A CONVERSATION BETWEEN FRIENDS
Two boys meet on a school playground...
Hey man, what’s up, you seem down and out. Why the sad face?
Dinesh I’ve just had it. Today, I got blasted by my teacher for sleeping during class and to top it all my buddies say I was snoring (groans) And you know what? I am fed up with all the name calling; bada, fat boy, kumbakaran and all.
I’m sorry to hear that, man.
It’s not like I can help it, you know. And so many things have been happening. I feel tired all the time. I have headaches when I wake up in the morning. I fall asleep during class. Even my brother doesn’t want to sleep in the same room because I snore and it keeps him awake. My mother keeps saying she can’t find clothes and shoes that fit me. What’s wrong with the world man? Can’t they just accept me for who I am? I am not the only fat guy around am I?
Take it easy bro, I am sure we can find a solution to this.
Dinesh Are you going to lecture me about my diet? But what can I do, man? I love food! I love cola drinks because it gives me a buzz. I simply freak out on burgers and fries. And man, I was born with a sweet tooth! I know I am a little overweight, but I’ll eventually burn it off. I just need a little space, without everybody going on about my weight!
Sandun Thaaththi is a Chest Specialist, and I’ve heard him talk about things like this. Why don’t we ask him about this? I’ll tell you what, why don’t you come over one of these days and talk to him. The best time to catch him is around twelve midnight.
DineshWhat?!?!
Sandun Just kidding, bro. He doesn’t work on Wednesdays and that’s when he escapes to his den, we can catch him then.
The next Wednesday, Sandun visits his friend’s home. Dinesh’s father invites them to have a chat in his den.
Hello Sandun! Come in, have a seat. I’ve been hearing about the problems you have been having. Let’s have a chat, I’m sure we can sort things out.
Father Thanks Uncle, it’s very kind of you to make time for me.
Sandun No problem, Sandun. Now let’s hear your story.
Father Ok then here we go. I used to do a lot of sports but with O/Ls coming up, I simply couldn’t find the time. So I just put on a little weight.
Sandun Ok, have you ever had problems breathing?
Father I had asthma and problems with my sinuses. I used an inhaler and things were ok. I could do my sports and everything was fine. Also, when I am studying I need something to bite on to helps me concentrate. So I eat a lot of biscuits, muruku and chocolates, and drink coffee to keep me awake while I study. I also drink a lot of cool drinks. And then, before I realized it I put on a lot of weight. That’s when the problems started.
Sandun And did your asthma problems get worse after that?
Father Yes. My asthma got worse and I needed to be nebulized frequently. I was also given steroid tablets to control my asthma and all of these made me put on a lot of weight. I also ended up having gastritis. I couldn’t fit into my clothes any longer, my collar size is 17½. I have a big tummy and my chest became big. It’s really embarrassing, Uncle.
Sandun I understand, Sandun. Keep going. I am sure you have more to tell me
Father Yes. I began to snore in my sleep, I fall asleep as soon as I hit the bed but always wake up around 2-3 am to use the toilet. My little brother also refuses to sleep in our room because my snoring has got really bad. I wake up with a headache some mornings and then I am fine during the day when I am active. The moment I sit down, watch TV or read a book, I fall asleep. I even got into trouble during class for falling asleep. It is crazy, Uncle, my life feels totally messed up. Please don’t tell me to diet Uncle – I have already tried and it doesn’t work.
Sandun Hang in there son. I think you have got a condition called Obstructive Sleep Apnea or OSA for short.
Father What is OSA Uncle, is it something serious?
Sandun Let me explain son. Obstructive sleep apnea is a sleep-related breathing disorder that involves a reduction or complete halt in the flow of air in your upper air passages. It occurs when the muscles relax during sleep, causing the muscle and tissue in the back of your throat to collapse and block your upper airway. This leads to partial reductions called hypopneas) and complete pauses called apneas in breathing that last at least 10 seconds during sleep. Most pauses last between 10 and 30 seconds, but some may persist for one minute or longer. This can lead to abrupt reductions in your blood oxygen levels, with oxygen levels falling as much as 40% or more in severe cases. When this happens your brain will respond to the lack of oxygen by alerting your body – this causes an arousal and you wake up abruptly. This pattern can occur hundreds of times in one night. As a result your sleep is fragmented, often causing you to be excessively tired in the day. Most people with OSA snore loudly and frequently, with periods of silence when airflow is reduced or blocked. They then make choking, snorting or gasping sounds when their airway reopens.
Father That’s exactly what happens uncle – even my mother says the way I breathe when I am sleeping scares her because sometimes I completely stop breathing in my sleep. She even wakes me up sometimes, thinking I have stopped breathing.
Sandun I know, Sandun. It can be quite a frightening experience.
Father Uncle why did I get OSA?
Sandun Those who are overweight with a Body Mass Index of 25 to 29.9 or obese with a Body Mass Index of 30 and above are at risk of getting OSA. Men and women with large neck sizes: 17 inches collar size or more for men, 16 inches or more for women and people with short necks and facial features with a receding jaw line are also susceptible. Other include, adults and children with Down Syndrome and birth defects that give rise to abnormal facial structures, Children with large tonsils and adenoids, nasal congestion or blocks. People with certain hormonal disorders of thyroid or, pituitary gland and Smokers are also at risk.
Father Now I am beginning to understand. Uncle, is this serious?
Sandun I don’t mean to scare you son, but it can be serious because, OSA can result in fluctuating oxygen levels at night and an increased heart rate during arousals. This puts you at risk of developing disturbance in electrical activity of your heart. Other issues include a rise in daytime blood pressure, an increased risk of stroke, changes in blood sugar control and increased risk of diabetes, changes in concentration and mood changes and more which will affect your studies. Adults with OSA are at risk of being involved in a deadly motor vehicle accident as a result of falling asleep when driving.
FatherUncle, I think I just lost my appetite. Can I be helped, or am I like doomed ?
Uncle, I think I just lost my appetite. Can I be helped, or am I like doomed ?
Sandun I didn’t mean to scare you putha, I was just trying to give you all the facts.
Father That is Ok Uncle, I understand. I am 17 and will be driving soon, I don’t want to put my and someone else’s life at risk. So please, let me know what I must do?
Sandun You are a really smart boy, Sandun. But first, I need to have a chat with your mother and father. Then I will do a thorough examination when you come with them. I need to see why your asthma is not properly controlled I also need to see what problems you may be having with your sinuses and tonsils. And I need to check your blood pressure. I will also need to do some blood tests to check your blood sugar levels, cholesterol levels and thyroid hormone levels Finally, we need to do a Sleep Test or Polysomnography to diagnose OSA
Father A poly... a sleep test sounds cool, I fall asleep all the time during tests as well. Can I please bring my teacher when I come for this test?
Sandun You have a fine sense of humour son. Let me explain what a sleep test is. Sleep Apnoea must first be diagnosed at a sleep-lab during an overnight sleep study, or “polysomnogram.” The study will chart your vital signs, like your brain waves, heartbeat, breathing patterns, obstruction to airflow and blood oxygen levels.
Father That sounds real cool! I really like to show my father my brain waves; he seems sure that I haven’t got any. Jokes apart Uncle, how is OSA treated?
Sandun CPAP or Continuous Positive Airway Pressure is the main way OSA is treated. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open and prevents it from collapsing during sleep. It also prevents pauses in breathing and restoring normal oxygen levels. The newer CPAP models are small, light and virtually silent. You can choose from a number of mask sizes and styles to achieve a good fit.
Father Is that all I have to do? Will that machine cure me? And does it feel like I’m in a sci-fi movie?
Sandun I wish it like that too! But now, there is some work you have to do too. You need to lose weight, practice healthy eating and sleeping habits. You also need a doctor to sort out your sinus and tonsil problems.
Father I didn’t realize there was a catch to it. Aiyo Uncle, you took me through all this explanation only to come to a “you need to lose weight” statement.
Sandun Loosing that amount of weight is not simple, Putha. It takes a lot of effort, commitment and time. You need help to sort out your OSA while all that is happening.
Father I am sorry Uncle, I didn’t mean to sound ungrateful. You have taken a lot of trouble and spent a lot of time with me. You have helped me a lot and now I actually know there is hope for me. I was going crazy with so much happening with my life! I will speak to my parents and come and meet you soon, if that’s OK with you.
Sandun No problem, I am glad to be of help. My son speaks very highly of you and I am glad he has you as a friend.
Father Thanks Uncle I am really happy he is my friend too. And now, he has also saved my life.
Sandun We all need each other, Putha; that is what friendship is all about.
FatherNo issue bro, that’s what friends are for.
Hey man, thanks for bring me to see your father. He is really cool.
Sandun No issue bro, that’s what friends are for.
DineshNo issue bro, that’s what friends are for.