Advice for "Severe O.S.A" and UPPP Surgery? - Page 3

**Mr. Kotter** · 01:05 PM

OSA = Obstructive Sleep Apnea
UPPP = Uvulopalatopharyngoplasty

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

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.

KC Kings · 05-22-2007, 06:53 AM

Quote:

Originally Posted by Mr. Kotter

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

Quote:

Originally Posted by KC Kings

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

Quote:

Originally Posted by KC Kings

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

Quote:

Originally Posted by NewChief

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.

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

Quote:

Originally Posted by Logical

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

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.

05-21-2007, 12:34 PM
Mr. Kotter The Dude Abides Join Date: Apr 2001 Location: Dakota Country Casino cash: $5905285	Advice for "Snoring" and Snoring Sugery??? OSA = Obstructive Sleep Apnea UPPP = Uvulopalatopharyngoplasty I'm undergoing the U.P.P.P. surgery on Thursday....anyone been through it before??? 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. Last edited by Mr. Kotter; 05-21-2007 at 01:05 PM..
Posts: 46,349

05-22-2007, 10:39 AM	#35
Logical Screw U if U can't take a joke Join Date: Aug 2000 Casino cash: $10004900	Good luck Rob. I won't even leave the obligatory smartass remark.
Posts: 31,579

05-22-2007, 12:27 PM	#37
GoHuge The Truth Join Date: Dec 2005 Location: Overland Park Casino cash: $10006072	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.
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