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Please advise sleep apnea and hurt


#1

Hello,
I am a dual citizen American/European. I am retired and living in Guatemala right now.Before this for three years I resided in Europe. I was diagnosed with sleep apnea in the States in 2001 but I was told I did not qualify for the CPap as I stopped breathing 5-6 times and 6 times was the minimum at that time to receive treatment. My sleep apnea has worsened considerably I will describe what has happened in the last six years and ask what you recommend because what happened to me on March 3 has scared me to such an extent I feel isolated and alone and without medical treatment and i am afraid I will die if i keep having hypoxic seizures and no sleep.
I have Medicare part A only since i live outside the country but I know that what happened to me on March 2 warrants a hospital visit.
On March 2, 2019 I was spending the night in a dorm at a hostel. I fell from the upper bunk which was considerably high since it was a colonial building with 18 foot ceilings in Seville Spain. I have just returned to Central America to live. The bunk had no protective bar. I guess it doesn’t allow for people with sleep disorders.
I began to notice in 2010 that I was snoring more loudly, I had snored since the age of 23 in 1994(my fiance told me) when I was placed on klonopin for hypoxic seizures I believe it worsened what may have already been the structure for sleep apnea but I never went for a sleep study until 2001. This message is going to seem disjointed because I did not sleep AGAIN last night so please do not assume i am mentally ill or intellectually impaired. It is just that so much has happened and I have not slept properly in so long and awakening in a panic not breathing is affecting me as it would anyone.
I guess I should start from 1994 when I was placed on klonopin and my fiance told me I snored. This was the first time I was aware that I snored. My siblings never mentioned me snoring as a child and I doubt i did or friends would have mentioned it too. So I am guessing that this issue began in 1994. I should also say I had a rhinoplasty which made my nostrils so small in 1991 that this could exacerbate the already extant sleep apnea.
On March 3 I fell from a bunk onto a marble floor in Seville Spain where i was flying out of to return to Central America because it is more affordable. As a European citizen, I have a European Health Card. I had a seizure after falling from the bed. I tried my best to orient myself but as I was doing so convulsed. I went to the “best hospital” in Seville, EL Virgen del Rocio. The hostel worker who took statements from the other females in the dorm was studying to be a nurse. She called the doctors in the emergency room while I was there instructing them that at minimum an xray was neded for my head and arm which was double the size and told the medics in the ambulance that took me to the hospital that I had a seizure I was convulsing and I did not remember my name or where i was for a few minutes after.
Incredibly, the doctor at the ER did NOT do ANY sort of exam though I am entitled to it under European law and it is unethical under the Hippocratic oath to not investigate what happened to me. I cannot explain why but I can tell you that I was NOT examined by the doctor. No neurological exam was done and my left arm was twice the size and I already had bruising and pain on my left side from my shoulder to my back. One of my ribs hurt and it was not examined. It still hurts as I may have cracked it. NO xrays were taken no cat scan done to see if I injured my brain in the fall. They did no tests. . I went to the airport form the hospital to await my flight in the morning. While there because i was limping from the pain a Belgian woman called the medic in the airport to see me. He told me it is likely I did not have a brain bleed because I would have a terrible headache and the first six hours had passed. I took a flight back to my place in Guatemala an eleven hour flight direct to cancun from Belgium. I took a flight to CHiapas and crossed the frontera.
I believe i fell out of the bed having a seizure from hypoxia. I then had another one in front of the girls in the dorm who awakened when i fell while i was trying to orient myself from the first one.
For the past six years I have been awakening form bed realizing i have not been breathing. This causes panic in me. I am an anxious person to begin with so this is very frightening for me.
I am frightened to return to the US to seek help because I don’t want to end up in the streets homeless. I live on a little over 1000 usd per month so the ticket alone will cost me and if I go to a hospital that is uncaring as I did in spain then I am stuck and homeless in the United STates which is not a good place to be homeless.I am so frightened because I had a seizure aura again last night and the night before awakening both times not breathing with my heart pounding. Inknow i need help I just don’t know where to get it. I am alone my parents are gone and my friends live here in Guatemala. I don’t have anyone in the USA. I am so frightened and I want to do the right thing for myself but I cannot show up to be told “this is not an emergency” and sent into the streets because I am an anxious person I am not able to live in the streets. I used to have medicare part b when I lived in the states in 2009. Now I only have hospitalization and i am petrified because I am in pain in my arm i believe i fractured it and I have tingling probably a pinched nerve in my back and I ache from the fall a week out. But those are just symptoms of the underlying issue which is much scarier the hypoxic seizures in sleep from apnea. I am so frightened and I don’t know where to turn I know I need qualified doctors to treat me but what do I do close my eyes and pick a state and go there?
I need to go to a hospital that has some experience with sleep apnea and compassion for it. A general hospital will not see this as a major issue although i think any doctor who read what happened in spain would be shocked. I am so frightened i am not ok and I am afraid i will die from this. I am sorry this email is all over the place and rambling but i am alone dealing with this and frightened. And I have not slept in weeks.
I should also add that my prolactin level is dangerously high and I was living in Europe before Guatemala and the healthcare system decided that an MRI was “not required yet” to see if it was an adenoma causing this or stress. Please help me find a hospital to go to I just want to get help. I just want to be seen. I just want to take care fo myself well. I am so frightened.Thank you.


#2

Hello,
Sounds like you’ve had quite the streak of bad luck! (I’ve been a nurse for 40 years) First of all, the pain. Do what you need to to get your pain under control. Take some Ibuprofen to reduce the inflammation. 2nd: Broken rib: They don’t do anything for broken ribs generally, no casts or surgery to be done there. I’ve seen them wrap an ace bandage around the chest for some support, but generally it just has to heal on its own. How’s your arm? Has the swelling gone down? The treatment for swelling is usually RICE R=rest, I=Ice or Ibuprofen C=Compression (meaning wrap it with an ace bandage or the like) E=Elevation(put it up above the level of your heart so the fluid causing the swelling is aided by gravity, this will help reduce the swelling)
Next, the hypoxic episodes: You are correct in that you should be seen by a doctor. There are many sleep clinics throughout the USA you could go to. I would suggest a big city, a public or university hospital usually has a budget for what they call “indigent care” and will treat you for free if you are unable to pay. This may be something you could inquire about over the phone with the social work Dept. at the medical facility you choose. I would recommend getting a copy of your medical records from your episode in Spain to send them in advance, as well as any medical history you have from the US.
That’s a start. This could turn out to be quite the project, so I would recommend choosing a large city you can get to with cheap airfare, Call the local hospital, see when you can get an appt, arrange to get there, then once you are there, find a room at the local Y or homeless shelter until your appt and go from there.
And not to be blunt, but I would start as soon as possible before someone finds you dead in your bunk, or worse yet, on the floor with your head split open. In the meantime, I would advise against sleeping in the top bunk; it’s a long way to fall and your chances of injury are much greater.

Good luck to you, hope this works out for you.

KimR


#3

Please don’t scare me any more than I am. I appreciate your help and I am purchaswing a ticket today. I will not sleep on the top bunk but why would they find me dead? This will not kill me. I have my own room now and I only stayed in a shared hostel once and that happened. I jhave put the mattress on the floor off of the boxspring where i am staying now. But I have panic disorder as well so please don’t say I could be found dead. It frightens me and obviously if I were that bad off I would be dead by now. Apparently if there was no brain injury and I was not hurt from that great a fall I am not suffering too badly. It is likely that from Panic from not breathing and the apnea TOGETHER that is causwing tghe hypoxic seizuresz because i was having hypoxic seizures before the apnea simply form panic. I need reassuarnce because I am already very aware that I need to be seen. I cannot wait to make all of those preparations. I was planning on going to the Mayo clinic in jacksonville. I looked on booking.com but there are no hostels in my opinion I need to be hospitalized for my state of panic and depression in addition to the apnea and seizures because of the high prolactin level causing depression. I am taking two antidepressantws to sleep and I have not seen a qualified doctor that is a specialist in years. SO I am presenting to the hospital with seizures aqnd panic. I fel I need to be hospitalized FOR both or at LEAST for the panic. If you saw the look on my face you would agree. It is clear that I am suffring great emotional pain and I am not mentally ill in that there is a reason why I am so worried because i have been mistreated in the past but the level of panic is sop high I am sure they will hospitalize me when they see me. I went to that same hospital a week prior to the seizure with extreme panic because i was having seizure auras they sent me aw2ay with four bottles of medication and told me the3n it wasn’t an emergency either. Apparently feeling that nothing brings you joy in life is not life threatening even though I was diagnosed with major depression at 27. I am so hurt please don’t tell me people are going to find me dead. I was told that hypoxic seizures cannot kill you only epileptic pnes. I am buying my ticket today and flying blind to the mayo clinic. Please i cannot take any more panic please say something helpful because i am so frightened.


#4

I just meant if you fell out of the top bunk and hit your head hard enough, you could injure yourself severely, break your neck, etc, and you just wouldn’t wake up. Hopefully that won’t happen, and it sounds like you have taken measures to prevent it, so that’s a good thing. Glad to hear you are headed somewhere to be seen by a doctor. Tell them about your fainting spells/hypoxic seizures, and insist they do some sort of a workup. Anxiety is a tough one to treat and most places don’t consider it an emergency, but with the seizure component, that moves it up the importance list considerably. Not that you would actually do this, but tell them “I would hate to have a seizure and get in an accident and hurt myself or someone else”. My daughter lives in Jacksonville, if you would like, I could ask her if she has any suggestions for overnight accommodations for you that are free(or minimal cost.) I am actually headed there next week to visit her, I should arrive on the 19th of March.

Let me know if there is anything else I can help you with. You are doing the right thing.

KimR


#5

Oh thank you so much<3 yes please ask her but I called mayo clinic tonight and the woman said to go to the er. She was only a protectionist but wheat i described to her alarmed her and i think they will help and admit me. I arrive i n orlando at 1:50pm then take amtrak on Friday March 15 after my flight arrives to jacksonville. Please pray for me until then waking with a racing heart from not breathing is so scary. Thank you for being there. I was being dismissed because these doctors were 22 year old residents not seeing the forest for the trees. Sometimes when someone is panicked a doctor chalks it up to panic and ignores the underlying CAUSE of the panic. I did some research online and the panic response is triggered by not breathing. I also saw several solutions mouth pieces but I am really at a loss for the outer anatomy component as I have a strong square jaw so I do not have a small jaw but really good bone structure I guess its the inner musculature that is different. But even a doctor once told me “you don’t have the one structure” for it. How ridiculous. Just becaue i have a long neck and good bone structure I should not have a collapsablePalate? I am so confused at this point but i know i wolke up the other night feeling my throught closed I think my tongue collapsed or something it was awful. The one good thing is i still dream which means i am having some rem sleep. In read some people had no rem sleep but I did not have rem sleep before they put me on an antidepressant for sleep because i was awakenign every 2 minutes the moment i fell into deep sleep. Anyway I am not going to worry since that is all this causes me to do. I have to call medicare for my number because i don’t have it anymore I need to get it.


#6

She said your best bet is to get an Air BnB room. You may not need it if you get admitted. Good luck.


#7

Thank you. I think the seizures will get me admitted in additon to the affect they are having on my mental health.


#8

also my prolactin is 1041 with the highest normal being 562 so there is A LOT going on that needs to be checked.