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psspectacledowl1

From their own positive experiences, several people were helpful and encouraging to me about the use of C-Pap or Bi-Pap machines, and I am grateful for that. We learn along the way much about ourselves, minds and bodies, and sometimes we learn that one size does not fit all.

Shortly after my last blog report, I learned more about my failure. I had “complied” in every respect with the advice to use my Bi-Pap machine, averaging seven hours of use per night at the end. The result was paradoxical. I was suffocating, and my blood oxygen level was declining, resulting in the 70% levels referenced in my last report, and increasing unstable angina during the night. I began with a moderate obstructive apnea, aggravated by chronic sinus problems. I ended with a serious central apnea, in which the connection between brain and breathing diminished. That is not desirable. I asked that question when the process began, “Does the use of a C-Pap machine sometimes replace the body’s own natural automatic impulses to breathe?” and I was told “No; that does not happen.” As it turns out, in special cases, it does. I am special.

Maybe it has something to do with the odd electrical wiring of my heart, which has two blocked fascicles, the electrophysiologist tells me. That has probably been the case almost all of my life, and it is not easy or safe to change. The nerve blockage at least complicates the issue of brain to heart and pulmonary system operation. I am all for easier solutions.

Finally, I was told to stop using the Bi-Pap device entirely. After a few nights I returned to the earlier pattern—no central apnea, and moderate obstructive apnea. Meanwhile I had gone to a dentist who was trained in fitting “oral appliances.”   (She was very kind and sympathetic.) The process is similar to fitting a set of dentures or braces—molds are taken of the existing teeth. A device is prepared that covers both upper and lower teeth, and the covers are connected so that the lower jaw can be gradually moved forward, using the upper and lower teeth as the anchors. Moving the lower jaw and tongue forward opens the airway in the throat. Combined with simple inserts for expanding the nostrils, this old “mouth breather” suddenly became a nose breather with expanded access to my windpipe. Adapting to the device was relatively simple, compared to the Bi-Pap machine. The oral appliance fits securely, so there is no problem with ever-shifting masks. The oral appliance is also very quiet. Gradually over the past four months the airway space has enlarged from my natural relaxed position to 7 mm larger in diameter. The resulting beneficial impact on apnea has been substantial.

I returned the BiPap machine. No hard feelings. Someone else will benefit from it—maybe even you. But if you feel like it is trying to suffocate you, even when the technicians increase the settings for the machine to work harder, it probably is.

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