Chained to the Bed

Sleep Paralysis and Sleep Apnea

I am suddenly awake in the pre-dawn hours. The heater is rumbling in the hallway and I can feel Lor and Vixen lying on the bed next to me. I decide to roll over and check the time, to see if I should get up.

But I can’t roll over.

As I struggle to move, to open my eyes, to twitch a finger, I can hear my breathing accelerating, and my heart rate is suddenly an increasing drumbeat in my ears. Through the sudden cacophony of the sounds of my panicking organs, unable to move a muscle, only one thought keeps racing through my head:

Oh no, not again.

A Waking Nightmare

Sound like a thriller or horror fiction? It isn’t. It is actually my personal experience less than an hour ago. The common term for it is Sleep Paralysis, and it apparently affects quite a few of us. But it isn’t anything I have ever heard anyone else talk about. It also affects those suffering from obesity (and epilepsy, lucky me) at a much higher rate than the rest of the world.

Sleep Paralysis, also known as hypnopompic sleep paralysis, occurs when you are transitioning out of REM sleep. During REM sleep (while dreaming) your body shuts down your musculature, so you don’t injure yourself while acting out your more active dreams. If the transition is somehow interrupted (for example, by a seizure) you may suddenly be awake, but without control of your musculature.

It is also one of the single most terrifying things a person can go through. Suddenly, you are the main character in Metallica’s “One” – completely trapped inside a body that doesn’t respond to your slightest command.

There is also another sub-group who suffer from sleep paralysis more than the average: those suffering from sleep apnea.

The Link To Obesity

Sleep Apnea occurs when your breathing is interrupted while sleeping. In more severe cases (like mine before bariatric surgery) this can occur dozens of times in an hour, every hour you are asleep. The result is that your brain is suffering from oxygen deprivation the entire time you are “asleep”.

One of the main factors causing sleep apnea is obesity: the extra fatty material in the neck around the airway closes it off. This is referred to as Obstructive Sleep Apnea, and the heavier you get, the more likely it is that you will begin suffering from it.

Now, here’s where things get weird. Let’s say you already suffer from sleep paralysis. Now, you also develop sleep apnea, thanks to your weight. Your sleep is being interrupted every night by your inability to breathe.

How many of those interruptions might take place during REM sleep, do you think? Your chances of a sleep paralysis-inducing interruption skyrocket. The combination of Obstructive Sleep Apnea and Sleep Paralysis deliver a devastating 1-2 punch that makes a person not want to sleep ever again.

Silence is Consent

I actually hopped on my blog this morning intending to write a short explanation as to why I wouldn’t be blogging today. An hour ago I was still panicked, turning lights on throughout the house so I wouldn’t be in the dark. I didn’t think I had anything coherent to say.

But, it turns out I was incorrect. It could be as many as 4 out of 10 people suffer from sleep paralysis. And I have yet to hear a single person talk about it. It is embarrassing as hell, akin to wetting the bed. But it doesn’t signify that there is something wrong with you alone. There is something happening to your physiology, or your sleep patterns, that is causing this to occur.

The solution? Start with a sleep study. After my original sleep study, I was diagnosed with OSA. I was given a machine called a C-PAP, which provides positive pressure down the airway, keeping it open while you sleep.

Since then, I have also lost 100+ pounds, further reducing my apnea. In fact, last night’s sleep paralysis is the first I have suffered from in over a year.

The Path Forward

Luckily for me, I already have an appointment for a sleep study follow-up on the books for next month. I had originally thought I would be getting released from my Darth Vader mask. Now, I am no longer sure that is such a great idea.

If you are suffering from these symptoms – talk to someone. You are not crazy. This is not a sign of impending mental collapse. Get yourself to a doctor and start looking into treatment. Don’t wait until your next mind-shattering episode.

Lack of sleep ties into a host of other physical and emotional problems. Do not be chained to poor health for a moment longer than you have to be.

Just remember, you are not alone.

Me Too,

Jeremy

 

The 3-Letter Word

The word we will be addressing today is a versatile one. It is used on playgrounds and in comedy clubs to get an immediate emotional reaction, whether laughter or tears. Dieticians and nutritionists argue its value or worthlessness. It is further broken down into “good” and “bad” versions.  Its presence is lauded in certain cuts of meat and denigrated in the human form.
The word I am referring to, of course, is “fat”.
So, what the heck IS fat, anyway? I mean, like, scientifically?
Despite what many trainers and late-night infomercials would like you to believe, fat is NOT actually a poison, out to wreck your health and your life. It is actually one of the three “macronutrients” that your body needs to survive (the other two being carbohydrates and protein.) Did you follow that? Needs to survive. Your body is specifically designed to run on a fuel mixture that includes fat.
So, why no love for fat as a concept, then? Mainly because of what fat is designed to do – act as an alternative energy source for our bodies during periods where we can’t get enough carbs or protein. When we were wandering from place to place looking for our next meal of carrion and berries or whatever, this was a good thing – the body’s fat reserves kept us going until we found our next source of balanced nutrition.
Nowadays, the nearest source of nutrition is the refrigerator. But no one has told the regulator in our brains that we probably don’t need to be storing quite as much fat to make it between meals. Add that to our tendency to overeat and under-exercise, and you have our sudden upswing in obesity, heart problems, high blood pressure, and the like.
Not to mention “fat kid” jokes.
The use of the term “fat” as an insult has reached epic proportions these days. Even I tend to use it on these pages in a negative manner, usually referring to myself. But, the fact of the matter is, the body is doing what is was designed to do: store fuel for use later, as an alternative power source. The fact that our society has turned “rail-thin” into the only desirable body standard means that our biological processes are working against our self-image. It is an ugly, ugly situation.
So, what can we do? Start calling things by their proper names, to start with. “Fat” is not a description – it is a nutrient. Obesity, the storage of unhealthy amounts of fat on the human body, is a medical condition, not a source of material for your stand-up routine. Try making fun of people with breast cancer or stroke victims and see how well that does with your target audience. Obesity is the same thing – an illness, a malfunctioning of the body’s natural processes.
For my part, I will endeavor to do the same thing – stop using the term “fat” to refer to myself or my condition. Change begins with ourselves, right? For everyone else, do what you can to set the record straight. Encourage those you know who are suffering from obesity to get help. Refuse to engage in banter abut the personal appearance of others. Teach your children that “fat” is not something that others should be shamed for. We should all do what we can, to convert the 3-letter word back to its appropriate usage, and away from the misleading and abusive form that is has taken. Only when we can take control of the concept again can we begin to re-define the issue.
Self-Correcting Behavior Is Hard,
– Hawkwind

Scary Stories

Photo Credit: Magda’s Maggots via Compfight cc

I spend a LOT of time (probably too much) hanging around on message boards and forums relating to obesity surgery. I don’t input very much – after all, I am not a “vet” yet, have not earned my surgical scars and all that. Every once in a while, I will put up a link to here on Misdirected if I feel it is especially relevant, but other than that – I lurk.

There are quite a few encouraging tales to be found out there. Formerly 600-pound men who are now avid wilderness hikers. A previously obese woman fitting into her wedding dress for the first time in 25 years. A grandmother getting into a swimsuit for the very first time in her life. The stories can be really heartwarming and encouraging to those of us just getting ready to take the plunge.

But I have recently been paying a lot more attention to those “other” stories”:

  • “I lost 100 pounds but gained it all back…”
  • “I am going through a bad time in my life and can’t stop eating…”
  • “My husband just left me and all I want to do is cry and eat…”
  • “After 5 successful years, I am regaining again and I don’t know why…”

Entry after entry of people whose surgery is not working out for them for one reason or another. Scary stuff.

I have not gone out of my way to look into relapse numbers. Normally this is the type of research I would be all over like stink on expensive cheese, but here I have held myself back. I couldn’t tell you exactly why, only that it didn’t feel right to be investigating failure before I have even started the process. I have been wanting to prepare myself for success, not for failure.

But the truth is out there: relapses happen. And it is scary to think that all this work, (and rearrangement of my innards) could go down the drain if I don’t watch my step.  So, I have been carefully reading these relapse stories and looking for common elements. I keep finding 3 common themes coming up time and again:

1. Lack of accountability. Most of the desperate pleas of those I see talking about their failures online are for someone to “straighten them out” or “tell them off.” At home, these individuals are not getting the support they need. Maybe they live alone, maybe their family is disinterested, or maybe (most frightening) their support system is working actively to sabotage them. But they need someone to call them out and tell them to get back on track.

2. Lack of exercise. This seems to be a major issue. I have yet to read anyone’s story about how they are suffering from massive regains while they are still exercising regularly. Just about all the horror stories I have read talk about how the pressures of life, or exhaustion, or just laziness have kept them off the street, away from the gym, and placed them on the couch.

3. Emotional turmoil. The big push that starts the plummet of the cliff of a major regain seems to frequently be an emotional trigger of some kind. A lost job, the death of a loved one, the breakup of a long-term relationship (sadly common for those who have gone through bariatric surgery) all seem to be things that have forced these individuals to seek comfort where they have always gotten it in the past – from food.

Lor and I are lucky. She has me to hold us accountable to our diets, and I have her to push us when it comes to exercise. As far as emotional turmoil – we have each other to rely on if something goes wrong in either of our lives. It isn’t like we’re going to get divorced again. Been there, got the T-Shirt – it didn’t fit.

For anyone else, I would encourage them to find a family member, community,  or friend to act as an accountability partner. My other advice would be to do it now – while things are still going well. Looking for help while you are desperate leads to bad, bad choices. Get someone in your corner right away, and keep them there – when the storm clouds roll in, you’ll have someone to run to before things get out of control.

This lifestyle change that we have undertaken is hard enough without handicapping ourselves by trying to go solo. Do it with a friend, find a support group, get plugged into a relationship with a trainer – anything you can do to make sure that one bad day doesn’t turn into one bad week, or one bad month, or a disastrous relapse to obesity. One thing we know about life – bad times will show up. Make sure that you have planned ahead, and have the tools you need to come out the other side with your “new self” intact.

Being Prepared Aint Just For Scouts,

– Hawkwind

Seeking: One Fat Hero

Photo Credit: Tolagunestro via Compfight cc

In the time when I am not gaming, creating blog articles, or reading, I write fiction. Like, quite a bit. Since being fitted with a C-PAP a couple years back I tend to have incredibly vivid dreams, and the last ones before I get up in the morning always seem to involve the same set of characters. So, I have created a mythology of sorts around these characters, and write little vignettes involving them. But, after I woke up and wrote down my notes this morning, it struck me – there are no overweight characters in these stories.

For that matter, I am hard pressed to think of overweight central characters in any story I have read, and I read a lot. I can think of fat and jovial innkeepers, large menacing bikers, and a bunch of lazy and obese programmers – but not a single overweight hero. It is as if the burden of carrying the story forward is so great that it acts like a constant cardio workout for these people, ensuring that they stay slim (or, in some cases, muscular.)

Even the oversized secondary characters in most stories aren’t treated well. They are frequently used as a kind of comic relief – a mental visual gag if you will: Let’s all laugh at the fatso as he tries to run away from danger. (Example: Any “slasher” horror film ever made.) Other times heavy individuals are used as more sinister characters: the overweight person is too lazy to achieve his goals as normal folks do, so uses treachery instead – the mercenary programmer from Jurassic Park is an excellent example. Very rarely, obesity is treated as a threatening quality – the previously mentioned “huge biker” would qualify. The original “Kingpin” character from Marvel comics comes to mind in this category. (Though a fine actor, Vincent D’Onofrio can hardly be described as obese, so his depiction of the Kingpin does not qualify here.)

In a sense, I get it. When we experience stories, especially when we read, we want to idealize the characters. We want to take their positive characteristics and find them reflecting off the fractal planes and edges of our own lives, hoping to recognize something “heroic” in ourselves. We do not necessarily want to see that which we don’t like about ourselves highlighted in our entertainment. But seriously – in the “real world” of the United States more than half of us are overweight. Why don’t the demographics of our entertainment reflect that?

More to the point, why don’t my demographics hold up? Why are my stories filled with active, muscular men and size 6 women? In real life I like large women – I do not prefer the body style that “looks like a teenage boy with plums in his shirt pockets.” (Spider Robinson) So, why am I not creating these characters? What flaw lies in me, and apparently in other authors, that does not allow for the creation of more realistic body types?

I am still troubled by this, and still don’t have an answer yet. But, the next time I sit down to write, I know I will be aware of my previous failures here, and hopefully can begin to correct them. Maybe spotting this weakness now, before any of my fiction is ever published, is the best outcome I could have hoped for.

Still Angry At My Subconscious,

– Hawkwind

PS – Just thought of an obese central character: Don Corleone, from The Godfather. But he isn’t exactly heroic, is he?

Top 10 Things I Won’t Miss About Being Obese

“Normal-sized” people, you might just want to skip ahead a couple of paragraphs. You are totally not going to get this. And, also, easily offended or delicate people might just want to wait for tomorrow’s post. ‘Cause I am about to get uncomfortably real in here.

My fellow members of the Fat Person’s Association, have you ever pulled that trick where you put both hands under your belly fat, lift it up, and then rest it on a convenient table/bar/desk? Don’t you just revel in how good it feels on your back and shoulders not having that weight there for just a minute? Yeah, me too. Pretty sure Lor has never done it, and I certainly wouldn’t do it in front of her since I would then have to spend the next hour disinfecting whatever surface I had performed this on. But, man, for just a moment it feels less painful to be obese.

This morning, after I (hypothetically) performed this maneuver so I could breathe for a minute, I was struck by how weird it was. And how much I am not going to miss doing this, and so many other weird things I only do because I am fat. Which leads me to…

Hawkwind’s Top 10 Things I Won’t Miss Post-Surgery

10. Tying Shoes: If you are of a normal size, this is something you probably don’t give a moment’s thought to. The shoe is untied, you bend over, tie it up, and you are on your way. Doesn’t work that way for me. I am so overweight that I can not see, much less reach my toes. I also have two arthritic knees. So, tying shoes for me involves sitting down, lifting a leg as high as I can, stretching my arm down to grab it by the ankle, then lifting it up to rest over one knee. THEN I can tie a shoe. Repeat for the other side.

Mostly, I wear slip-ons these days.

9. Creaking Furniture: Getting into a piece of furniture designed for a normal human frame is a challenge. I lower myself ever so gingerly onto whatever I am sitting down on, listening to the creaks and groans of structure not designed to hold this much weight, hoping it doesn’t buckle and leave me on the floor in a pile of wood fragments.Getting into bed is even worse, as my bedframe screeches and groans like an F-150 being used to transport a killer whale.

Those computer desk chairs that are supposed to last 10 years? I’ve been through 3 of them since 2010.

8. Gasping For Air: The story is the same, no matter where I am. Walking the dog. Getting groceries from the store to the car. Walking from one end of the house to the other (and we have a SMALL house). I am invariably gasping and wheezing as if I had a 20-year long 2-pack-a-day smoking habit. Any exertion at all and I am gasping like a fish, huffing and puffing like an old steam locomotive. Yes, I know I live at 5,500 feet, but once upon a time I didn’t have this problem.

7. Living In The Slow Lane: Speaking of walking the dog, I used to think there was nothing worse than walking the chihuahua and not being able to keep up with her. I was wrong. Now that Lor is walking as well, I have two expectant faces looking back at me from half a block away, waiting for me to catch up. No matter where I go or with whom, you can guarantee I will be the caboose, trying valiantly to catch up and failing.

6. Not Looking In Mirrors:  As I detailed yesterday – when you are in my condition, mirrors are not your friend. You look away, you focus on another part of the room, you do whatever you can to avoid seeing yourself by accident. Whatever it takes, I do not look directly at the melting snowman covered in flesh that I have become.

5. “I Can’t Believe I Ate The Whole Thing”: Fellow members of the FPA, you’ve all been there with me. The entire bag of Doritos. The whole Chocolate Cream Pie. The 5th trip through the line at your favorite all-you-can-eat place. Followed immediately by the soul-crushing guilt. How did I eat all that? What is wrong with me? The astonished looks on the faces of your dining companions don’t help, so we tend to do this kind of thing at home. In front of the TV. In the dark. With the blinds closed. At least we can go to bed afterward and tell ourselves that “Tomorrow I’ll do better.”

But we never do, do we?

4. Eye Contact: Once upon a time, before I became a code monkey, I was a hell of a salesman. Firm grip, sincere tones, and most importantly – solid eye contact. When the potential customer had to look away from my gaze, I knew I had won.

Yeah, I let Lor handle our face-to-face negotiations now. Because I can not maintain eye contact with anyone for any length of time. I see the disgust, or the loathing, or worse yet the pity reflected in their eyes. “Poor guy – if only he would learn to put down the ice cream and pick up a barbell.” Yeah, I know you are thinking it, buddy. I want to grab them by the shoulders and yell “It’s not that simple!”

But I don’t. ‘Cause, you know, eye contact.

3. Dressing: Oh my God, where to even begin here. My wife is a clothes hound. Color, form, and fit – these things are so important to her. But, unlike me, she still has a figure. I look like a potato with legs. So, I wear the loosest pants I can find (so I can breathe). I no longer tuck in shirts, accepting looking like a slob in the hopes that this will help disguise my fat. (Hint: It doesn’t work.) I don’t worry about colors, or fabrics, or matching – I care only that I can fit things around my corpulent frame. Lor constantly tries to convince me that I would feel better about myself if I worked more on my personal appearance.

I constantly tell Lor that you can’t shine shit.

2. Going to the Bathroom: This might be a good point to get young children and easily offended people safely moved to other activities. Because going to the bathroom in my condition sucks. As a man, you’re supposed to be able to urinate standing up. As a morbidly obese man, this becomes an issue. Why? Because your fat obscures your genitalia, that’s why.  If you urinate standing up without making some pretty serious weight-bearing adjustments, you will be peeing on the back side of your fat pouch. Not fun.

So, no matter what operation I am performing, I have to do it sitting down. Now, have you ever been in the position of estimating the opening on a toilet? Because I certainly have. With so much mass it is very easy to “miss” your placement and make a mess at the front end or back end. I do everything I can to just take care of my business at home.

Plus, not all toilets are terribly stable. See issue # 9.

1. Fat Person Sex: Oh, man. The sexual life of an obese person is not a happy one. When you lay 300+ pounds on top of another person, it is not commonly thought of as pleasurable. Mostly it is thought of as “death by asphyxiation”. Flip things around, and your partner gets to listen to you wheezing like a dying animal while watching waves of fat rippling across your body like sand dunes being blown across the Sahara. Sounds really sexy, right? Yeah, not to mention the fact that male obesity also carries along with it depressed testosterone levels – not only are you less interested, but you are less able to do anything about it when you are interested.

Yeah, not going to miss that one bit.

Many people I have chatted with pre-surgery are still on the fence about the whole process. They worry about reduced diet, about social stigma, about being killed or damaged on the operating table. And, while their concerns are valid, I am ready to get going on this surgery thing, even considering my fear of hospitals.

Becuase I am mainly worried about leaving fat residue on the kitchen table from “resting” there for a minute.

Breaking Out The 409 (‘Cause Lor Is Gonna Read This),

– Hawkwind