ten year checkup

I went to the doctor this afternoon for a general checkup, something I haven’t done in around ten years. The reason I went in is because I have been absolutely exhausted lately. I already know from my wife’s observations that I have sleep apnea, but it’s been getting a lot worse lately. I’m fairly sure that I’m going to end up with a CPAP machine after they jump through all the hoops for the insurance company.

Right off the bat with the nurse, I learned that my blood pressure was a little high at 136 over 90.

The doctor told me that my thyroid is larger than he would expect. Apparently what happens with the thyroid is that the hormone levels start dropping, which prompts the body to make the thyroid larger to increase the levels. He also said that he thought he felt a small bump on the thyroid. If the blood test for thyroid shows any problem, he’ll get an x-ray and ultrasound.

He’s referred me to a dermatologist. He doesn’t think any of my moles are problematic, but there are a lot of them and he wants an expert to look at them. I also have a bunch of skin tags in various places. They aren’t likely to be cancerous, so removing them is optional. He’s recommending that I get my first colonoscopy at 45 instead of 50, because apparently people who get skin tags are more prone to polyps.

At the end, I had a bunch of blood drawn for various blood tests like thyroid, anemia, and cholesterol. They have put me on their list to take a pulsoximeter home so they can track my oxygen for a night. If that shows low oxygen levels, they’ll get me in for an actual sleep study, which will likely show that I need a CPAP machine.

It seems that both thyroid problems and sleep apnea can cause high blood pressure, so the doctor isn’t worried about that part yet.

3 responses to “ten year checkup”

  1. On the blood pressure (BP), I wouldn’t worry about it. The theoretical optimum is 120/80, with the upper limits being around 220 (when people start having strokes from bursting arteries) and the low being around 50 (when people aren’t moving enough blood to maintain oxygenation). Where you are at 136/90 is just about 10-15% above perfect, which is not bad at all, especially if you have resting heart rate (pulse) in the 60s or 70s.

    Here’s the skinny on “I feel tired all the time” – it’s a very broad differential. It could be thyroid imbalance, depression, sleep disturbance (with that whole range of medical, psychological, behavioral, and environmental causes), inappropriate medications, anemia, hypoglycemia, and etc. The etc. is the more rare stuff, but it’s a very long list.

    Now the most likely cause is that your wife is right and you stop breathing while you sleep. That’s incredibly common, especially among middle aged guys. The good news is that the CPAP will make you feel like a teenager again. The bad news is a word called “aerophagia” that I don’t need to describe – you’ll find out for yourself. The *best* news is that by dropping as little as 20% of your body weight, you can improve OSA symptoms by up to 50%, so if you can lean it out enough you’ll sleep again without the machine.

    Oh, and free advice from a guy who’s been there – if you have *ever* thought about going for the short, short buzz cut hairstyle, the day before your sleep study is a truly excellent time to get it done. Trust me.


  2. It’s been a couple of years since I sat down at one of those automatic blood pressure machines they used to have in every grocery store, but typically when I would, my blood pressure was about 110/70. So for me, that’s a bigger spike than I want to see. I’m not going to worry about it too much unless it stays elevated.

    Of those potential causes, the only way it might be incorrect medication is that I’m not taking something I should be taking, because aside from the occasional allergy pill, 800 mg of OTC ibuprofen for my infrequent migraines, and a little too much caffeine, I don’t take any medications. Depression is something that I’m not sure about. As far as I know I’m not depressed, but what do you use as a measuring stick?

    My wife tells me that I’ll stop breathing for 20 seconds or more at a time while I sleep, which the doctor said was almost guaranteed to be cause for a sleep study. He considers it a bit of a formality to do the pulse-ox test, but the insurance company doesn’t.

    I definitely plan on dropping the weight. My hope is that the CPAP will, if not make me feel like a teenager, let me feel better enough that I won’t cringe at the idea of walking around the neighborhood and ultimately getting back on my bike.

    A couple of people told me about what they do to your hair to get the electrodes to stay. I’ll keep a buzzcut in mind. I’ve done it several times in the past, though I never did shave it to the skin.


  3. That’d work (the buzz). The stuff they put in there does come out, eventually, but it’s like having snot in your hair. The best solution I found was a good long soak in a warm bath followed by careful use of a fine comb.

    The pulse oximetry may be a formality (sounds like it), but hey – opportunity to do the ET joke.

    What do you use as a measuring stick for depression? Damn good question, it really is. Depression is one of those incredibly subtle diseases that is *so* obvious to everyone else but *so* freaking difficult to recognize in oneself. I would say – ask someone close to you if you seem depressed. Watch Annie Hall and see if it brings you down (it will if you’re healthy). Try British comedy – if it doesn’t make you laugh, then – yeah.

    Dropping the weight: Try these people for a beginning. I’m finding them very educational. http://www.fat2fitradio.com/

    The podcast can be picked up using your directory of choice – each show is about a commute long and very honest.

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