Up & Coming Treatment for OSA

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Wed Jan 18, 2006 9:21 am

Where would I find information about your comment "evidence to suggest that in about two years the effects of surgery will be nil"?

I have never had allergies. I'm 38 years old. I'm overweight and my tonsils have always been big and I've had long term problems with tonsillitis. Most recently just getting off long term antibiotic therapy and BAM I'm sick again.

He told me with tonsils out and the fact that I am dedicated to weight loss my chances are extremely good. He has had many patients get off.

The key issues are: WEIGHT LOSS and whether you had OSA when you were skinny. I did not have any problems when I was thinner.

Since I have gained so much weight, I have high cholesterol, sleep apnea and GERD (just had the Lap Nissen Fundoplication 12/14/05).

I'm going for a cure, I want to be healthy. All of my above mentioned problems are weight related and no one can deny that!

Heidi

DCTom · Post by **DCTom** » Wed Jan 18, 2006 9:57 am

Seems to me a few weeks of pain is very tolerable when you compare it to a lifetime of poor sleep and/or taking antibiotics. Antibiotics are extremely dangerous to take for very long (soon your body won't know how to fight disease). If your tonsils are indeed overly large, then your ENT is right to recommend they be removed. For some people who get a lot of tissue carved out of their throat, scar tissue builds up and OSA returns. But for people with unusually large tonsils, it's unlikely scar tissue will return as big as your current tonsils! Sometimes people on these boards seem bent on telling everyone CPAP is the answer. I believe it's not the answer for all people. Your alternative sounds good for your situation.

Janelle · Post by **Janelle** » Wed Jan 18, 2006 12:51 pm

Since the tonsils are kind of a recepticle for infection or during sickness, where does your ENT think the cause of them being so large come from? Was it childhood sickness, the effects of snoring or what?

The part about most effects being nil after a few years has been mentioned several times in the last few years when surgery has been mentioned, and even my Sleep Dr.'s PA has spoken with my ENT and questioned her if she ever did followups and was told no. They have seen plenty of patients who have had the surgery similar to yours or the one also involving the soft palate reduction.

Weight loss is great but it is going to be extremely difficult if you are not getting restorative sleep, and I'm just not sure that having all that extra tissue removed is going to help you sleep the way you need to. When you are overweight and have OSA/ Sleep Apnea your body's metabolism is all out of kilter because you are not getting deep sleep. This includes the cortisol that you see so much about on weight reduction adds. This is why so many people cannot lose the weight they want, no matter what diet they go on and keep it off, because cortisol won't let them. When your body returns to normal metabolism the weight will come off and stay off, as long as you get restorative sleep.

I sincerely hope the surgery is all you will need to effect a cure. And once the weight is off your cholesterol will probably return to normal along with a lot of other metabolic problems. This is the way the human body was meant to operate.

Guest · Post by **Guest** » Wed Jan 18, 2006 3:25 pm

Sleeping With The Enemy wrote:I went to ENT this morning. On February 1st, I'm having a tonsillectomy and 2/3 of my uvula clipped. My tonsils/uvula are huge. I don't smoke.

I have shown many people and they can't believe how big my tonsils/uvula are, so out they go!

I have had tonsillitis/uvulitis so many times, I can't stand it.

I have also recently dropped from 221 to 202 (weighed in this morning)!!

Heidi

I can see getting your tonsils out because of the infections, definitely. But I wouldn't get my hopes up TOO much about the surgery (that and UPPP...why the 2/3 instead of the whole thing, Im not sure) curing your apnea. There is such a dramatic failure rate with that...I had it in July of 2002, and my apneas went from 70/hour to 64. A glaring failure. I hope you can maybe be an exception. The doctor also told me that by having my uvula removed, I was MORE likely to mouth breathe with CPAP...wish I'd known that before I did the surgery, or I wouldn't have done it. YMMV though...congratulations on the weight loss!!

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Wed Jan 18, 2006 7:39 pm

My ENT went to medical school at Mayo Clinic in Rochester, MN and also did his residency there.

He is only taking 2/3 of my uvula because he has seen way too many problems with a UPPP.

He already told me that this surgery alone will not cure my OSA, its going to take some work on my part to get back to a normal weight.

I'll be using my Remstar Auto with C-flex until I know without a doubt that I no longer need it.

I have huge tonsils, its something that has run in my family. My kids have huge tonsils and my siblings, etc.

Time will tell whether this works or not. I know its going to hurt. I've been through pain before. I've been through lots of pain, physical and emotional. I'm pretty tough, but I expect this will have me down for a couple of weeks, but it isn't the end of the world!

Heidi

Swordz · Post by **Swordz** » Wed Jan 18, 2006 11:03 pm

I would say that surgery would definitely help in your situation, especially if you have big tonsils/uvula. Of course, you won't know until you get the surgery and a new PSG.

Unfortunately with OSA and surgery, its not a science but an art. You have to seek treatments that may be unsuccessful to move onto the successful treatment.

I am a classic example of this whole procedure. After being CPAP-intolerant I went to turbinate reduction and septoplasty. Knowing the surgery wouldn't reduce AHI or cure my apnea, I did it anyways becuase of my congested breathing. Onto treating my OSA: Somnomed MAS dental device. I'm 1 1/2 months into advancement, but no results. I may have results a week from now, or I may have none. If no results are seen, I'm going for an MMA/GA in summer.

Being 23, I want to get my severe OSA taken care of ASAP. Unfortunately, with no insurance and limited finances, it lengthens and complicates the whole situation.

Keep me up on your surgery as I'm very interested in seeing people's results. I watch the MMA blogs on Sleepnet religously, especially knowing I'm probably heading that route. Oh, one last thing: My uvula use to swell, and I would wake up not being able to swallow becuase it was swollen so bad. This would happen infrequently and just 2-3 times a year. Does that happen to you? With no current success from Dental device, I"m thinking my problem is more palata/uvula related.

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Wed Jan 18, 2006 11:29 pm

I've been in the ER because it was closing off my airway. It is very long and most of the time drags on my tongue.

My tonsils are huge and red all of the time.

I'll keep you updated. I'm now wondering if I can have the more gentler tonsillectomy, I think its called powered intracapsular tonsillectomy or cobal something or rather....????

Anyway, I'm not going to complain about the weight loss that goes along with it.

Heidi, who into surgical weight loss of a different kind....self torture!

Janelle · Post by **Janelle** » Thu Jan 19, 2006 11:02 am

I believe they also say that removal of the tonsils, etc, is only advised for those with MILD Sleep Apnea, not severe.

Guest · Post by **Guest** » Thu Jan 19, 2006 11:15 am

Removing constantly infected tonsils is a good idea. If you were only having this surgery because you thought it would resolve your OSA, that would be an entirely different story. But it looks like you have very real expectations, because you're well aware a tonsillectomy won't cure your apnea, but are doing it to eliminate the infections. Good luck!

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Thu Jan 19, 2006 12:43 pm

By some of the responses on here to this subject, you'd think I was taking someone else's tonsils out.

I am capable of making informed decisions, mind all of you.

I was just wondering what other people who have had it done thought.

Heidi

Sleeping With The Enemy · Post by **Sleeping With The Enemy** » Thu Jan 19, 2006 12:47 pm

Another thing for everyone to remember is that having your tonsils out, especially if they are big, is going to bring your required pressure down.

That means, if I'm not mistaken, that I would go from severe to mild?!?

If you guys could only see the size of my tonsils, you wouldn't believe it. There is only about a 3/4 inch area in the back of my throat.

Heidi

Guest · Post by **Guest** » Thu Jan 19, 2006 2:58 pm

Janelle- Can you please refer us to your source for this statement regarding tonsillectomy:

Janelle wrote:and that there is evidence to suggest that in about two years all the effects of the surgery will be nil

You wrote:

Janelle wrote:The part about most effects being nil after a few years has been mentioned several times in the last few years when surgery has been mentioned, and even my Sleep Dr.'s PA has spoken with my ENT and questioned her if she ever did followups and was told no.

Where has this evidence you refer to been mentioned several times? I would like to read these studies.

Thank you.

Janelle · Post by **Janelle** » Thu Jan 19, 2006 4:58 pm

I believe if you do a search on this forum or even on one of the search engines, for Sleep Apnea,tonsils or something of that sort you will find a lot. Especially on the internet, there are roomfuls of medical documents indicating the effects of Sleep Apnea, the various surgeries and treatments and their longterm effects.

We used to have someone on the forum, can't remember who, right now, but maybe someone will come up with his name, who used to supply us all kinds of URLs to documents of this sort.

But obviously they are out there or my Sleep Dr., his PA and many others would not know about it, would they?

Guest · Post by **Guest** » Thu Jan 19, 2006 5:56 pm

Thank you Janelle. I have been searching the internet for the past two days and have not found any studies indicating following tonsillectomy

Janelle wrote:there is evidence to suggest that in about two years all the effects of the surgery will be nil

which is why I asked you for the source of the evidence you cited.

There are studies dealing with tonsillectomies for children with excellent long term results but I can find nothing regarding adults which would support your statement. If you (via your sleep doctor or his PA) can direct me to these studies you are referencing, I would be very appreciative.

Janelle · Post by **Janelle** » Fri Jan 20, 2006 4:55 am

I'll try to do some searching as well, also on this forum. when I get a chance.

But I do know that adult tonsilectomies are considered rather major surgery, which you already know, and I know that in a lot of kids the tonsils grow back, not sure about adults.

Up & Coming Treatment for OSA

DCTom