Obesity hypoventilation syndrome?

[SuddenlyWornOut45]

Anybody here got it? If so, how do you treat it?

I saw my pulmonary sleep doctor two weeks ago, he spends very little time with me and the first words out of his mouth were, "how would you like to have surgery?" I was kind of taken aback, took me off guard I did not know how to respond right off. I replied, "surgery, what KIND of surgery? Weight loss surgery?" He replied "that and jaw surgery, where they break and reset your jaw to make your airway more open."

Long story short, I agreed to the weight loss surgery, he believes a massive weight loss of fifty pounds will drop my pressures well under ten, into the low 9s or into the 8s. A weight loss of 80 pounds, I believe my pressures would drop into the 7s or 6s. So I have an appointment with a medically supervised weight loss group soon.

But here is the real kicker and why Im posting today. On my discharge sheet, my pulmonary/sleep doctor wrote two codes down under DX. One I am familiar with and 327.23 and thats the code for obstructive sleep apnea. The other code was brand new and Id never seen it, so I googled it. It is 278.03 and that came up with obesity hypoventilation syndrome. Yet he told me "I did great" with the pulmonary function tests" I did that day, even though I felt like I was going to literally black out and pass out (and honestly felt like I came close to doing so.

I have called the office and am awaiting their response. If I have obesity hypoventilation syndrome, what should I be doing besides seriously losing weight? I see it is a subtype of sleep apnea and read that serious weight loss can reverse OHS.

thanks,


Eric

[Julie]

Hi, the first thing I'd do is to look at Wiki's idea of what OHS is - hopefully you can get a better idea, and the second thing is to look at Le forte jaw procedure (there are other types). It's the jaw thing, and is pretty radical for OSA... I'm not sure if it's known to work or not, but is certainly permanent. I'd ask to see a neurologist or pulmonologist and leave surgeons out of things for now - they're rather 'cut crazy' and see everything as an occasion to operate.

[ChicagoGranny]

Long story short, I agreed to the weight loss surgery, he believes a massive weight loss of fifty pounds will drop my pressures well under ten, into the low 9s or into the 8s. A weight loss of 80 pounds, I believe my pressures would drop into the 7s or 6s.

There is no way to predict that.

But it is good to think optimistically. Go for it.

[SuddenlyWornOut45]

Uh, my experience has been the more weight I gain the higher my pressures go and when I lose weight, the lower my pressures go.

Eric

Long story short, I agreed to the weight loss surgery, he believes a massive weight loss of fifty pounds will drop my pressures well under ten, into the low 9s or into the 8s. A weight loss of 80 pounds, I believe my pressures would drop into the 7s or 6s.

There is no way to predict that.

But it is good to think optimistically. Go for it.

[JDS74]

Just looking around and came across this article.

http://www.hopkinsmedicine.org/digestiv ... apnea.html

[Janknitz]

Weight loss is ALWAYS a good thing, but it may or may not reduce or cure your apnea. We see people here who lose significant amounts of weight. Some need less pressure, some need MORE.

Don't go blindly into bariatric surgery or jaw advancement surgery. Make sure you understand implicitly the lifelong effects of BOTH as well as the short term risks and pain associated with these procedures. Don't just talk to the doctor, talk to other people who have had the procedures.

I'm sure you've dieted and tried to lose weight, but if you've only tried the conventional advice to reduce fat and calories, increase whole grains, and exercise more, you've only tried something with a very poor track record of success. Take a look at this http://www.dietdoctor.com/lchf and see if it's something you could live with. I've lost 72 lbs this way, I'm never hungry and I'm 1000% healthier than I ever was before. It's free, and if you try it and it doesn't "stick", the weight loss surgery will still be out there for you.

Remember that bariatric surgery is basically an enforced diet. It will greatly restrict the AMOUNT you can eat (until you learn to stretch the pouch and override the restriction, which happens to many people). You will have to eat a sort of LCHF type diet anyway, just to get adequate nutrition (plus supplements), you will probably have GI issues that can be quite unpleasant (nausea, vomiting, diarrhea, etc.).

On an LCHF diet with UNLIMITED portions you can lose weight without the side effects--the fat in that diet will reduce your appetite so you are not going to want to overeat, and your blood sugar will be steady and even. You won't have to be hungry or in GI distress. It's worth a try before you do the weight loss surgery.

[SuddenlyWornOut45]

Yeah, good article.

I found out today that I might not have obesity hypoventilation syndrome. I dont know if Im being played or conned or whatever or if it is just an honest mistake or what. But here is the deal. On my discharge sheet, my sleep/pulmonary doc wrote two codes, under "DX." 278.03 which is obesity hypoventilation syndrome and 327.23, which is obstructive sleep apnea.

I had called the office Friday and they called me back today and I explained my concern, that the diagnosis code of 278.03 was new and when I googled it under the ICD codes it came back as obesity hypoventilation syndrome. The nurse said she had just 278.00, which is the code for obesity. I asked her politely if she was telling me the truth and she acted insulted and I explained nicely that I know sometimes doctors withhold how bad things are sometimes if they think the patient will get upset. She insisted the code they have is 278.00 and mentioned "is it the doctor's handwriting?" and I did not reply because I dont know but I think it is, as the doctor signed off on it before ripping off the top and giving me the bottom yellow copy.

I had already called my insurance company last week and they said the code they had from the most recent visit were the two codes I have on the yellow bottom copy, 278.03 and 327.23 and they said "yeah obesity hypoventilation syndrome."

So the insurance agrees with me, the yellow discharge sheet clearly displays 278.03 and NOT 278.00 but the office denies 278.03 and claims it is 278.00.

WTF?????

Eric

Just looking around and came across this article.

http://www.hopkinsmedicine.org/digestiv ... apnea.html

[SuddenlyWornOut45]

yeah, well I need to drop my pressures a good amount. I dont care if it "cures" me of sleep apnea, Im not really looking for a cure. What Im looking for is a big reduction in my needed pressures. I need to drop down into the 7s or low 8s or high 6s, if possible. My past experience has been that when I lose weight my pressures go down and when my weight goes up my pressures go up.

Ive gained over ten pounds since the last time I was posting here regularly and my pressures have gone up about a point in three months. Last year about this time, after I had a tonsillectomy and after the recovery was over and I came off all the narcotic painkillers they rxed me for recovery, my pressures dropped like a fffing rock, to the high 10s and the low to medium 11s and stayed that way until recently.

I need something that is permanent and longterm and none of these ups and downs with dieting. Dieting and exercise for weight loss do not work for me, Ive lost up to fifty pounds on my own thru dieting and exercise on my own and it helped me greatly and pressures went down and that was BEFORE I had the tonsils removed. The only thing I can think of that is really solid and permanent is this bariatric surgery stuff. I frankly could not care if I cant eat much afterwards and the side effects of it dont sound that bad considering what Im having to put up with now, being obese...80 lbs overweight. My BMI is 39.2 and I feel sick as a dog every day and Im so fatigued it is ridiculous.

BMI is 39.2 and neck circumference is almost 19" and sleep quality is awful, almost as bad as it was BEFORE CPAP.

Eric

Weight loss is ALWAYS a good thing, but it may or may not reduce or cure your apnea. We see people here who lose significant amounts of weight. Some need less pressure, some need MORE.

Don't go blindly into bariatric surgery or jaw advancement surgery. Make sure you understand implicitly the lifelong effects of BOTH as well as the short term risks and pain associated with these procedures. Don't just talk to the doctor, talk to other people who have had the procedures.

I'm sure you've dieted and tried to lose weight, but if you've only tried the conventional advice to reduce fat and calories, increase whole grains, and exercise more, you've only tried something with a very poor track record of success. Take a look at this http://www.dietdoctor.com/lchf and see if it's something you could live with. I've lost 72 lbs this way, I'm never hungry and I'm 1000% healthier than I ever was before. It's free, and if you try it and it doesn't "stick", the weight loss surgery will still be out there for you.

Remember that bariatric surgery is basically an enforced diet. It will greatly restrict the AMOUNT you can eat (until you learn to stretch the pouch and override the restriction, which happens to many people). You will have to eat a sort of LCHF type diet anyway, just to get adequate nutrition (plus supplements), you will probably have GI issues that can be quite unpleasant (nausea, vomiting, diarrhea, etc.).

On an LCHF diet with UNLIMITED portions you can lose weight without the side effects--the fat in that diet will reduce your appetite so you are not going to want to overeat, and your blood sugar will be steady and even. You won't have to be hungry or in GI distress. It's worth a try before you do the weight loss surgery.