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Ask Dr. Hasan Your Own Question

Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 7288
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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are there any ENTs with JustAnswer?

Resolved Question:

are there any ENTs with JustAnswer?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Hasan replied 1 year ago.

DR HASAN :

HI, Thanks for your question. My name isXXXXX and I am here to help you today. I will be happy to help you with your follow-up questions also.

DR HASAN :

I am an ENT and Head and Neck surgeon and can help you.

DR HASAN :

What is your question?

Customer:

Hi Dr. Hasan, how r u ?

Customer:

thanks for your help

DR HASAN :

You are welcome.

DR HASAN :

How can i help you?

Customer:

I am 55, and had nasal polyps removed 7 years ago

DR HASAN :

ok

Customer:

my apnea is down I think

DR HASAN :

ok

Customer:

I used a security camera and videotaped myself (infrared) in the dark

Customer:

I could note no apnea events in the 7 hours

Customer:

being a layperson

Customer:

i interpret apnea visually -- snoring, then 20-25 seconds of no snoring sound -- then waking up gasping for air

Customer:

is this a fair visual assessment protocol

DR HASAN :

I am sorry but this is not a fair protocol because visual inspection is never sufficient.

Customer:

isn't the end of an apnea session signified by a jerking kind of motion

DR HASAN :

However lets talk about your symptoms.

DR HASAN :

Yes it does but pattern is not the same for everyone.

Customer:

the typical sleepiness, lack of good sleep, etc.

Customer:

ok

Customer:

my sleep study in 2001

DR HASAN :

Do you have symptoms like daytime sleepiness?

Customer:

and in 2007 -- both pre-surgical

Customer:

yes, not terrible sleepiness

Customer:

mild

DR HASAN :

It was worse before your surgery?

Customer:

i would rather not pay $$$ for a sleep study

Customer:

yes, i think so

DR HASAN :

Yes i understand but lets see how you are doing now.

DR HASAN :

Ok do you have a partner?

Customer:

and my ENT says that the polyps have not returned

Customer:

no

Customer:

that's why i bought the camera ;-)

Customer:

also a parnter is not a good observer, ;-)

DR HASAN :

LOL, yes you are right.

Customer:

not reliable to stay awake the whole night with clip board

DR HASAN :

Yes because partner has to sleep too.

Customer:

i never snore on my side, and i have a cervical pillor

Customer:

pillow that aids my rest

Customer:

my 7 hour recording confirmed two things

Customer:

1) i rarely snore on my side

Customer:

2) I nearly always snore on my back

DR HASAN :

Do you get any complaint from your colleagues that you sleep on chair or while working?

Customer:

not that bad

DR HASAN :

Was it same before and after surgery.

Customer:

surgery wsa a long time ago ;-)

DR HASAN :

You never snore on back, that's good.

DR HASAN :

Ok i see.

Customer:

no

Customer:

i wrote above -- most of my snoring is ON BACK

Customer:

i hardly ever snore on side

Customer:

50% of time on back i snore

DR HASAN :

ok sorry i agree.

Customer:

2% of time on side i snore

DR HASAN :

Well definitely it's not a standard protocol to monitor someone on camera this way.

Customer:

and -- luckily -- my 7 hours was 80% on back

Customer:

aaccording to video

Customer:

SORRY

Customer:

I MISTYPED

Customer:

80% of my night was spent on side

Customer:

20% on back

Customer:

95% of time on side -- no snoring

Customer:

50% of time on back -- snoring

Customer:

APPROXIMATELY

DR HASAN :

but considering the fact that you are not going for a sleep study and considering the apnea attacks you saw on camera and more importantly for me according to your current symptoms, i am of the opinion that you are doing good.

DR HASAN :

Ok you have done a good assessment then.

Customer:

YES, but Dr. H., would you not say that MOST apnea is visually apparent

Customer:

with jerking kind of motion

Customer:

even subtle jerking

Customer:

gasping for air, somewhat

DR HASAN :

I would say most are apparent this way by waking up suddenly by jerking movement but not all.

Customer:

i know that sleep studies have 15+ variables examined

DR HASAN :

Snoring and sleep apnea are not one and the same thing.

Customer:

I know

Customer:

if someone snores continuously

Customer:

that is a sign of NO APNEA

DR HASAN :

Someone who snore doesn't have sleep apnea always.

Customer:

as apnea is the absence of breaking

Customer:

i kno w

Customer:

apnea is the absence of breathing

Customer:

so if the only variable I want to examine -- occurence of apnea --

DR HASAN :

For me reassuring thing is insignificant daytime sleepiness in your case.

Customer:

and I was snoring 100% continously throughout the night

DR HASAN :

Yes that is what you can do.

Customer:

ok

DR HASAN :

and how many times you woke up gasping for air?

Customer:

zero

Customer:

;-)

Customer:

that's what i wanted to ask you

DR HASAN :

Then it's snoring simply and not sleep apnea.

Customer:

i studied and listend to all my snoring and i could see no (minor) violent episodes

DR HASAN :

Are you over weight?

Customer:

i'm 5'11"

Customer:

with a little tummy

Customer:

185 lb

Customer:

mildly overweight

DR HASAN :

let me check from chart.

Customer:

ok

DR HASAN :

Yes you should be around 160 to 165.

Customer:

yes

DR HASAN :

I guess reducing weight can really help you.

Customer:

i know

Customer:

agreed, in so many ways

Customer:

and more exercise

DR HASAN :

Let me give you a foolish idea.

Customer:

but my main query tonight was getting ur advice about the poor man's sleep study ;-)

Customer:

i used a $50 security camera with infrared -- a lot cheaper than $1500

Customer:

hehe

Customer:

i know that a real sleep study measures many many things

Customer:

and is more useful

DR HASAN :

We usually ask our patients to sew a ball in the back of their trouser (in which they sleep).

Customer:

but I just wanted to get ur expert advice

Customer:

yes

Customer:

i have heard of that

Customer:

do u recommend that ?

DR HASAN :

This doesn't let them sleep on back and as a result no snoring and no apnea.

Customer:

ok

Customer:

let me ask you this.

DR HASAN :

Yes if you can tolerate but it's not badly needed for you.

DR HASAN :

I am impressed by your study.

Customer:

if you -- dr. H. were sitting by my bedside for 7 hours, with no instruments

DR HASAN :

Really, not a bad idea.

Customer:

A HORRIBLE TASK ;-)

DR HASAN :

:)

Customer:

BUT IF YOU WERE sitting by my bedside with strong coffee

DR HASAN :

ok

Customer:

could you -- say with 80% confidence -- that you could detect an apnea session

Customer:

with your naked eye (and ears)

Customer:

god forbid that you would have such a boring assginemtn ;-)

DR HASAN :

Being a doctor, NO

DR HASAN :

But being just an observer thinking on common sense, yes

Customer:

so you mean an apnea session can be "invisible"

DR HASAN :

So combining these too, in my opinion you are doing good so far and no sleep study required right now.

DR HASAN :

Yes it can be.

Customer:

oooooooo

Customer:

invisible apnea will "slip by" my video system

DR HASAN :

But definitely it's a variable phenomenon.

DR HASAN :

Yes it can be.

Customer:

o

Customer:

that's a bummer

DR HASAN :

We call something apnea when oxygen concentration goes down.

Customer:

that shoots a hole in my theory

Customer:

yes, of course, that's the danger

Customer:

reduced oxygen

Customer:

so the key variable is oxygen in blood

Customer:

not jerky motions

DR HASAN :

Without oxygen session going down how can we say that it's apnea.

DR HASAN :

No oxygen saturation must be monitored ideally.

Customer:

of course

DR HASAN :

If at anytime, you want, consider home sleep study.

Customer:

ok

Customer:

they have such things I have read

DR HASAN :

It's cheap and you can get lots of info.

Customer:

ok

Customer:

i need to go to physicain to get the script for this, correct?

DR HASAN :

Yes but private labs do this too.

Customer:

ok

Customer:

one last question

Customer:

is an apnea session always associated with snoring

DR HASAN :

But i reassure you that in my clinical experience you are doing good.

Customer:

i know that snoring doesn't mean apnea

Customer:

but does apnea always mean snoring

DR HASAN :

Yes snoring is a cardinal symptom of sleep apnea, specially obstructive sleep apnea.

Customer:

so the lack of snoring is indicative of no OSA

DR HASAN :

Yes

Customer:

very good

Customer:

thanks again, dr. h.

Customer:

grateful for your help.

DR HASAN :

Snoring and daytime sleepiness has to be there.

DR HASAN :

You are most welcome.

Customer:

got it

Customer:

thanks

Customer:

good bye for now

DR HASAN :

I wish you good luck for a good health, please ask if you have any question because our discussion always remains open so you can always ask more till you are satisfied, You can click the smiley to rate the answer. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.

DR HASAN :

BYE

DR HASAN :

Do you have any question?

DR HASAN :

If so i am here for you always :)

Customer:

no, clicked the wrong button ;-)

Customer:

sorry

Customer:

bye

DR HASAN :

It's ok.

Customer:

there is some bug in software

DR HASAN :

Your feedback is requested and will be appreciated.

DR HASAN :

It's ok.

Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 7288
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
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