Did my insomnia make me sick? Before getting into that CTEPH hypothesis, I am aware that the forum is down. I was ‘programming’ last night and made rookie mistakes, like not saving a copy of the old code before changing it. I also forgot that little things like font make a difference when entering code for HTML. I have contacted a friend who knows much more than me, and hopefully he can help.
Readers know I’ve become obsessed with finding out why my lungs filled up with blood clots. One thing I haven’t mentioned is that I had a large, saddle embolus that can be seen in the photographs of tissue removed from branches of my pulmonary arteries. Maybe that large thrombus threw off a bunch of smaller clots. Or maybe it created turbulent flow, or slower blood flow, that led to clotting. That is probably the most likely sequence of events, but I still don’t know where the large embolus came from.
Here is my newest thought on the subject. A few years ago I began taking a prescribed sleeping medication. It is a good med, as it lasts about six hours and I have always been a very light sleeper (ask my kids about trying to walk up the stairs at 2 AM without my noticing!).
I cannot sleep on my back or stomach. I won’t go into that. But I sleep on one side or the other, 100% of the time. I often sleep with my legs pulled up at the hips, and my knees tightly bent, which I guess is the lower half of the fetal position. Because of my sleep med, I might stay in that position for hours. The position doesn’t seem that different to me than a person on a long trip by car or plane. It may even be worse, as I’m not shifting position as people do in those other cases.
I also think of what happened two months ago. I woke suddenly at 6 AM with severe pain in my chest. I did not call 911 (I’m a doctor dammit!) but I tried to find a comfortable position. I eventually found a little relief by lying prone, and the pain passed over 20 minutes. I later learned I had a small pulmonary infarct within that time frame.
Is it possible that over the last few years I slept deeper on my sleep medication? Is it possible that my ‘fetal positioning’ blocked the flow of blood from my legs to my heart? Pooling blood is clotting blood… did small clots form during my sleep, that flowed to my lungs when I woke and straightened my legs? Did the normal discomfort that would occur, when blood backs up a bit, escape my attention because the sleeping pill kept me asleep?
I won’t do the whole null hypothesis thing, but information (and a publication) could be gained quite easily by asking PTE patients about their meds and sleeping habits. The only problem is that maybe only 10% of CTEPH patients are identified, which could throw off the statistics.
Or, did I have a large developing clot in my legs that moved when I straightened out, eventually flowing to my lung? I doubt it, because I’ve never had leg swelling and a large, chronic clot would likely cause that. As usual I have no idea. But I have to wonder. I have been doing a literature search this morning and I haven’t found anything along this line.
If you work in trhe field, consider reaching out to me. If you use this idea and discover something (yes, I realize that is unlikely) I only ask to be part of the discussion. Readers, please share your thoughts.