CGNorena Weekly

I am an Apnea Patient

I am an 83 year old man, and I have been happily married to my wife for 44 years. During those years I have always thought I was a model sleeper. I had some problems going to sleep, but that was radically remedied by a pill of Triazolam.

After 44 years of sharing my bed with my wife, she revealed to me she was worried about the apparent intervals of no breathing following bouts of almost operatic snoring. The snoring part was no surprise to me: I have been haunted all my life by complainers who slept near or in my room, including my twin brother. But I simply could not believe that I would frequently stop breathing during my sleep. Apnea patients, like myself, lack any memory or awareness of such experience. That is one of the dangers of apnea: the last person to know that he or she has a serious disease – a disease that can kill you— is the very apnea patient. Unfortunately, some of the symptoms that might alert even your doctor to the presence of apnea are frequently outsourced to other diseases, such as an enlarged prostate, prostate cancer, diabetes, high blood pressure, obesity, or just plain old age.

My wife’s revelation directed me to my primary physician, — a very prudent, caring, and knowledgeable gentleman, who, as a colleague of mine in the university used to say, belongs without any doubt to that legion of doctors, nurses, and others in the health care business who are “the unsung heroes of our civilization.” My doctor sent me immediately to a sleep disorders specialist. That visit, and the ones that followed, have in many ways changed my perception of old age. I will explain how.

The sleep disorders specialist ordered a nightlong test of my sleep. Machines of all kind were attached to my body by a dozen or so of electrodes to monitor brain waves, sleep configuration, blood pressure, sleep position, breathing stops, etc. The next day I was shown a chart of my sleep patterns: I had a severe case of mixed apnea caused by a blockage of the airways and  by a failure of the brain to control breathing, resulting in high blood pressure, episodes of apnea (a word that names the disease and its episodes), time without breathing, etc. I was shocked: in an eight-hour sleep I had almost four hundred interruptions of breathing. No wonder I felt fatigued and very sleepy during the day. The nurse said that “it was not a pretty picture,” a nice euphemism.

How could that happen without me having the slightest consciousness of it? My experience (or absence of it), however, is not unique. About 85% of people with apnea don’t even suspect they have apnea, are never diagnosed with apnea and are never treated for it.  And here comes the most startling part of the story: the treatment of apnea is simple, inexpensive, totally painless, hardly invasive, and almost 100% effective.

All you have to do is to sleep with a mask attached to an air compressor and vaporizer that constantly send into your nose waves of humid air that maintains your airwaves open from the nose to the lungs all night long. It amazes me to hear from doctors that many people refuse to use the mask and the air compressor (although it is paid 100% by Medicare!), because they are uncomfortable or the machine is slightly noisy. Some people think that only 50% of people urged by the doctors to use their mask, actually use it. Not a compliment to American resilience and determination.

I want to be absolutely honest with you: I hate discomfort and can hardly tolerate severe pain, but I have never failed to use the mask or the compressor since the doctor told me to use them every night, almost four months ago. I admit that occasionally the ‘machine’ leaks air and becomes abnormally noisy.  In my own case a persistent nasal congestion aggravated the problem. But the congestion is (slowly!) fading away. Furthermore, for the first 45 minutes the machine gradually increases the pressure. By the time it reaches the pressure decided by the doctor, a normal apnea patient is already happily sleeping.

The effects of such treatment are quite incredible. While I used to go the bathroom eight to twelve times every night, I only go  now TWICE ! It is a joy to wake up for the first time in the night about 3am or even 4am. Doctors tend to blame an enlarged prostate for that problem, a problem that is solved by having air forced through your nose into the lungs. But that’s only the beginning.  Mask treatment diminishes your daytime sleepiness and fatigue, lowers your high blood pressure, increases the oxygen content of your blood, significantly depresses your appetite for food, helps to prevent heart attacks and congestive heart failure, controls depression and irritability, improves insulin resistance, and — are you ready for this? — actually increases your alertness and your recall memory.  More importantly, the mortality index of apnea patients who are treated for it. reverts to the same levels of those people who never had apnea in their life.

If you want more details about my own case write to me at norena@cruzio.com or to my blog CGNoreña Weekly.

I am an Apnea Patient

I am an 83 year old man, and I have been happily married to my wife for 44 years. During those years I have always thought I was a model sleeper. I had some problems going to sleep, but that was radically remedied by a pill of Triazolam.

After 44 years of sharing my bed with my wife, she revealed to me she was worried about the apparent intervals of no breathing following bouts of almost operatic snoring. The snoring part was no surprise to me: I have been haunted all my life by complainers who slept near or in my room, including my twin brother. But I simply could not believe that I would frequently stop breathing during my sleep. Apnea patients, like myself, lack any memory or awareness of such experience. That is one of the dangers of apnea: the last person to know that he or she has a serious disease – a disease that can kill you— is the very apnea patient. Unfortunately, some of the symptoms that might alert even your doctor to the presence of apnea are frequently outsourced to other diseases, such as an enlarged prostate, prostate cancer, diabetes, high blood pressure, obesity, or just plain old age.

My wife’s revelation directed me to my primary physician, — a very prudent, caring, and knowledgeable gentleman, who, as a colleague of mine in the university used to say, belongs without any doubt to that legion of doctors, nurses, and others in the health care business who are “the unsung heroes of our civilization.” My doctor sent me immediately to a sleep disorders specialist. That visit, and the ones that followed, have in many ways changed my perception of old age. I will explain how.

The sleep disorders specialist ordered a nightlong test of my sleep. Machines of all kind were attached to my body by a dozen or so of electrodes to monitor brain waves, sleep configuration, blood pressure, sleep position, breathing stops, etc. The next day I was shown a chart of my sleep patterns: I had a severe case of mixed apnea caused by a blockage of the airways and  by a failure of the brain to control breathing, resulting in high blood pressure, episodes of apnea (a word that names the disease and its episodes), time without breathing, etc. I was shocked: in an eight-hour sleep I had almost four hundred interruptions of breathing. No wonder I felt fatigued and very sleepy during the day. The nurse said that “it was not a pretty picture,” a nice euphemism.

How could that happen without me having the slightest consciousness of it? My experience (or absence of it), however, is not unique. About 85% of people with apnea don’t even suspect they have apnea, are never diagnosed with apnea and are never treated for it.  And here comes the most startling part of the story: the treatment of apnea is simple, inexpensive, totally painless, hardly invasive, and almost 100% effective.

All you have to do is to sleep with a mask attached to an air compressor and vaporizer that constantly send into your nose waves of humid air that maintains your airwaves open from the nose to the lungs all night long. It amazes me to hear from doctors that many people refuse to use the mask and the air compressor (although it is paid 100% by Medicare!), because they are uncomfortable or the machine is slightly noisy. Some people think that only 50% of people urged by the doctors to use their mask, actually use it. Not a compliment to American resilience and determination.

I want to be absolutely honest with you: I hate discomfort and can hardly tolerate severe pain, but I have never failed to use the mask or the compressor since the doctor told me to use them every night, almost four months ago. I admit that occasionally the ‘machine’ leaks air and becomes abnormally noisy.  In my own case a persistent nasal congestion aggravated the problem. But the congestion is (slowly!) fading away. Furthermore, for the first 45 minutes the machine gradually increases the pressure. By the time it reaches the pressure decided by the doctor, a normal apnea patient is already happily sleeping.

The effects of such treatment are quite incredible. While I used to go the bathroom eight to twelve times every night, I only go  now TWICE ! It is a joy to wake up for the first time in the night about 3am or even 4am. Doctors tend to blame an enlarged prostate for that problem, a problem that is solved by having air forced through your nose into the lungs. But that’s only the beginning.  Mask treatment diminishes your daytime sleepiness and fatigue, lowers your high blood pressure, increases the oxygen content of your blood, significantly depresses your appetite for food, helps to prevent heart attacks and congestive heart failure, controls depression and irritability, improves insulin resistance, and — are you ready for this? — actually increases your alertness and your recall memory.  More importantly, the mortality index of apnea patients who are treated for it. reverts to the same levels of those people who never had apnea in their life.

If you want more details about my own case write to me at norena@cruzio.com or to my blog CGNoreña Weekly.

Obama, Afghanistan and Beyond

I have been an Obama supporter from day one; I am still one now, more than ever. However, Obama has made some statements on Afghanistan that truly bother me.

During the primaries – which are mercifully over—Obama liked to repeat that America is involved in two wars: the war in Iraq, which we should have never started; and the war in Afghanistan, which we have not won yet.  I have no qualms with his thought on Iraq, but I have disturbing misgivings about his words on Afghanistan.

Obama seems to assume that, unlike Iraq, the occupation of Afghanistan was fully justified because of the 9/11 disaster. Such manner of thinking presupposes that Afghanistan was directly and mostly responsible as a nation  for  the tragedy of that day. It was not, not as much as our “allies” Saudi Arabia, Yemen, Pakistan, or even Egypt are, all of which share some responsibility for the attack.  It is true that bin Laden was hiding in some caves (where he belongs, anyhow) in northeastern Afghanistan.  But he moved into other caves in the tribal areas of Waziristan, Musharraf’s haven in northwestern Pakistan. He is still there.

What bothers me about Obama’s words is that they still seem to reflect President Bush’s distorted world-view, a view I thought was about to be changed.  It just terrifies me to think that Obama wants American soldiers to bring the Afghanistan war to victory, a victory that will prove as elusive as in Iraq. Pakistan alone can provide thousands of suicide bombers for years to come. Such “American war” would unfortunately make Obama’s presidency a Bush Third Term in foreign policy, as much (or potentially much worse) as a MacCain presidency would. Most Americans would not tolerate another American war against an Islamic nation in the name of American national security. Obama, if elected this fall, would be doomed to be a one-term president.

Therange of American diplomacy, should be anchored in Afghanistan and Pakistan, and take into account the big powers that still dominate the entire region. Russia, that provoked the jihad against her troops in Afghanistan, still attempts to manipulate the republics of Central Asia (more of this later). The new President of Russia, Mr. Medvedey, might not be as fiercely opposed to American influence in the region as Mr. Putin has been.

Turkey, the model of a secularized Islamic society in transition, will for years to come affect the destinies of those Central Asia republics that are in a similar stage of secularization (such as Kyrgyzstan or Kazakhstan) or are dominated by Turkmen as a distinct ethno-linguistic group (such as Turkmenistan), or whose language is Turkic (such as Kazakhstan). Tajikistan, which was for centuries part of the Persian Empire, has close cultural relations with Iran. Both India and China have no qualms in making public their interest in the vast oil and gas reserves, particularly those in Kazakhstan.

The republics of Central Asia have some features in common and some very distinctive characteristics. All of them are land-locked former Soviet provinces that reached independence from the Soviet Union in the last decade of the 20th century, and are generally speaking, ignored by Americans.  In all of them independence was followed by more or less corrupt rulers and, as a reaction to them, by a rapid growth of radical Islam imported mostly from the Afghan Taliban at first and then by bin Laden’s  al-Qaeda. They are all Sunni Moslems, but there are also scattered minorities of Diaspora Jews, Nestorian Christians, and some Sufis.

Some of them are huge and wealthy, and some are small and impoverished.  Kazakhstan is the largest–larger than all of western Europe—and the richest: the republic holds about 4 billion tons of proven recoverable oil reserves and about 8 billion barrels of natural gas. The country is also rich in uranium, chromium, lead, zinc, manganese, copper, coal, iron, gold and diamonds. Tajikistan is the smallest, but it has great hydropower potential.

Some of the republics, such as Kazakhstan, have a respectable political structure and a well managed monetary policy while seeking good relations with Russia, China, the United States and the European Union: an ideal stage for a “surge” of American diplomacy in the near future. Tolerance to other societies has become a part of Kazakh culture. The government provides scholarship funds to Oxford and to some American Ivy League universities. American scholars, oil technicians, economists, contractors to build the pipes badly needed to bring oil and gas to market, will play a decisive role in the future of Kazakhstan. The impact of Islamic radicalism has so far been substantially blunted in Kazakhstan

Uzbekistan is an authoritarian state with limited civil rights. Inflation after independence reached a galloping 1,000% per year, but a highly protectionist policy and the profitable export of cotton and gold have stabilized the situation. Nearly 90% of the population—half of the region’s total population (almost 28 million) is Sunni Muslim. Uzbekistan has the largest military force in Central Asia. For a while (until 2005), Uzbekistan approved a request for the US military use of some air bases and supported American war against global terrorism. Recently, though, Uzbekistan has tilted toward Russia and increased its isolationism from the West. Unfortunately, the Islamic Movement of Uzbekistan (the IMU) has enjoyed the clandestine support of bin Laden and the Taliban.. If the work of American diplomats looks promising in Kazakhstan, it promises to be a tough job in Uzbekistan.

Two other countries, Turkmenistan and Kyrgyzstan, are less populated and far less disturbed by political unrest. Turkmenistan is mostly a sub-tropical desert that will probably provide routes toward the Caspian Sea for the oil pipes of the future, as it provided the land for the Silk Route in the past.   Kyrgyzstan, “the Switzerland of Central Asia,“ will most likely become an idyllic and beautiful tourist resort for Europeans, Indians, Chinese, and the everywhere present Japanese and American tourists. Not a bad place to make “global” friends.

In these nations, whose names we are beginning to learn without ever being sure about how they are spelled, an important part of contemporary history will be written. American college students who care about humanity, have the moral obligation to become acquainted with them, eager to become part of their future. The war in Afghanistan is not going to be “won” by more American boots on the ground, but it could and should be decisively affected by a friendly, constructive, intelligent, unselfish, and peaceful  “surge” of new Americans. This is the change “we can believe in.” Obama’s flight to the center has to go straight to the center of Asia.

Islam experts think that, globally speaking, Muslim societies (with more than one billion of mostly peaceful Islam believers) will yield to the advances of western secularism, as Ataturk’s Turkey did after the First World War. The American role is to bring about that day as soon as possible everywhere. More army brigades will not help much, but American diplomats and American young people have a glorious responsibility in their hands. Was not something like this what Obama promised to America?

America is not supposed to “win” the war in Afghanistan all by herself. An international force of Kazakhs, Pakistanis, Afghanistanis, Turks, British, Canadians, Indonesians, etc should see to it that the border between Afghanistan and Pakistan is closed to terrorists from both sides and the opium trade does not go to pay for suicide bombers in Madrid, London or Bali. The capture of bin Laden would be the laurel of those who prevail. It might take a few years of diplomatic surge, but humanity mandates the effort.