Complications, Heartbreak and Disappointment - Pre-Opp Assessment No. 3, 4 and 5 (Sleep Study, Ultrasound and Meeting Anesthesiologist)

Super Long Update on everything ahead......

Sleep Study-Results-Obstructive Sleep Apnea

So about two weeks ago, I did my sleep study to test the severity of my obstructive sleep apnea ("OSA").  I had to be hooked up to this machine, which we obtained privately which costed around RM 300.

The tubes go in my nose and there is a pulse thing attached to my finger. I taped them down with bandage tape so they would not fall off my face and off my finger. I would say that it was not the most comfortable sleep with all these stuff attached to you.

Anyway, so after that we got the results :

So what exactly do all these numbers mean mean? Well, for a situation like this the key thing to be aware of is the result of the AHI (Apenea Hypopnea Index). The severity of OSA is classified as follows :

• None/Minimal : AHI < 5 per hour
• Mild : AHI > 5, but < 15 per hour
• Moderate AHI >15, but < 30 per hour
• Severe : AHI > 30 per hour

My AHI is 37. Severe Obstructive Sleep Apnea. 

In addition to the above, what is also looked at is Oxygen Desaturation. Dips below 80% is usually considered severe. My lowest desaturation is 55%. Which is also a red flag. 

Just a small brief explanation of OSA:

Obstructive sleep apnea (OSA) (or apnoea) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation.

Below is an image of what OSA actually is :

Getting back to the point,the test confirmed what I kind of already knew, because OSA can cause sleepyness during the day despite getting a full nights rest, always feeling tired, headaches here and there all of which I have had before and now I know that the reason for the above is because my body is not getting the oxygen at night that it actually needs. 

Generally, people who have severe OSA would be advised to not to any elective surgeries because the risks and complications that may arise while under general anesthesia are much higher due to the blocked airways. 

So,after hearing all this and furthermore reading up about it broke me down. I want this surgery so bad, and I am so prepared for it, and now I find out about this. I was utterly heartbroken and could not stop crying that night. I am not prepared to take such a big risk for an elective surgery. I do not want to die. 

But then I thought to myself, ok calm down, let me first go meet the Anesthesiologist, maybe there would be a way around this. 

Consultation with Anesthesiologist

So today after my ultrasound ( I have Gallstones btw) which was already scheduled as a pre-op assessment, I went to meet the Anesthesiologist with my sleep study results. And they confirmed that it would still actually be possible to go through with the surgery, but the risk of complications are a lot higher because of the blocked airways.

What they have recommended me to do , is postpone the surgery first, lose some weight and go get a Continuous Positive Airway Pressure(CPAP) Machine. They have referred me to the Institute of Respiratory Medicine to go and get a CPAP Machine on loan. These CPAP machines are really expensive to buy here and ranges from RM2,500 - RM6,000, Bottom line is that I need it tho. 

A CPAP machine is a small machine that supplies a constant and steady air pressure through a hose, and a mask or nose piece throughout the night while I sleep. It is basically a machine that will help me breath better when I sleep and get more of the oxygen that I actually need at night. 

Apparently the benefits of using this is that I will feel less sleepy and have more energy throughout the day.This could be a good thing, because then I will have more energy to be more active and exercise towards losing some weight. 

Postponement

So in light of all the above, I have decided to postpone the surgery. I am not willing to go through an invasive elective surgery with all these risks if my body is just not read yet. I need to fix my sleep apnea first. I really feel quite down about it, but I have to remember that this is just an obstacle, and my end goal should remain the same no matter what, even though it may take a little longer or I may have to take a different way of getting there, the end goal remains the same. 

Moving Forward

So next action step I have to take, set up an appointment with the Institute of Respiratory Medicine, and find a way to get a CPAP Machine.

Speak to my Surgeon who also runs a lose weight programme for obesity, see if I can sign up for it, and hopefully if I lose some weight, it could bring down my AHI.

I have to remind myself to keep moving forward.

Thank you everyone for all the support you have been giving me so far, I will continue to update my progress with everything on this blog. 

Not Giving Up! Not Backing Down!

Yesterday, I went for one of my first participation's in a longer distance run. 6.4km Be a Runner Be A Giver. (Previously, the Jog for Hope was 3km)

And since I am purely honest in this blog, I would say I was quite disappointed and upset in myself, and I felt the worst I have ever felt after a run. I felt a kind of down, I haven't felt in a long time that I went home and cried.

Trying to push myself made the sharp pain in my foot come back, and it came back full blast, the pain was excruciating. And being yelled at to run and not walk when you have an excruciating pain in your foot, not the best experience.  Further more, taking part in it made me realize I am so far behind, and I've got such a long way to go. My friends are way up there, and I felt I will never be able to get there. It probably got to me more because I was doing it alone. It upset me quite a bit, and I felt extremely demotivated yesterday, and wanted to give up on participating in these events, till I am actually ready. I wanted to scratch the 7km PJ Marathon and the 5km Putrajaya Night Run.Because yesterday, I just felt like I really can't do it. Emotional and mental pain.

BUT, after I spoke to a few friends and I did some proper thinking, and watched the Shay Carl video again. I changed my mind and I have decided to not give up.

If I think I can't I never will be able to. The power of the mind.

So,I changed my perception and decided to suck it up. Yesterday I did 6.4km, even though it be slow, the fact is , I did it. I got up in the morning and did it. I lapped everyone who was in bed that morning. It IS something.

And I should be happy that I have actually gotten that far. I  have to remind myself, Small Steps. I mean, that is the title of my blog.

There is no fast road to achieving my ultimate goal. I just have to suck it up and keep going.

So I am doing the PJ and the Putrajaya, even though I suck! I will do it, I will keep going, to the extent my foot allows me to.

I should be happy and proud that I got up and did it, because I can. When I first started this, doing 4kms. I thought that was my limit. Now,my daily workouts are 6.5kms. Slow progress, but its progress non the less.

So, I had a bad day. It has to not stop me. It should never stop you. Yes, I had some irrational thinking. But now with my head clearer, I will not let it pull me down.

I will have one big challenge to overcome, which is the pain in my foot, but I will do something about it, and it should not stop me. And I will keep going.

Some pictures from yesterday. My favourite colour as well.

Thank you Wils, for making me do this. And Thank you Hanna for telling me to not let it discourage me. And thank you Hariz and Sam for making me feel better. :)

Small distance it is. But , I did it. And I will keep on trying. 

P.S, as of today, I've lost 13 KG! =)

New Personal Best!

Yesterday, I beat my personal best!! Yay!!

A 1m: 52s improvement from the last!! Small Steps! Everything can be done in small steps!

I owe a part of this improvement to Dr.Blake. I found his site while surfing around for advice on my foot condition (Accessory Navicular Syndrome, flat feet, collapsing arches etc.) and decided to write him in, and he replied with some advice which helped me tremendously during my workout yesterday. If you are having any foot or ankle problems, do go check out his sight because he addresses quite a number of conditions and gives recommendations. 

I did not feel the pain I usually feel when I run. 

So,the things he recommended and I attempted :

1.To heat up my insoles which are "Sole" brand for a more custom fit of my foot (though I knew these could be heated up, I didn't do this when I got them, cause it said you could either heat it up, or just wear them straight away and they would eventually form). 

These insoles provide me with the arch support I need, and I find these are the best insoles around so far, as I have tried many different types. I got them from Running Lab in Tropicana City Mall, the ones I got below costed RM169. These insoles have reduced the pain I feel in my foot by a huge margin. 

These are the pair which I got, they are called Softec Response Heat-Moldable Orthotic Arch Support Insoles which are for people who have plantar fasciitis ( a condition common for people with flat feet or low arches) or for people who need extra support.

2.As I was worried about the heel blisters I was getting which was getting to be quite painful ( a common thing to occur when you change your insole from the original one for support because it is thicker).He recommended to use BodyGlide on my heels, however I am not too sure where to find it here so I looked online for alternatives, and most of the results said to try Vaseline, which I tried and it work.

Of course in addition to this, I also bought anti-blistering socks. Which I picked up from Athlete's Circle in Jaya One. I believe they were call Wright Socks, as below. A pair of these are about RM50.

Double layered socks to prevent blistering.

3. He recommended taping my foot with either Kinesiotape or Rocktape, to provide arch support. I do not know where to find kinesiotape, but Rocktape can also be found at Athlete's Circle and costs about RM60 for a roll, which can last pretty long. There are a variety of patterns and colours, which I find quite cool as below :

But the shop didn't have the purple colour one, which I really wanted, so I decided to go with Black.If anyone sees purple RockTape out there, please do let me know where I can find it in Malaysia. 

Now, I am not too sure how this RockTape actually works, but it has something to do with the lifting of skin away from the soft tissue and it is supposed to accelerate blood flow, reduce swelling, strengthen muscles and other things. You can read more about it here. Once you apply this tape on your foot, you can leave it on for 5 days, if it doesn't come off before that. This kinesio type tape can be used for a number of purposes eg. Shin Splints, Knee pains, Thighs etc.

Anyway I followed Dr.Blake's method for taping for Arch Support as below :

There are many other ways to tape for arch support which I have watched on YouTube. I will slowly try these and see which one fits the best. 

But the taping really helped me a lot yesterday. My pain was almost to a point where it was non-existent during my run, and I didn't get the burning sharp pain I usually get after running. This I guess added together with the more comfortable fit of my insoles helped. 

So there, these three things helped me push myself yesterday, and it worked. Now, that I have sort of sorted out the issue of the pain in my foot, he has told me to try to find an every other day running distance that does not seem to push it too far and cause pain. And to stay at that distance for 10 runs and if all works out increase by 10% the next 10 runs, and so on. This I will definitely do. I find it so awesome that there are such helpful people out there, his advice helped me instantly boost my personal best time. 

Oh he also recommended to get either the Brooks Ariel, Brooks Addiction or Brooks Adrenaline shoes, which I checked out online are shoes that have really really good support, which is something I definitely need, however these do come at quite a high price and I am not even sure they have them here, the Ariel one seems like the one I need. Those shoes would be an investment. But anyway,  I shall make do with what I have now, and see how it goes. 

When you have a problem, find the source of it, and fix it. You won't regret going through the trouble or going that extra mile. 

The absence of the excruciating pain during my work out has really motivated me to keep going and keeping pushing myself. I admit the fasting month, did bring me down because I could not do the workouts as often. But now it is ending, and it is time to get back on track!

I feel motivated to give it my all again. Beating my personal best makes me want to beat it again, but slowly of course. Small steps! I will not give up on this, I will keep going. Today, I could fit into a skirt which I have been trying to fit into ever since I started working out. I have been trying it on constantly, and have never been able to close that buckle. 

Today, I could close that buckle and wear it to work.

Small steps.

ARGH!!

Sigh. This puasa thing is really getting to me. Not because of the no food or energy or anything to do with that whatsoever, but mainly because it is messing up the timing of things in so many ways!!

I feel so very frustrated!!

I MUST do a workout tonight, I haven't done so in two days (because I was resting my foot due to the ankle pains), BUT I also need to do my work tonight. My night run can only start at 9pm which will end at about 10pm and by the time I get back to my work it would be 10.30pm!!! ARGHHHHHH!!!!!!!!!!!


If I could have done my run in the morning, I wouldn't be faced with this problem! I could just continue doing my work, quickly eat , break fast and get back to it.

Sigh.

I am thinking if it would be possible to do a workout from 6pm to 7pm, and finish just in time for break fast. Then I could get back to my work earlier.

Problem is, is that I don't think I would have the energy to do so because I don't wake up in the mornings to eat sahur (maybe I should start doing this, but then I don't think I should be waking up, eating and then going back to sleep). The last time I would have actually eaten a sort-of meal would be 7.30pm yesterday, having my yummy sad baked potato for dinner. My mom said my dinner looked so sad lol.

 It does look sad. lol. But it was yummy!!

I feel like I have to come up with a solution for this work out thing. I gotta find a better way to do this. I can't stop the workouts. Suggestions anyone?

7.2km =)

Last night I did the furthest I have ever done so far which is 7.2km!! and I felt quite ok doing it. I also was within my 5km under an hour timing as well, so all in all yesterday was a good day. Yay!

The ankle pain was of course inevitably there, I really should take it easy on my feet. But it just feels so good working out.

Puasa (Fasting Month) has started. =(

And I feel like it is  messing up everything! I can't do my morning runs any more and being dehydrated throughout the day is a pain. Even when break fast time comes, I try not to eat so much because I want to do my workout after. So all in all, my daily intake has quite drastically reduced. Also I don't actually wake up in the morning for Sahur, because I don't want to get up eat and go back to sleep.

I guess it could be a good thing, that daily intake has reduced, hopefully I will lose weight faster. But I can't help but think that this is not the proper healthy way to lose weight.

Sigh. I know I should not complain. But I really view this fasting thing as something extremely unhealthy, where people gorge themselves in the early morning to last throughout the day, and then gorge themselves again at night because of the hunger throughout the day.

How on earth is that healthy? And not to mention the sleep in between, falling back to sleep after sahur?.

AND to top it all off, the end of fasting month is celebrated with one month of Raya (another occasion where people continuously gorge themselves with calorie loaded food).

I must remind myself constantly not to succumb to the above and just continue my daily routines somehow. Puasa and Raya are two months huge obstacles I have to overcome and keep going.

Fallen Tree

This morning I went to my favourite park to do my usual workout at the TTDI Park (aka Taman Rimba Kiara Park).Took it slightly slow today because I don't want to aggravate my foot too much, so I did not do a 5km under an hour today. Also there was an obstacle in the way today at the TTDI park on the usual jogging track :

Apparently last night there was a storm and a tree fell onto the track. I took the above picture after someone had cut it up to provide a pathway, but before that I had to sort of hop over a branch to get across. Did this for about two rounds until it was cut, and there were lots of pauses while waiting for everyone to hop over the branch. I feel this slightly slowed me down today. 

But never mind, still did a work out today! Yay!

 The foot was slightly more painful than it was yesterday, but it was not too bad. I've got to keep reminding myself to take it easy. I need this thing to heal, and I gotta go for a physio therapy sessions ( which I have yet to schedule). 

I always feel good after a workout at this TTDI park. I love going there in the morning. Sad to say it will all have to come to a pause once puasa month hits. Then it shall be Desa Park City at night all the way for me till Raya. Booo, I don't feel as energised at night compared to the morning. 

But I will not stop this workout!! I will go on!! I will not make excuses for myself, just because it is puasa month it does not mean the exercises will stop. 

 

Jog for Hope 2012

So on Sunday 15 July 2012, I did my very first Fun run of 3km- Jog for Hope.

It was a good first run. I couldn't actually really run much which upset me a bit due to my inflamed ankle which was giving me issues, but I am just glad I completed it, my very first fun run. small steps!  =)

7.30am before the start, drops of drizzle falling on our heads.

Me, Feez and Bren before the start. 

Approaching the u-turn for the 3km, when I was here I was walking, the pain in my ankle was a bit too much and I pushed myself too much running up the initial hill. 

 My motivator and sunshine doing his 10km coming in at 6th place! Congrats Wils!

Complete random storm trooper walking about after the run. lol.

Me and Wils. Hopefully one day I would be able to do a 10km with him (of course not at his speed tho, he is too fast)

Sunnies from my Sunshine!!

After the run, Wils gave me this, for the completion of my first run. Its something I have been needing for quite a while, a good pair of sunnies. It was very sweet of him to do so. =) 

It was a good day! And I cant wait to join more. The next one I have already signed up for is the Putrajaya Night Fun Run of 5km. I gotta step up on the training, and hopefully my accessory bone will not give me problems. Arches Arches! I must wear my Arches!

Speaking of which check out my new Birkenstocks! The Doc told me Birkenstocks are the best for Arch Support, and I should try and wear them as often as possible for my condition, so I decided to make an investment and get a pair.

Purple ones of course! These were the prettiest purple ones of them all, and the arch support is awesome.

I have never really been a fan of them, as they aren't the best looking kind of sandals. But I have discovered when I do wear them, my foot feels so much better. It's like a constant massage on the pain I feel at the area surrounding my accessory bone. 

Today I did my workout. I was supposed to rest a few more days but I was tired of sitting still and resting my feet.I love swimming, but when swimming you don't sweat and it doesn't feel like much of a workout for me.

The past week, I have been swimming and not doing my usual morning walks/runs. Slowly I felt myself slipping and giving up which I know I cannot let happen.Swimming just doesn't feel the same was walking/running. I feel I get a better workout when I do walking/running compared to swimming, though they like to say you burn more calories with swimming. I am not too sure, but I know my heart is not in it compared to running. I want to be able to run with my friends one day. I want to be able to do a run with sunshine, one day, hopefully, eventually. 

Anyway, so today when my usual morning alarm when off at 6am, I decided to get out of bed and just do it. I was tired of not being able to do my walks. I rested 3 days last week.Even though I promised myself and Wils I would rest today because of my foot, I decided to screw it and just do it, and I am glad I did!

I made sure I wore my arches in my kicks, and I did purely power walking with no running intervals up to the very last round. Only on the 5km lap round, I ran a lil to try and make it under an hour (my July goal) and I did! 5km in 59 minutes and 55 seconds! Yay!  Also, I achieved a personal best at 6km of 1 hour 12 minutes! Yay again! There was minimal pain today, which is also another Yay thing for today. 

Down Week.

So this week so far has sort of been a down week. Actually a super down week, and all I feel is frustration!

Why? Well because of my ankle. Its been acting up quite badly ever since last week. I don't know why and I am kind of scared. My doctor's appointment was supposed to be on Monday, but I had to reschedule to this Friday because I couldn't walk over there due to rain.

The picture above shows where I feel the pain. The pain is there when I walk, and also when I run. It feels like a sharp stabbing pain, which kinda scares me. I fear going to the doctor because I fear what he will tell me, but I know I gotta do it at some point.

Maybe I have been pushing myself a bit too much. But I want the results and I am getting the results!

I only walked on Monday and Tuesday this week. Yesterday I decided to give my ankle a rest and swim, same goes for today as well.

But somehow I feel so unsatisfied with swimming. There is no sweat and I don't burn as much calories as I do when I do the walk with running intervals.

On the plus side, I have been losing about 1kg a week consistently. This regime seems to be working for me, which is why I hope I wont have to stop it for a while because of my stupid ankle. Argh!!!!!! Frustration!!!!!!

Frustration!

Today was another down day. My body just seems to not want me to run. I started off fine, hyped because I rested my feet yesterday an I wanted to run today, but the minute I started running today the shin pains kicked in followed by my stupid ankle pains. I haven't had this ankle pain in a long time, but today was the day it decided it wanted to return!

It could be because I have been slacking on my ankle strengthening exercises. I have to remind myself to keep doing it, along with the exercises to prevent shin splints. These are a must do! I need to strengthen my feet! I feel so frustrated with all these leg pains! All I want to do is run!

Today I did not hit my 5km under one hour lap time once again, so I did 6.4km. I did however do a personal best on the 6km marker at 1hr 14mins. Slightly better than Tuesdays work out. But I still feel quite disappointed in myself and extremely frustrated with my ankle. I just could not run. Argh!!! And now after the work out, it decides to be a complete bitch. 

I know, I know, these things take time. You can't push yourself to the extreme to a point where you ignore signs of pain and keep going (which I was wrongly doing today). It's your body's way of telling you to ease up. 

The doctor appointment that was supposed to be yesterday did not happen. Some complications and it had to be moved. I am thinking of just taking things into my own hands and not relying on my mother to get me an appointment. I need to know what I can do about this ankle. I don't want to have to give up what I am doing. 

Anyway, hopefully I will do better tomorrow. I shall do my feet exercises today. I'm glad however that I did the workout and I did the 6km. I find the below quote very motivating :

My ankle is being scary painful. I need to see a doctor. 

Keep Going!

Today was not the best of days. Woke up with cramps, and achy legs. I was a bit worried and was thinking of resting today, but then when I turned on my phone and saw my wallpaper which is this :

I decided to suck it up and get out of bed.

Doing a work out with cramps is not the easiest thing in the world, to add to that I may have pushed myself a bit too much yesterday and my legs were really achy. I just could not run today, so I decided to make today full on power walking day. Since I couldn't run, I power walked 6km. I did reach my personal best for 6km which is 1hour 15 mins, previously my times were 1hour 20mins, 18mins, 17mins. So I guess today wasn't so bad. 


I did not meet my 5km time today, I was a bit slow because of the walking and no running, I felt kinda disappointed that my body was acting up. But I guess its my body's kind of way to say "take it easy". 


I have to remember that this is a long journey. I can't push things too fast. Small steps! Small Steps! 


I am glad I got up and at least did a work out today. I think I have to pace myself, I can't run ever single day because I am still too heavy and I have to take it easy on my feet. But at least, I have to do some sort of work out, as long as I do it. I told Wils I was disappointed with myself today, and he said to me the quote below, a famous motivational running quote :

I'm glad I got up.

Down Day

Gosh, I feel more tired than I felt yesterday. But I think it's the not enough sleep thing hitting me. I need to get to bed earlier. My head feels very heavy today.

I can't wait to sleep in tomorrow. The weekend is the time to re cooperate! On weekends I do the work outs in the evenings, because the weekends are the only time I get to sleep in. And sleep is very much needed.

I decided today would be a rest day from the walking/running routine, BUT that doesn't mean I don't do any exercise. I know have to keep my body going everyday. I pushed myself to get my ass out of bed and wake up at 8.30am today and then swam 600meters within 20 minutes, which apparently is the equivalent of 500 calories, much more calories lost compared to when I run. But I guess that's cause swimming is a full body work out.

I ALMOST wanted to screw swimming this morning because I felt so extremely tired and have a full on rest day, but then I remembered I just gotta keep the momentum of exercising going. I can't stop, even for a day. Even if I am too tired and need a down day, I must force myself to do some form of exercise that day, never mind it be low intensity, as long as it is done. I must keep going and keep my self disciplined.

Gosh, all I want to do now is to just crawl back into bed curl up like a ball and sleep. I need my sleep.

Tired.

Today my time was 14 seconds faster than it was yesterday at my 5km lap. I feel a lil unsatisfied that I couldn't break that 1 minute and do 5km in an hour,but I know, these things take time, I can't expect to be so much faster in a day. It took me a month to move from 4km to 5km. I must remember small steps!! Slowly and hopefully I will be able to do it.

Also, I feel so extra tired today after the run. I know it's the lack of sleep, got a bit dizzy today at one point in time. Sigh,getting home at 12.30am, sleeping by 1am and waking up at 6am to work out only gives me 5 hours of sleep. I lack sleep. Even more this week I did it 4 days in a row, which I normally don't do. I break on Wednesday and do a swim.  If I swim, I get to wake up at 8am, that is two whole extra hours. I gotta get to bed earlier, sleep is an essential.

Waking up in the morning with lack of sleep is extremely hard, and there are times that I just want to fall back into bed and continue sleeping. But then I remember this :

I didn't want to regret not working out, so I got my ass of the bed and went to the park.