tonsillectomy and uvpp surgery on Wednesday.

[ljmcd]

I am having surgery on Wednesday. I am hoping that I will not need the CPAP after that. My husband had the surgery and had complications attributed to a bad dr., but now he sleeps like a dead person. I have a good dr. but am very concerned about the pain. Need more information. If anyone has had this please share the gory details. I would rather know too much than not enough. On the upside, I hope to lose about 20 lbs.

[Barb (Seattle)]

[quote="ljmcd"]I am having surgery on Wednesday. I am hoping that I will not need the CPAP after that. My husband had the surgery and had complications attributed to a bad dr., but now he sleeps like a dead person. I have a good dr. but am very concerned about the pain. Need more information. If anyone has had this please share the gory details. I would rather know too much than not enough. On the upside, I hope to lose about 20 lbs.

[Goofproof]

Going to loose 20 LB, those must be some tonsil's, I only lost 8 Lb with a Quad By-Pass, and I gained it back.

I tried sleeping like your husband. (dead), and it didn't work for me, so I'm on the hose to the end. Good Luck with your surgery. Jim

[rested gal]

ljmcd, if you're hoping UPPP might be a cure for your sleep apnea, I'd suggest you read as much as possible about UPPP while you still have time to cancel that largely ineffective surgery. Discussions about UPPP are in the bottom third of this page:

LINKS to surgery, turbinates, Pillar, TAP experiences

Unless your husband has a full PSG sleep study at least a year (and another one at the two or three year mark) after having had his UPPP, there's no way to know he's not still having apneic episodes. Sleeping like he's "dead" is no indication of having cured sleep apnea. The UPPP might have stopped his snoring without stopping apneas and hypopneas.

[ljmcd]

I have very mild sleep apnea, thus the CPAP was ok'd. My problem is that I snore loud enough to wake the neighbors. My palate vibrates and my uvula is huge so hopefully the surgery will correct all this. I can't put off the surgery, since I will not have 100% paid coverage after this month. My husband drank the pain med and it was brutal.

[sleepyinsunnyvale]

If your desired outcome for this surgery is to quiet your snoring then perhaps you are doing the right thing. However, if your desired outcome is not only to stop snoring but to stop CPAP use also then perhaps you may want to rethink your decision based on the low probability of success.

I understand your concerns about your insurance coverage but 100% coverage on surgery that won't achieve your desired outcome (no snore and no CPAP) and therefore isn't necessary doesn't seem like the correct rational for undergoing the knife (IMHO)

[Guest]

Rested Gal is right. Please research all the articles about the success rate of the UPPP surgery. Initial results look good. Long term results do not. It is a largely ineffective surgery based upon medical papers discussing its efficacy.

UPPP does not cure sleep apnea. UPPP has a low success rate curing snoring. Also, don't let lack of snoring lull you or your husband into a false sense of security as it pertains to sleep apnea. You don't have to snore in order to have OSA. Here is just one brief example of some of the research:

Uvulopalatopharyngoplasty (UPPP) has become a widely practiced procedure in the management of snoring. In a number of studies, all based on short-term follow-up, snoring was reduced or eliminated in 75% to 95% of patients. Because a decline in the initial success rate was casually observed, a formal analysis of the initial and long-term results of UPPP for snoring was made in the present study. From 1985 to 1989, 69 patients with severe habitual snoring were retrospectively analyzed. A scoring system was devised for snoring, and each patient was interviewed regarding the effects of UPPP on his or her snoring 16 to 75 (mean 44) months after surgery. In 60 (87%) of 69 patients, snoring was initially significantly reduced or totally eliminated. After 13 months the success rate dropped to 46% (32 of 69 patients). Most failures occurred between 6 and 12 months of surgery, after which time the success rate remained relatively stable. The authors' conclusion that the long-term success rate of UPPP for snoring declines significantly with time has obvious implications regarding presurgical patient counseling.*

I understand the insurance coverage dilemma. But to go forth with a surgery that has been statistically determined to be a failure in the long term by so many surgical research studies, does not seem prudent. Time and again we read, "If only I had known before I had my surgery what I know now. If only I had known it would turn out to be worthless, I would never have done it."

I am not a doctor or a health care professional. I am just a passerby who knows a little bit about your situation. I speak to you as someone who has done a great deal of research on this specific surgery over the past 8 months, and I would be remiss if I didn't say all I could to encourage you to carefully examine all the evidence before you consent to this operation. You will likely change your mind. I did.

*Uvulopalatopharyngoplasty for snoring: long-term results.

[SLEEPYCD]

ljmcd,
He's my story again, I hope people aren't tired of hearing it. Had strep/tonsillites since childhood, had deviated septum all my life. ENT wanted to do all surgeries long time ago. Had septopasy in 1999. Surgery was a breeze, could breath again. My tonsils were huge (and closing in on me) and my uvula would be so swollen from snoring sometimes it was hard to swallow upon waking. I discovered a growth by my uvula (no choice now, I had to have the surgery) so Feb 05, had everything removed. In the overnight stay at hospital is when they discovered I had Sleep Apnea. (Did not have Sleep Study until May 05). The pain was really bad, I was off work for two weeks. I did not get any sleep (I wish I would have been on CPAP then, it would have helped). In my case, it was a godsend, any pain I suffered then was well worth it!!!!! I don't have throat infections and I breath so much better and feel alot better overall. It HAS NOT changed my need to use CPAP!!!!! IT IS NOT A CURE FOR SLEEP APNEA, BUT IT MAY HELP IN THE LONG RUN!!!! Upside to all this, I did lose 19 lbs in about 10 days (hurts too bad to eat much). Downside, got addicted to Dairy Queen soft serve ice cream (took months to get rid of that addiction)!!!!! Well, my 2 cents worth. I WISH YOU THE BEST, AND HOPE FOR A SPEEDY RECOVERY!!!!!! TAKE GOOD CARE OF YOURSELF!!!!!
Carolyn

[Sleeping With The Enemy]

ljmcd,

If your sleep apnea is very mild the surgery may be helpful for you. I only had 2/3 of my uvula take off. My ENT did it with COBLATION, if you can have it done with coblation, do it, it will decrease pain and healing time!!!!

I just had it done 2 weeks ago, my pressure went from 12-14 down to 7-9. I have lost 15 pounds with this surgery. I need to lose another 60 and then I will be in my normal BMI range and am hoping to get off CPAP. I am a strong believer that lots of us are "FAT" and need to lose weight in order to get off CPAP.

Negative attitudes won't get anyone off CPAP, so you keep a positive attitude. The pain was not the worse I've ever felt. Just take your liquid pain medication and make sure to have lots of popsicles, seriously. It's only 10-14 days of pain out of your whole life. I was scared because of all the negative feedback I got but it turned out to be a bunch of hooey! I made it through it.

What have you got to lose? I am at the point that I want to be healthier and thin more than I want to fill my head with lots of excuses and rationalizations on why I can't get off of CPAP because of sleep apnea.

"As a man thinks, so is he".

Heidi

[Guest]

I am a strong believer that lots of us are "FAT" and need to lose weight in order to get off CPAP.

You're absolutely right. Statistically speaking, the majority of us OSA sufferers who are sitting here right now reading these words on our computer screens, are FAT. No doubt about it. For those of us who are fat, we cannot deny our OSA is worsened by our gluttony; we've gotten so fat our throats are compressed with pounds of extra flesh. If we lost weight, would our OSA go away?

I wonder what the statistics are for getting off CPAP with weight loss. Can you cite any studies or evidence? I have found information on weight loss resulting in the lowering of pressure requirements, but not in getting off CPAP. I want it to be true, but all I ever hear is, "I know someone who heard of someone who got off CPAP by losing weight." I have never seen any studies to this effect. I have never seen a pre-weightloss PSG compared with a post-weightloss PSG proving the OSA was gone. I wonder if the people we "hear about" who lost weight and stopped using CPAP actually underwent a final PSG to verify their own conclusions, or if they just decided it was probably gone. This is the part that concerns me. Did they quit snoring and assume they were cured? And what about the people who aren't overweight and were never overweight, but still have OSA?

Anyone who posts on these and the other OSA message boards who has gotten off CPAP by weight loss (as verified by a followup PSG) would certainly pass this information along, wouldn't they? Are you of the opinion these people would not bother to share their success? I sure would. You certainly would.

There are plenty of past threads where people candidly discussed their weight and it is evident many of us are unhealthy and overweight and many of us sitting here right now reading these words are morbidly obese. No one can deny being overweight is unhealthy and no one can deny being overweight is a contributing factor to OSA. I wish there were studies proving the need for CPAP therapy was eliminated by weight loss because maybe that would provide the additional incentive many of us need. We already know we need to push ourselves away from our plates and eat less, and we need to push ourselves away from our computers and move more. Wouldn't it be amazing if we knew we'd no longer had to sleep in a mask at night while air is being forced down our throats?

Once you've lost the rest of the weight, and have a followup PSG that proves your OSA is gone, PLEASE publish your results. I look forward to reading about your success story in the future!

[Sleeping With The Enemy]

I guess I'm just going to try and see if it works, losing the weight and getting off the cpap.

What the hell have I got to lose besides about 60 lbs of fat!!!

Or I could just be a Thomas and say "forget it, because it won't get me off cpap anyway", that is a lazy attitude and simply disgusts me!!!

[SLEEPYCD]

To All,
I have to agree with Guest. Looking back on my life, I think I've had Sleep Apnea for many years (Yes, I'm talking about the skinny years, not my current weight of 195). I have no doubt that Sleep Apnea played a major role in the weight gain, but I also WILL NOT assume that if I lose 50 lbs, I will magically cure my OSA. My family and Doctor probably wishes that were true, but the numbers just don't support that notion. There are people with OSA who are not overweight and alot who are!!! The bottom line is that we all need HELP, whether it's surgery, losing weight, eating sensibly, exercising, keeping a positive attitude, and helping each other thru the rough spots, that's the purpose of this forum!!!! I want to hear success stories of not having to use CPAP after weight loss or surgery, but WHERE ARE THOSE PEOPLE???? In conclusion, I'll keep having surgeries, if necessary, keep exercising, eating right, keep laughing and enjoying life, and keep learning from the great people on this forum, AND MOST OF ALL KEEP USING MY CPAP...
Carolyn

[Barb (Seattle)]

You bring up an interesting point. If someone HAS 'cured' their apnea by losing weight, they surely would be shouting it on the boards, right? My take on this? Very FEW of us ARE losing weight enough to even see if we can get off of CPAP Losing and maintaining a normal weight is very difficult, and there are more overweight people now than ever. Not saying I'll give up trying....have been trying for most of my life

[sleepyinsunnyvale]

I was diagnosed in 2001. Since then I've lost 25 lbs and now at BMI of 25. Weight has been off for 4 years now. Exercise 50 minutes 4 days a week and 90 minutes 3 days a week. No difference in my pressure as reported by Encore Pro or need for CPAP. Dr says it has more to do with airway structure and age (loosing muscle tone. I'm 62).

Just one data point.

[Guest]

Or I could just be a Thomas and say "forget it, because it won't get me off cpap anyway", that is a lazy attitude and simply disgusts me!!!

You're right. It would be sheer laziness (and downright stupid) not to try to lose weight just because you don't believe it will eliminate the need for CPAP. Particularly since there are a million other serious life-threatening health reasons to lose weight besides OSA. If we weren't so lazy, we wouldn't have gotten so fat in the first place.
Please keep us informed when you have lost the weight and had your followup PSG. We'll finally be able to point to some verifiable proof and say, "See! It is possible!"

I want to hear success stories of not having to use CPAP after weight loss or surgery, but WHERE ARE THOSE PEOPLE???? In conclusion, I'll keep having surgeries, if necessary, keep exercising, eating right, keep laughing and enjoying life, and keep learning from the great people on this forum, AND MOST OF ALL KEEP USING MY CPAP...

Carolyn, you have a great attitude. If only all of us were exercising, eating right, laughing and enjoying life!