Surgery?

[giantred]

I'm getting to the point of surgery. I got the septoplasty, yes I can breath better, but I still have the apnea. I noticed when I open my mouth that everything collapses and the uvala is sitting over the tongue. I'm assuming that there is minimum air going down my throght and this is why I'm cholking and not sleeping so well. PLease help me, is surgery the last option I have. I'm starting to develop depression symptoms from all of this, the apnea is really controlling my life. I need help. Please should I beg the doctors to do the surgery. The mask is causing severe pain in my neck/back, and I"m running out of options. If I cry enough to the DRs they will do the surgery, Do you think I will be better?

[JohnBFisher]

I've been using xPAP for almost 20 years. During that time, I've known several folks (about 10) who decided to go the surgery route. It helped none of them. Oh, it might help some. But none I know. It made CPAP use impossible - without a full face mask - for two of them. One of them had to have a tracheostomy. Yuck! One continues to struggle and refuses to use xPAP. And the rest now use xPAP.

When I researched surgery options almost 20 years ago the figures for the effectiveness were just as bad then. Of course, the one party in this equation that does well is the surgeon.

[wil]

My brother and mother each had the surgery done about 15 years ago. It helped neither of them. My brother is a doctor, formerly an ENT surgeon, and he told me directly that it was not worth doing. My AHI was over 100 before treatment.

With a case as severe as yours, I can't make a suggestion based on my own limited experience, of course. Just keep in mind that the surgery means a painful recovery, and any benefit you do receive will be short lived. The palate will grow back and the surgery will need to be redone every five years or so...

[kteague]

Couple things... The headgear in your listing has the lower strap in the worst place for those with neck issues. I have problems with those too. They tighten down right where the muscles attach to the base of the skull that connect to the shoulder neck area. I had to experiment with strategic homemade strapping to avoid the pain. I'm wondering if you might be a candidate for the PapCap. I don't think its straps around the back are that low or that tight, but someone else can correct me if I'm wrong. I'm using the Headrest nasal pillows mask totally with my own straps. Maybe since your prior surgery your sinuses wouldn't be as sensitive as they once were. Maybe you could scroll thru the different masks looking particularly at the headgear design to see if one may be better for your neck issues. Sometimes the headgear can be interchanged between masks even. Sounds like creativity is your best bet. Further surgery being of enough benefit to resolve your need for cpap is a high stakes risk. Any surgery is. I'd hate to see you make a desperation move when you might achieve success without extreme measures. I remember how excruciating my neck pain was when at its worst, so I understand you wanting - no, needing - relief. At least mine is more sporadic now, but a couple bad spells the last few days has me in tune with your situation. Sure hope you find relief soon.
Kathy

[momsworry]

Surgery that does no good? How many more surgeries might be like this? No wonder health care is expensive?

[kteague]

There are several surgical procedures to help open the airways, and not all are maligned. The one of removing the uvula came into popularity around the mid 80's. (I say that based only on my job in the pathology dept of a local hospital and observing the surgery schedule daily.) While I know 3 people whose uvula removal did not cure their OSA and caused other issues, I don't know anyone personally who had their uvula modified instead of removed. It's not that the procedures are worthless. It's that there's limitations to who they help and to what degree. I could be wrong, but it seems there is more recognition of the limitations, and selectivity used in recommending surgery reducing the soft palate (with uvula) and/or tongue as a treatment for sleep apnea. If you are in the statistical group of those helped by this surgery, that is wonderful. My contention is with painting all apnea sufferers with the same wide brush and allowing (even if not giving) an unrealistic expection of the outcome.