We Can Do Hard Things
A friend of ours told Tracy that I sounded stressed in my last couple of posts. I’m thinking, only the last couple?
It’s been a week. Again.
A year ago Travis had blood work done and his primary care doctor was concerned because his hemoglobin, hematocrit and red blood cells were elevated. The primary care doctor referred him to the ENT (Ears, Nose and Throat) doctor. Travis’s tonsils were extremely enlarged. At the time the doctors agreed that the best course of action would be do remove the tonsils. They believed this might also take care of his sleep apnea.
If you’ve been keeping up with our story you may remember that this was not an easy time for Travis. He had the surgery in July, in the midst of Covid-19. He spent one night in the hospital and then spent the better part of a week at our house.
A few weeks later Travis completed an at-home sleep study at our house. His sleep apnea had improved a bit but they decided that he still needed a CPAP. In the end they fitted him with a BiPap as he wasn’t able to tolerate a CPAP so he hadn’t used it regularly in the past.
It took us several visits to the sleep medicine doctor to get the settings comfortable and the right mask.
Travis had his physical with his primary care doctor earlier this month. Instead of being better his hemoglobin, hematocrit and red blood cells were even higher. In fact, all of his numbers were out of whack. His A1C was 9.7 and fasting glucose was 282. If you know anything about diabetes, you know those numbers are not good. His cholesterol was high, the first time ever. And his albumin was high.
The sleep medicine doctor ordered a nocturnal oxygen test. I picked up the test watch from the medical supply company and taught Travis how to use it. It malfunctioned the first night. I had Travis keep it an extra day and try again.
The results were concerning. For three hours while Travis was sleeping his oxygen level was below 88% and for five hours it was below 89%. This is while using the BiPap.
It should be in the mid 90’s.
The sleep medicine doctor said his organs are not getting the proper amount of oxygen. That could be the reason all of his other numbers are so far out of whack. The next step is to have an in-lab sleep study. Last time we did an in-home study because the lab was closed due to Covid-19. This time around they need to do an in-lab because they want to closely monitor what is going on while he is sleeping and titrate his BiPap. Meaning they want to continuously measure and adjust the settings. (Don’t worry, I had to ask the doctor what titrate meant too!)
They didn’t have any openings until the second week of June. The good news is that we will have our week in Lake Powell getting Travis on a regular sleep schedule. He is a night owl and usually stays up until around 3am and sleeps until around 12pm. For the sleep study they would like for him to fall asleep between 10-11pm.
But then he has to get a Covid-19 test before he can do the study. So they scheduled the study for June 9th, so they are sure to have the results. So hopefully Travis will not be back to his usual late nights yet.
In the meantime the primary care doctor doubled his Metformin. He wanted to add Lisinopril for kidney function and high blood pressure. I reminded the doctor that his blood pressure is actually on the low side. And Travis is already complaining about being light headed, most likely due to lack of oxygen.
We see Travis’s psychiatrist tomorrow. He worries that the Abilify Travis takes for his mental illness issues is contributing to his weight and diabetes issues. I share with the doctor that Travis was overweight long before the Abilify. Maybe some of it due to past pharmaceuticals, but mostly because of poor eating habits and lack of exercise.
The psychiatrist did stop the Abilify prescription at one point. The results were scary. I did take Travis to see him for an emergency visit while he was off Abilify and the psychiatrist put him right back on it.
I get that taking Abilify or a pharmaceutical like it might not be the best for Travis’s physical health. Especially because he does not do any of the healthy things to counter it. I have to put his mental health before his physical health. If he dies by suicide it won’t matter what his glucose level was. So I sent a long email to the psychiatrist to update him on Travis’s physical health. And to share with him that the sleep medicine doctor believes that if we can get to the bottom of the oxygen level issue, the other numbers will likely go to their lower, yet still not great, level.
The problem we have had in the past is that when too many things are changed at the same time, we cannot tell what is working, which change is actually making the difference.
Travis believes that all of his health issues are my fault. He told me that the pharmaceuticals that doctors put him on when he was still a young child altered the functioning of his brain. So not only does he suffer with chronic depression and anxiety because his brain isn’t functioning properly, now his brain isn’t getting enough oxygen to his organs.
I have told him as kindly as possible that it is important to give our organs proper nourishment. And that his smoking doesn’t help. The doctors tell him that our bodies were not made to be up at night. That we need sunlight. That if he was awake during the day and slept at night it would help with his depression. If he moved more it would help with his depression. But because of the depression he has zero motivation.
Round and round we go. It’s simply impossible to reason with a person when their brain doesn’t function properly. When I talk to him about these things, I am nagging him. When he hears my voice talking about his health, I imagine he hears the muffled sound like Charlie Brown’s teacher in the cartoons.
As much as I understand that we made the best decisions we could, with the information we had at the time, and at the advice of professionals, with only his best interests at heart, it still hurts to hear him say that his pain is because of me.
I am only human.
Sometimes I wallow in how hard this all is.
This weekend I finished the book I am reading for my next book club meeting, “The Nightingale” by Kristin Hannah. It tells the story of two sisters living in German-occupied, war-torn France during World War II. Per the back cover, “a heartbreakingly beautiful novel that celebrates the resilience of the human spirit and the durability of women.”
Suddenly I am able to gain a bit of perspective. It was like a smack upside the head.
Corey is probably rolling her eyes right now. She doesn’t like me to undermine what I am feeling by comparing it to the hardships of others. She reminds me that it is ok to have rough days because what I am dealing with is hard too. At the same time, she is a big proponent of mental attitude, your mindset.
Various things happen that remind me I can do hard things. This week it was this amazing book.
In fact, we can all do hard things.
“I see your pain, and it’s big. I also see your courage, and it’s bigger. You can do hard things.” - Glennon Doyle
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.” - Author Unknown