Monday, January 15, 2007

Operating beyond design limits, part 1

"Our text books like to illustrate evolution with examples of optimal design—nearly perfect mimicry of a dead leaf by a butterfly or of a poisonous species by a palatable relative: But ideal design is a lousy argument for evolution, for it mimics the postulated action of an omnipotent creator. Odd arrangements and funny solutions are the proof of evolution--paths that a sensible God would never tread but that a natural process, constrained by history, follows perforce."
Stephen Jay Gould

Even if no one (and nobody) can be said to have designed the human body, it definitely must be said that I am operating my body "beyond design limits."

I have obstructive sleep apnea, caused by overweight. At some point, probably around 220 pounds, fat deposits built up in my soft palate and around my throat, causing an already small airway to close down whenever I wasn't consciously keeping it open. When I fell asleep, I couldn't breathe. After a few seconds, I would pop awake; I'd grab a breath and go back to sleep. A sleep study revealed that this happened about 90 times per hour, all night long.

In other words, I wasn't able to sleep for more than about half a minute at a time. Until my wife figured out what was happening and got me treated, I was a zombie, always on the edge of falling asleep, always half-dreaming.

Talk about "odd arrangements and funny solutions"! I sleep with a mask strapped to my face, covering my nose; the mask is connected by six feet of flexible ribbed tubing to an electric air pump. The apparatus is called CPAP, pronounced "see-pap," for Continuous Positive Airway Pressure. We refer to it as my breathing machine.

I can't go anywhere without it, and I can't even risk putting it into checked baggage on airplanes lest the airline lose it. Loads of people must be boarding with CPAP machines, because most TSA screeners seem to know what it is when they inspect my carry-on bag—although last time we flew, the San Jose inspectors rushed it over to the bomb sniffer. This was annoying, yet not half as embarrassing as another time I got frisked, presumably because of my jutting belly's resemblance to a jihadi's explosives belt.

CPAP is a pain in the neck, but I'm fortunate that I can use it. Many apnea sufferers never learn how. They can't master the trick of closing the back of the throat and sleeping with their mouths shut. Or they can't stand the noise. The secret of my success is a squirt of Afrin in each nostril, and a pair of foam earplugs.

I never don my mask except in the dark. The straps get tangled and I've learned to straighten them out without looking. I've even repaired a broken mask with duct tape without opening my eyes. I never look in the mirror while wearing the mask;I couldn't bear it. I know it would look too much like something I wish I'd never seen, the sight of my stepsister
in a hospital bed in New York City, comatose after a cerebral hemorrhage, breathing through a face mask.

Are you dieting to look good in tight jeans or fit into last year's bikini? Good for you. I'm dieting so I can take a nap on the couch without asphyxiating myself. How did this happen to me?


  1. Wow. That's pretty intense. I snore, and for the same reason. You didn't freak out with all that equipment, though. That says to me that you, like me, had grimly determined that losing weight was impossible anyway, so you might as well just cope.

    My sense of operating beyond design limits was sharpened by some foot problems: metatarsal algia, or, "pain in the toes". It's a very odd sensation: you feel like you are walking on wadded-up socks stuck in the front of your shoe. Nerve damage. The only practical remedy was -- you guessed it -- to lose weight. I never cared so much about the ability to walk as when I began to lose that ability.

    You haven't talked much about age. Unfortunately, having lost weight at various times (only to gain it back), I can tell you that it gets much harder to lose weight as you get older.

    We've been asleep while the quicksand has been eating us alive.

  2. I knew I felt a kinship with you. I, too, sleep with a CPAP mask. I very nearly lost my job before discovering that my depression was being caused by getting the equivalent of 1 night's sleep every 17 days. I do not like my mask, but I cannot sleep without it. Someday, my weight will come down to a level where I may not need it....but I'm not holding my breath.


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