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In February 2014, David was diagnosed with obstructive sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts due to muscles in the back of the throat relaxing, which causes a constriction or closure of the airway. As in David’s case, the condition often is accompanied by loud snoring and abrupt awakenings to gasp for air. The recurrent episodes of breathing cessation not only inhibit restorative sleep but can result in dangerously low levels of oxygen in the blood and brain.
“There have been many times when I would physically have to shake him to wake him up to start breathing again,” David’s wife, Kristi, says.
Although David was provided with a continuous positive airway pressure (CPAP) machine to keep his airway open during sleep, he refuses to use the apparatus every night. “It gets curled around my neck. It’s just a big, bulky, aggravating thing,” David explains. “The way I see it is the doctor told me I’ve had [sleep apnea] for a while, so if I’ve made it to 43, it’s not going to hurt me to skip one or two nights.”
David admits that he neglects his health. “I do not take care of myself the way that I should,” he says. “I don’t do much exercising. I kind of put myself on the back burner.”
In addition to having sleep apnea, David has high blood pressure, smokes a pack of cigarettes per day and deals with daily fatigue from sleep deprivation. Since David drives a truck for a living and Kristi often rides with him, their 18-year-old daughter, Leigha, says she fears he will fall asleep at the wheel and cause a deadly accident.
Leigha wrote The Doctors expressing her concerns about her father's health. To help David realize the potential dangers of his condition, The Doctors sends him to internist and oncologist Dr. Lawrence Piro for a health scare experiment.
During the evaluation, Dr. Piro discovered three reasons David has not been receiving the benefits of CPAP when he wears the device. David has a deviated septum from a previously broken nose, which blocks the flow of oxygen through his nasal canal. Additionally, David’s airway is impeded by the length of his uvula, and his throat is constantly inflamed and closed off from gastroesophageal reflux disease.
After undergoing a series of tests, which included an EKG, a CT scan and a comprehensive blood workup, David joins The Doctors, accompanied by Kristi, Leigha and Dr. Piro.
In an alarming turn of events, Dr. Piro reveals that he did not need to simulate what potentially could happen to David, because it already was occurring. David’s liver enzymes were found to be elevated, due to an infiltration of fat cells. “While fat may just look more cosmetic on the outside, when it gets inside of an organ, it can damage the organ so that it doesn’t do its functions,” Dr. Piro explains. “Left unattended, this can lead to cirrhosis.”
To make matters worse, David’s CT scan showed calcifications in the arteries of his heart, putting him at high risk for suffering a heart attack, and his lungs showed moderate to severe changes from emphysema.
“There’s a lot of inflammation and damage going on in your lungs from the smoking, so much so that I found two nodules in your lungs,” Dr. Piro says. “It’s my hope that these nodules are just nodules of scar from all of the damage to the lungs, but these kinds of nodules can also be cancers.”
Despite the alarming diagnoses, ER physician Dr. Travis Stork explains that David can prevent his conditions from progressing if he makes major lifestyle changes.The Doctors offer resources to help David quit smoking and eat healthier, and encourage his family to incorporate the changes into their lives, as well.
“The CPAP, which started this whole thing, may have saved your life — and you may wind up not even needing it, if you can own the changes,” Dr. Piro says. “This was the best health scare of all, because you came for a health scare, and you’re leaving with health care.”