Apple Foot

Cancelling RCN

Many, many years ago, I subscribed to a dial-up account at a small, local Internet Service Provider. After a few years, that small provider was absorbed into RCN. I kept the RCN dial-up account for several years. In November I got DSL from Verizon (not, I should point out, because I have even a sliver of love for Verizon). I hung onto the RCN account for a couple months to make sure I was getting all my email, etc. A couple months turned into six months, because I am a loser. Yesterday I finally called RCN to cancel my account.

I worked my way through the usual long phone tree, eventually finding an option that specifically said it was for "canceling dial-up service". Of course, at large, soulless corporations like Verizon and RCN, the number you press on the phone tree does not actually route your call any differently than pressing any other number. It's a useless exercise designed to keep you busy so you won't notice how long it's taking to get a representative on the phone.

So I choose the "cancel dial-up account" option and get "Brian", who makes me give him my home phone number, address, reason for calling, reason for canceling, etc. Then he announces that he can't cancel the account, and he'll have to transfer me to Billing. After 15 minutes on hold, the Billing guy makes me answer all the same questions again, then informs me that Billing doesn't do any cancellations at all, and he's going to have to transfer me to a dial-up technician. At which point I tell him to whom I've spoken already, and point out that this sort of poor customer experience is precisely the reason I'm running from RCN. In transferring me to the dial-up tech, our man in Billing disconnects me.

I go back to the toll free number, work my way through the phone tree, and am sent back to a customer service rep, who makes me give her my phone number, street address, reason for calling, etc. Then she announces that she can't cancel my account, and she'll have to transfer me to Billing. So I tell her my whole customer experience so far today, emphasizing the fact that someone in Billing has already told me that their department absolutely cannot assist me.

Now suddenly she can handle this herself without transferring me any further. This takes several minutes, during which I repeatedly wonder if I've been disconnected again, due to the static on the line and the lack of a speaking voice.

It took almost 45 minutes and considerable aggravation to close an account costing me $21.95 per month. I can't tell you how often I thought, "It might be worth it just to keep paying them," but I'm convinced that their nefarious plan includes making things so difficult that I will do just that, continuing to pay them for the convenience of not having to deal with them.

New excuse: time crunch

My phone service was restored almost two weeks ago. Turned out the wire outside the building (but past Verizon's demarc) was all broken up and pulled away from the house. Verizon didn't charge me, since it was outside the building and I'd already had them in telling me the problem was fixed, but he could have. This last guy was pleasant, professional, and fixed the problem, all of which was an excellent start to my Saturday.

So now we're back to me not posting for my own reasons. It comes to this: I am utterly crazed at work. We're going through the merger process, which means a lot of merging systems, databases, networks, etc., and there aren't enough IT people to keep all the plates spinning. It's been very difficult to keep up with longer term projects because we have a lot of fires to put out. I keep thinking I'm getting too old for this. I don't know how I would get through if I weren't sleeping so much better than I was last year.

Hello

Just so you know, this latest long blog silence is not the usual kind of long silence, where I can't even come up with anything uninteresting to post. No, this long silence is because my phone service (and therefore my DSL) is hosed. I'm posting this from-- well, not from home.

You may remember I have a history with Verizon. The current outage stretches back several weeks (during most of that time I had my DSL, but not phone service, so I didn't really care), due to a combination of typical Verizon service standards, my neuroses (basically, after an unsuccessful service call, I got so frustrated I couldn't call them to come back), and my heavy work schedule (I already spent one morning sitting around waiting for the service guy, I can't kill another half day this way). So I'm not sure when I'll actually get the problem fixed, although I'm becoming sufficiently aggravated that I will soon work up the energy to call Verizon again.

Call in the (Salvation) Army

While conducting this evening's ritual of shoehorning my coat into the closet, I took a census. The hall closet has 27 coats in it. Plus, my roommates were both out at the time, and given the weather, I assume they were each wearing a coat. That's 29 coats total.

Only one of them is mine.

Aging

We've all noticed that time passes faster as we get older. The classic example is summer vacation: when you were eight or ten, it lasted forever. Now I think, "How did it get to be October?"

I've gotten used to the fact that years slide by ever more quickly. In the last few weeks, though, I've realized that it doesn't take nearly as long for a pot of water to boil as it used to.

Shoe Shopping

I needed new sneakers.

This presented a problem, since I have for years bought my sneakers at Filene's Basement's original store at Downtown Crossing, which is currently closed for renovations. I decided to suck it up and visit the Boylston Street store. Like many of the Baby Basements, Boylston Street is not actually in a basement. It is also not grungy. The thing that makes the store and its bargain-hunting potential most suspect, however, is the doorman.

What kind of Filene's Basement has a doorman?

So I bought my sneakers (I didn't think the price was all that great, but it was in the realm of what I'd be willing to pay) and headed down the street to Borders. When I walked in the door, the alarms shrieked, and the nice fellow at Borders told me to go back to Filene's and have them remove their security tag. Despite the fact that there's an actual doorman and a loss-prevention system in place, they didn't catch me leaving the store with tagged merchandise.

I was always doubtful that the alarms worked at Downtown Crossing. Maybe Boylston Street is a member of the family after all.

More Sleeping

Tuesday I saw the sleep specialist. The technician had told me that she needed to record me asleep for at least two hours (for insurance purposes) before trying the CPAP, but I hadn't understood that she meant two hours asleep in the clinical, EEG sense, not just two hours I don't remember being conscious for at all. Lights out was at 10:30 and I didn't fall asleep until about 11:30. Between that time and slightly after 3AM, I was only actually asleep for 127 minutes. The little chart on which my sleep and its interruptions are displayed looks rather strange, but among other things apparently tells the doctor that I'm getting virtually no REM sleep. Doesn't that mean I should be psychotic? Apparently not. I averaged 120  "events" (apneas or hypopneas) an hour, and dozens of these were accompanied by at least a 4% reduction in oxygen saturation. The doctor managed to tell me in a fairly non-hurtful way that weight loss would likely improve the situation. She also said it would be "exciting" to see what changes I experience once my apnea is treated.

I got my CPAP machine that day as well. Tuesday night I spent rather a lot of time fussing with the straps on the mask, which I was sure was either leaking or too tight. The second night was much better, though. On the third night I snapped the earpiece off my glasses when I forgot to remove them before putting on the mask.

I asked my psychopharmacologist about sleep debt. Specifically, I recall reading a few years back that sleep debt accumulated indefinitely, over a lifetime. This theory has now been discredited, and it's believed that you accrue a week or two's debt, no more.

Sleep Apnea Update

The psychopharmacologist called today. He's got a copy of the sleep study results, and he described my apnea as "significant". To try and explain it to me, he said that a healthy person of my age should have a sleep efficiency of 90-95% (i.e., 90-95% of the time spent in bed is actually spent asleep). My sleep efficiency was more like 40-45%. Granted, it took me an hour to fall asleep, some of which might be lab effect, but that's still a whole lot of not sleeping.

With his encouragement, I called the sleep center conglomerate to ask if I can see a doctor earlier than my scheduled November 16 appointment. It turns out that the center where I had the study done only has physicians on site one day a week, which is why the wait is so long. At another center, also readily accessible by public transportation, I was able to schedule an appointment for this coming Tuesday. This means I had to cancel a conference call and my oboe lesson, but I dropped both like hot rocks for an opportunity to get closer to treatment.

Now that I'm aware of the problem, I think I've subconsciously given myself permission to feel really miserably tired. I'm just very aware at all times that I need sleep. The diagnosis does explain why in the last few years I have on several occasions been out doing errands and felt an urgent need to go home to sleep. If you've diarrhea or vomiting, there's usually a public restroom to relieve your needs, but an attack of sleepiness can't be handled in a public facility.

I've been talking to people about apnea, and many have close friends or family who also have it. Several people told me the apnea patient in question refuses to use the CPAP, apparently uncomfortable with it. One person reported that his neighbor believes being diagnosed and treated for apnea changed his life. I'll try not to expect that much from my own treatment, but any improvement in my energy level and daytime sleepiness will be a relief.

Sleep Study

My psychopharmacologist recently hit the point most of my psychopharms do: no matter how much medication we throw at it, my depression and anxiety don't seem to improve past a certain "functioning" level. This never fails to cause me long nights of trying to decide if I'm a hypochondriac (if the meds aren't doing much, there must not be much wrong with me). The angst comes with a side dish of "What the hell is the goal of this, anyway? Maybe I'm not just a peppy person, this is my personality, and you can't medicate that away."

Before giving up altogether, the current doctor suggested I have a sleep study done to look for sleep apnea. Apparently sleep apnea is a clinical interest of his, so I wasn't sure I wasn't just being subjected to his favorite diagnosis, but what the hell? I'm fat, I have no energy, and I spend much of my free time either sleeping or wishing I could be sleeping; sleep apnea isn't that wild an idea. On the negative side: the sleep study is subject to a $500 deductible. Ouch.

As it turns out, the study can be scheduled within a week (I was sure it would be months for an opening), so I buy new pajamas and check the bus schedule for that part of town.

This was a split night study. The first part of the night, my sleeping was monitored. If I reached a certain threshold of "events" (that's 'not breathing') during the first two hours of sleep, then for the second part of the night the technician would put me on a CPAP machine to see if that helped.

Thursday night I went to the sleep clinic. I was taken to what resembles a small hotel room (sort of like a European pension--it's got a bed, and enough room to walk around the bed, and what do you want more space for?) When I had filled out the various forms, I got into my pajamas, removed my contacts and eye makeup, and brushed my teeth. Following this I got to watch a 15 minute information video. Whee!

Amy, the sleep technician, took me down the hall to set up all the electrodes and such. This took 40 minutes. I had two lines threaded down through my collar and pants, one attached to each calf. These detect leg movements, identifying people with restless leg syndrome. I had two EKG electrodes, one on my side and one on my chest. An electrode was fastened to the outer corner of each eye to detect REM sleep, and two electrodes on the chin detect whether my mouth is flopping open for mouth breathing, or I'm grinding my teeth. A snore mike was taped to my throat. Four electrodes were placed on my head (after Amy made careful measurements to decide where to put them, and then applied an exfoliant and significant quantities of sticky gel crap.) There was a band around my abdomen and one around my chest to measure breathing. The chest band also had a little button on it to detect movement/orientation (like whether I'm sleeping on my back or side). I also had a nasal cannula to measure breathing and air temperature and a pulse oximeter on one finger.

While she's wiring me up, we chat, mostly about the sleep clinic. There are three technicians for six patients. I ask if Amy and her colleagues don't have sleep issues themselves, keeping this awake overnight schedule. Amy usually works Thursday, Friday and Saturday nights. Sunday morning she gets a couple hours of sleep, then retires by 8:30PM that evening. Monday-Wednesday she's on a more or less regular schedule of nighttime sleep. Amy also has a three year old, which no doubt makes the sleeping issue especially challenging.

Once all the gear's on, the box that the wires lead to is hung around my neck for ease of transport, and I trundle back to my room. Amy wants me to sample the CPAP machine, so that if I need it during the night, I won't be making my first try at it when I'm groggy. The CPAP has what looks like an oxygen mask, only it goes over the nose, not the mouth. A hose runs to the CPAP machine, which is pushing pressurized room air through my nose. The best explanation I've seen of this is that it's an "air splint": the pressurized air keeps your throat open so your airway is unobstructed. The mask is held on with a bunch of straps, and the whole rig looks like some sort of pig costume, or perhaps an S&M outfit. I discovered that opening my mouth while the CPAP is running is a bad idea--it's a weird and unpleasant sensation when the pressurized air can escape through the mouth/sinuses. Unfortunately, just like at the dentist, the technician asks me questions, so I can't help but open my mouth to answer.

At this point Amy hooks everything up to the monitoring equipment. She goes to the monitoring room and over the intercom instructs me to do various things (close your eyes, hum loudly, flex your foot) to test the equipment. Once everything is working, she turns out the lights, and I'm supposed to go to sleep.

You can see the problem here, of course. I'm in a strange place (although that might be an advantage, considering the state of my bedroom), I've got a pile of wires attached to me, and somebody's monitoring me. Rolling over is somewhere between difficult and impossible. Sleep is a while in coming.

I'm not sure I was actually asleep when Amy came in to reseat the EKG on my side, which had stopped sending signals. OK, back to sleep.

At some point, Amy came in saying something about "extending your baseline" and explaining that she was going to put me on the CPAP machine now, since I was "having plenty of events" and therefore had sleep apnea.

I took this opportunity to use the bathroom. One chunk of my hair is sticking up and pulls my scalp whenever I move. I think one of the electrode wires has gotten pulled over my head and is tangled in my hair. Amy removed the nasal cannula and strapped on the CPAP. I flopped back into bed, reminding myself to breathe through my nose. Since I also grind my teeth (I wear a night guard), I hope that keeping my mouth closed will not be a big issue. If I am mouth-breathing, Amy will come in with a chinstrap and make me look like Jacob Marley.

It's a little odd, a little claustrophobic, to be breathing through the mask, but I quickly become accustomed to it, and it doesn't cause me to panic. At one point I woke to find condensation on the inside of the mask (the CPAP humidifies the air to prevent nasty dry throat and such), which is a little gross.

Amy wakes me by 6AM. We go through the whole testing of the equipment again (flex your right foot, smile, hum), then she comes in and slings the box over my neck again so we can adjourn to an exam room, where she removes all the wires. As a technician, Amy can't tell me much; she doesn't have the proper letters after her name. She does tell me that there was a huge difference for me with and without the CPAP. I fill out some more forms, shower (and try to peel off all the gel and goop), get dressed, and leave.

The good news is that I have sleep apnea, and that I respond well to treatment with CPAP. Despite the fact that this is one more piece of equipment to haul around, one more medical condition to deal with, I'm pleased. If I can get back some energy and lose some of the daytime sleepiness, I think it would make a big difference for me. Plus, I believe the $500 deductible also applies to DME, so the health insurance company will have to foot the bill for the CPAP machine. The bad news is that my consult with the doctor isn't until the third week of November (there's that wait time I expected), so I may have to keep muddling along like this for several more weeks. My doctor told me that if I have apnea, he'll try to pressure the sleep center into putting me on a wait list for any cancellations, so I'll just keep my fingers crossed.

My two year old nephew is scheduled for a sleep study this month. I didn't ask Amy if she'd done any studies with someone that young, but I can't imagine how you keep all those electrodes and stuff on a toddler.

Always Her Child

My mother sent me a package last week--brass candlesticks she got at a rummage sale. They were wrapped in what looked like blue washcloths. Enclosed note explains that these are machine-washable microfiber cleaning cloths. Last sentence of note: "Stick under cabinet with other cleaning products for the house."

Because, being 38 years old, I need to be told where to store these in my own home.