Symptoms Spotlight: Melanie's Updates on Sleep Apnea and Constipation

After recording our earlier Symptoms Spotlight episodes on sleep and constipation, Melanie Sisk comes back with real-life updates that prove these topics hit closer to home than she expected. First, Melanie shares her surprising new diagnosis of obstructive sleep apnea, discovered thanks to a sharp-eyed friend at a cancer conference. She breaks down the symptoms to watch for, why they're so easy to confuse with cancer treatment side effects, and how simple the at-home sleep test really is.

Then, Melanie reveals what happened after we recorded the constipation episode: her CT scan showed she was significantly constipated, leading to a gastroenterologist visit and a diagnosis of chronic constipation with diarrhea breakthrough, something she never saw coming, even as a nurse. Her takeaway? Don't automatically chalk every symptom up to cancer treatment. There may be something else going on that's very treatable.

Both updates are a powerful reminder of the importance of primary care physicians and specialists who can see the full picture of your health beyond cancer.

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Transcript

SPEAKER_02 0:10

Could a few of questions be closer than you think? Welcome to Life from Stage 4, where MBC takes center stage as we talk to experts, share inspiring stories, break down signs, and shine the spotlight on what matters most. Because when it comes down to it, the spot for us and by us is all about us.

SPEAKER_00 0:37

Hi, I'm Abigail Johnston.

SPEAKER_01 0:41

Hi, I'm Melanie Sisk.

SPEAKER_00 0:43

And we're here today to talk about symptom management. This series is called Symptom Spotlights, and we will regularly be bringing information to you on various symptoms caused by cancer or the treatments for cancer and how different patients are managing them. We learn so much from each other. What a great example of how we are stronger together.

SPEAKER_01 1:04

And we are so excited to bring this hard-won peer wisdom directly to patients. And please let us know if there is a symptom you would like us to talk about. And now let's get to it. Abigail, what symptom are we shining the spotlight on today?

SPEAKER_00 1:22

Melanie, we recorded two symptom spotlights before you had some specific updates. And so I wanted to ask you we recorded the one on sleep, and then you've had a new diagnosis. So tell us a little bit about that.

SPEAKER_01 1:37

I have. Isn't it so ironic? Here we were talking about having sleep problems with cancer and cancer treatment. And we did the recording, and then all of a sudden, I get diagnosed with obstructive sleep apnea. Who knew? So I have a friend, Amy, who actually works in the medical field. And so she's been my roommate at several of the conferences and cancer events that we've been to. And she heard me sleep, heard me snore, which I've always snored, so that's no big deal. But she told me, I really think you have obstructive sleep apnea. And I'm like, Well, I don't think I do, but I'll tell my primary care provider and we'll see. So after that weekend, I sent my PCP a message telling her what my friend thought that I had. And she's like, Okay, we'll order a test. So when I got home, they ordered a at-home test. And so I took it, which is just you wear this thing on your wrist and it checks your oxygen level, and if you have any events during your sleep, did it, went to turn it in. I thought, I'm gonna be fine. I'm not gonna have sleep apnea. Well, turned out I do, and so I was right between mild and moderate. I was having like average of 12 events per hour and did not even know it. So that is an update to sleep problems. You could be suffering from obstructive sleep apnea and not even know it. Especially for someone like me who I've always snored, even when I was skinnier and younger. And you always think obstructive sleep apnea, some people think it's probably for only obese patients, you know. Yeah, I'm a little overweight, but I still didn't expect it. And I'd had one tonsil removed because of cancer, because we thought it could be cancer, but turned out it wasn't, thank goodness. So I have a little bit more room since I'm missing that one tonsil. I thought, no, there's no way. There's no way. So it was affecting my sleep, and I did not even realize it. Of course, we know what the solution is to obstructive sleep apnea. They have these mouthpieces that you can wear that helps prevent you from relaxing so much and it covering up your airway, or you have a CPAP machine. So if you are someone who is struggling with sleep, or even if you feel like you're sleeping, but then when you wake up, if you're like constantly tired during the day, or you're like easy to fall asleep during the day, those are some of the questions they ask you before you actually take the test. So it could be affecting you in different ways. So that's something that everyone should think about. Abigail, has anyone told you that they thought that you could possibly have that?

SPEAKER_00 4:44

Sleep has not been something that I have struggled with in terms of like waking up at night or snoring or anything like that. But the thing that came to mind as you were talking was what a great reminder that even though we see our medical oncologists and they are watching all of the cancer stuff, there's still an important role for a primary care physician. Somebody who's looking at the rest of your body, uh, who might be looking at the possibility of vaccinations or other interventions that are important to support us as we're dealing with cancer stuff. Great reminder how important it is to have your primary care physician on board. Melanie, other than snoring, what other signs or symptoms should people watch out for to know if they should be screened for sleep apnea?

SPEAKER_01 5:33

Well, one thing, if you're waking up several times during the night, which how many of us are not waking up several times during the night, right? I woke up a few times during the night, but I didn't really wake up like gasping for air that I knew about or that my spouse knew about. But apparently that could have been in my body's way of letting me know, hey, breathe, woman, you need some oxygen here. So one thing, you know, of course, if you wake up with dry mouth, which I am a mouth breather, so that's always been a thing for me, having a little bit of a dry mouth in the morning. Another symptom is morning headaches. How many times have we woke up with headaches in the morning because of allergies and things like that? So it's kind of hard to know if you're irritable, which how many of us cancer patients are not irritable? We have that. And then daytime fatigue. Well, that's another common thing with cancer patients. We have fatigue all the time, it seems like. And then another one is if you have difficulty paying attention while you're awake, which I didn't really notice that with me, but another one is difficulty thinking clearly. So those are just some of the signs and symptoms that could be with obstructive sleep apnea, but are also very common in cancer patients. So it's kind of hard to know. But the overnight sleep test that I did at home was super easy, super simple. I just went by, picked up the equipment, took it home, wore it. It was you wear it on your wrist and your finger, wore it that night. I think I might have had something attached to my chest, but wore it while I slept, took it back, turned it in the next day, and then it took them maybe a week to hear from the results. So if it's a possibility with you, if you think this could be possible, just talk to your primary care because it is a really easy test to take to see if you do have obstructive sleep apnea.

SPEAKER_00 7:36

Just goes to show you having friends who are paying attention to something can be another way we can support one another in the metastatic community. But I think you had a second update after we talked about constipation, that there was something else that happened.

SPEAKER_01 8:03

I did. Like, what is this? Every time we talk about a side effect, then all of a sudden I'm having an issue. This might be jinxing me, Abigail. We might have to rethink this. But yes, after we did the episode of constipation, I had my normal scan, my CT of abdominal chest, and pelvis, and my CT scan showed basically that I was constipated. It was plain and clear in there. I was like, oh my goodness. And I did not realize how constipated I had been. And one evening I was at home and I was just getting really nauseous and having abdominal pain. And come to find out that night, I, of course, was dealing with constipation, but I had diarrhea, and then I also had nausea and vomited. And this has happened to me several times over the past few months, and I just chalked it up to part of the cancer treatment on a targeted therapy, and that therapy has tended to make me more constipated. So, with looking at my CT scan and having that event at night, that's when I reached out to a gastroenterologist to find out what is going on with me. So, in going over my symptoms with everything that I was experiencing, she told me that she thought that I had chronic constipation with diarrhea breakthrough. And I was like, wow, I hadn't really thought of that or even knew that that could be something I was experiencing. So she instructed me to do a clean out like you would do for a colonoscopy. And then you kind of start over. So I did that, and it wasn't as bad as people think. And then I started treating the constipation. And to this day, I have not had any more bouts of severe abdominal pain with diarrhea and vomiting. And you know, when I'm sitting there and I'm struggling, I did not think that, you know, vomiting and nausea and all this was coming from constipation. When you're sitting there and you're having diarrhea, but yet you're really dealing with chronic constipation, I had no clue. And I'm a nurse, and I was like, what is happening to me? So that goes to show that just because you're having a certain symptom, don't just chalk it up that, oh, it's just the cancer treatment. It could be something else underlying that you're not even aware of. And that's what happened to me. I had chronic constipation with diarrhea breakthrough, and that's what was causing my diarrhea, my nausea, my vomiting, and I had no clue. So that was a huge lesson learned. So now I'm taking daily fiber, doing all the things to help me to not get in that position again.

SPEAKER_00 11:09

And just a reminder that those GI doctors, those gastroenterologists, can be super helpful. It's outside of cancer, right? It's just the other things that our body is doing, and having experts to support us as we're dealing with those things can be very important. So thank you for those updates, Melanie. I appreciate you sharing that with everybody.

SPEAKER_01 11:29

You're welcome. And I hope that I don't have any more updates from any more side effects that we do. Please.

SPEAKER_00 11:37

We're definitely not speaking anything out into the universe for you any longer, Melanie.

SPEAKER_01 11:53

We hope you have enjoyed this conversation as much as we did and learned a little along the way.

SPEAKER_00 12:00

Please don't take any of what we've shared today as medical advice. If you have a question about a product or if an intervention is safe for you, we encourage you to engage with your team. You will find links to each of the products and the interventions we talked about today in the show notes.

SPEAKER_01 12:15

We want to hear from you. Did you enjoy today's spotlight? Is there another product that you have had success with? Is there another symptom you would like to hear us talk about? Engage with us, and you may find yourself receiving samples.

SPEAKER_00 12:32

This episode was produced by me, Abigail Johnston, and my dear friend Melanie Sisk. Until next time, be well and keep thriving.