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Old 05-22-2007, 04:20 PM   #38
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Quote:
Originally Posted by GoHuge39
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.
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