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i'm fucking sleepy and fuck moral panic about over-prescribing doctors

Because I don’t really trust doctors or their shit, I asked my family doctor for whatever report the sleep specialist I saw sent to him. And I can’t stop looking at it because it has an entirely mysterious word in the results that makes no sense in context. I’m hoping its a typo or whatever. I’m going to try and get the complete results and stuff from him. And maybe a second opinion. Because if what he wrote is true (if we take out the random word) then… I have Feelings about how he treated me.

Here’s what he wrote was the result of my multiple sleep latency test:

The following day mean sleep latency was (venous) 26 seconds but there is no sleep onset REM.

Now the word I have now fucking clue why is there is in parenthesis, ‘venous’. It literally makes no sense in context. Googling the word lets me know its usually associated with the veins in your legs. As it applies to a period of time who the fuck knows what its supposed to mean.

Supposing that it is some kind of mistake, removing the word leaves with a mean sleep latency of 26 seconds.

I did a bunch of looking, obviously, after seeing this to see what this might mean in terms of results. A diagnosis for narcolepsy usually requires a mean sleep latency of less than 8 minutes with two incidents of REM. So no REM but my mean sleep latency was a ridiculously fast 26 seconds. Anything less than 5-8 minutes is considered abnormal.

Now, I definitely have sleep apnea. That’s for sure. And this low mean is, as the doctor says, most likely a result of that. Its also for sure that CPAP is the best treatment for this. I haven’t been able to afford one and it, tbh, wasn’t a really high priority overall. Now that I’m fundraising to become a busty superstar, I’m trying to get my hands on a CPAP for the surgery (since it’ll help things).

I just… cannot forget his reaction to me when I first asked about options other than the CPAP bc I couldn’t afford it. He quickly said, “if u don’t have narcolepsy, the medications are Bad bc they could give u a heart attack” or some such junk. At the time, I was actually more looking for sleep hygiene suggestions and stuff. This was before I did the MLST, though.

Post MLST… I’m still like. Okay. Yeah. Sure. But seeing these results. I’m like. Really!? He couldn’t suggest anything other than really expensive shit I can’t afford???? Choices are: cpap, dental appliance, or surgery. He said the surgery (which migh be free bc canadian healthcare is ridiculous like this) is the least effective. Most effective is the cpap. Most expensive is the dental appliance.

I do get why he’d be so resistant overall to perscribing medication for excessive daytime sleepiness. Pretty much the only options are stimulants like ritalin or ‘awakeness promoting agents’ like modafinil. The latter is the one with potentially deadly side effects. And, of course, we know from ADHD and narcolepsy ppl that getting hooked on ritalin will destroy your life (I’m being super sarcastic here).

I’m lucky in the sense that no one watches me close enough at work to care if I fall asleep at my desk. Which I do. At least once a day. And its unlikely that anyone would care all that much even if they did catch me. My office is super casual like that.

Remember how I was poking the job postings in Ottawa bc my br0friend is doing his PhD there? And how although I was interested in, I knew I could apply for a data entry position because I’d fall asleep all the time at my desk and probably be fired within a week? Yeah. I realize now that this probably applies for any and all jobs that require me to sit and concentrate on anything longer than 10 or so minutes.

Hypothetically, I could maybe find another understanding employer who wouldn’t care that I randomly fall asleep on the job one or two times (possibly even more depending) a day for anywhere between 15min - 30min. Heck, maybe anyone I apprised of my sleep disorder would be understanding and not penalize me for it. Although, I bet most would expect me to make up the lost time.

But honestly? My overall quality of life bc of this one thing is pretty heavy hit. Its hard being tired and sleepy all the time. I loose entire days because I’m too sleepy to think coherently. I have a pile of work that I need to do but have been avoiding bc I know that when I start, I’ll start struggling with staying awake and its not a feeling I particularly enjoy.

Part of my rant here is also thinking about the general moral panic of doctors over-prescribing medications. Because I can’t help but wonder who is getting over-prescribed what medication. As far as I’m able to tell, getting a prescription for certain kinds of helpful medications has been like fucking pulling teeth.

All because some can be addictive, if mishandled, and apparently doctors have been handing them out like candy. And it might be medication frequently abused by people who may not ‘need’ it for a Officially Diagnosed(tm) reason. So all of this means that people who might benefit from it, like me, can’t access it.

But who? That’s what gets me. I have an Officially Diagnosed(tm) panic disorder. Which means… I get panic attacks. I’m currently on prozac to help with my generalized anxiety (eg my other anxiety disorder) and it is helping, overall, to reduce the frequency and intensity of my panic attachs. But I still have them. My doctor, begrudgingly, has prescribed me 0.5mg of sublingual ativan. It does help, esp. since it works very fast. But he’ll only prescribe me ten at a time with no refills.

His reluctance makes me feel like I have to be extra mega careful about how much ativan I take. I mean… what if I have, idk, four panic attacks within a week like I did a month ago? That’s like almost half of my supply right there (assuming I have a freshly filled prescription). So. I actually now have anxiety over whether or not I’ll have an ativan if/when I have a bad panic attack. Please remember than one of my main panic symptoms is bowel distress and I have absolutely shit my pants in public. So yeah. It worries me.

On the other hand… I know of one middle-aged, white middle class lady who has a monthly prescription for ativan. One a day, every day! Now. she doesn’t actually take one everyday. But she could. She certainly doesn’t have to fucking worry about running out and shitting her pants in public like I do.

The thing that gets me about this situation is that I don’t even like how ativan makes me feel. Yes, it calms me down and I appreciate that. But it also makes me feel stupid and fuzzy headed. Worse, bc things like that tend to make sleep apnea more severe, it also tends to fuck up my entire next day too. So anxiety about running out aside, I tend to not take one if deep breathing will do the trick (as it sometimes does).

Anyway. Fuck doctors.