Medical Procedures: What It’s Like to Have a Steroid Injection

Approximately six weeks after hand and wrist surgery, I developed “trigger finger” in the pinky finger of my surgery hand.  After the splints were removed and I started using my fingers again, I noticed my pinky finger “clunked” when I curled it, and it “clunked” upon full extension too.

Trigger finger (medical name: stenosing tenosynovitis) happens when inflammation occurs in the sheath surrounding a finger’s tendon, narrowing the space through which the tendon moves and impinging its movement.

After two weeks of occupational therapy and treatment for the swelling in my hand and wrist (eight weeks post-surgery), the clunking in my finger had gotten worse.  So the therapist informed the surgeon, and he decided to treat the trigger finger with a steroid injection.  This was not fun.

My orthopedic surgeon cleaned the injection site thoroughly with an alcohol wipe and then he sprayed an icy numbing spray on the area.  I felt the needle go in.  But the discomfort started as he began to inject the steroid solution.  It felt very similar to an arthrogram injection – there is increasing discomfort as the space begins to fill.  In the case of an arthrogram contrasting solution injection, your joint fills with fluid.  In the case of this steroid injection, my tendon sheath filled with fluid.

As the discomfort increased, I once again found breathing exercises very helpful for controlling the discomfort (for more on breathing exercises, see this previous post).  Additionally, my surgeon was applying pressure to the tip of my finger which helped focus my attention away from the discomfort at the injection site near the base of my finger.

About halfway through the process of filling the tendon sheath with the steroid solution there was a noticeable “clunk”.  Both the surgeon and I could feel it.  He asked me if I felt it, then grinned and said “That’s a good sign.  We’re getting the solution where we want it.”

Toward the end of the injection there was a second “clunk”.  My surgeon was very pleased.  As he continued the injection, he asked if it felt to me like the area was getting too full.  When I said no, he finished emptying the syringe, removed the needle, and placed a band-aid over the injection site.

My surgeon warned me that it would probably hurt the next day – possibly a great deal.  He mentioned that I might find myself saying very uncomplimentary things about him.

[As it turned out, I had no pain or discomfort the next day.  I don’t know if it made a difference that I was wearing a compression glove, a compression stocking, and a brace on that hand.]

My occupational therapist cautioned me not to do my therapeutic exercises for the remainder of the day, as that could cause the steroid solution to work its way out of the target area.  She also told me not to apply heat to the area for the remainder of the day, but said that I could ice it as desired.

For several days following the injection, I am supposed to modify my therapeutic exercises to exclude my pinky finger as much as possible.  My surgeon said it can take up to five days to achieve the full effect.  The steroid injection should reduce the inflammation and allow the affected tendon to move freely again.

I did notice the temporary side effect of facial flushing, but it didn’t last very long (maybe 20-30 minutes).  My finger was also swollen and numb after the injection.  I’m not sure how long that lasted, because I went home immediately and applied a cold pack to the area.  By the time I removed the cold pack, the numbness was gone and most of the swelling was too.

In theory, the steroid injection will relieve the inflammation and cure the trigger finger.  Meanwhile, the rest of the post-surgery swelling of the hand and wrist should gradually abate and hopefully the trigger finger condition will not return.  In other words, hopefully this one treatment will fix it and I shouldn’t need another steroid injection.

Bottom Line: It was pretty uncomfortable during the injection, but I didn’t experience any after-effects.  If this cures my trigger finger in one treatment, it will have been totally worth the temporary discomfort.  As far as medical procedures go, for me, this one was no big deal.

Where Do You Get Your Health Information?

Previously, I spoke about becoming a critical consumer of health information. Today I read an article at U.S. News that adds another element to the discussion – the element of celebrity health advice.

As the article points out, most celebrities are not medically trained, nor are they experts in health science.  Neither are we.  So we often listen to celebrities because we are familiar with them, and they’re good at getting their message across.

Sometimes, we don’t even know where the health information we’re hearing originated from.  A friend tells us.  Then we hear it from our mail carrier, barista, or barber.  If we hear the same health advice from many acquaintances, we start to believe it.  But that doesn’t mean it’s true (or scientifically proven).

I am beginning to read more frequently the argument that scientists and health experts are not as good at getting their health information out to the public as celebrities and other sources are.  I tend to agree that they could be much better at this.

In the Information Age, the traditional academic and scientific methods of distributing information are too slow and too narrowly distributed.  If they do not improve, they will be seen more and more as irrelevant, and the public will get their information elsewhere (as we are already seeing).

Please read this article about celebrity health advice, and why we tend to believe it even though we probably shouldn’t.  Hopefully it will make you more aware of where your health advice comes from, and it will encourage you to get your health information from expert sources such as the NIH, the CDC, the Mayo Clinic, Johns Hopkins, or other academic and scientific sources.

After all, if you get health information from academic and scientific sources, controlled experiments have already been safely conducted on other people.  If you follow health advice from unproven sources, you’re conducting uncontrolled experiments on yourself.

Here’s to your health,

Crew Dog

Status Update

ALCON: The Botox has worn off, and I have two more weeks until the next treatment.  I’m back to spending my days strung out on the couch.  Blog posts will most likely be scarce for the next few weeks.

Guest Post: Diet Decision Making when Tired

[Here’s the next post in the series of guest posts on healthy diet and lifestyle from Dave Banko.]

One of the interesting experiments performed on ‘What’s the Right Diet for You?‘ assessed the effect of being tired on the decisions you make about what to eat.

The participants were divided into 2 groups: one group was given a good night’s rest and the other was forced to stay up until early in the morning. The next morning, both were sent shopping and given identical lists of types of things to purchase, but not given specific items.

When the groups finished shopping, their shopping baskets were compared and the results were astounding! The well rested group made excellent choices: lots of fresh fruits and veg, whole foods, and lean meats. The tired group purchased a lot of sugary and high fat items with a calorie content more than double the amount of the rested group!

Why is this?

When we are tired and drained of energy, our natural preservation mechanism is to quickly boost our energy levels, so we crave sugary and fatty foods.

Making good choices in this state will take every ounce of will power to overcome this fundamental self-preservation instinct.

This also relates to the discussion in my previous blog post about how when we are drained after exercise we crave sugary and fatty foods, but eating them would wipe out the positive weight loss effects of the exercise.

How do we counteract this? First and foremost is to get enough rest. I’ll be writing another post about the additional benefits of a good night’s sleep, and this is certainly one of them.

We live busy lifestyles though, and can’t always get enough rest or do things when well rested. In this case, the best thing to do is make a plan while rested. If grocery shopping, make your list in advance while rested, then stick to it when shopping!

In the end, knowledge is power. Just knowing what our bodies want helps us to make better, healthy lifestyle decisions!

As always, please contact me at daveb.uk@hotmail.com if you have any questions or comments. 🙂  [Crew Dog: Or comment below.]

Guest Post: Hydration and Weight Loss

[Here’s the next post in the guest post series on healthy diet and lifestyle from Dave Banko.]

There is a lot of content available regarding the importance to weight loss of drinking plenty of fluids. I’m including this blog post for completeness, but won’t really spend a lot of time on it.

Below is a great diagram from a post called 11 Reasons Why Dehydration is Making You Fat and Sick.

Just remember to be drinking the right kinds of fluids: plenty of water (perhaps with a squeeze of lemon or other fruit/veg infusion) and green/herbal/fruit teas and limit or eliminate sugary and/or caffeinated drinks. Check the labels and you’ll be surprised how many drinks contain sugar, fructose, and a chemical sweetener.

Please contact me at daveb.uk@hotmail.com with any questions or comments.  [Crew Dog: Or comment below]

[Crew Dog NOTE: For more information on proper hydration, such as getting water from foods, times when you need to increase your fluid intake, and what can happen if you drink too much water (hyponatremia), see this Mayo Clinic post.]

Book Review: The Simple Path to Wealth

SPW cover finalAs a certain TV show used to say, “And now for something *completely* different!”  Not only is this the first book review on this blog, but the book is about Money, not Health.

Rest assured, there is a method to my madness (at least, that’s what I tell Spousal Unit).  Money is related to heath directly, such as when you can’t afford the healthcare you need, and indirectly.  Indirect effects of money on health include the physical and emotional stress that comes from not having enough money to meet your needs, and the strain money problems can have on your relationships.

Therefore, I decided when I was a young lieutenant that understanding the world of finance and mastering my money was a critical life skill.

I started reading personal finance books in the early 90s: Your Money or Your Life, The Wealthy Barber, The Millionaire Next Door, The Tightwad Gazette, and the Bible of personal finance: Making the Most of Your Money, by Jane Bryant Quinn.  Over the years, I put what I learned into practice.  I started saving and investing.  I tried to fight the impulses to buy (too many) cool toys, and the peer pressure to live an affluent (some might say hedonistic) lifestyle.  I made a few mistakes, and I got smarter.  I kept reading books and articles about personal finance.  And then the internet happened.

In 2011, I started reading a personal finance blog – Mr. Money Mustache. That lead to other personal finance blogs: Early Retirement Extreme, The Military Guide, Get Rich Slowly, madFIentist, The Military Wallet, Root of Good, and many more.

And I noticed this guy, jlcollinsnh, in the comments section of many of these blogs. He was making comments that were insightful, with a wry sense of humor. I followed him back to his blog, jlcollinsnh, and I’ve been reading it ever since. In fact, it is my favorite personal finance blog (no offense, Nords!).

At the same time, and even prior to reading personal finance blogs, I was reading blogs about Simplicity and Minimalism.

I remember thinking, “If only there were a way to simplify personal finance”…

“Why can’t there be a simpler way to invest than holding a diversified portfolio of growth and value stocks, small-cap, mid-cap, large-cap, international, and sector stocks, short-term bonds, intermediate-term bonds, long-term bonds, and cash, spread across retirement and non-retirement accounts?”

JL Collins provided the answer: There *is* a simpler way to invest.

**Financial Independence is not incompatible with Simplicity.**

JL Collins gave me my financial freedom: I didn’t have to worry about asset allocation (Is this blended fund more growth or value? Do I have the right percentage of each asset class?). In fact, he blew my mind when he advised his daughter that she’d do quite well financially if all she ever did was live within her means and invest in just one fund. ONE fund??? Inconceivable!

But what I like best about JL is that he backs up his assertions with logic and data.

He “shows his work.” He doesn’t ask his readers to take his word for it. He explains how he reached his conclusions, and he welcomes challenges because he knows he’s not infallible and he just might learn something. He’s not the Oracle; he’s just a smart guy with a knack for explaining personal finance in a very accessible way, and he’s interested in having conversations with like-minded folks so that everyone can learn from each other and get smarter about our money.

That’s why I did a happy dance when I heard JL Collins was releasing his first book, The Simple Path to Wealth.  [Disclaimer: I was sent an advanced copy of the manuscript in exchange for my honest review.  JL doesn’t hustle his readers, and I don’t either.]

To be honest, I think it’s very difficult for authors to transition from a column/blog post format to a book format.

I loved Dave Barry’s newspaper columns, but was disappointed by a few of his books (although others were brilliant). I was slightly disappointed by Jenny Lawson (aka The Bloggess)’s first book, but feel she really hit her stride with her second book.  (Read it.  She talks candidly but humorously about health issues, including depression.)  I will admit I felt that slight prickle of disappointment initially with JL Collin’s book, The Simple Path to Wealth, as well.

The first section (Part One) felt a bit meandering – not the usual tight, crisp prose I’m accustomed to on his blog. But perhaps this is because I am already well-acquainted with the financial fundamentals and philosophy he outlines in this section. If you are still learning the basics, and the whys and wherefores of personal finance, you may benefit from Part One much more than I did.

However, Part Two is classic Collins: the clear, no-nonsense financial advice that I recommend to others, because it is easy to understand and will get them to where they (presumably) want to be – Financial Independence. And it will get them there with a minimum of hassle.

Collins speaks with the wisdom of someone who has spent a great deal of time thinking about personal finance, and has learned some lessons through trial-and-error. And he shares his hard-won wisdom so that, if you will listen, you can avoid his mistakes.

Furthermore, he understands that most people want to save for retirement, but don’t want to (or are so busy they cannot) spend a bunch of time figuring out how to do it. In Jim’s words, “Financial geeks like me are the aberration. Sane people don’t want to be bothered. My daughter helped me understand this at about the same time I was finally understanding that the most effective investing is also the simplest” (p.111).

Collins continues, “Complex and expensive investments are not only unnecessary, they underperform. Fiddling with your investments almost always leads to worse results. Making a few sound choices and letting them run is the essence of success, and the soul of The Simple Path to Wealth” (p.111).

Read that again: “Making a few sound choices and letting them run is the essence of success, and the soul of The Simple Path to Wealth.”

You can simplify your life by simplifying your investments (including retirement accounts), and you’ll probably reach financial independence sooner than your peers with complicated investment strategies who spend a great deal of time, effort, and emotion fiddling with their finances.

Also in Part Two, Collins is one of the only non-military personal finance educators to actually cover the Thrift Savings Plan (TSP) in his discussion of retirement accounts.  He highlights the often-overlooked consideration that TSPs *not* be rolled over to IRAs after separation from the military/civil service because the fees are so low – often lower than industry-leader Vanguard’s IRA fund fees.

He also includes a case study in Part Two.  Case studies are always fun because you get to see the practical application of the theoretical.  In other words, what does this advice translate to in real life?  Go to Chapter 22 to find out.

Part Three contains more whys and wherefores.  In Part Three, Mr. Collins discusses several hot topics and “shows his work”.

Finally, Part Four of The Simple Path to Wealth talks about what to do once you’ve reached financial independence.  Many talk about how to save and invest to reach retirement/financial independence, but few explain what to do once you get there.  This section talks about the nuts and bolts in such a way that you will feel confident you know what to do once you’ve “arrived”.

Afterword: Chapter 33 contains JL Collins’ blueprint for financial independence.

The Big Idea: “Over the years I’ve come across any number of people embracing life on their own terms.  They are intent on breaking the shackles of debt, consumerism and limiting mindsets, and living free. They are filled with ideas and courage.  This freedom, to me, is the single most valuable thing money can buy and it’s why I offer you the strategies in this book” (p.138).

[NOTE: This book is written for a general audience, not a military one.  For military-specific financial advice, see these blogs: The Military Guide and The Military Wallet.  And this book: The Military Guide to Financial Independence and Retirement.  These resources discuss topics such as military pensions, SBP, TSP, VGLI, and many other military finance alphabet soup words.  However, the basic information and the advice in The Simple Path to Wealth still apply to a military audience.]

Bottom Line: The Simple Path to Wealth is exactly what I hoped it would be: a solid financial reference book that I can confidently recommend to people who want to learn a simple, but effective, way to manage their money and to progress toward financial independence. I like the website, www.jlcollinsnh.com, because I still learn useful things about personal finance, despite having decades of experience. This is true of JL Collins’ book, The Simple Path to Wealth, as well.

Read this book.  Get smart about your money.  “Remember that nobody will care for your money better than you” (p.101).  The Simple Path to Wealth will show you how to manage your money simply and effectively.

Health Hack: Travel First Aid Kit

When I was much younger, I travelled the world without a care.  I took for granted that I would always be healthy.  Then came the time that I got food poisoning (salmonella) on a trip.  I had no first aid kit with me, and I didn’t know how to get medications in another country.

I had a two-day layover in the UK and no way to get even an aspirin – the hotel staff said it was illegal for them to give me any, not that they had any in the hotel.  After a very miserable 48 hours (plus the interminable flight home), I decided to start taking some over-the-counter medications with me when I travel.

The list of remedies I pack has grown with subsequent experiences (an epic hangover in Russia led to the inclusion of an antacid, for example).

My travel first aid supplies currently include:

  • A pain reliever/fever reducer (aspirin/Tylenol)
  • A non-steroidal anti-inflammatory (NSAID; such as Ibuprofen/Alleve)
  • An antacid (Pepcid/Rolaids/Tums)
  • An anti-diarrheal (Imodium)
  • upset stomach medicine (Pepto-Bismol)
  • sleep aid/jet-lag remedy (Melatonin)
  • decongestant/expectorant
  • cough/sore throat lozenges (Cepacol)
  • a travel thermometer
  • tweezers
  • alcohol swabs
  • band aids

You could also include an anti-histamine (Benadryl).  [Update: having had my first allergic reaction, I am adding Benadryl to my kit.]

If you know you will be walking or hiking a lot, you might also want moleskin and an ace bandage.  Depending on local conditions, you may also want to include some travel toilet paper (think MRE TP, but commercially available).

[NOTE: Brand names are included for familiarity.  I buy bargain-sized generic versions of these drugs whenever possible.]

[NOTE: When possible, I buy these drugs in blister packs.  I can take a few sheets of the blister packs with me, instead of an entire bottle, to save weight in my bags.]

[NOTE: I don’t include polysporin because of TSA liquid/gel restrictions.  Soap and water and alcohol swabs are usually sufficient.  You can include polysporin if you place it with your other liquids for screening, and if the container is 3 ounces or less.]

[CAUTION: Do not mix aspirin and NSAIDs.  It can cause stomach ulcers or other problems.]

[CAUTION: Medications which are over-the-counter (uncontrolled) at home may not be uncontrolled in other countries.  For example, Melatonin is only available by prescription in Australia.]

In addition to my travel first aid kit, I always take a bottle of Afrin nasal decongestant spray with me when I fly.

It is a very bad idea to fly with a head cold, but sometimes you don’t realize you’re coming down with a cold until you have trouble clearing your ears on descent.  Afrin can help relieve congestion, which should make it possible for you to clear your ears (equalize the pressure).  If you cannot equalize the pressure, you could rupture an eardrum.  This is why I always carry a bottle of Afrin in my carry-on luggage, just in case.

Even better than having remedies with you when you travel is to avoid needing them in the first place.

I will talk about ways to maintain your health while traveling in another post.

[DISCLAIMER: All information is provided for educational purposes only.  I am not a trained healthcare provider or medical expert.  Use common sense, know what works for your body, and if you have any questions, consult with your healthcare provider.  Many medications, including over-the-counter medications, are contraindicated for patients with specific health conditions.  Do not take a medication if it is unsafe for you or may aggravate other health conditions you have.]

CALL TO ACTION: If you currently do not travel with a first aid kit or over-the-counter remedies, I encourage you to assemble a kit before your next trip, TDY, or deployment.  You don’t need a fancy container – I keep mine in my toiletries bag.

What do you pack in your travel first aid kit?

Guest Post: Eating to Lose Weight

 

[Here’s another guest post from Dave Banko on healthy diet and lifestyle.]

This may sound counter intuitive, but the worst thing you can do to lose weight, particularly to burn fat, is to starve yourself.

Your body has a primitive defense mechanism for self-preservation to protect fat reserves in the event of actual starvation, going back to days when the availability of food was cyclical. When no calories are coming in, your body slows the metabolism down to conserve energy (making you feel lethargic and moody) and consumes muscle and organ tissue along with the fat to protect reserves and supply the brain and red blood cells.

You will lose weight, but not all of it will be fat, and this method can have serious negative effects on your overall health.  As soon as you start eating again, most of the weight comes back on as your body rebuilds.

Consuming calories, even a small amount, stimulates the metabolism and releases fat reserves.  This is also another reason breakfast is so important, as you haven’t been consuming calories for 8-12 hours overnight.

In ‘What’s the Right Diet for You?‘ scientists stress 80% of successful dieters start with breakfast.

A good breakfast including protein (eggs, fish, poultry, other lean meat or high protein legume) and complex carbohydrates in fruit and whole grains, and, of course, one or more glasses of water, is the perfect way to kick-start your metabolism and fat burning for the day.

Adding a cup of tea or coffee isn’t the end of world, unless you are also cutting down on caffeine. 🙂 I would avoid fruit juice as it has a high concentration of sugar without the fiber naturally found in whole fruit to slow down its hit to your blood stream.  Also be careful of hidden sugar in spreads, commercial cereals and even muesli.

However, you don’t need a lot of calories to trigger the fat burn which is why the 5 and 2 diet can keep the calorie content on the fasting days to 500-600 total calories. But even the 5 and 2 diet encourages breakfast on fast days to get you going, and regular eating on non-fast days.

Be sure not to fast on consecutive days, and eat properly on the days in between fasts.

According to the National Institute of Health, women should consume a minimum of 1200 calories per day and men should consume a minimum of 1500 calories per day for a healthy metabolism, appropriate balance of protein, fat, fiber and carbohydrates, and avoidance of malnutrition.

If intermittently fasting (this should only be for 2, at the most 3, non-consecutive days per week and for no longer than 12 weeks) the minimum should be 500-600 calories per day on fasting days, and 1500-1800 calories on the non-fasting days.

When aiming to lose weight, average women should aim for a weekly total of 8,400 to 10,500 calories per week and men, 10,500 to 12,600.  If you are heavier or very active, this target should be higher.

When I started this new healthy eating lifestyle (I prefer not to call it a diet, because I will be eating this way for the rest of my life), I weighed 351 lbs (having peaked at 365 lbs) and consumed around 5,000 calories per day.

I tried and failed with numerous starvation and detox diets.

Eating to lose weight made absolutely no sense to me, but I tried it anyway, and my successful weight loss convinced me.

Eating the right foods, in the right combination and at the right time of the day made me feel better, gave me plenty of energy, and made it easier for me to eat less (you may not feel ‘full’ but you will feel ‘satisfied’ and for longer), and the weight melted off.

At the time of this writing (17 months after starting to change the way I ate), I’m down to 218 lbs and working to lose the last 8 lbs to get down to my military weight of 210 lbs.

Every now and then, I still have bad days where I blow the diet, and it shows on the scale the next morning. My natural inclination is still to stop eating to counter my binge from the day before, but I remind myself how my body works, and then go cook my 2 whole egg cheese & veg omelette to have with my morning fruit, full fat natural yogurt, whole grain toast, lemon water, and tea (no sugar), and I’m right back on the program. The weight keeps coming off.

For more information on eating to lose weight, here’s a good blog post from My Fitness Pal.

Feel free to contact me at daveb.uk@hotmail.com with any questions or comments.  [Crew Dog: Or comment below.]

Medical Procedures: What It’s Like to Undergo a Sleep Study (Polysomnogram)

“So, why are you here?,” the technician asked me.  “My spouse says my snoring is pretty bad,” I responded sheepishly.  The technician laughed. “That’s the number one reason we see people here.  If it weren’t for spouses, a lot of people wouldn’t realize they have a problem.”

Well, I didn’t think I *had* a problem, but Spousal Unit did not agree.  A discussion with my PCM led to a consultation with a sleep doctor, who decided a sleep study was in order.

I arrived for my sleep study one evening after dinner.  I was told to bring my pajamas, toiletries, any medications I normally took, anything that was part of my normal night routine, and clothes for the next day.  I was also told that I could bring my own pillow if I wanted.

In preparation for the sleep study, I was told not to have any caffeine or alcohol after noon on the day of the study, since caffeine and alcohol can disrupt sleep patterns.

[For more information on preparing for a sleep study, see this article from the UCLA Sleep Disorders Center.]

A technician showed me to my room, which was something between a hospital room and a hotel room.  It had a linoleum floor, industrial fluorescent overhead lighting, a double bed, nightstand with lamp, dresser, television, and private bathroom.

The technician explained the sleep study procedures and asked if I had any questions.  Then he told me to change into my pajamas and do my evening routine to get ready for bed.  He told me to open my bedroom door when I was done, and he’d be back to get me hooked up to the monitoring equipment.

When he returned, the technician placed electrodes on my face (including the corners of my eyes) and scalp.  The electrodes have sticky backs, and attach directly to your skin/scalp.  The electrodes are connected by a tangle of individual wires to a relay that sends electrical signals from your brain and muscles to a computer.  These electrodes monitor various aspects of your sleep.

Next, the technician fastened bands around my chest and abdomen to measure breathing.  Then he attached a clip to my finger to measure the level of oxygen in my blood and monitor my heart rate.  (You’ve probably seen this clip before at your doctor’s office or in a hospital room – I call it the E.T. finger because it glows at the tip.)

None of the monitoring equipment was painful or particularly uncomfortable – it was just incredibly awkward.

Two sleep study warriors wired up for their studies:

After the technician got me all wired up, he gave me a call button in case I needed to summon him and told me to get comfortable, watch a little TV or read, and try to go to sleep around my normal time.

If I needed to go to the bathroom, I was supposed to summon him, and he would come and unplug some wires so I could get to the bathroom.  Everything would remain attached to me (electrodes etc.), so it would be a fairly simple process to disconnect and reconnect a few connections.

After he left, I watched TV for a while, then turned off the TV and the lamp and tried to sleep.

I know veterans are supposed to be able to sleep anywhere, but I have never been able to sleep lying flat on my back.  I can sleep sitting straight up, I can sleep on top of a cargo pallet in the back of a C-130, and I even fell asleep standing up once, but I cannot sleep lying on my back.  This was a bit of a problem, since I had all of the monitoring equipment hooked up to me, which made it difficult to sleep on my side, and impossible to sleep on my stomach.

To make matters worse, I was hyper-alert because I was sleeping in a new place, with lots of unusual noises, and I knew I was being monitored via a video camera.  Try sleeping while someone is watching you.

At one point I heard some commotion in the hallway – I found out later that one of the other patients had been sleepwalking.  How they managed that with all the equipment hooked up to them, I do not know.

Several times during the night the technician came over the intercom and encouraged me to try to sleep.  I must have fallen asleep eventually, because he woke me up in the morning and said it was time to go.  I asked if I had had a long enough sleep-cycle for him to get sufficient data, and he said just barely.

The technician disconnected and detached all of the monitoring equipment and left the room.  I took a shower, got dressed, packed up my gear, and was shown out of the sleep center.

Once all of my data was processed, I had a follow-up appointment with the sleep doctor.  The sleep doctor informed me that I have sleep apnea, and that I needed to remedy that by sleeping with a continuous positive airway pressure (CPAP) machine.

This diagnosis meant that I had to return for a second night at the sleep center, to determine what CPAP machine air pressure settings would alleviate my sleep apnea.  Oh joy.

The second visit was pretty much like the first.  Because I had had trouble sleeping the first time, they gave me a room down a dead-end hallway, which had less traffic and was darker and quieter than my first room on the main hallway.

This time, in addition to all of the monitoring equipment, I also had to wear a CPAP machine mask.  The mask allows the machine to provide pressurized air through your passageways in order to keep your airway open and provide enough oxygen to your lungs while you sleep.

I had tried on several types and sizes of masks during my follow-up appointment with the sleep doctor, and we had settled on a specific type and size.  The technician had this type and size mask ready for me to try the second night, as well as some others if the first mask didn’t work well for me during the second sleep study.

The technician adjusted the mask straps and fitted it for me, then showed me how the CPAP worked.  Like many of the newer CPAP machines, the one I used that night had a “ramp” feature that lets the air come through the mask at a lower pressure, and then gradually increases the air pressure to your prescribed setting.

This gradual increase usually takes about 15 minutes, and is supposed to give you time to fall asleep as you gradually adjust to the pressure.  If you have not fallen asleep by the time the machine reaches full pressure, and it is uncomfortable for you, you can press the ramp button, which will drop the pressure and start the gradual increase again.

The purpose of this second night was to determine at what air pressure my sleep apnea symptoms would be alleviated.  This meant that the technician would try various settings, and then I was supposed to fall asleep and the technician would see if the setting worked.

I got even less sleep the second night than I had the first night.  In addition to the awkwardness of all of the monitoring equipment, I now also had a mask strapped to my face with straps that went across my cheeks and over the top of my head.  The mask forced air through my nostrils, and the air flowing through the hose made noise.  It was nearly impossible for me to sleep with all of this stimuli.

A few times I dozed off and then the machine reached full pressure, which startled me awake.  By the end of the night, the technician was frustrated (although he wasn’t rude about it).  He said he barely had enough data to be able to calibrate the machine, but called it good enough.  None of us wanted to try that again on a third night.

As before, the technician removed all the equipment, and I got dressed and left.  I was glad I didn’t have to work the day after the second sleep study, because I was wiped out.

Results: As a result of my sleep study, I was diagnosed with sleep apnea and prescribed a CPAP machine for home use.  The mask was fitted for my head, the machine’s air pressure settings were adjusted for my required level, and I was told to sleep with this machine every night for the rest of my life.

Do you sleep with a CPAP machine?  Have you found a way to make peace with it?  Any hacks to make it less awkward?  Please share with us below.

Guest Post: Low Fat or Low Carb?

[Here’s the next in the guest post series on healthy diet and lifestyle from Dave Banko.]

One of the main debates in our Facebook weight loss group was whether we should focus on reducing carbs or fat. When focused on weight loss alone, studies have repeatedly shown a ‘low fat’ diet loses more body fat over the same period than a ‘low carb’ diet.

Having said that, there is more to consider for a healthy lifestyle than weight loss alone.

Let’s first separate carbs into complex carbohydrates, which tend to have a low glycemic index (GI), and simple carbohydrates like sugar, fructose and processed grains (skin, husks and other fiber removed), which have a higher glycemic index.

Take an apple for example. An average-sized apple is about 65 kcal and 14g of carbohydrates. The carbohydrates are complex because the natural sugars are locked with the cell structure. This naturally provides fiber so, when you eat an apple, it takes time for your digestive system to break down the cell walls and release the sugar. The cell walls also provide fiber and other nutrients to the body even after releasing the sugar.

When you drink apple juice, the sugar has been squeezed out of the cells of the apple.  There is no fiber to slow down the processing, so the apple sugars are immediately digested and hit the blood stream causing a spike in sugar levels and the need for insulin similar to drinking a commercial cola or other syrup-based drink. As a result, while I eat lots of whole fruits, I no longer drink fruit juice or syrupy drinks. Click on this link to read an excellent article illustrating the difference.

Fat, on the other hand, is dense and energy packed. It takes a lot longer to digest, so eating fat will not cause a spike in blood sugar. Dietary fat becomes an energy source in the blood stream, and any excess energy (no matter the source – whether fat, sugar, carbs or protein) will be converted and stored as body fat to use as an energy reserve for another time when you need it.

For me, I found fat in foods more satisfying in taste and the feeling of fullness than low or no-fat foods. I was satisfied with 1 150g pot of full fat natural yogurt where 2 150g pots of no-fat yogurt still left me longing for more.

In investigating low or no-fat products, I found that because removing the fat leaves the food tasting less satisfying, many manufacturers have compensated by increasing sugar or chemicals to fool your body.  The increase in sugar again leads to the blood sugar spikes which can lead to diabetes.

Since I have a family history of diabetes, I steer clear of anything that can serve as a precursor to becoming diabetic myself.

The negative to fat, of course, is the amount of calories it packs in a small amount of food. If you are satisfied and stay within your calorie targets, it’s fine – remember the French high fat diet is the 7th best in the world; but overeat a little, and it adds a lot of calories.

My personal diet includes a balance of protein, complex carbohydrates (low GI) and full fat items. I’ve gone to more natural foods and avoid processed foods and chemicals wherever possible.

I am not a doctor, and you may have a medical history or condition which requires you to go a different direction with your diet. This is fine, because I’ve hopefully shown that while there are general principles to follow, there is not one diet that works for everyone. Please seek medical advice when putting together any program.

In an article by the BBC on Low Carb vs Low Fat debate, Prof Susan Jebb of Oxford University (and one of the ‘What’s the Right Diet for You?’ team) sums it up like this:

“The investigators rightly conclude that the best diet for weight loss is the diet you can stick to. All diets ‘work’ if you stick to an eating plan that cuts calories, whether from fat or carbohydrate, but sticking to a diet is easier said than done, especially given the prolonged time it takes to lose weight.”

As always, feel free to contact me at daveb.uk@hotmail.com if you have any questions or comments, and good luck!  [Crew Dog: Or comment below.]