Dormus Interruptus

To continue documenting the process of admitting a “behavioral health” problem to the VA medical system, undergoing various general practitioners, social worker, psychologist interviews and most recently a sleep study, below is a description of the lattermost ordeal.

*To review the progress thus far, please refer to these two posts: "Walking Past the Guard," and "Into the System."

Due to some other planned events, I found myself in downtown Richmond Saturday evening prior to my appointment across town at the VA Medical Center (VAMC). My meeting ran late, and I didn’t even find myself attempting to LOOK for the highway again until several minutes after 9PM – the time at which I was supposed to be stepping into the sleep chamber at the VAMC. Naturally, I couldn’t find the highway – or at least the connector road that would have allowed me to get ON it. I knew exactly where it was: directly overhead or to either side of me, and totally inaccessible. There were no entrance ramps, and I don’t know Richmond enough to find a parallel road and follow it. With concern increasing that I would be too late for my appointment, I called the VA to inform them that I was running late, lost, and didn’t know how to get back to the highway. Nobody answered. And then nobody answered again. And again.

When I finally connected, I explained the situation, and a small team of nurses and late-night staff rallied around a computer, rummaged for maps, pulled up Mapquest, and began to realize that as long as they’ve lived in and around Richmond, they never really learned the road names. “Where are you?” I’d indicate my location, they’d start searching frantically, and a moment later they’d have directions – and I’d be ten blocks away by then and would immediately further lost myself attempting to reorient to their directions. Finally, another lady grabbed the phone.

“Ben? Where are you?” I indicated my location.

“Okay, take your next left, drive across the bridge, and lock your doors.”

“What?”

“Just lock them.”

“I’m not concerned about it, ma’am. I’m legally armed.”

“Good!”

Twenty minutes and one police crime scene detour later, I was crashing through the doors into the behavioral health clinic it the VAMC and meeting with perhaps one of the nicest ladies I’ve ever encountered.

A soft-spoken, grandmotherly woman, she indicated, “I was one of the people on your navigation team. I was the one that said lock your doors.” I released my long list of apologies for being late, she consoled me quietly, and pointed me towards my bed. “You just lay here and as soon as I’m done wiring up the other patient, I’ll come back and get you set up.”

Despite my irritation at being lost in downtown Richmond, I nearly fell asleep during the brief wait, and was stirred again by two technicians going to great lengths to untangle an impressive knot of wires that would somehow be soon affixed to me.

One Velco band wired to each ankle monitors movement of one’s legs – indicating Restless Leg Syndrome (RLS). I envisioned them wrapped around my ankles PREVENTING movement. Two elastic bands wrapped my chest to monitor breathing, and a pulsimeter affixed to my left hand. To my chest were attached two EKG monitors, and the technician taped over them liberally to prevent their falling off.

Two more electrodes attached behind my ears, two more on the front of my forehead, two on the temples, two on my cheeks, and a final pair on either side of my neck. To get around the matter of electrodes sticking to my scalp, the technician simply rammed them there firmly with a high power glue. “I’ll take these off in the morning with acetone.” Oh thanks.

The most obtrusive device, however, was the canula rammed into my nostrils and a small loop of sensors that also crossed over my mouth. “We want to make sure you’re not forgetting to breathe.” Armed thus, I was beginning to wonder if I’d be able to sleep at all. It was the nose/mouth senor that bothered me the most, and a growing concern that I’d wake up a few hours into the night unable to move, bang on the wall, or even shriek for help. Despite being tired, the prospect of sleep in this condition was diminishing rapidly.

“If you need help for any reason, we’re recording you, filming you – there’s the camera – and monitoring you all night. Just call my name, bang on the wall, or something. We’ll come and help you out. And if you need to go to the bathroom, here’s the bottle.” So they’re going to film me miturating into a cup now? Some job…

“Well, sweet dreams,” and she killed the lights, shut the door, and it was quiet again. Wires notwithstanding, I was asleep in ten minutes.

I slept like I always sleep – lightly, restlessly, and with frequent waking for inexplicable reasons. Save from one rather frantic ordeal in the early morning wherein I had to untangle my hand pulsimeter wiring from the face wiring (I have no idea how this happened), it was relatively uneventful. My ankle bands also fell off, greatly reducing the likelihood of tying them in a knot.

“Good morning,” said the nice lady, wandering in and switching on a low light.

As she started ripping taped electrodes from my face and dousing my hair in acetone, I asked, “did you observe anything?”

“Well, you don’t have apnea, we registered minimal leg movement, and you’re a restless sleeper.” I was so fixated on not losing my face to electrode tape that I neglected to inform her that the leg sensors had fallen off before I had even fallen asleep. I’m confident the sleep study technicians aren’t allowed to make any on-site diagnoses, so I wasn’t expecting much more from her. I am currently waiting for a trained medical doctor to analyze the 1,000 pages of compiled sleep data and reach any solid conclusions on what may be happening – in addition to what may be done to mitigate the problem (preferably without drug intervention).

Perhaps the greatest frustration was that I was kicked out of the sleep facility at 6:20AM Sunday morning and banished to wander downtown Richmond until I caught up with a friend for coffee. Yet 6:20AM is about three hours after I typically go to bed, and about three and a half hours before I typically wake up. The radio was playing some awful hymn and the sun was rising beautifully. As I called my friend to determine where we would meet, one thought, above all others, hit me powerfully: I needed a nap. Instead, I pulled over and commenced peeling tape glue off my forehead.

Copyright © 2009, Ben Shaw
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