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Sunday, Sept 21
On my way home from Yakima, I filled my Subaru with 13 gallons of gasoline at Costco, saving the .18/gal under the price in Ellensburg. I made it home at 8:00 a.m. from my overnight “sleep” test in Yakima. I only managed to sleep for 3.5 hrs, if that, at the start of my study. The mask was uncomfortable and confining and of course, my nose itched and I could not reach it. My bed was raised to ~40°, pillows set, and I managed eventually to go to sleep because I was tired and ready to be done with this experience. I awoke abruptly at 2:30 a.m. and asked what happened. Also, it was impossible to talk with the mask in place blowing air in my nose, because one’s mouth needs to stay closed so as not to leak air. I was afraid I had had an “event” to cause me to awake to regain breathing properly, but that was not the case. She said, “You just woke up.” I realized I was hot and too heavily laden with covers, so asked her please to come help me and to turn the temperature down a little. I had already kicked off the spread. This occurred while my tech was on a break, so another tech came to my room to help me. She adjusted the thermostat and turned on a fan. While she was still there, I asked if she could disconnect me to go to the potty, as I was already awake. She did. When I got up, I realized the fan was blowing too hard, right into my face, and I asked her to turn it off. She had lowered the temp on the heating/cooling system. She hooked me back up but apparently, I got into the bed differently from before, and I could not get comfortable or put the pillows into the positions they had been in earlier when I began the test. I struggled for way too long, trying to go to sleep even moving my knees up to relieve the lower back pain, but I still could not do anything about the neck pain. I had shoulder pain as well. Finally, I called my own tech back in to readjust the pillows and bed. I asked the time, and it was 3:50 a.m. almost an hour and a half since the wake up episode. While there, she also found me a lighter-weight spread. And, because we could not seem to re-orient the pillows properly, I tried another I had carried along (it is the little kind from an airplane). We put it under my neck and that seemed to work to relieve the pain — however, it was pushing my head forward, and I think it was affecting the nosepiece of the mask, because I heard a sound of air escaping. Apparently, that did not show up at the control room (I was told later when I complained).
Regardless, I could not get back to sleep between all that discomfort and sounds. I was hearing water running in the wall (turns out the toilet was still running from my earlier visit, but we didn’t find it until I was completely done with the test), and my technician shook the handle to stop it. She mentioned she thought she heard something over my microphone room tap, but didn’t realize what it was. At 5:00 a.m., I was “awakened”; I am sure I had never gone back to sleep during the previous hour. My estimate is that I barely got maybe 3.5 hours of sleep on this entire visit. (turns out I found out Friday, that I only slept for 3 hrs. & 14 minutes. I think they prefer to have at least 4 hours of data. The only very positive result was the answer to one of my questions, “What was the lowest percentage that my blood oxygen saturation level reached?”
Apparently, it went to 89% for a minute, but was in the 90s the rest of the time. I think that is promising. She could not give me a count of the number of times my breathing paused during the test, but indicated I did have some “events.” I will have to wait until the final chart printouts are reviewed by the staff during the week. I don’t know if I will get any feedback at all until my appointment with the doctor (October 7), but I will ask. I requested a printout of today’s overnight data charts collected, and as expected, I was refused. Not sure why, considering the graphs will not change. I am allowed a copy of them after the doctor has reviewed everything.
My first experience goes back to June 19th with an explanation in June 20th date below in this blog of all the measurements taken and the reason for them.
I received an offer of a CPAP machine, 5 years old, from a person on the Buy Nothing Ellensburg site (it is only for freely given items). I will accept and if I don’t need it I shall re-gift to another member of the site who wants it for her mother as a backup unit. I fully expect them to rule I must have one.
Today, I received a nice boost from a member of my Jobs list serve efforts–with the following she put on her Facebook page and “tagged me” so it went to all my Facebook friends.
She said, I am so excited to announce that I’ll be joining the Washington Water Trust as their newest Project Manager working to restore stream flows in the Yakima, Walla Walla, and Okanogan basins. This is an incredible opportunity for me both personally and professionally and I couldn’t be more grateful for all of the support from my friends and colleagues with the Yakama Nation, my dear friend and mentor Jeanne Demorest, and my amazing husband Caleb L Ribellia. I must also acknowledge the wonderful Nancy B. Hultquist for the daily job announcements that she continues to send out. It’s because of her that so many of us are able to find such rewarding paths in life. Here’s to the next chapter! It somehow keeps getting better and better.
An interesting side note is the previous person in this job was also my student, and he sent me the job description to send to the list.
Monday, Sept 22
Up early (but with 9 hrs of sleep)–guess I was playing catch-up from the bad Saturday sleepless night fiasco. John slept in too. I had to soak my feet before going to the foot doctor for a toenail trim (he does it every 3 months), it’s on Medicare’s tab, and he is the one I go to for the laser treatment every 6 months on the toenails on my right foot. That work has to be done in the Yakima office, and I’m not scheduled until December.
John had to get the horses ready for their trims today at 10:00 a.m. I left at 9:30 and went by Carl’s JR for some of their large Biscuits: Sausage, Cheese, & Egg. I bought 6 at the special sale price, and brought them home for the freezer, yet, I ate 1/2 for my breakfast and froze the other half for a later single breakfast for me. Made it to the doctor’s office in time for my 10:15 appointment, but I didn’t get in right away and was upset at what happened. I had visited with another woman in the waiting room, and she was scheduled for the same doctor as I was, but after me at 10:30. Yet, she was called in before me. I went to the receptionist to inquire if the woman had more of a set up procedure, because my appointment was scheduled before hers. She said, “Oh, well she was here before you.” I told her that was a wrong procedure. She went away and apparently talked to the nurse, who shortly came out and got me. I still had to wait to see the doctor, but it was worth the wait, because he did a very nice job. That’s the same place I have had scheduling problems before, such as being put in a room, and forgotten. I guess he did see me first because when I left, I was in the parking lot making phone calls about my next stops and also arranging my produce in the back of my car for delivery, when I saw her come out of the building.
On from there to deliver some tomatoes to a friend a few blocks from the office, but we were drenched by a rainstorm. I didn’t have a hat or jacket, but did have an extra shirt, which I threw over my head and shoulders. On from there to deliver more produce, squash and tomatoes. During the rainstorm, I made a couple more telephone calls to arrange the rest of my deliveries. The next one was north of town because I knew they’d be leaving for the SAIL exercise class I normally attend, but couldn’t today because of a meeting during the same time. When I got there, they asked me if I wanted to visit and have a cup of coffee, so I accepted. That turned into an invitation for lunch; we had a cup of lentil soup, a homemade muffin, and some slaw. That was a nice surprise. Next stop, back on the south side of town to friends to share more tomatoes. I was beginning to feel like a produce person for sure. I still had a few tomatoes left, and decided to keep them to offer to the woman on my last stop in town. We met after she got off work at 1:00, but she was running late leaving and didn’t call me until 1:15. She decided we could meet downtown at the Dollar store because she had to deliver another gift to someone who worked there. She was cleaning out her house and one thing she listed was a CPAP machine, as mentioned yesterday, which I spoke for. We arranged to meet in Ellensburg.
Once there, she walked the unit over to my car, and took time to explain everything to me. I first asked her to tell me the history of the machine. She got it for herself about 5 years ago to stop her snoring. Her doctor told her if she lost weight, she would stop snoring. She lost about 50 lbs, and it did negate her need for the machine. She showed me how it worked and told me the medical supply place (in Selah, WA), it came from Howard’s Medical Supply. She demonstrated all the working parts, but told me I needed to take the unit to Howard’s Medical Supply, and they would program my “pressure” requirements into a computerized “smart card” (a little smaller than a credit card) to slip in the machine that sets the correct pressurized air flow. I knew that was going to be one of the things in my report from the test on Saturday, and I knew the importance of the technician raising it slowly and watching my body’s reaction to get the proper pressurized flow amount. This unit [from Philips Respironics] has a built-in humidifier, and she showed me how to open, fill , and clean the parts. She showed me the filters and how to remove the humidifier to make the unit smaller for use as a travel version. It is in a nice case with a shoulder strap and barely looks used. She also had had the nasal piece on the head part switched to one for a female, so it fit her better. She showed me how to put the head gear on, it seemed to fit me just fine, and was not as confining as the one I had on last Saturday night. She was careful to warn me not to go home, turn it on, and start using it without the proper adjustment. Her initial testing work-up was done at the same place I went to in Yakima through Memorial Hospital. She was thrilled to take the remaining tomatoes because she lives NW of us, and said her husband’s tomatoes are all still green. It could be she is at a slightly higher elevation. I don’t know her specific address, so cannot check her elevation on Google Earth.
One of the other attempted deliveries today was to give away my contribution to the Ellensburg Buy Nothing group — 6 Macramé hanging flower pot holders. The person they are for lives in Kittitas, but I couldn’t reach her on the phone today, so have postponed that delivery until another day. I have since tried to reach her later in the week, but have been unsuccessful. I am not willing to leave them on her porch by her door. I’m sure someone would walk off with them.
John has David, our farrier, coming at 10:00 to trim two horses. I left a check for him.
Talked to Nan B. at Stoneridge Resort (our timeshare) accounts receivable and am set on an annual automatic payment, so I can ignore any bill I receive from here on out.
Tuesday, Sept 23
We left the house for Yakima at 9:30 a.m. and did not return until dark. It was crazy, mixed with an ICD check appointment for me at the heart center, trying to obtain my sleep study results from upstairs (unsuccessfully), stopping to pick up pizzas to take to our visit 30 minutes west of Yakima (past Wiley City) for lunch. Our friends insisted on paying for the pizzas, and I objected, to no avail. Our lunch was a Cowboy pizza (their choice), and a Papa Murphy Special (our choice), with 1/2 Pepperoni & 1/2 Hawaiian. They had cherry and small orange tomatoes we ate on the side. We had a nice long afternoon visit with them and their golden retriever female, loaded our chipper (we had loaned to them 10 years ago), into our truck in the rain, and left for Costco.
Below is the loading process near the end with John pulling the chipper from the ramp to the front of the PU bed.
Filled the truck with 25 gallons of gas totaling, $90.65 (.18/gal cheaper than Ellensburg), shopped at Costco, and came home to all the animals needing attention and food; we did not get around to eating until very late. They sent us home with some leftover pizza and the great dessert Suzy had made. We saved the pizza for the next day. We put some coconut shrimp in to bake, had it with tomatoes, and then ate the dessert, without blackberries this time, because we had taken all we’d picked and didn’t have time in the dark and rain to pick more. It was made with a yellow cake mix, pouring a sugar pineapple cooked mixture into the cake, and then covering that with Vanilla pudding. Right before we ate it she put on Cool Whip topping, and then poured grated roasted coconut on top. We had taken along some of our blackberries, and we had them on top of the cake. It was very delicious. We also took them one of our Butternut and an Acorn squash. They offered us in trade a spaghetti squash, but neither John nor I are really keen on them, having grown a few many years ago. It’s an interesting concept, however.
Wednesday, Sept 24
Today was a long day starting a little later than yesterday, but consisted of leaving at 11:10, going to town and dropping off two huge butternut squash, the smallest was over 5 lbs, and the other we didn’t weigh, but it was much larger. The idea was to give them to the woman in charge of lunches at the Food Bank to make for lunches for noon. I played and sang there today, with me on the fiddle and our banjo player. We had two folks from the Food Bank (the director, Roger), and Bob, one of the servers and dishwasher loader today, sing with us. Today for lunch, we had quite a spread. The main dish came from Cornerstone pizza, and was LAMB…no joke, and very good. With it, we had a warm pasta with yellow squash, cheese, tomatoes, and some other kind of white cheese, I think. Green salad. A large homemade biscuit, a helping of plum preserves, and some sort of apple cake for dessert.
Answered a few emails, and went with John to help pick blackberries to share with our neighbor. Then I delivered them while he took care of finishing picking some for us. I drove them down the road 3 houses, and carried her the paper and mail, plus the cashews I got for her while at Costco yesterday. Visited with her, her dog and cat, and peeked at her own pineapple plant she started. This is her third time, and it has a little pineapple on it. So cool. She took me back to her computer to see pictures of her previous plant (last in 2008), in all stages of flowering. She will call me to come photograph it when it gets its purple bloom. The following description is from the web: The pineapple is a tropical plant with edible multiple fruit consisting of coalesced berries, and the most economically significant plant in the Bromeliaceae family. Pineapples may be cultivated from a crown cutting of the fruit, possibly flowering in 20–24 months and fruiting in the following six months. Pineapple does not ripen significantly post-harvest. Click for a picture of a flower . Her own pictures have more pastel colors and the purple blossoms are lavender. I cannot wait to see the next steps.
We enjoyed a great supper tonight. To the leftover pizza, I added sliced pieces of our own sweet white onions, and some fresh mushrooms we got at Costco yesterday. Ate a handful each of our nice cherry tomatoes we picked this afternoon.
Thursday, Sept 25
Music at Hearthstone. Carried produce for Mary Ann and George, who enjoyed our performance. Got The Old Rugged Cross finished, and got Froggy Went a Courtin’ completed, with correct notes but realized once there, that we still had problems with chords. Tim helped me out and I have checked them out and returned to two people to check who play chords regularly on a banjo, mandolin, and guitar. Fixed up Gotta Travel On, by adding two previously left out chords.
John went along, and read the Wall St. Journal in an adjacent room, and we carried in some produce for several in town, in addition to there at the music venue. We went by the grocery on our way home, picked up one of my meds there, and then drove by the Feed Store for two bags of pelleted feed for our old horse, Ebony, who has made a miraculous recovery, then on to pick up 50# onions. Next to CWU to drop off a bunch of yellow pear and cherry tomatoes in the building where I had an office for 13 years. They are for a pasta salad and the family of the woman entertaining our scholarship luncheon tomorrow.
When we arrived home, there had been a message left at 1:24 p.m. from the Sleep Center, for me to call and get a message from Natalie. I called right away (just after 4:00 p.m.) knowing they would close at 5:00. There is never a live answer there, so I left a message. No phone call was forthcoming. John used the oven for pork ribs with a scattering of onions on top to keep the aluminum foil off the meat. After a couple of hours in a slow oven he added mushrooms and some BBQ sauce. We had some just- picked tomatoes with dinner. Here’s the thing about averages. Put one foot in a bucket of cold water and the other foot in a bucket of hot water. On average, you will feel just right. So, our average 1st frost date is the 2nd or 3rd of September. We haven’t had frost yet and none is expected during the next week – well into October. Compared with tomatoes, the demise of the summer squash seems to have been early but we have had plenty and have given many away. There are still a dozen little yellow ones but they increase in size very slowly now with cooler temperatures.
Friday, Sept 26
Called the Sleep Center this morning, and got the proverbial voice-mail message, so I left another — obviously in a disturbed / frustrated state. I mentioned not having a call returned yesterday before quitting time. I also gave my times at home this morning (only until 11:20 and I would be leaving for town and left my cell phone), because I wanted a response before they close on Fridays at noon. I had a call recorded on my home phone when I got home that had come at 11:29. I was gone (but I had also left my cell phone #). Thankfully, about 11:36, she called my cell.
Backup a moment to earlier today — after I got the message again, I called the direct line to Iona (the sleep specialist scheduler) whom I had to go through for both previous sleep studies. I got her in person (she has an office away from the reception area), and told her my story and she said Natalie would not be back until Monday. I told her I did not want to wait to find out what the message was because I figured it was related to the second overnight test, 9/20. She said she would look on my record and see what she could find. Lo and behold, the interpretation had been done, and Dr. Kumar wanted me to schedule an appointment with a CPAP provider to get fitted. He wants me to start using a CPAP mask to sleep. I asked Iona what some of the parameters from the test were. She did not know, as she didn’t have access to those records. So, I told her I needed to speak with someone right away who could satisfy my concerns. I did not want to wait until Monday to reach Natalie. I wanted to have the figures from the interpretation, my questions and concerns answered, and to visit with the doctor prior to starting the CPAP process of fitting. She said she would notify the front desk.
Back to this morning — on my way to town, now 11:36, I received a call from Justin, (responding to my earlier phone message left on the machine for Natalie). I only knew that because when she introduced herself, I said, “Oh, Iona must have told you I needed to talk about this.” She indicated that message had not made it to her, just my other morning message about wanting to know what the message from Natalie was about. I was driving and talking in my speakerphone; first, I told her I was on my way to town, and could only talk, not take notes. And, she first reiterated that the Dr. said, based on my results, that I needed to go visit the CPAP fitting place before my appointment with him on Oct 7. I told her I did not want to visit anyone (including the doctor) until I had a copy of the interpretation and a copy of the parameters determined, plus the graphs. Then, she said I would have to come down and sign release paperwork to pick up my records. I told her I was 50 miles away and was down Tuesday of this week downstairs to the Yakima Heart Center, and I tried calling ahead to come by and sign any paperwork releases (if needed), to get a copy of my results. I told her that no one ever acknowledged my request.
I had a copy of the June 16 first session, which I got from Dr. Pham. The only reason Dr. Pham had them was my request through Lori before my appointment with him. They had not sent them down and it had been several weeks. My family physician didn’t have a copy either. They seem very protective of the information, which I am entitled to, and which should also go to my cardiologist and my family physician.
This gal’s name is Justin. She was far more professional in explaining things, than most anyone I have spoken to there. After a few minutes talking, she must have decided I was asking intelligent questions and so she said, I can go over the results on the phone. I explained that I was not at a place where I could pull over and take notes yet, but would be in 3 minutes, so to keep talking and answering my other questions, please. She did. I told her my desire to have a hard copy of the results without driving 100 miles and asked if she couldn’t send me the “release” paperwork and let me sign and return it. She said she could and would. I asked her to please get it in today’s mail so I would have time to get it back so they would send the results. (John just picked up the Saturday mail and it is here!). Then I asked if I could request a particular medical supply place to get my CPAP machine or if I had to go with the one I originally checked in June. Now I know more about them and local people’s experiences with providers. I have been highly recommended to Howard’s Medical Supply in Selah, WA. She said yes, they could send a referral to them.
Finally, I got to a place where I could pull into a parking lot and take notes. She provided what she had and then explained further some of the findings. I asked several questions, a couple I already thought I knew the answer to, and I then made some more requests. She told me my pressure setting for the machine would be 8. That is what has to be programmed into the “smart” card on the machine. She also told me I only had 1.9 apnea (paused breathing) / hypopnoea (shallow breathing) events. Of course, that’s with the mask on, so I don’t know how anyone ever gets through the second test without being recommended for a mask. My blood oxygen level this time was mostly in the 90s, with one minute down to 89%. The fact I did not get a good night’s sleep and was not rested by morning makes me question the benefits of wearing a CPAP mask. Perhaps over time and in one’s own bed things improve.
She also said I was asleep only 3 hrs & 14 minutes. My guess of 3.5 hrs was right on.
The other question she could not answer, but said the Dr. could, was my concern IF the pressure was changed (lowered) after I awoke at 2:30 a.m. and never could return to sleep. I know the technician started my pressure low and intended to build it up overnight. She told me she had to keep track of the titration for the results (I guess to get the best pressure to prescribe for me). I asked Justin what the times were on the pressure changes. I assume whenever 2:30 arrived, that the technician did not lower my pressure. I am concerned that contributed to the reason I couldn’t get back to sleep, as well as my uncomfortable positioning. All she could give me was the pressures I experienced over the entire test, without any times associated; they were 4, 5, 6, 7, 8, 9, 10, and 8. I still have questions about that part of the test. I want to know if I was re-ramped lower when I awoke — and if not, if that’s why I was so uncomfortable the rest of the night. I doubt it was, or at least it was not reported in the list of pressures given over the course of my study. The apparatus may keep people from dying prematurely but the process seems confusing and comfort is low on the priority list.
Then I had one more stop before lunch. It was to the old Lind Hall, where I had an office from 1988 till 1997. Geology and Physics are still housed there, and I was taking 5 historical books and magazines to Nick Zentner. All about Mt. St. Helens and one on the Channeled Scablands. He was thrilled and I was happy to find an appreciative home. From there next door to my Scholarship Luncheon, named for Ruth Harrington, who started them many years ago to raise funds for students. I have been a member of this group since I arrived on campus in 1988. We donate $50 to the scholarship fund, and then we have to fix a meal for ~12 people one month. I’m scheduled to do the October meeting (4th Friday), and then in December, early, we have a potluck. That’s the one they always expect John to come to and make two of his famous Pecan Pies (from his mom’s recipe). He’s been doing it every year since 1988, when he was still in Troy, and I moved over alone for the first year of teaching. I’d go home on weekends, and that is how I brought the pies back over for the luncheon.
Saturday, Sept 27
I started the morning with washing (clothes and dishes), and with doing some emails. About 2:00 p.m., we received nice news from my friend Sonja Willitts with “Tug” a brother to “Daisy” and son of her dog (from our breeding), Kip. She had him in Carson City, NV today for competing in his first Open Dog show event at the Bonanza Kennel Club show. He took a 3-point major today. That’s not all! It is his second major and he now has the 2 majors required for a show championship title, except for getting the rest of the required 15 points. The best news of the day is that he went Best of Winners over all the dogs and 20 bitches for a 5-point major! So, with only a few shows and just over a year-old, he has 8 points (his first 3-pt major was in a previous show from the puppy class, and you have seen that picture below in this blog). I was extremely happy to learn of the news, but enjoyed even more hearing the excitement in Sonja’s voice on her replay of the event. She goes back tomorrow for another show appearance. My fingers are crossed for more points (only get points for a first placement). Later in the afternoon, I had more good Brittany news from Jeri Conklin, the breeder of Tug and Daisy (our co-owned dog). Daisy had won a first place in an Amateur Walking Derby event in Corning, CA. She had an exceptional run, and a couple of birds. She received one field point for that win. Tomorrow, she will be entered in Open Derby and we have our fingers crossed.
We had a nice lunch and John returned to do more tree and brush removal. He has been working on a fuel-laden spot 100 feet or so off the SW corner of the house. Many downed tree limbs are there and a couple of large fallen trees – parts are crunchy like toast. In the middle there is one large Hawthorne and many smaller ones. They are a pain to get out – very hard wood and very sharp thorns.
Source: Janet Pesaturo
He will pick tomatoes today, so we can have enough for him to carry along to lunch on the Franklin Falls trail work again tomorrow. I need to finish this blog so he can finalize it to put out tonight, because he will be gone all day tomorrow. While he was working on the blog, I cleaned the tomatoes and put our dinner on the table. Then our connection went down, but now is back up and he has put the box of tomatoes in his vehicle. Now he can add the photos and the links, and publish tonight.
He has to be up early to leave by 6:50 a.m. for Franklin Falls WTA work day.
Hope your week was fine.
Nancy and John
Still on the Naneum Fan