Tontine Therapy

The trusty old CPAP has its benefits, that is for certain.

A recap:

Among E@L's many deviations is his septum, thanks to his nose's interception of a speeding, suddenly expanding in size and eclipsing the batsmen and the steel pole of the net off which it ricocheted, cricket ball, way back when No1 son was a rising star in the juniors and his own weaknesses in those left-arm round-the-wicket mediums were becoming obvious, slipping to well-bashable slows and he was ignominiously dropped to the 3rds, were no one could bat so it didn't matter that he could no longer bowl (shin splints, rotator cuff). Add precipitous weight gain to that, also thanks to cricket, viz: the copious beers and sausages in wrapped white bread and ingested in a thrice weekly ritual (the game and training) integral to the social aspect of playing in the 3rds, in a 2nd Div district league of a non-descript provincial city in a distant country girt by sea, and you have a person who snores, a person whom someone can easily HATE. E@L has told you all this..

That shattered ethmoidal plate has restricted his air intake capacity too, and he finds it difficult to breathe with sufficient efficiency when right lateral decubitus. Those BreatheRight nasal strips help, but only so much, and they don't prevent his snoring.

Industrial strength snoring, as mentioned. And eventually he developed sleep apnoea as well. It took an inordinate time for E@L to discover this, and its severity, sleeping as he used do back in that land-girt, open-cut mine, alone. No doubt much of the blame for the brain-rot which afflicts his cogitative abilities and his (what was it again?) memory can be directly directed at these frequent near-ischaemic episodes. There was no-one there to prod him, gently or otherwise, out of his semi-comatose state, to rouse him, to shake him, to kick his shin, to stuff a pillow over his face and press, press, press until the snoring stopped.

So E@L snored on: he dropped his soft-palate, stopped breathing for 20secs and, spluttering into state just below consciousness, took a great last gasp in order to breathe again for a few seconds. And the cycle of little-deaths started, and so he grew dumber and dumber and... [fuck, this is starting to sound like a fairy-tale!]

~~~~~~~~~~~~

E@L is using his third CPAP, one especially designed for travelling: it's lighter, smaller, etc... His main machine sits at home, unloved for long periods like this current three week stint in Thailand, and it has a humidifier, which makes it a bit bulky to cart around. The small portable one's base is a bit slippery so he places it (upside down so it doesn't suck in all the bed-bugs) on the bed next to the pillows. The hose he wraps over the pillows and the nasal-plug mask is light and barely noticeable if he keeps his nose-hair and moustache trimmed (hence the hipsterish half-height mo). It is a simple matter to turn off the machine, easily de-nasalify the plugs and trundle off to the toilet...

AIYAH! those bathroom lights. Why so fracking bright!

~~~~~~~~~~~

There are several advantages to sleeping with CPAP.

Well, number one, fucking obviously, is that he can breathe properly and not wake the sleeping hooker(s), nor, in the cheaper places E@L stays, the guy in the next hotel room and his hooker(s). And not choke and effectively cut off the blood supply to his (E@L's, not the guy in the next room) brain by dropping his oxygen saturation to coma level in that apnoeic half-minute.

Second, or third if you count the last sentence which is really a follow on from the number one benefit, he can sleep under the sheets.

Third/corollary to Third/Fourth/whatever: he (or his hooker) can fart while his head is under the sheets because his air supply is coming from the CPAP on the outside! Brilliant!

Fifth (fuck it): E@L has never tried this, but he supposes he could use it as a cunnilingus snorkel if he were that way inclined (to sexually gratify a hooker, pffft!). Carefully clean with an antiseptic wipe after each use.

And sixth, he can sleep on his stomach, face into the Tontine, and not suffocate. Awesome, as he often tosses this way and that as he tries to drop off, and might end up face-down [end UP face DOWN ha!] a few times.

But why (other than the hypothetical cunnilingual point) is E@L under the sheets, you ask. Not just to see if he can Dutch Oven himself faultlessly, but also to hide his alcoholically lucifugous eyes and, by extension (the optic nerves), his brain, from the all those hotel room lights: eerie green and red USB chargers, the red glowing fuse-confirmer of his multi-plug extension cord, the slow blinking fire-detector, the ineluctable glow through curtain which never quite closes off the big city's 24hr bright lights. But all this candle power is never enough to light up the path for his 4am trip to the bathroom and to enable him roughly determine the correction of his direction. And so, on go those retinal blasting lights every time.

But new on the scene is an eyemask, one from Singapore Airlines. Black. From First Class, the time he got that well-overdue upgrade. (Yes you can ask for them anytime, and you get them in business class, but not the black ones - it's like the black Amex, they are only for the high, um, fliers.)

What E@L does now is sleep with both the CPAP and eye-mask on. And, get this, with the blinds open! That way, when his bladder wakes him there is enough ambient light to either wake the AEI-worker for another go with his piss-hardon, or to trundle to the loo and not turn on the lights!

Why didn't he think of this simple life-hack earlier? It's brilliant, amazing, life hacking, he means life-changing. He is even considering sending it to Corey Doctorow so it can go viral on BoingBoing, or even LifeHacker itself.

~~~~~~~~~~

But! (There's always a "but", like when females tell you that they love you, bu-u-ut something about why they hate you as well. "I love you bu-u-ut you fucking snore like a fucking demented animal, getoutofmylifenow!" for example.

Bu-u-ut, the dye in the black eyemask comes off.

Oh NO!

It's not onto E@L's face thankfully but, to the horror of the hotel's laundry (he anticipates), it does silhouettes of itself onto the pillow, like the shadows of evaporated humans on the walls of Hiroshima. You can almost track E@L's nocturnal movements (body movements, not bowel) from its telltale marks. Oh dear.

Ah well, he sighs and admits to his privileged, arrogant, white-mans-burden, post-colonial self, it's a small price to pay for not having to turn on the bathroom lights.

He means it may be tough on the laundry staff, but it's a small price to pay for

E@L

Zen And The Art Of Continuous Positive Airway Pressure

First night with the Respironics (a Philips company) CPAP machine was not so successful. I thought it would be a good idea to put some ear-plugs in to mask the noise of the pump.

Mistake.

All I could hear all night, all I listened to, was my breathing. In. Out. In. Out. Thus saith Guru Bob: Listen to your breathing, my pupils. Concentrate on each breath. Let everything else fall from your mind...

Very Zen. Very Transcendental. Very fucking annoying.

You know how they say you don't notice your rhythmical and regular breathing pattern until you start thinking about out it? That's my story for the ENTIRE night. At least I think it was. It's also difficult to be sure you're not asleep, as you might only be dreaming that you are awake. Or a butterfly.

I do remember having an apnoeic episode that woke me up - see, I must have been asleep. I was dreaming that I was lying under the low branches of bush/tree in my mother's back-yard, in my cave, protected, hiding away, (a Freudian return to the uterus fantasy? [Shit must call my mum, haven't spoken to her for a few weeks!]) as someone yanked me out by the leg in order to get me to breath, to break me out of this drawn-out breath-stoppage, to wake me up. I woke up.

Another thing that bugged me was that this "soft cloth" mask, The SleepWeaver, has little perforations in it to blow off the excess pressure. These pinholes shot annoying javelins of chilly air all over my face, onto my arms and shoulders. I didn't realize there were part of the construction until I read the manual this morning (!) and I was completely distracted all through the night, wondering at first if the seal was not good, but it seemed fine when I put my hands to the edges, or that the mask was faulty. I kept pinching off these jets for a few seconds until I pulled the bed-sheets over my exposed limbs.

Once or twice I opened my mouth slightly and the compressed air in my naso-pharynx sharply charged out like the scorching fire from a dragon on the attack. That was a weird sensation, as my palate fell back with the release of the pressure. I closed my mouth straight away and it went back to "normal" quickly. This was all done in a semi-real state of semi-consciousness...

I was, I suppose, fortunate that I didn't yank the bloody SleepWeaver thing off my face in the middle of the night or do the auto-erotic asphyxiation thing with the 2m of hosing as I rolled from left to right and back again. It pulled on the soft mask when I did turn in this manner, but it when I just brought more of the hose with me it seemed OK.

Eventually, at about 6am I gave up on sleeping, turned off the pump, took off the mask and removed my ear-plugs. The whine of the air-con. The swish of the fan.

I couldn't hear myself breathe. THAT was Nirvana.

~~~~~~~~~~~

Half an hour later I decided to try sleeping once again and this time without the ear-plugs. Sure enough, with shoulders and arms protected from the air-jets, I dropped immediately into sleep (deep, shallow, REM, I don't know) for two hours.

I'm not sure that I feel rested today. Indeed, it almost feels like grandpa nap time now (4pm). It wasn't the spring out of bed, leap with fervor and enthusiasm into the tasks of a busy day (buy some socks, choose a birthday card or two) sort of instant recovery that I was given to expect by a friend in Australia.

He had had a bad run with apnoea, falling asleep at traffic lights (embarrassing if you're a pedestrian), during meetings, etc... After his first night with the CPAP, he didn't recognize the new energy that was charging through him. Completely worked for him.

~~~~~~~~~~~

Well I'm not *too* bad I guess, as I managed to stay awake on the MRT for a two stop jump down Scotts Rd. Fingers crossed for Night Two.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

However I have a party to go tonight - Great Gatsby is the theme - and I might be a tad under the weather with bootleg gin when I get home. Hope I remember how to turn it on! For those interested I have a white linen suit, with waistcoat, white shoes, white hat, white socks, apricot tie. Oh and a white hat.

Something like this is the plan:

(Oh shit, he has a double-breasted vest; mine is single!)

Someting more like Sydney Greenstreet will no doubt be the result of my efforts:

Yes, mmm-mm,  well,  indeed, mmm-mm, yes, excellent... 

E@L

p.s what is the minimum angle for a hat to sit in order for it to be classified as 'rakish'?

Why Am I Still Up?

Why go to bed?

Last week's overnight in-hospital sleep test shows that I have apnoeic or hyopopneic episodes on average 51 time an hour. That's 10sec plus without taking a proper breath. So at least 510 seconds, or 8 and 1/2 minutes every hour, I am not breathing. At all.

Looking at the chart, I seem to go into this mode after every 4 breaths snores.

And I wake up 23 times an hour! May as well stay up, at least I can do stuff on the computer.

I'd sigh but I don't want to waste the oxygen.

I'm dying of everything.

~~~~~~~~~~~~~~

The best sleep I've had was in the ENT clinic; 2 hours of neck-aching snooze sitting up in the waiting room... and even when I got called in they didn't have the charts ready (Have you had your test? - Well, yes. Last week!), and had to send to the ward for them. Tin-pot organization. Tan Tok Seng Hospital.

~~~~~~~~~~~~~~~

Who sleeps at night? No one is sleeping.
In the cradle a child is screaming.
An old man sits over his death, and anyone
young enough talks to his love, breathes
into her lips, looks into her eyes.

Once asleep - who knows if we'll wake again?
We have time, we have time, we have time to sleep!

Maria Tsvetaeva, from INSOMNIA, 1916.

E@L

Laugh And The World Laughs With You; Snore and You Sleep Alone.

Snore? Moi?

It's interesting. You can like someone when you first meet them, you can think they are interesting or funny, really hit it off, but if you have to share a room with them and they snore, you turn into a hate monster.

It's as if they robbed you of a lot more than sleep. It's completely disproportionate to the actual offense they caused. And you BLAME them for their snoring... It's like they have control over this, like they did it on purpose, just to offend and disturb you. You don't care about the details and cures: lose weight, have an operation, oh that's interesting you have a deviated septum from a cricket ball exploding into your nose, all that medical stuff. These are just flimsy excuses. They SNORE. That's all it is. You hate them!

Invade Poland, annex the Sudatenland, fine, so long as they don't snore!

That's right; you are not interested in finding a reason for them snoring, that is irrelevant. You just HATE them because they snore. Doesn't matter you liked them last night, this morning they are out of your life completely. You storm off, hoping that your paths, or at least beds, never cross again.

~~~~~~~~~~~

Examples:

1) My darling wife gave up and went to sleep in the spare room, then she went to sleep in London. Two steps to the right and she could have been as far away as possible.

2) My skiing buddies in the shared room in New Zealand threw their shoes at me all night. I skied alone, sob.

3) I used to share a room for expenses reasons, at my hospital's and State Premier Jeff Kennett's insistence, when attending conferences. My room-sharer referred to my snoring as "industrial strength" and vowed to get drunk each night so he'd fall asleep first.

4) When I first met my current bestest buddies, M@&Km, after a party in Sydney where we were all too drunk to drive home, (over 0.08, at least) so about six of us crashed around the living room. M@&Km threw their shoes at me in the middle of the night. At one point Km got up and forcibly turned me onto my side (she's a strong girl) which did not interfere with my snoring at first. However, for some reason, I did eventually stop. M@&Km thanked heaven... but then someone else started instead. They hated me next morning and called me "Snoring E@L". I moved to HK and then a year later so did they. It took me three months to work up the courage to give them a call...

5) After I'd had a few red wines, Izzy could hear me (just) through two closed door and eight feet of concrete.

No more evidence required; I need help. My name is E@L and I am a snoraholic

~~~~~~~~~~~~~~

Hang on, help is on its way.

Last night I slept in the Tan Tok Seng Hospital's sleep centre.

But first, what is it with Singaporeans?

The ward nurse was OK. She smiled asked to asked me to get changed into my sleep gear, which were a grey tee-shirt and grey gym shorts. Shorts? I never wear shorts to bed! But I did so and I came out of the bathroom; she was gone. For a few minutes I was by myself. Whatever.

But then in came the world's most uncommunicative "sleep technician" (a nurse?), a young woman in jeans, casual shirt and a lab coat. I was by now comfortably ensconced (there's word you don't hear everyday, thankfully) on a vinyl chair (which might have been a commode chair, I didn't look underneath) listening to one of Melvyn Bragg's amazingly good podcasts from the BBC, this one on Joyce's "Portrait" (I need to reread that; I realize now that I know nothing).

Lab Coat said nothing to me, didn't even look at me. She began arranging her gels and scraping ("desquamating") tools on the desk, with her back to me.

For about five minutes she seemed to be squeezing stuff out and tearing packing tape into little strips. She explained nothing about the procedure, nothing about what she was doing, nothing about the weather, asked nothing about my family, offered nothing about her family, the missing dog, the world economy. She didn't talk to me, she didn't look at me, she didn't acknowledge my existence. I began to wonder if I was really in the room.

I also imagined having this procedure done in say, America. I'm sure some grossly overweight woman in a nurse uniform three sizes too small would be fussing about the room, doing this and doing that, talking non-stop at volume about everything under the sun and I'd be thinking, "Shut the fuck up," by now. Somewhere in the middle of these two extremes would be nice.

When Silent One had done preparing whatever it was she was preparing (an enema kit for all I knew) she pulled out the desk chair and indicated that I was to sit. So I AM here!

She then broke her vow of silence to ask a series of questions, including, "What race are you?"

I said nothing, mimicking her style. Pretty fucking obvious, what? She asked again, in an even tone, "What race are you?" And again I said nothing but I raised my eyebrows at her. She asked with exactly the same couldn't-care-less emphasis, "Are you Eurasian?"

"Do you think I look Eurasian?"

"Are you Eurasian?" she repeated, a tad hopefully.

"What do you think I am?" Like it fucking matters what 'race' I am anyway. I regret, in retrospect, not saying, "Homo Sapiens". I guess she would put me down as a homosexual with that answer anyway.

She was silent. She didn't know.

"I am a westerner, a Caucasian."

"I'll just put down Caucasian then."

"You do that," I mumbled.

~~~~~~~~~~~~~~~~

I considered asking her out for a quiet (ho ho) drink some time, as you would a waitress or a golf caddy (as some would). She was not at all unattractive, but I guess there are plenty of reasons why she wouldn't fraternize with her patients, one of which is that they all snore.

~~~~~~~~~~~~~~~~

Then, without any warning or explanation, she began to measure my head. I wonder if the ghost of Galton looked on with approval. At various key points, she scribbled marks onto my skin. She put the tape away and at these marked points began her desquamating process. Grab a pencil rubber and rub it on your semi-bald head. It warms up pretty quickly, hey? I wondered if this irritating pain was how it felt to get a tattoo.

Then on went the gel and on went a series of electrodes, all around my scone, the ones in my stubble held with HUGE patches of tape or something, maybe those clear plastic surgical patches. It felt gooey, cold and horrible. She made me stand up and, with a stretch and a maximization of velcro, she managed to get some straps around my chest and belly which held breathing sensors.

She then told me to get on the bed and lie down while she continued planting electrodes around my body and taping them on with the packing tape. She put them on my neck on my shoulders, on my legs, next to my eyes and then she hooked me up to some breathing sensors. One went in front of my mouth and a double pronged one up my nose. I took a photo of myself and looking at it, wondered how the fuck I was going to get to sleep tonight. A O2 sensor went onto my finger, was taped on. I felt like the mummy by this stage, like Laura Palmer, wrapped in plastic.

The process of mummification...

I tossed and turned all night, as far as I remember, am not even sure that I got ANY sleep. Left side, right side (ow, my left hip hurts). Yuck, I am drooling onto the pillow. Hell, the gel is oozing from my scalp onto the pillow cover as well; it's like putting my head onto a giant over-firm slug. Amazingly, none of the sensors came off in all this wriggling and reconfiguring of the pillows and bedclothes. I must have slept because I dreamed, but I can't recall what the subject was, something dark and *CLANG* - a trolley outside room woke me up to the chill of the over-airconditioned room.

Note to self: if doing this again bring your own pillows and own duvet (it's freezing in there).

And with nothing else to think about, except young Stephen Dedalus being tossed into the muck at Clongowes and coming down with an hallucinatory fever, I waited for sleep to come. I listened to myself breathing, watched myself in the near dark from above the bed, aware of all the wires on me and I hoped not to rip them off, as Silent One had threatened to come in from her video surveillance room and put them back on. In this toss and turn time, I arrived at the unexpected realization that I can breathe better in and out of my nostrils when I am left lateral decubitus than right lateral decubitus. Thought you might be interested in that icicle of key info. No? Pretend you didn't read it.

You're not interested in any of this?

Piss off then, I'm having a well deserved nap.

~~~~~~~~~~~~

Results next week.

E@L