Complex Sleep Apnea

Frequently Asked Questions

1. QUESTION:
   does complex sleep apnea disqualify a pilot from flying?

   • ANSWER:
     If you tell your AME that you have been diagnosed with sleep apnea, which you are required to do, then you will have to demonstrate that you are being successfully treated. This will usually include a complete sleep study to demonstrate that the sleep apnea has been successfully treated, followed and a Maintenance of Wakefulness Test.

     CAUTION: you will need to find a non-accredited sleep lab to do the FAA required MWT. The FAA wants a MWT-20 and insists that you must not fall asleep or even doze one time during the day. The accredited labs all want to do a MWT-40 which requires lying recumbent in a dark room with nothing to do for 40 minutes some number of times during the day of the test. I am not a physician, but IMHO, they want you to fall asleep so that they can measure the depth and length of the sleep. The FAA just wants to know that you can stay awake. If you fall asleep, even once, it is a failure, and you will not have a medical certificate.

     Soooo, let me see, you will spend the night in a strange bed, hooked up to all manner of tubes and wires, roll over in the night and disconnect a wire, and the nurse has to come in, wake you up, and re-hook you up. This, IMHO, almost guarantees a bad night's sleep, and then having to spend the day being tested on the quality of last night's sleep.

     If you go to a non-accredited sleep lab, your insurance will still cover the procedure, but they will do the minimum required by the FAA which is a MWT-20 and you will not be required to spend the night before under their supervision. In other words, a good night's sleep in your own bed or that of a hotel. SHOP AROUND, don't just go where your Dr. tells you to go.

2. QUESTION:
   central sleep apnea and hypopnea?
   I've just been diagnosed with central, obstructive and complex sleep apnea, as well as hypopnea. Does anyone have any info on these afflictions? Maybe I'm being a bit of a hypochondriac, but what I've read so far sounds kind of scary.

   • ANSWER:
     It can be scary if untreated. There is a respirator type mask you can be fitted wiyh to relieve the symptoms.

3. QUESTION:
   What is Sleep Apnea..?
   What can you tell me about it?

   In my story I'm thinking about giving him sleep apnea so I just wanted to know some details about it.

   If this helps at all, I remember a few months ago for about a week I constantly had nightmares and woke up gasping for air. In my dreams I'd be unable to breathe, I told my friends and they said it could be sleep apnea but it doesn't happen anymore.

   So like what happens if you don't sleep with whatever that oxygen mask is in that picture, and how do you know you have it if you don't snore? The signs/symptoms of obstructive (which I think is snoring), and complex, and central.

   I'm only 13 so I don't really no much about this, sorry if it might be difficult to explain to me. Wikipedia just won't do y'know =P

   • ANSWER:
     In general, a patient with sleep apnea doesn't know when he stops breathing in sleep or when he wakes up. That's the problem when you try to diagnose sleep apnea: if you don't have other person to watch your sleep, then you can wake up 1000 time and you don't know about it.

     However, if you are very tired during the day, every day, then this is a real symptom of sleep apnea.
     I think you've had a panic attack, or an anxiety disorder. Sleep apnea doesn't treat by itself.

4. QUESTION:
   How often should a person get a complete blood count and why?
   I am 53, male, former smoker(I smoked for 19 years and quit in 1992). I do not drink.

   I have epilepsy(since 1966), Charcot-Marie-Tooth disease(since birth), essential non-pulmonary hypertension, gastro-esophageal disease, BPH, complex central sleep apnea.

   Could you please cite your sources for your answer, i.e., National Institute of Health, American Heart Association, etc. Thank you

   • ANSWER:
     Everyone is unique and no one person is the same, so as their health. There is no specific guidelines to how often should the physician check your CBC. Your physician will determine the frequency according to your need. The decision will mainly be affected by your current health (more ill, more frequent), your medication and the physician preference. There is some recommendation to some medication of how often should the physician check your blood work (may not be CBC). Also some physician like to check it more frequently than others.

     If you really want to know, you should ask your primary physician, s/he know your health the best.

5. QUESTION:
   very very sensitive penis?
   so im a 23 year old male who has high blood pressure, high cholesterol and complex sleep apnea. my penis for some reason is extremely sensitive. i can only last for a min while having sex! and its same all around its extremely sensitive. and no im not on water pills. help please i dont know what to do

   • ANSWER:
     Hi,

     Try to control your blood pressure with transcendental meditation. Find more infos at,

     http://the-transcendental-meditation.blogspot.com

     Thanks,
     Narza

6. QUESTION:
   Re Hubby's Hi BP, low pulse, atenolol Question; If take water pill, contraindicated w/ cozar due to potassium?
   Thanks for the info regarding this issue (Husband has lo pulse genetically and is on atenolol which makes him out of breath and lower pulse, e.g. 40)
   My husband has taken acetazolamide (which I requested from doc) due to a small study that found it helped some with severe sleep apnea. But after the 2 stents were placed in Dec. 06, doc gave him cozaar, which is contraindicated w/ postassium, but when take acetazolamide, need to take potassium supplement. I understand that blood tests could monitor this interaction; and the acet. does help with the sleep apnea (a bit, he has complex apnea and is getting the new vpap machine in about a month). Cardiologist is on vacation now, I have called twice about this question and tried to ask him last visit, but he only has about 15 minutes per patient (he spent more like 45 minutes w/us), yet I still didn't get through my list of questions.

   • ANSWER:
     Better go to an ER or second consultation.

7. QUESTION:
   I'm so sick of being tired, exhausted, and lacking energy. Should I have a sleep study done?
   I think my anti-depressants and being back in school have made things better for me but I'm still having some problems being exhausted, tired, and lacking energy. I eat decent, exercise almost every day, get about 9 hours of sleep a night plus a half hour nap, and have a somewhat regular sleep pattern. Since I am in college with 18 credits, work, working out, clubs, and other things, I only got 5 hours of sleep the night before last. Last night I got about 10 plus a 2 hour nap. I know there's such a thing as getting too much sleep. But I was so exhausted that all I wanted to do was sleep. Typically my sleep schedule is much more regular but I still feel almost as exhuasted, tired, and having little energy. It's hard for me to do much without getting a quick nap. It's been similar to this my whole life and I wish I could fix it. I suppose I should also mention that I don't have any thyroid problems or vitamin deficiencies according to my blood work. My blood levels are a bit off but apparently I'm just supposed to continue being monitored - slighly high PTH and calcium I think. I take a B complex vitamin and multivitamin anyway. I feel like I've already done everything I can. Maybe I have hypersomnia (not sleep apnea though) and a sleep study would help?
   I did start trying to drink a little coffee this year and it has no effect on me. As far as protein goes, I drink a cup of chocolate milk 2-3 times a day and drink 2 bottles of Ensure Plus every day (each one has 26% DV of protein). I try to eat yogurt almost every day too.

   • ANSWER:

8. QUESTION:
   This is what makes you dream! i know they will add a question mark after this! lol! !!!!!!!!!!!!!!!!!!!!!!!!!!?
   i already know

   The discovery of rapid eye movement (REM) sleep, a mentally active period during which dreaming occurs, provided a biological explanation for this phenomenon. It also inspired interest in sleep research by giving scientists a marker for changes in the brain during sleep. From this knowledge, they have begun to understand and develop treatments for major sleep disorders such as insomnia and sleep apnea.

   Everyone sleeps. This fundamental activity consumes one-third of our lifetimes and can overpower all other needs. But what does sleep do for us? What happens when you are sleep deprived? What are sleep disorders?
   Much of what is known about sleep stems from the groundbreaking 1953 discovery of rapid eye movement (REM) sleep. This is an active period of sleep marked in humans by intense activity in the brain and rapid bursts of eye movements. At the same time, scientists discovered that REM sleep is when dreaming occurs.
   Before the 1950s, most scientists thought of sleep as an unchanging, dormant period of little interest. Hardly anything was known about sleep or dreaming.
   The earliest hints that sleep was a changing state came with studies showing that blood pressure, heart rate, and other body functions in humans rise and fall in a pattern during sleep. Because researchers had observed some eye movement during sleep, they recorded these movements by placing electrodes behind the eyes. They also recorded muscle activity and brain waves. They found regular periods of very rapid eye movement and rapidly changing brain waves that alternated with periods of deep, quiet, sleep marked by large, slow brain waves. Later, scientists found that the body is paralyzed during REM sleep.

   The REM sleep discovery:

   Suggested that sleep is a complex activity, fundamentally different from waking, but just as active.
   Provided a biological marker for dreaming so that immediate dream reports could be collected.
   Compelled scientists to examine the physiology of sleep.
   When researchers woke people up during REM sleep and asked them about their dreams, they found that almost all who awakened during REM sleep could remember their dreams. They realized that people who claim they do not dream really do not remember their dreams the next morning. Also, scientists found that, rather than being fleeting events, dreams vary in length according to the length of REM period.
   In later studies, scientists divided non-REM sleep into four stages, accounting for about 75 percent of total sleep. In each stage, brain waves become progressively larger and slower, and sleep becomes deeper. After reaching stage 4, the deepest period, the pattern reverses, and sleep becomes progressively lighter until REM sleep, the most active period, occurs. This cycle typically occurs about once every 90 minutes in humans.
   Scientists found that brain activity during REM sleep begins in the pons, a structure in the brainstem, and neighboring midbrain regions. The pons sends signals to the thalamus and to the cerebral cortex, which is responsible for most thought processes. It also sends signals to turn off motor neurons in the spinal cord, causing a temporary paralysis that prevents movement.
   Research on normal sleep led scientists to recognize and study sleep disorders, which afflict up to 70 million Americans. These disorders include insomnia, or difficulty in falling asleep, and sleep apnea, which causes breathing to stop for extended periods during sleep. These can cause behavior problems and accidents related to fatigue.
   Once sleep disorders became recognized, scientists began to find treatments for them.
   Almost everything known about the physiology of sleep has been learned by studying experimental animals. For example, scientists found that sleep phases are closely related to the activity of certain groups of nerve cells releasing brain chemicals that relay information from one neuron to another. Research on these specialized cell groups is helping scientists to devise specific drug treatments for sleep disorders.
   Yet much remains to be uncovered. Exactly what sleep does for humans is unknown. Researchers are just beginning to unravel the mechanisms explaining why and how people nod off and wake up.

   • ANSWER:
     LOL. COME ON MAN. IM ONLY 16 AND I KNEW THIS ALREADY! ITS NOT ROCKET SCIENCE.

9. QUESTION:
   Almost fainting from using albuterol inhaler... WHY?
   I've been very very very sick for the last 2 weeks with either bronchitis or pneumonia, and therefore I've had to go back to using my inhaler.

   So the problem is that lately when I use it, I get extremely lightheaded on the verge of passing out... At work a couple days ago I went completely blind for about 10 seconds. And last night was a very scary experience, and I'll describe most of what happened:

   - first it was the most intense headrush I've ever felt (very warm)
   - I felt extremely weak/slow
   - vision: almost lost it momentarily, got very blurry and still is, for the next 2 hours everything was fuzzy and kinda like "TV snow"
   - had a very strange pain in my neck and upper back
   - after laying down to return blood to my head, my face and neck were very red and warm (warm to touch and warm sensations)
   - I was dizzy, confused, very "out of it", couldn't talk intelligently, etc.

   If this a few mins I wouldn't be concerned, but these all lasted for 2-3 hours until I went to sleep.

   And this morning it's still somewhat the same, I can't see very clearly and I feel like a zombie.

   Other info:
   - I haven't been overusing the inhaler
   - Medications: Adderall 40mg/day, +cold medicines (dayquil, tylenol, etc.), multi vitamins, B vitamin complex, marijuana (I use it instead of sleeping pills), and I had consumed "magic" mushrooms 2 days prior to this incident.
   - Medical problems: diagnosed sleep apnea, hypoglycemia (I've been controlling it), and an undiagnosed illness; probably a thyroid issue although the doctors haven't come to a conclusion yet.
   - Yesterday when this happened I hadn't eaten in about 12 hours (I was actually using the inhaler right before going to make dinner), and I had walked 3-4 miles earlier, also sat in the cold for about 2 hours... obviously I wasn't in the best of shape but still this kinda scared me.

   I'm also going to assume my blood sugar was very low since I didn't have any food for 12 hours and no sugary drinks for about 8 hours. And that could probably contribute to this but I can't help thinking there's some underlying reason.

   I dunno............

   • ANSWER:
     I'm on the same inhaler. you have another underlying issue. have you been exposed to a infection of the breathing track or a flu bug. sounds like it from what you wrote. you also get light headed where else normal lung people don't so this is your lungs problem in the combination of this other condition. can you eat regularly. I mean so your blood sugar is normal. or take 1000 mg of vitamin C and the special zinc lozenges. they can help but you may be in for the need of antibiotics. my husband just had a bad case and his first. he got a new job at the airport in hard hit michigan. he used to design cad eng for new constructions now he goes outside doing maintenance help work. and he got sick as all the guys do. he had to be on antibiotic.

10. QUESTION:
    Recent minimally invasive hip replace ment surgery/Anesthesia Issues?
    Have received 25 rounds of anesthesia in my lifetime/no problems, this time major problems. Surgery was 5/23/08; am 49, 18 year history/very complex mental health/auto immune disorders(very high functioning bipolar, CFS, mild Fibro), sleep apnea. Am overweight but 5'11''/ lg frame. Maternal history of multiple chemical sensitivities. Been in and out of an altered state of consciousness, amnesia or aware but memory/motor skills slow as molasses. Saw family Dr./full blood work done 7/21; everything is at theraputic levels, kidney/liver function is fine. Psychiatrist appt this afternoon. Hip replacement total success but what the H is going on with me? Articles to help me back this up would be helpful. Prefer medical professionals or someone who went through similar thing. Surgeon was aware of vulnerabilities, dropped ball in aftercare/won't speak with me. Documenting everthing to keep track, not stable enough to drive, friends checking in on me. Two more hospitalizations, some PTSD.

    • ANSWER:
      It is usually reasonable to try a number of non-operative interventions before considering hip replacement surgery for arthritis. Prior to surgery, an orthopaedic surgeon may offer pills (either non-steroidal anti-inflammatory medications or analgesics like acetaminophen, also known as Tylenol), knee injections, or exercises. Your surgeon may talk to you about activity modification, weight loss, or use of a cane.

      The decision to undergo a hip replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of hip pain. When basic activities of daily life--like walking, shopping, or reasonable recreational pastimes--are inhibited or prevented by the hip pain, it may be reasonable to consider the surgery.

      Very rarely, the arthritis can cause a destructive pattern of bone loss. In this instance, a surgeon might recommend the surgery in order to prevent a type of pelvic fracture (called protrusio acetabuli), even if your symptoms are otherwise manageable non-surgically. But again, this is quite uncommon. In almost all instances, the decision and timing of hip replacement surgery for arthritis are a personal decision to be made by the patient, not by the surgeon. The decision should be made in consultation with a trusted surgeon who can help educate the patient as to risks, benefits, alternatives, and issues related to recovery from surgery. If a surgeon says you “need” a hip replacement for arthritis, without discussing alternatives or asking you about quality-of-life issues, it might be worth considering getting a second opinion.

      What happens without surgery?

      Arthritis is often progressive, and symptoms typically worsen over time. In other patients, the symptoms wax and wane, causing “good days and bad days.” Hip arthritis does not usually improve on its own. Sometimes, if the hip becomes quite stiff, this can result in increased stresses to the lower back with low back pain being the result. As mentioned, in very rare cases, the arthritis can cause a pattern of bone loss in the pelvis (protrusio acetabuli) that can predispose patients to fracture of the hip socket.
      Surgical options

      “Traditional” or “minimally-invasive” hip replacement?

      This topic, more than any other, is on the minds of patients who come to the office to discuss hip replacements today.

      Traditional hip replacement--using an incision that varies proportionally with the size of the patient, and may be between 5 and 8 inches long--has been done, with a few modifications of surgical technique, for over 40 years. The results of this approach have been published by literally thousands of surgeon-scientists, from hundreds of medical centers, in dozens of countries. There is a known success rate from this surgery, and it is above 90% with more than 10 years of follow-up after the operation. It is predictable, and considered one of the great surgical innovations of the 20th century. It would appear from this that we ought to set the bar fairly high before trying something radically new or experimental.

      In contrast, “minimally-invasive” hip replacement is a new surgical approach; few surgeons have even been doing it for two years. “Minimally-invasive” means different things to different surgeons. There is no accepted definition--it can be the same operation done through a slightly smaller incision than the surgeon used to use (say 5 inches rather than 6 or 8 inches), a much shorter incision (an approach calling for a 3 inch incision is popular in some places), or even two 1.5-inch incisions using an x-ray machine to find the bones and put the components in the right place.

      Surgeons who perform these approaches often say that the shorter incision results in a number of benefits: shorter recovery time, less blood loss, less post-operative pain, or fewer days in the hospital.

      The problem with these claims is that, to date, they have not been proved in a single scientific study. And even if one or two studies come out on the topic, most scientists agree that before advertising that something in surgery is true, it should be validated by different surgeons in different medical centers--to make sure that the claims are in fact true and that the results can be reproduced by others. As of now, this has not been done.

      One might reasonably ask “What could be wrong with a shorter incision--if anything, the results would be the same, but the scar would be more attractive, right?” The answer is, not necessarily. If the shorter incision causes the surgeon difficulty seeing the hip socket or the thigh bone (femur) clearly, or if it impedes his/her ability to work in the tighter surgical field, the result could be badly positioned hip replacement components. That could cause surgical complications like fractures or nerve injuries, hip dislocations (where the ball painfully comes out of the socket after the surgery), and premature wear of the artificial bearing surface.

      This is in contrast to minimally-invasive partial knee replacement, which has been around only a few years longer than the hip technique, but already has a number of studies proving patients recover faster, and that surgeons are able to get the components properly positioned through the smaller incision.

      It is particularly telling that the Journal of Arthroplasty, which is the main research journal for joint replacement surgeons, recently wrote an editorial criticizing surgeons who have advertised the “minimally-invasive” hip technique to the public before any reasonable scientific analysis has been performed on it.

      On the other hand, innovation and new approaches are essential to the improvement of techniques in all areas of medicine. It seems very possible that some, if not all, of the benefits of “minimally-invasive” hip replacement may be realized. It is quite likely that we will learn much more about this technique in the near future. At this point, it is reasonable for patients who are attracted to the idea of a more cosmetic appearance of the shorter incision, and who are not troubled by the as-yet-unanswered questions about this approach, to consider “minimally-invasive” hip replacement. Others might consider going with a traditional surgical approach.

      Like so much else in medicine and surgery, this is a personal choice that is best made in view of all the facts.

      Links

11. QUESTION:
    HELP!!!! I need to know what condition my symptoms are describing!?
    All of a sudden, since the age of 13 aprox., all of these symptoms occurred:
    -Dizinnes
    -Extreme Headaches, I can usually feel them before they turn from manageable to crippling
    -Numbness in my arm and half my face
    -Worsening vision. My vision was like a hawk's eye, now I have snowy vision and floaters all since that one point in time. It's hard to read now, and I have to strain my eyes. I got my eyes checked and they said 20/20 vision. I get round spots around my visual field, usually red or black or green and when I feel weaker or headaches are coming on, my vision tinges, and then worsens even more to the point where I can barely see like they are drained of light. That's when I feel lightheaded and even more throbbing than usual.
    - I was a star athlete, and all of a sudden, my muscles would always feel week. I was fitter and working out in the best sports, swimming, triathlons, cycling, Track and field, rowing and I was good at all of them. Then my performance just took a huge hit, and no matter how hard I try, I can't get back.
    -I have really bad tremors that become uncontrollable. If I am just sitting around, mostly my symptoms are present, but as soon as I move just a little bit or go out, it's crippling, and to get somewhere it takes me longer.
    School performance, I was and still am the brightest in my classes, but my focus and concentration has been reduced to a point where no matter how hard I try or how many strategies and how much help I get from others, I am barely scraping by on a reduced course load. I was in university, honors, and that took 100 times more effort then it should have.
    -My stress levels because of this, and so many unfortunate life events that I could of managed without this condition but with this condition just compounded to a point of intolerable constant stress.
    -I have sleep apnea, and I am only 20. I've been having sleep paralysis since I was a young child and it's terrifying!
    -My body temperatures is always out of wack, and I am always soooo incredibly hungry, I eat so much and crave certain foods. When I say hungry, I mean A LOT!
    -My heart skips a beat all the time, my breathing is shallow and irregular and It's like I am shell shocked.
    -I am extremely irritated by even the slightest noises and smells, and I am extremely sensitive to my environment.
    - No matter how much, or how little, my sleep is never satisfying. I was on vacation for a year! And it didn't work...
    -I am very forgetful, and I drop things easily all the time. I hear high pitched noises, and ringing a lot.
    I halucinate a lot, but I've gotten used to it and so the effect isn't so frightning, I just ride it over.

    The doctors are hesitant and say they think it may be as a result of the abnormal blood vessels in my brain but they said that this is just so complex, and that I am not showing any life threatning signs, they are making me wait despite the urgency. My doctor has just stepped up the pressure on the neurologists and the process, she is now taking it more seriously. Another doctor who is not my family doctor but who has more experience told me that all of these are extremely serious indicators of a physical problem in my brain, and he said it is in his opinion, he is 99.9% sure it's the avms. He said he's seen it soo many times and the same symptoms. Just other doctors don't know.

    Help, I have lost some of the prime time of my life! I need to know what this could be, or at least if anybody is suffering from the same thing and has viable strategies to survive and thrive regardless. I just want to move on with life and be a good person. So much was invested into me and still is, but it's my responsibillity to support my family now, and be a better man. I've always had the best of intentions though.
    -Uncontrollable sadness, despite no reason to be. Huge mood swings, I have to pull away from people when my head hurts and I can feel the irritation or sadness coming on.
    -It feels like I am not my self, and everything is depersonalized, so distant and cold. I dislike this feeling so much and it makes me anxious.

    Please guys, help me with some honest and constructive feedback so that I may do away with all these frustrations and be a better member to my family and society. I just want to be myself again. I never take advantage of people, I've gone out of my way to protect them at the expense of my own vanity. My problem though, is when is the nice guy going to have a lucky break for once?

    Please help !!

    • ANSWER:
      Go to your primary care physician, and ask for a referral to a "sleep specialist". A sleep specialist will conduct an overnight sleep study which will provide a wealth of information about your condition and appropriate treatment.

      Hope this helps

12. QUESTION:
    Will vitamins and minerals interact with these medications?
    I am 22,and take a Multi vitamin,Omega 3-6-9 complex,calcium with vitamin D,Magnesium and B-50 complex daily for 5 years.
    My dad who is 67,takes the following medications daily for years.He has bad sleep apnea,gets maybe an hour or two at a time,chest pains,poor circulation and feeling weak/fatigued constantly.
    He had a quadruple bypass and aoertic valve replacement 6 months ago.

    Allopurinol 300mg
    Metformin 500mg
    Benazepril HCL 5mg
    Simvastatin 20mg
    Metoprolol
    HCTZ 25mg/Triamtererene 37.5mg
    Aspirin 81mg
    Hydrocodone 10/325(x5 daily)

    He doesn't ever take any of the supplements I have when offered,because he says he does not want to take a chance on them interacting with his cycle of medications. However,How would magnesium/calcium/and B-6,B-12 etc , seeing how they are completely natural,interact in a negative way?

    Thanks guys,please no criticism. I just want to see my dad live a longer and healthier life,if i can help I'd like to.

    • ANSWER:
      Isn't it amazing that his doctors don't have him on any supplements or vitamins? They've turned into pill pushers. My mom had the bypass and valve replacement and we finally talked her into talking to her dr to take her off some of her 12 meds. She feels much better. Now, if I could just get her to eat right.

      You're going to have to ask a pharmacist about your question. With that cocktail of drugs I wouldn't want to be the one to go out on a limb.

      Big question is what does your dad eat? Has he changed his diet to fresh, raw and natural? Because that's probably what caused his problem in the first place. Does he drink soda? Coffee? Water?

      Have him ask his doctor what he should do. I'm pretty certain the doctor won't have a solid answer.

      RICK

13. QUESTION:
    How to stay awake while at work?
    I been having trouble staying awake at work. I did some online research and tried just about everything. I got a plant for my desk, bought a fan, chewed gum, apples, sunflower seeds, none ofit worked. I've chased No-Doz down with Monster Energy drinks, no help. Ive tried 5 hour power and even 7 hour power and yet Im still falling asleep at work. Im taking vitamins, (B complex and E) Chromium Picolonate, Flax Seed Oil - this was a suggestion to help aid digestion and keep from feeling sluggish, no help. My wife tends to think I may have sleep apnea, so Ive been using the throat spray w/nasal strips and Claritin on a daily to aid in allergies. And Im still sleeping at my desk. Our boss is a hard a$$ and doesnt allow talking or music when working (I do data entry) When I do feel like im getting sleepy at work I usually get up and gop to the bathroom and splash my face a few times with water as cold as I can get it. This helps for abt 10 minutes and then its back to the nodding. Coffee is no use, chilled Mt Dew no help. Ive tried it all....im this close to starting a cocaine habit just to stay awake at work! Anyone have ANY suggestions short of getting another job???

    • ANSWER:
      Drop the the caffeine and all the energy drinks.

      They only work until your body builds a resistance to it.

      The Vitamins and minerals are great but aren't going to help you to any degree, if your dehydrated or just don't drink as much water as you need.

      If you smoke, stopping will help tremendously but beside that, get outside and working or exercising until you feel like going to bed before Jay or Conan comes on!.

      Eat a large breakfast, but most importantly, is the way you feel about your work place.

      Try to see your boss, in a newer light, and except things that you can't change, you 'd be surprised how that would make you feel!

      Good Luck!

14. QUESTION:
    TPDR from the Navy Dealing with the VA.?
    Hi hows everyone, let me start by saying god bless. Well I have been TPDR from the navy due to epilepsy/seizure disorder I have complex partial seizures at least 2 grandmal and 3-4 petty mal seizures a month which means I probably never be ever to drive again in my life unless it magically goes away, I also have obstructive sleep apnea with a CPAP. I just had my C&P exam with the VA I was wondering how long before I get an answer and what is my percentage looking like. Please be serious in you answers thank you and have a blessed day!
    40% disabilty form the navy, I was in for 7 years, none of the conditions were listed as EPES, No since I was retierd I have tricare pirme, I dont believe I have a VSO but I will find out, and yes VA has all my medical records and I have a copy for me also. The VA told me I would be at the top of the list since I started the process before I got out the military.
    and I just finished with my c&p exam, eveything has been pretty fast so far Im just wondering how long before I get an answer on my precentage from the VA, I have heard some horror stories from other people but all of my conditions were well documented by my neurologist.

    • ANSWER:
      A very complex question...
      You don't give a lot of Details...
      01...What was your Disability % given by the USN ???
      (It should be at least that...)
      02...How long were you in the Navy ???
      03...Was it listed as EPES ???
      (Existed Prior Entry into the Service...)
      04...What is your GAF Score ???
      (Global Assessment of Functioning)

      05...Did you Transfer your Military Insurance
      to VA Insurance as you will never be able
      to afford or get civilian Insurance...

      06...Did you file with SSD...

      07...Do you have a National Service Officer
      from any of the VSO handling your claim for you ???
      (If not you will get screwed by the VA...)

      08...Hope you have copies of ALL of your
      USN Medical records...

      It can take 30 days to a year...depending on
      how long the USN takes to transfer your med
      records to the VARO...

      Any other questions...
      Feel free to email me...