UPPP & Turbinate Surgery Please Help

[chaz_28]

Hello I'm new here and to cpap ,I have been on my cpap for about 6 weeks now,and I think it is going o.k. Before I had my sleep study done I saw my ENT and he said that I need the UPPP & Turbinate surgery ,well to make a long story short, after he got the results from my study he is even more adiment that i need the surgery....I adgree that I need the turbinates worked on,but I am scaired of the UPPP I have read a lot of negitave things about this on the boards but I would like to hear some posative results if there any?????
THANK YOU, Chaz

[Wulfman]

Hello I'm new here and to cpap ,I have been on my cpap for about 6 weeks now,and I think it is going o.k. Before I had my sleep study done I saw my ENT and he said that I need the UPPP & Turbinate surgery ,well to make a long story short, after he got the results from my study he is even more adiment that i need the surgery....I adgree that I need the turbinates worked on,but I am scaired of the UPPP I have read a lot of negitave things about this on the boards but I would like to hear some posative results if there any?????
THANK YOU, Chaz

You SHOULD be scared about the UPPP surgery and it could be a very long time till you read any positive results.
If you haven't yet, go up to the Search line above and type in "UPPP" and start reading.
Most people who have UPPP done require even higher pressures and many times Bi-Level/Bi-PAP therapy. You'll have a bigger hole in your throat for your tongue to fall back into and it'll take more pressure to keep your airway open.

If you're not already doing nasal rinses before bedtime, I'd suggest starting. Keep your nasal passages open. Drop your humidifier heat.....or turn it off completely. Too much humidity can actually cause your nasal passages to close up.

Den

[kopoloff]

UPPP - be afraid, very very afraid.

I had UPPP. Now I recommend it only for drug dealers, somalian pirates, terrorists and banana growers.

Seriously, I had this surgery some time ago. Thereafter followed the worst 10 days of my life. I didn't eat for that period (lost 10kg, not so bad!) hardly slept at all, ate painkillers like they were chocolates, cried all day and whimpered all night. (And I have a reasonable tolerance to pain, having had all my other surgeries for sporting injuries repaired without anaesthetics)

So what was the result. Reduced snoring for about 6 months, then back to where I had been before. At that stage OSA wasn't diagnosed.

When i first went to see my sleep specialist she told me that If I was in the USA, and if the procedure was conducted more recently, then I should consider a malpractice or negligence action against the surgeon, since that procedure was now considered to be of dubious benefit.

Of course everyone is different, and there may be special circumstances, but if I was you, I'd be getting another opinion.

Good luck

K

[OldLincoln]

UPPP - be afraid, very very afraid.

And that, my friend, was "The Rest of the Story!" [May Paul Harvey rest in peace.]

[Wulfman]

And, if you're still following this thread, you might want to read THIS one, too.

viewtopic/t41306/Coworker-died-from-OSA-operation.html


Den

[ozij]

Turbinates: yes.
UPPP: no - and it makes CPAP therapy much more difficult to maintain afterwards.

You won't find the UPPP success stories here - this forum is not a place where people whose OSA is resolved by means other than CPAP come to post.

"Sleeping With The Enemy" did report success - but I don't remember many others.

Get a second opinion from a qualified sleep doc.


I don't see how a sleep study can tell the ENT you need a UPPP. Terrible obsturctive sleep apnea is not necessarily an indication for a UPPP.

How about sharing your sleep study data with us?

You should also be aware that you machine makes it impossible for any doctor to track you results on CPAP.
O.

[Snorebert]

I had UPPP done over a dozen years ago. I'd like to tell you something positive about it. But I can't.

Terribly painful. Couldn't eat solid foods or even talk for weeks. I got so frustrated that I literally put my fist through the bedroom window.

What little benefit I got from it was gone inside of a year.

But on the positive side, my ENT doc that did the surgery got paid a good deal. He probably thought that was success.

-Clark

[jnk]

http://www.healthcentral.com/sleep-diso ... -apnea/pf/ :

PAP is the "gold standard" and the most effective therapy for obstructive sleep apnea (OSA), . . . A good sleep center will . . . improve the long term compliance to CPAP. . . . Surgical procedures for OSA are unpredictable and generally less effective than PAP. . . . Nasal reconstruction targets extra or distorted tissue in the nose that blocks the flow of air. The advantage of the nasal reconstructive surgery is that, even though it does little for treating sleep apnea itself, it might make a person better able to tolerate PAP treatment with a nasal mask.

http://www.webmd.com/sleep-disorders/tc ... ea-surgery :

Surgery for obstructive sleep apnea (OSA) is usually not done unless other treatments have failed or you are unable or choose not to use other treatments. . . . Experts generally suggest trying continuous positive airway pressure (CPAP) before considering surgery. . . . In adults, uvulopalatopharyngoplasty (UPPP) is the most common surgery used to treat sleep apnea. There is no clear research on how well UPPP works for sleep apnea. UPPP may stop snoring, but apnea episodes may continue.

So, after UPPP, you may not be able to use an APAP that uses snores to adjust therapy.

WebMD continues:

Limited research indicates that about 40% to 60% of people who have UPPP see an improvement in their symptoms.

Those are pretty lousy odds, in my book.

WebMD contiues:

You may still need other forms of treatment, including continuous positive airway pressure (CPAP), after surgery. You will need sleep studies after surgery to make sure periods of apnea do not continue or return.

My summary of the above is that nasal surgeries may help PAP therapy go better. Palate surgery may make it go worse and may make using an APAP impossible. Either way, you are still likely to need to keep using PAP therapy, depending on the results of the sleep studies that follow.

http://books.google.com/books?id=jUEFn5 ... &ct=result:

Page 115:

"If one were to select only young, otherwise healthy, nonobese, mildly apneic snorers with identifiable, correctable abnormalities (large tonsils, drooping palate, long uvula), success with UPPP and tonsillectomy, by any measure, might exceed 90% of patients. Contrarily, if one selected obese, severly apneic snorers with a bulky tounge, receding chin, and flabby narrowed hypopharngeal air passages, success with UPPP would be unlikely. Somewhere in between those two extremes falls the majority of snoring and sleep apneic patients. For them the probablility of success versus failure of UPPP is often unpredictable."--Snoring and Obstructive Sleep Apnea By David N. F. Fairbanks, Samuel A.

Ask yourself, would you sign the following form?:

http://www.shaheye.com/images/uppp_informed_consent.pdf

[ozij]

jnk's admirable collection of information reminded me of something:

Unlike surgery to your palate, a tonsillectomy (taking out your tonsils, without reshaping you palate) can be a very big help in avoiding some of the obstructions. It's very painful for grownups -- but if you search the forum for tonsil or tonsillectomy, you will find people whose tonsillectomy helped - it let them use much lower pressure than previously.

O.