dont know what to do-surgery or not??

[lfranek]

I went to my dr today just to talk about my experiences with CPAP for the past 5 weeks. Wondering if maybe my pressure needed to be adjusted...currently at an 8. I have to sleep with some kind of sleep aid...ie....sleeping pills-prescribed or OTC....or valium but those only help for about 4 hrs then I am up every hour or more for the rest of the night.....I can tolerate the mask fairly well I think. My dr suggested having the surgery and referred me on. I made that appt for the consult on the 23rd. Just wondering if anyone has had the surgery and how successful was it? Obviously I dont want to have the surgery and then still be having sleeping problems. He did prescribe me an anti-depressant which will also will help me sleep but only for 30 days. Dont know what to do?????
Thanks
Larissa

[Offerocker]

lfranek: You didn't say the name of the procedure you're contemplating.
If you don't mind, what is the antidepressant you are now taking?

The doctor usually Rx only 30 day's worth of a new medication, in case it doesn't work, or you have a reaction to that particular med. Too bad he didn't give you some samples.

IF it does help you, ask him if he will Rx you another...before any surgery, in case you do need it afterwards. Getting to & staying asleep can be different issues from OSA. The cpap therapy improves the quality of your sleep, from my experiences.

[Guest]

My prescription is for Trazodone-50mg at night
I can remember what the surgery was called....it involved removing the uvula (sp?) I had my tonsils removed about 10 yrs ago. I guess I just dont see how the surgery is going to help things and I know I will learn more in the consult with the ENT but I've also read that success rate after surgery is maybe 50%-If I will have to be on a cpap anyway-why bother with surgery? He did say I could do a titration test.....is that just another sleep study basically? should I call the dr at the sleep lab and get his opinion? He has been very helpful in the past

[lfranek]

that last post was mine-I hadnt logged in.....

[Guest]

The UPPP surgery has proven to be largely ineffective. It has a very low success rate. Perhaps the best measure of success is talking to the individuals who have had it done; those with the misfortune of being (mis)guided into to having this surgery by their doctors. The good news is we see fewer and fewer physicians suggesting the UPPP.

Following are just some of the snips of posts from here and TAS where people who have had UPPP share their unsuccessful results:

Welcome to the forum! I had UPPP and Deviated septum surgery in 1995. 6 months later had a cpap. I'm also claustrophobic. There are masks out there now that you won't feel closed in on while wearing. It's worth a try, because this treatment really makes you feel better. If I had it to do all over again I would still have the nose done (I could only breathe using 1 nostril) but would not have had the UPPP. Good luck in your treatment, whichever path you choose.

Hopefully before my insurance company commits to buying this machine I can convince them to reimburse me for an apap. Looking forward to a good nites sleep again since my UPPP did not work out that well. Thanks again for all the posts it is helpful to know that there is a place to go for good advice from people who have been there and done that.

I've had both and neither were lasting. I had the UPPP 20 years ago and it was moderately effective for a year or so. I recntly had three sessions of somnoplasty and I'm back to where I started. CPAP is the only thing that I found that works.

A bit of history. I was first diagnosed about 10 yrs ago and opted for UPPP surgery (uvulopalatopharynogoplasty) because after my first experience with CPAP in my sleep study I didn't think I could deal with it every night. Well, what they tell you before the surgery and what happens is like night and day. Their description of the surgery "It will be like the worst sore throat you have had." Actual experience, weeks of extreme pain, months to feel better in the throat and over a year before my throat felt normal. The good part was a 35 lb weight loss because I couldn't eat. The surgery (or maybe the weight loss or maybe both) worked for about a year. 1 1/2 years later I was back to exhaustion and depression due to poor sleep. Another sleep study and I started CPAP.

I agree on NOT having the UPPP. I had it done about 7 years ago and wish I never did. I would try the Pillars or Somnoplasty over UPPP.

Gip

I had the UPPP surgery several years ago and for almost a year following surgery I slept restfully. Now the osa is back.

I have had the UPPP and really couldn't tell a difference afterwards. The treatments for Sleep Apena have various results for different people based on my reading and participation in this forum. If I were to start my journey in trying to cure my Sleep Apena again I would have started at Stanford to begin with or would have consulted with a Doctor that could tell me actually what the cause is for my sleep apena. I feel confident with the staff at Stanford who in a matter of minutes while being examined told me that it was my tongue causing my sleep apena not my UPPP. UPPP in my opinion for me was a waste of time and whole lot of pain for no results.

Out of frustration, scheduled surgery. UPPP, turbinat reduction, and septoplasty. For what it's worth, it's as painful and miserable of a process as you've all likely been told about. I knew it was going to be painful and knew it had a less than stellar chance of success, but I wanted to roll the dice to see if I could untether myself from the need for a machine/mask. This was early April 2006.

Recently had a new sleep study and found that the surgery was not successful (altho I was told that there may still be some healing to do).

A plastic surgeon and orthodontist both agree that I am a good candidate to have both my upper and lower jaw advanced. I have already had the UPPP with deviated septum done, to no avail.

My sister had the UPPP surgery and it didn't do a thing for her, other than make her talk funny, and whatever she drank come out her nostrils.

My friend who swore by UPPP and had his done by one of the best surgeons around, now has his apnea back full bore, after less than a decade, AND has all the swallowing issues associated with UPPP.

It's been about 2 months or so and now I have my Resperonics Bi-PAP-Auto. My pressure setting as prescribed from my doctor is 17/11.
I went from not being able to tolerate a CPAP from 10 years ago to falling asleep in about 20 min or less the past for nights.
Another little tid bit of info I had the UPPP done and all the other nasal goodies that goes along with it. This was in 1997.

Beware of UPPP surgery. Lots and lots of pain, very few success stories. My untreated AHI 1 year after surgery was 94, and I still snored.

Well ya'll, unfortunately, I had the UPPP surgery a year ago last January. I thought it helped tremendously, until I had another sleep study, and the results were worse.

I was going to say too, about the snoring...I've definitely stopped snoring with my UP3...but, I still have severe apnea, so someone can be fooled if they think if they aren't snoring, they don't have apnea any more.

[Ms Piggy]

I have seen postings on the American Sleep Apnea Association forum which say the same thing, take a look there too.

[Snoredog]

when you go in on the 23rd to see the ENT, ask:

Will this surgery prevent my tongue from falling into the back of my throat?

or will it just make a bigger hole for it to land in?



As you can see from above, the tongue is causing the obstruction. You can also see your Uvula at the end of the hard palate, even if you remove a portion or all of the uvula, the tongue will continue to block the airway.

There is a reason they test you sleeping on your side, on your back etc during a PSG. Sleeping on your side or stomach makes it harder for the tongue to be pulled into the airway by gravity. It is also the reason UPPP is not very successful. If your ENT is any good they will examine your anatomy and if not blocked from tonsils or other abnormalty tell you that UPPP will not help your condition.

[lfranek]

Thanks to all who have replied so far....I did check out the ASAA forum-found lots of helpful information-at least I know exactly what the surgery entails....I'm pretty sure I am NOT going to have the surgery...but will still meet with the ENT and I think I will call the sleep center tomorrow for their advice. Thanks again-you guys are most helpful!

[jeepdoctor]

My research indicates that the best surgery place in the country is the Powell - Riley Clinic in Palo Alto. This is the only place that I would even consider using.

You might PM Rudyrx. He had a genioglossus advancement done there about three weeks ago.

[SelfSeeker]

Larissa

Is the Dr suggesting the surgery because of your need to use medication to sleep?

Why do you need the sleep aid?

Did you use sleep aids in the past?

Many if not most Sleep aids relax the mussles even more so you need more pressure to open the airway.

What do you mean by:

I can tolerate the mask fairly well I think.

Why do you think?

Are you keeping it on, with great mental distress?

Is it uncomfortable that you take it off?

Is there a physical problem with the mask not being a godd fit, leaking etc.

Or is the mask causing claustrophobic or orther problems?

[lfranek]

SelfSeeker-
I told the dr that I didnt want to be taking sleep meds for the rest of my life and he said that he would do the surgery before he let me take them forever. I would take OTC sleep meds on occasion prior to CPAP-maybe once or twice a month, if that. Mainly because I hated the groggy feeling in the morning-that was when I was working and had to be up by 4:30 or 5:00.
I intially started taking them to help in adjusting to the CPAP. I tried on 2 nights to not take anything and my sleeping was worse...meaning I woke up alot and felt horrible the next day and that dreadful headache returned. At least now I dont have the headaches. With the sleeping pills I can remain asleep for longer periods of time and keep the mask on. Without the sleeping pills I tend to really struggle with the mask-like it is just too cumbersome and since I am "awake" more often I roll back and forth from side to side which moves the head piece then the nasal pillows leak.........and I usually get so frustrated that I take the mask off after a 4 or 5 hour struggle. Last night I kept it on 8 1/2 hrs-feel ok this morning-probably gonna go lay back down though-I just feel like I cant get enough sleep. It is a struggle to get out of bed to get my daughter off to the school bus! I know I am depressed....that is why my dr prescribed the Trazodone. My sleep study results showed that my REM sleep was decreased by 60% with AHI of 33/hr.....my AHI not in REM was 17. It also said significant Alpha EEG intrusion was seen. I'd like to think that the sleep aids allow me to get to REM and stay there for a bit, undisturbed.

[SelfSeeker]

Larissa

I also go back to bed after I get everyone out the door in the morning. I take a few naps.

What kind of Dr is this Dr. Get some more opinions.

Is it your understanding, that once you do this procedure you would no longer need the CPAP or the meds or would need nothing?

Is this what your Dr is telling you?

If you still needed meds or CPAP would you have the surgery done?

No need to answer for me, just things for you to think about.

I have no first hand info, or have not done much research to give a solid opinion.

Good Luck in deciding

[jeepdoctor]

Larissa,

A person here in town had MMA surgery ten years ago. Completely successful. Done in Phoenix. The disturbing thing about what he went through is that he had 2 or 3 prior surgeries which were unsuccessful. The docs at the clinic told him that this would be the case, but that they had to be done first in order to build up a case with the insurance company for the MMA.

If you want to know about this particular surgery, go to http://www.robotics.com/mma.

As others have said before, be careful with surgery. You can't put the tissue back after it is gone and things aren't working as promised/expected.

Here's a web site to look at: http://www.sleepsurgery.com/ Call them and talk to Dr. Sesso. He was very helpful with me. He looked over my PSG's and gave me a frank assessment.

[rested gal]

Larissa,

I agree with everyone who has said, "Say NO to UPPP."

Unless, as jeepdoctor pointed out, a person was shooting for the MMA-GA and absolutely had to jump through insurance hoops of other surgeries on the way to that most effective one.

Clickable LINKS to surgery, turbinates, Pillar, TAP experiences

Topics about UPPP and MMA-GA surgeries are in the lower third of that page of links.

[snork1]

I would check out a dental device if CPAP wasn't working out, and skip the idea of surgery, other than getting your nose breathing to work.

Oh yah I did. And it worked for ME.

Be sure to go through a certified sleep dentist if you do though.
http://www.dentalsleepmed.org/FindaDentist.aspx

But we aren't allowed to talk about apnea dental devices on THIS forum, so you need to check out talkaboutsleep.com dental treatment forum if you decide you are curious about a non-surgical, non-CPAP POSSIBLE alternative.

And yes its a gamble. But its reversible, which surgery isn't and the pay CAN be huge IF it works for you.

just a thought.

I will expect the flamers to jump in now.....