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View Full Version : Advice for "Severe O.S.A" and UPPP Surgery?


Mr. Kotter
05-21-2007, 12:34 PM
OSA = Obstructive Sleep Apnea
UPPP = Uvulopalatopharyngoplasty

I'm undergoing the U.P.P.P. surgery on Thursday....anyone been through it before??? :shrug:


Long story, made....not-so-short....

I've always snored. Ever since I can remember. Even when I was a kid. Over the past 25 years, it's become progressively worse--especially during the last 10 yrs. Over the course of our marriage, my wife says it's gradually worsened....over 18 yrs. During the past year, it's become....unbearable for her. She "diagnosed" my problem last year, and said I needed to see a doctor. Well, I hemmed and hawed and I dragged my feet....until I finally decided to go to the doctor, as it was becoming real sore spot for her.

After a sleep study I was diagnosed with "Severe OSA" (I "stopped" breathing an average 102 times per hour.) The Doc recommended use of a CPAP (night-time breathing machine,) and strongly recommended that I consider surgery. I had always kind of laughed off "snoring surgery" as it's sometimes called, so I literally asked the doctor: "So, what you are really trying to tell me, is 'hey, fatso....get off your ass, and get some exercise and lose some weight?'" She said, "I wish it were that easy."

Doc told me losing 25-30 lbs could help--but probably not much...at least not in my case anyway (that the severity of my problem was more indicative of a person weighing 100-150 lbs or more than I do.)

Long term effects of OSA can lead to hypertension, heart problems, and other organ failure--as a result of long-time and chronic oxygen deprivation during sleep (yeah, colleagues have subsequently dubbed me "braindead"....heh)...that, apparently, leads to quite a number of premature deaths...in otherwise normal and healthy people whose only apparent problem is varying degrees of being overweight (....I know, I know...I'm fat, but certainly not morbidly obese--which is often the stereotype for this ailment.)

The bottom-line is I still have my tonsils and adenoids, along with a "constricted" or narrow air passage, and a thick tongue (someone mentioned this may be what Reggie White died of?) They immediately put me on a CPAP machine to assist my night-time breathing. In a sentence, I've become a new man. Even though I still only get 5-6 hours of sleep, I awake refreshed....like I used to, 20 years ago.

I had just resigned myself to the thought that getting fatter and older, with four young kids, was draining me. I've always been a, "ah, just quit your whining and suck it up....screw going to the doctor" kinda guy. But of course, being dog tired 70-80% of the day....I had little energy or desire to exercise the way I used to, back in the day. Which, of course, compounded the problem with weight gain---about 4-5 lbs a year over the past 9-10 years. And weight had never ever been a major issue for me....so I should have paid closer attention, I guess.

According to the doctor (and some reading I've done,) it becomes a self-perpetuating problem: snoring leads to poor sleep (no REM--it's great "dreaming" again...heh), which leads to decreased energy/chronic exhaustion, which leads to less exercise, which leads to weight gain....which aggravates the sleep apnea, which compounds the whole cycle....and can contribute to depression and the physical ailments I mentioned earlier.

On Thursday, I go in for the dreaded UPPP. Apparently, it's a pretty nasty procedure, and takes 2 weeks or so to recover. Doc says though, afterward....I should REALLY be a new man. And that I may not even need the CPAP machine afterward. I guess we'll see.

Anyone have any experiences or knowledge they would be willing to share, I'd be interested to hear about it. Thanks in advance.

NewChief
05-21-2007, 12:37 PM
Sleep Apnea is horrible. My wife's uncle has it, and he falls asleep constantly during the day. His doctor put him on Ritalin (as a stimulant) because he kept falling asleep at work and was going to get fired.

noa
05-21-2007, 12:39 PM
Good luck Kotter! Hope the surgery is a success and you have a speedy recovery.

My cousin had this done a couple years ago and said everything went smoothly, but I don't have any more details than that.

Mr. Kotter
05-21-2007, 12:43 PM
Sleep Apnea is horrible. My wife's uncle has it, and he falls asleep constantly during the day. His doctor put him on Ritalin (as a stimulant) because he kept falling asleep at work and was going to get fired.

Fortunately for me, I hadn't reached that point....I'm also ADHD (undiagnosed and unmediated, but I'm sure of it)....so I'm normally hyperactive. So now instead of bouncing off the walls, I'm just "awake" and "engaged" enough when I'm with other people.....my problem is the moment I get ANY down time....in a chair, with no stimulation....watching TV or a movie with my kids (that I'm not really interested in)....and on a rare occasion, "dozing" or eyes closing at a stoplight---which is what finally prodded me to going into the doctor.

Fortunately, for me....it doesn't affect my daily responsibilities in a marked way, other than I'm probably less efficient than I use to be, or should be.

Hopefully, this surgery will get me back to "normal."

Bob Dole
05-21-2007, 12:44 PM
Bob Dole's dad did not have to undergo surgery, but started using the CPAP a couple of years ago after they determined that he regularly stopped breathing for periods exceeding 3 minutes. Just the use of the CPAP has improved his quality of life 300%. (It's done wonders for the quality of life of the people who have had to tolerate his tired, cranky ass, too.)

Mr. Kotter
05-21-2007, 12:50 PM
Bob Dole's dad did not have to undergo surgery, but started using the CPAP a couple of years ago after they determined that he regularly stopped breathing for periods exceeding 3 minutes. Just the use of the CPAP has improved his quality of life 300%. (It's done wonders for the quality of life of the people who have had to tolerate his tired, cranky ass, too.)

Good to hear. I'm sure my demeanor has steadily deteriorated as well....I had attributed it to getting older, fatter, injesting rat shit, and other life "issues"....if the past three weeks are any indicator, my old cheerful self may still be in here, afterall. :)

Mr. Kotter
05-21-2007, 12:57 PM
Good luck Kotter! Hope the surgery is a success and you have a speedy recovery.

My cousin had this done a couple years ago and said everything went smoothly, but I don't have any more details than that.The "success rate," overall is not real encouraging, only about 50% long-term.....but for someone younger, with less of a weight problem (than many,) my chances improve.

noa
05-21-2007, 01:09 PM
The "success rate," overall is not real encouraging, only about 50% long-term.....but for someone younger, with less of a weight problem (than many,) my chances improve.


Yeah, I saw that on Wikipedia. Do you know anything about the Stanford Protocol?

Phobia
05-21-2007, 01:11 PM
I thought your problem was rat poison?

phisherman
05-21-2007, 01:29 PM
please get this done...

i don't know you from adam, but i lost a very close friend of mine a few years ago from complications due to sleep apnea, he was 23 years old

it's serious business

Mr. Kotter
05-21-2007, 01:53 PM
Yeah, I saw that on Wikipedia. Do you know anything about the Stanford Protocol?

Stanford Protocol? No....but I can Google it....:hmmm:

Cave Johnson
05-21-2007, 02:12 PM
Now that I'm back in the land of the fully insured (after a 4+ year absence for grad school), I'm going to press for a sleep study. Per the various g/f's, I have quite a bit of sleep apnea.

I guess the first step would be to find a GP, however.

Mr. Kotter
05-21-2007, 02:27 PM
Yeah, I saw that on Wikipedia. Do you know anything about the Stanford Protocol?

Well, it's apparently a two-step procedure....involving, first, the UPPP; then a surgical procedure on the jaw that involves moving the tongue forward.

My doctor did mention, IF this doesn't work.....that would be the next step.

KC Kings
05-21-2007, 02:34 PM
Well, it's apparently a two-step procedure....involving, first, the UPPP; then a surgical procedure on the jaw that involves moving the tongue forward.

My doctor did mention, IF this doesn't work.....that would be the next step.

Move the tongue forward??? I never heard of that part, but I got a UPPP and a tonsilectomy at the same time back in 99. My sleep apnea did not get any better. The surgery sucked and was pretty painfull for 3 days, but the military hospital would only give me Tylenol 3 for the pain.

I went back in for a sleep study 3 months later, and the surgery didn't help my apnea at all. It altered the sound of my voice and I soar throats are a lot worse now than they were before. With the uvula gone if you ever vomit, make sure you plug your nose or the vomit will keep going straight up into your nasal cavity. Don't drink beer to fast or the foam will go up there as well. I waited until I got out of the military, had another sleep study done and was put on a CPAP. It is a pain being hooked up to a machine every night, but it resolves the apnea issue.

Hopefully you will have better luck than I had, but with over 10 other diseases such as kidney failure, heart problems, alzimers, etc... having had partial links found to sleep apnea you have no choice but to do something about it.

KC Kings
05-21-2007, 02:35 PM
The "success rate," overall is not real encouraging, only about 50% long-term.....but for someone younger, with less of a weight problem (than many,) my chances improve.


BTW, I was 24 years old, 6'1" 220lbs at the time of the surgery. I'm 5 years older and 50 pounds fatter now, but the severity of the apnea is still the same.

Fish
05-21-2007, 02:50 PM
I'm pretty sure I've got some degree of sleep apnea as well... My grandfather and uncle had it, but my father says he doesn't. I've never had a sleep study done, but my ex and several old roommates claim to have witnessed me wake up gasping for air like I was having an asthma attack quite often. I very rarely remember those episodes though. I do wake constantly throughout the night.

Do you happen to know a rough cost estimate of a polysomnogram? Out of curiosity...


I don't think I could ever get used to a CPAP machine though... I'd have to drug myself just to fall asleep in that getup...

Mr. Kotter
05-21-2007, 03:21 PM
Move the tongue forward??? I never heard of that part, but I got a UPPP and a tonsilectomy at the same time back in 99. My sleep apnea did not get any better. The surgery sucked and was pretty painfull for 3 days, but the military hospital would only give me Tylenol 3 for the pain.

I went back in for a sleep study 3 months later, and the surgery didn't help my apnea at all. It altered the sound of my voice and I soar throats are a lot worse now than they were before. With the uvula gone if you ever vomit, make sure you plug your nose or the vomit will keep going straight up into your nasal cavity. Don't drink beer to fast or the foam will go up there as well. I waited until I got out of the military, had another sleep study done and was put on a CPAP. It is a pain being hooked up to a machine every night, but it resolves the apnea issue.

Hopefully you will have better luck than I had, but with over 10 other diseases such as kidney failure, heart problems, alzimers, etc... having had partial links found to sleep apnea you have no choice but to do something about it.

Yeah, I've heard and read about reactions/results like yours. I'm hoping to be more lucky, I guess. Doc says I'm an ideal candidate....but there's a part of me that wonders if that's her medical credentials or checkbook talkin'. If you are gonna have something "wrong" with you, this isn't too bad...as long as I've caught it in time to avoid the related issues.

Thanks for your insights.

Mr. Kotter
05-21-2007, 03:24 PM
I thought your problem was rat poison?

It was rat dung, man. Turds. That was the cause of the encephalitis issue a couple of years ago.

With Tabasco, they aren't bad.... :shrug:







:p

Mr. Kotter
05-21-2007, 04:37 PM
I'm pretty sure I've got some degree of sleep apnea as well... My grandfather and uncle had it, but my father says he doesn't. I've never had a sleep study done, but my ex and several old roommates claim to have witnessed me wake up gasping for air like I was having an asthma attack quite often. I very rarely remember those episodes though. I do wake constantly throughout the night.

Do you happen to know a rough cost estimate of a polysomnogram? Out of curiosity...


I don't think I could ever get used to a CPAP machine though... I'd have to drug myself just to fall asleep in that getup...

I'll have to check on the sleep study....off the top of my head, it was a couple of grand, but I have insurance so it was like $400-500 out-of-pocket.

go bo
05-21-2007, 04:48 PM
* * *
I don't think I could ever get used to a CPAP machine though... I'd have to drug myself just to fall asleep in that getup...works good for me... PBJ PBJ PBJ

Fish
05-21-2007, 04:53 PM
works good for me... PBJ PBJ PBJ

I spend money on a CPAP.... money on drugs..... I can't keep up man.....

Mr. Kotter
05-21-2007, 06:17 PM
works good for me... PBJ PBJ PBJ

Do you use the CPAP?

mikey23545
05-21-2007, 06:47 PM
Hey Mr. Kotter

The symptoms you described are so similar to mine it is spooky...

I have always had some degree of apnea, but when I was younger as long as I slept on my side and stayed off my back, it was a minor problem. Unfortunately, as I age it seems to be a worsening problem. Sometimes on my worst nights, I'll awake 15 or 20 times a night gasping for air.

And after a quick google search, I see some long term effects that are not only scary, but in many cases I have already experienced. About two and a half years ago I had a heart attack (one listed effect of sleep apnea) and now have sometimes severe heart arrhythmias (another), high blood pressure (another), diabetes (another), weight gain (another)...well, you get the picture. My wife (who is an RN) has been urging me for years to have this problem checked out, and I have just been blowing it off, and, like you, attributing it to age and gaining weight. I think your little post has just changed my mind.

Just out of curiosity, what does a "sleep study" consist of? What's it like trying to sleep with one of those machines attached to your face? I've always been a bad insomniac, and I wonder how much trouble I would have trying to sleep with it....

At any rate, thanks for your post. I am going to be making a call to my doctor tomorrow....

Mr. Kotter
05-21-2007, 07:39 PM
Hey Mr. Kotter

The symptoms you described are so similar to mine it is spooky...

I have always had some degree of apnea, but when I was younger as long as I slept on my side and stayed off my back, it was a minor problem. Unfortunately, as I age it seems to be a worsening problem. Sometimes on my worst nights, I'll awake 15 or 20 times a night gasping for air.

And after a quick google search, I see some long term effects that are not only scary, but in many cases I have already experienced. About two and a half years ago I had a heart attack (one listed effect of sleep apnea) and now have sometimes severe heart arrhythmias (another), high blood pressure (another), diabetes (another), weight gain (another)...well, you get the picture. My wife (who is an RN) has been urging me for years to have this problem checked out, and I have just been blowing it off, and, like you, attributing it to age and gaining weight. I think your little post has just changed my mind.

Just out of curiosity, what does a "sleep study" consist of? What's it like trying to sleep with one of those machines attached to your face? I've always been a bad insomniac, and I wonder how much trouble I would have trying to sleep with it....

At any rate, thanks for your post. I am going to be making a call to my doctor tomorrow....Wow. Sorry that you may share my ailment; but I'm glad it may have waken you up. PLEASE, if you've already had a heart attack...you REALLY need to check into this, at the very least. I may have been fortunate to have caught it before it caused any real issues for me. I hope you can help yourself too, man.

As for the sleep study, for me it was no big deal. Go in about 8-9 pm, they "prep" you....allow you to follow your normal routine (read, TV, music, etc)...and when you are ready for bed, they just hook you up to a bunch of monitors and electrodes. If you are a light sleeper, it might be weird....but I'd guess you'd fall asleep eventually. Anyway, if they see strong evidence of sleep apnea...they'll hook you to a CPAP that night, and try to see how it may affect your apneas during the rest of the night. Then some sleep specialist doc will review your 1100 page "record" of the night, and pass on the results to your doc.

In addition to snoring (and now, the sleep apnea) I'm also a really HARD sleeper (someone told me that was Reggie White's mistake too.) So I don't "wake-up" gasping for air....I just snort/chortle/cough....and remain "asleep" but I never reach REM--so it's low-quality sleep along with the depleted oxygen levels (mine dropped to around 76% before they put me on the CPAP--it's supposed to be about 89% I guess.)

Being an insomniac, may make the study and using the CPAP difficult for you---without some sleep aid. I don't know though, but I'd certainly discuss it with your doctor. Be sure to check into the "nasal pillows" option for the CPAP....for me, it was less confining, more comfortable, and easier to keep the head gear on. It depends on individual preferences though.

Whatever you do, bro...get yourself into an EENT specialist soon. You may need a referral, depending on insurance....but the sooner the better--given what you've said. Be sure to let me know how things go for you too. Of all the "ailments" we could have though, this isn't too bad. So I guess we should count our blessings.

You'll be in my thoughts man. Good luck.

go bo
05-21-2007, 07:43 PM
Do you use the CPAP?yes, every time i go to sleep...

works great for me...

Mr. Kotter
05-21-2007, 07:51 PM
yes, every time i go to sleep...

works great for me...

What's your Doc said about the surgery for you?

Mr. Kotter
05-21-2007, 08:18 PM
Now that I'm back in the land of the fully insured (after a 4+ year absence for grad school), I'm going to press for a sleep study. Per the various g/f's, I have quite a bit of sleep apnea.

I guess the first step would be to find a GP, however.
Good luck, Pittsie...if it's the worst of your problems, like me....you can consider yourself pretty lucky.

BTW, I was 24 years old, 6'1" 220lbs at the time of the surgery. I'm 5 years older and 50 pounds fatter now, but the severity of the apnea is still the same.

Wow. That's kind of depressing to hear....do you use the CPAP?

JohninGpt
05-21-2007, 08:25 PM
I was just diagnosed with severe sleep apnea. My CPAP machine and I have not made friends yet. Hopefully I'll get used to it, but it's the full mask and I feel kind of claustrophobic wearing it.

GoBo, how long did it take you to get used to that thing?

NewChief
05-21-2007, 09:02 PM
Go in about 8-9 pm, they "prep" you....allow you to follow your normal routine (read, TV, music, etc)...

So do they furnish the porn, pills, and pilsner?

Just kidding, the idea of going to a hospital/doctor's office and trying to get a "normal" night's sleep just seems so weird.

mikey23545
05-21-2007, 10:48 PM
Wow. Sorry that you may share my ailment; but I'm glad it may have waken you up. PLEASE, if you've already had a heart attack...you REALLY need to check into this, at the very least. I may have been fortunate to have caught it before it caused any real issues for me. I hope you can help yourself too, man.

As for the sleep study, for me it was no big deal. Go in about 8-9 pm, they "prep" you....allow you to follow your normal routine (read, TV, music, etc)...and when you are ready for bed, they just hook you up to a bunch of monitors and electrodes. If you are a light sleeper, it might be weird....but I'd guess you'd fall asleep eventually. Anyway, if they see strong evidence of sleep apnea...they'll hook you to a CPAP that night, and try to see how it may affect your apneas during the rest of the night. Then some sleep specialist doc will review your 1100 page "record" of the night, and pass on the results to your doc.

In addition to snoring (and now, the sleep apnea) I'm also a really HARD sleeper (someone told me that was Reggie White's mistake too.) So I don't "wake-up" gasping for air....I just snort/chortle/cough....and remain "asleep" but I never reach REM--so it's low-quality sleep along with the depleted oxygen levels (mine dropped to around 76% before they put me on the CPAP--it's supposed to be about 89% I guess.)

Being an insomniac, may make the study and using the CPAP difficult for you---without some sleep aid. I don't know though, but I'd certainly discuss it with your doctor. Be sure to check into the "nasal pillows" option for the CPAP....for me, it was less confining, more comfortable, and easier to keep the head gear on. It depends on individual preferences though.

Whatever you do, bro...get yourself into an EENT specialist soon. You may need a referral, depending on insurance....but the sooner the better--given what you've said. Be sure to let me know how things go for you too. Of all the "ailments" we could have though, this isn't too bad. So I guess we should count our blessings.

You'll be in my thoughts man. Good luck.

Thanks dude....Good luck to you as well with your upcoming surgery.

KC Kings
05-22-2007, 06:53 AM
Good luck, Pittsie...if it's the worst of your problems, like me....you can consider yourself pretty lucky.



Wow. That's kind of depressing to hear....do you use the CPAP?

Yes I use the CPAP, and I guess I should have clarified that I only have the apneas when I do not use the CPAP.

I have to go to a yearly meeting of CPAP users and they check the hours on the machine to see how much I am using it. They doctors want it to be some kind of group therapy where a bunch of guys sit around and hug each other and support the people who can't use the machine. I am a little less tolerant for the mushy crap. You can either use the machine, or don't use it. People can make themselves do anything, and sleeping with a CPAP is not one of the more difficult things in the world. There are 50 different masks, built in humidifiers, ramp mode that puts the pressure way down and slowly builds it up so you can sleep, etc...

The quickest way to kill cells is to deprive them of oxygen. Sleep apnea has been proven to be associated with Alzhimers. You can either be a baby, not use the machine, and in 10 years you can be another alzimhers guy crapping in the kitchen sink and humping the dog, or you can use the machine.

Being a younger guy yourself if the UPP doesn't work you should have no problem getting used to the machine. It is mostly the 65+ guys that whine the most. It took me a couple of weeks to get used to it but some of the older guys would rather take the easy way out and die rather than be uncomfortable for a couple of weeks.

Mr. Kotter
05-22-2007, 07:28 AM
Yes I use the CPAP, and I guess I should have clarified that I only have the apneas when I do not use the CPAP.

I have to go to a yearly meeting of CPAP users and they check the hours on the machine to see how much I am using it. They doctors want it to be some kind of group therapy where a bunch of guys sit around and hug each other and support the people who can't use the machine. I am a little less tolerant for the mushy crap. You can either use the machine, or don't use it. People can make themselves do anything, and sleeping with a CPAP is not one of the more difficult things in the world. There are 50 different masks, built in humidifiers, ramp mode that puts the pressure way down and slowly builds it up so you can sleep, etc...

The quickest way to kill cells is to deprive them of oxygen. Sleep apnea has been proven to be associated with Alzhimers. You can either be a baby, not use the machine, and in 10 years you can be another alzimhers guy crapping in the kitchen sink and humping the dog, or you can use the machine.

Being a younger guy yourself if the UPP doesn't work you should have no problem getting used to the machine. It is mostly the 65+ guys that whine the most. It took me a couple of weeks to get used to it but some of the older guys would rather take the easy way out and die rather than be uncomfortable for a couple of weeks.

Heh. You sound a lot like me. That's pretty much my attitude about it. I've been using the CPAP for almost a month now....and I don't really understand what the big deal is. I suppose for light sleepers or those who have difficulty getting to sleep, it could be an issue. But given the alternative, I'd think you could find a way to get use to it.

Bob Dole
05-22-2007, 08:02 AM
Being a younger guy yourself if the UPP doesn't work you should have no problem getting used to the machine. It is mostly the 65+ guys that whine the most. It took me a couple of weeks to get used to it but some of the older guys would rather take the easy way out and die rather than be uncomfortable for a couple of weeks.

Bob Dole's father was 65 when he started using his and had no problems getting used to it.

It's such a small hassle for the dramatic difference it makes during his waking hours that he was pissed off when he had a melanoma removed from his ear and couldn't wear his for a couple of weeks.

Mr. Kotter
05-22-2007, 10:36 AM
So do they furnish the porn, pills, and pilsner?

Just kidding, the idea of going to a hospital/doctor's office and trying to get a "normal" night's sleep just seems so weird.Heh....sorry I missed this earlier. No, sorry....no porn, pills, or pilsner. :(

LMAO

The gal that did my sleep study though, I swear to God.....could have passed for Monica Lewinsky's double--from her appearance, to their demeanor( from what we saw in the press.). There was another dude, scheduled for the night I had mine done....but he didn't show. So we just chatted about almost everything you could imagine for a couple of hours before I went to "bed." She was a great gal though; really nice, friendly....but, alas, very professional too.

Logical
05-22-2007, 10:39 AM
Good luck Rob.

I won't even leave the obligatory smartass remark.

Mr. Kotter
05-22-2007, 10:39 AM
Good luck Rob.

I won't even leave the obligatory smartass remark.

Thanks, Jim.

GoHuge
05-22-2007, 12:27 PM
All right guys here's the deal. I'm a PA for a head&neck surgeon/ENT. Sleep apnea is a slow killer. When you go and have the intial sleep study that lets us know the degree of your apnea as well as potential treatment options.

You could have a nasal septal deformity, tonsil hypertrophy, a thick dependent palate, or an excessive uvula. Most of the time the main culprit for sleep apnea is being fat. Plain and simple. It crowds your hypopharnx and will diminish your airway. That is why your apnea and snoring is worse when your laying in the supine position. Laying on your side relieves this strain. CPAP will cure anybodies apnea, but the setting which is measured in cm/h20 may be so high the patient may not be able to tolerate it.

This brings surgery into the equation. Not every one is a candidate for surgery. If you don't have a thick dependent soft palate, tonsillar hypertrphy, excessive uvula, or retrognathia (your jaw doesn't line up right and places your tongue into your airway) a UPPP will not help you. If your fat....you'll still be fat. If you have an anatomic problems (as mentioned above) being even 15 lbs over wieght will be a contributing factor, and it is usually the biggest.

The measure of success when doing a UPPP is measured by how bad your anatomic problems are. If your physical findings are minimal than you can expect your surgical results to reflect that and vice versa. Your going to have a rough post op period. Lots of fluids (a big drink hurts just as bad as a big one) and lots of Loritab elixir will do the trick.

You should not expect to be cured by this surgery, but your apnea may be diminshed enough that you will no longer need the CPAP. I had a patient with an RDI of over 100 like you did. After septal surgery and a UPPP his number was 13, which is considered mild OSA. He was satisfied by that and doesn't use his CPAP any longer. We reduced his sleep apnea by 8 times, but he was an ideal surgical candidate. You may or may not need to continue to use CPAP. A post op sleep study will show the results of the surgery. At that point you and your doctor can re evaluate your treatment options. I can not stress enough how important it is to try and maintaim your ideal body wieght. Let me know if I can be of any more help.

Mr. Kotter
05-22-2007, 04:20 PM
All right guys here's the deal. I'm a PA for a head&neck surgeon/ENT. Sleep apnea is a slow killer. When you go and have the intial sleep study that lets us know the degree of your apnea as well as potential treatment options.

You could have a nasal septal deformity, tonsil hypertrophy, a thick dependent palate, or an excessive uvula. Most of the time the main culprit for sleep apnea is being fat. Plain and simple. It crowds your hypopharnx and will diminish your airway. That is why your apnea and snoring is worse when your laying in the supine position. Laying on your side relieves this strain. CPAP will cure anybodies apnea, but the setting which is measured in cm/h20 may be so high the patient may not be able to tolerate it.

This brings surgery into the equation. Not every one is a candidate for surgery. If you don't have a thick dependent soft palate, tonsillar hypertrphy, excessive uvula, or retrognathia (your jaw doesn't line up right and places your tongue into your airway) a UPPP will not help you. If your fat....you'll still be fat. If you have an anatomic problems (as mentioned above) being even 15 lbs over wieght will be a contributing factor, and it is usually the biggest.

The measure of success when doing a UPPP is measured by how bad your anatomic problems are. If your physical findings are minimal than you can expect your surgical results to reflect that and vice versa. Your going to have a rough post op period. Lots of fluids (a big drink hurts just as bad as a big one) and lots of Loritab elixir will do the trick.

You should not expect to be cured by this surgery, but your apnea may be diminshed enough that you will no longer need the CPAP. I had a patient with an RDI of over 100 like you did. After septal surgery and a UPPP his number was 13, which is considered mild OSA. He was satisfied by that and doesn't use his CPAP any longer. We reduced his sleep apnea by 8 times, but he was an ideal surgical candidate. You may or may not need to continue to use CPAP. A post op sleep study will show the results of the surgery. At that point you and your doctor can re evaluate your treatment options. I can not stress enough how important it is to try and maintaim your ideal body wieght. Let me know if I can be of any more help.

Thank you, sir. I really do appreciate your feedback and candor. I'll be in touch, if you don't mind.