swallow it.  Do this for six months and then see the doc again.

Then, this afternoon, I finally had the follow-up visit to get the results of the sleep experiment I did a month ago.  Remember those 1,000 pages of data?  As expected, I suffer from sleep apnea.  Treatment is to wear this mask that injects air into your mouth while you sleep, a thingie called a CPAP, which reduces the apnea.  We'll find out soon if it makes me feel young again.

So let's summarize.  I have arthritis between two vertebrae in my lower back, I suffer from peripheral neuropathy (which I have not discussed), I have eosinophilic eosphagitis and a hiatal hernia, I exhibit sleep apnea, and I have high cholesterol.  All of this simply proves my point that as you get older, all sorts of systems and parts of your body deteriorate (= senescence).  (J.F. Fries' classic study in The New England Journal of Medicine in 1980 lays all of this out beautifully.  Over the past century, average longevity has increased dramatically, primarily due to reduction of juvenile mortality due to infectious disease.  But maximum longevity has not increased and is not likely to do so, even if we eliminated all diseases.  Maximum longevity is about 85, with only 1 in 10,000 persons making it to 100.  Organ dysfunction simply takes over with advancing age, regardless of any disease process.  The goal, therefore, would seem to be as vigorous as possible until the predicted, and inevitable, "terminal drop".)  My list of medical afflictions is probably pretty standard and, fortunately, doesn't include anything really serious.  For example, when I was diagnosed with neuropathy, my neurologist said to me, "Tom, this is not what is going to kill you".  Oh great!  I love surprises.  Cancer, heart attack, Mack truck, step bare-footed on a rusty garden rake, or stray bullet from a deer hunter?  The possibilities are endless.

It is said that the Eskimos put their elderly on an ice floe when they are near death and send it out into the frigid waters.  This could be a rural, snowy myth--not sure.  But I hate the cold.  In the U.S., we spend tens or hundreds of thousands of dollars in the last 1-3 months of life, and then die anyway.  So I have been pondering what would work for me.  When it is obvious that I am on death's door, here is what Management can do to hasten the end inexpensively:

1.  put me in front of a tv and make me watch NFL football for 24 hours straight while eating Lay's plain potato chips; to cut the time in half, turn on Fox News

2.  wheel me into a room full of cell phones, which are all ringing, bonging, and vibrating; to speed up the process, make sure that some of the ringtones include the William Tell Overture or rapping by Eminem

3.  have a dozen students who I haven't heard from in 10 years contact me to write them a letter of recommendation for law school

4.  take me to Cornell, and have me sit-in on faculty meetings in five different departments in the Ag College in one day when they are discussing budget issues

All of those suggestions will bring the end more quickly and save someone a lot of money.  But for the finale to be more peaceful, and more pleasant, please do the following for me.  Place one of my blue canvas folding chairs in my forest under a large red maple, and then leave me alone with a bottle of scotch and a lap full of cigars, and a dog.  Latin music playing in the background would be a nice touch, but that depends on the cost.  Don't be too extravagant.  The music doesn't have to be live.  Dominican cigars, not Cuban.  A cocker spaniel, not a French poodle.  And 12-year old scotch, not 18.  Then I can drift off wondering why I had been such a gall-darned cheapskate all my life.

Senescence sucks: The virtues of Versed (part 4)

(When you see this guy coming, just say "Versed please".

Last week, I had occasion to be given an "ultra short-acting benzodiazepine derivative, which has potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties"?  Of course, this was done under medical supervision at the hospital.  Don't try this at home.  The occasion was a procedure called an upper GI endoscopy, and it was conducted by the same doc that does my colonoscopy every five years.  Hopefully, he uses different instruments for each procedure; no double-dipping, please.  This most recent procedure involves having the specialist thread a tube with a small camera attached down your throat into the esophagus and into your upper digestive system to reconnoiter, take pictures, or even repair some problems.  This was recommended because of that hiatal hernia that I wrote about earlier. 

The barium swallow that I took several weeks ago was a preliminary look inside the problem area but, as my doc explained, the endoscopy procedure is the "gold standard" for examining that area of the human body.  I may not invest in gold when I trade online, but you can be damn sure I want the gold standard applied to figure out what to do about this hernia.  The doc and I sat in his office as we discussed all this.  It took only five minutes to explain the endoscopy procedure, and we spent 20 minutes talking about cigars, wines, and scotch.  I really like this guy!

Part of the reason the medical discussion went so quickly is because as soon as I learned that the patient is sedated with a drug called Versed, I needed to hear little more.  This is the same drug they used for the colonoscopies, so I was an old pro at this one.  Understand that I have never done recreational drugs in my life (well, there was that one time at the Delta Chi house), but I now go around to cocktail parties, wedding receptions, and bar mitzvahs giving free testimonials about Versed.  What is sad is that my testimonials are more interesting than most conversations at these events, so I always have good attendance in my corner of the room.  There are a few jock-types standing around the hors d'oeuvre table discussing the Yankees, but there are really impressive numbers in my corner where I am discussing my favorite ultra short-acting benzodiazepine derivative.

In short, and I'm obviously being very non-technical, Versed works not only by relaxing and sedating the patient, but it results in total amnesia about the event that occurred while you were under the influence of the drug.  You are completely awake during the procedure, you can answer questions, and you are able to respond to the medical team's directives, but you remember absolutely none of the gagging and swallowing of the tube.  Think about that for a moment.  You realize they are putting 2-3 feet of tubing down your throat while they are doing it, not a very comfortable thought, but when you recover from the drug, you can not remember a single second of the experience from the time they injected the IV drug until you recover. 

Think of all the times in your life you wish you would have been under the influence of Versed.  Your boyfriend breaks up with you.  The next day you feel great, because you don't know you have no boyfriend.  Your boss fires you, the next day you feel great, but you don't know you are unemployed.  The stock market crashes as it did last year, but the next day you feel normal, even though you have no money for retirement.  Wow!

But there are two problems with this antidote for life's miseries.  First, you don't know when these adversities are going to occur, so you would have to be on Versed all the time to gain the benefit.  On your 50th birthday, you wouldn't have any memories until before your 20th, when you began the Versed regimen.  And second, eventually you will realize you don't have a boyfriend, and that you're unemployed and broke.  At that point, you would probably employ Plan B, which is to partake of a more common drug of choice, alcohol.  So Versed is not a long-term solution to life's problems.  But when it comes to someone in a white coat sticking a tube into one of your body's orifices, it is fantastic.  Who needs to remember the details about that?

Plus, I have always adopted the view that life is mostly about creating memories, which you can draw on later in life.  In fact, bad memories may be better than no memories at all.  Memories enrich life, help us realize that our time was not spent for nothing, give us something to discuss over and over, and entertain us when we are alone.  They represent material for sharing with others. But when you see the doc comin at ya with a tube and a camera attached, just say "a benzodiazepine derivative, thank you very much".