h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

At some point you begin to think of all the times you invited people to assist you nag your mutually loved one, but they missed the point.

One of the first was the only check-up I ever remember my husband having. We had talked about how important it was that we both have physicals before we were married, to start our life together healthy and informed. I had mine, as I did every year. He went in a mere three years after the wedding, only because of a mysterious abdominal strain. He invited me to go in with him, because he said that I understand "this medical stuff" better than he did. So I went, wondering if men have cold metal implements inserted in them, too.

The doctor, who my husband used for years (but probably only saw five times) came in, looked at me, and said "one of us must be in trouble, because she's here." The examination seemed competent (if brief), with the usual questions about what goes in, what comes out, what happens, what doesn't, and the like. The doctor recommended my husband loose a bit of weight, and they both professed knowing how this effort should happen without discussing exactly how to make it happen. I broached the topic of the snoring. I explained that he stopped breathing, had night terrors, and the combination were causing me health problems from lack of sleep. The doctor minimized it, saying that he'd heard that none of the surgical procedures were successful in stopping the snoring. My husband shot me an "I told you so" look, and I shot the doctor a look that clearly indicated that I questioned his identity, species, ability to transport himself to work, button his shirt properly without help, etc.

A few weeks later, the doctor left a message on our answering machine asking if my husband's abdominal strain had resolved itself. I know that doctors don't generally take the time to do this, but my husband didn't probably because he just didn't go to the doctor often. The message also contained an unconcerned caution that snoring can be serious and that he should get it checked out. His tone of voice, coupled with the rarity of follow-up phone calls led me to conclude that this "doctor" had become alarmed at my response, consulted his references or collegues, discovered that this was potentially serious, and wished to backpedal without loosing face. However, by then my husband had written the whole snoring issue off as my problem, not his.

My husband's father snored, too. I tried on many occasions to enlist his help. He regularly asked if his son was in good health. When I'd mention it, his father would give the same response: "Oh, I've had mine checked, and it's not apnea, don't worry." I think either his hearing was bad, or he jumped into an defensive mode from hearing complaints about his snoring.

Needless to say, I did not have much respect for my husband's doctor. Eventually, he decided to change doctors to one closer to our home. He chose mine. This filled me with hope, because my doctor had been very sympathetic while treating my problems that arose (at least partially) from lack of sleep. My doctor knew that I was feeling better since moving to another bedroom; and about my concern for my husband's health. Unfortunately, my husband only saw my doctor once before he died--for a shoulder problem, and the doctor referred him for physical therapy.

In about 2001, I convinced my husband to see a specialist. Based on the books my husband checked out from the library (I read them, he did not), the best I knew to do was suggest an ear, nose, throat specialist. She was very nice, discussed how insurance companies cover (or don't) these issues, and gave him a referral for a sleep study. When I've been referred to a specialist, my doctor has contacted the specialist, and their office has corresponded with the insurance company to determine who would pay what. Not this time. She left it to my husband to decide what to do and talk to his insurance company. I think he was under the impression that persuing this would help me, not him, and that it would cost him money because the insurance would not cover it. I kept nagging him to have the study done.

He never got around to calling the insurance company. He'd complain about my decision to sleep across the hall, and I'd chew him out about how stressful it was to hear someone you love stop breathing; I was literally afraid to go to sleep when I could hear him. He would feel bad about it, but never actually did what he needed to do. He ran out of time and died.

The autopsy was done the day after he died. The deputy medical examiner, a very nice man, called me afterwards to discuss the findings. It turns out that he uses a CPAP machine for his own apnea, and is both sympathetic and informed on the issue. My husband was a very healthy man. The only health issues he had were being a bit overwieght, having some arthritis in his upper back (which caused his shoulder pain), and an enlarged heart (left ventricular hypertrophy). The stress of stopping breathing puts additional stress on that part of the heart, and it enlarges to try to compensate. This condition as well as the apnea itself seem to cause cardiac arrythmia. Most likely, my husband fell asleep in front of the TV, and died in his sleep without ever knowing that anything was wrong. He did not suffer. He did not yell for help. I couldn't have saved him if I'd awakened a half hour earlier. He died at about 2:00 in the morning, the popcorn and soda he ate at the movie still in his stomach.

The deputy medical examiner said that my husband had large tonsils, a low palette, and a large tongue. He was certain that apnea was the cause of my husband's death; but there was no way to certainly say beyond any doubt that an arrythmia was what actually killed him. So it would still take time to have toxicology tests and tissue samples examined. It turns out that it took another couple of months before I could get a death certificate that said anything but "under investigation." Months of people asking what happened.