24 August 2010

A man's best friend

Sometimes, information from odd sources comes together at the perfect time to effect a great good. I view these as minor miracles and am always grateful for the cosmic assistance.

I had a patient who believed he was suffering from empty-nest syndrome. His last child had departed for university and he was blue, often on the verge of tears, he said. He was also finding it hard to sleep. He visited me for some advice but was not amenable to any medicinal intervention, and there isn’t much a practitioner can do about the complaint of fatigue. I offered the usual naturalistic recommendations and reassured him that tincture of time is a great healer.

I saw him frequently around the embassy and usually asked how things were going for him, since I expected, as the days turned into weeks, that his sleep and mood would improve. But they didn’t. One day, we were chatting in a hallway and he mentioned that his dogs had been acting very strange at night and were adding to his sleeplessness. He told me that, when his child left home, he began letting the family dog sleep in his room and now, several times a night, the dog would jump on the bed, bark and wake him up. As soon as he spoke, the dog would lie down and be quiet.

Immediately, an article I had read about how dogs can sense medical dangers popped into my mind. Call it a hunch or an inspiration, but I instantly asked if he snored. Yes, he said, his child often complained about how loudly he snored. Returning to my office, I sent him the Epworth Sleepiness Scale and, wow, his score was very high! That was enough to get him scheduled in the sleep lab for evaluation of possible sleep apnea.

My colleague and his dog are now having peaceful nights, thanks to the CPAP that treats his severe sleep apnea. And, perhaps because of the passage of time, or maybe because he gets adequate oxygenation at night, his blue moods and fatigue are long gone.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.