OSA OPERATION ? LATEST ENT SURGERY TO CURE IT!

When a patient dies due to a botched surgery, the guilty parties need to be charged with a CAPITAL CRIME.

Pugsy wrote:But maybe as a younger person the risk is worth it. Not my place to judge a person's perceived quality of life and if "cpapless" would GREATLY increase their perception and they think the reward is worth the risk......

I would suggest that younger people need "older" folks to call them on risky, vain pursuits by providing wisdom of experience. I think, as a self professed "older" CPAP user it is exactly your place to warn so called "younger" suffers of what wisdom and experience has taught you!

Goofproof wrote:Both of you put funds matching the bill in a escro acct, if after five years you are still cured, pay him, if not he pays you, to cover z little of your pain and suffering. If you die from untreated sleep apnea, both monies go to your next of kin, they can try to get smarter with it. Jim

Hi Goofproof pleased to meet you - I could always have a six month sleep study done every six months to see how my post - operated OSP is holding up - with love Peter from Australia.

ems wrote:

The Latinist wrote:

Pugsy wrote:When a person is a surgeon...everything looks like it can be fixed with knife. Sometimes it can...sometimes it can't.
What happens if you are among the 15% (docs % numbers) that it fails? Are you prepared to accept the problems that comes with having all that tissue cut on? If you are...hey, go for it. For you the reward may very well be worth the risk.
You don't have to convince me that your doc speaks the gospel and walks on water.

I was about to post the same thing: as the saying goes, "when all you have is a hammer, everything looks like a nail."

Another +1

And another +1000......

Surgery can only deal with anatomic features. But they are not the only ones in play with Sleep Apnea.

You really should look into the research concerning the actual cure rates for the surgeries intended. Surgery I do believe is very unlikely to get your AHI under five per hour. You should ask your doctor how much actual improvement he expects to see. The number I recall from the reading I have done on this was a 50% reduction in AHI which would be a “cure” if your measured AHI were ten events per hour.

Surgery can help prevent obstruction by removing tha anatomical features which contribute to them, however nonanatomic features play an important role in 56% of patients with OSA[1]. Indeed:

37% had a low arousal threshold

36% had high (respiratory control) loop gain

28% had multiple nonanatomic features.

Both low arousal threshold and high respiratory control loop gain are likely to be directly related to the stress level in the persons life.

I used to think that a tracheostomy was indeed “the ultimate cure” for sleep apnea. But as they related in the a recent commentary[1] that is not the case:

“...central apnea following tracheostomy is well described in severe OSA patients, perhaps suggesting that the mechanism underlying baseline OSA may be a critical varialbe.[10,11]”

[1] Orr J, Javaheri S, Malhotra A. Comparative effectiveness research in complex sleep apnea. SLEEP 2014;37(5):833-834

[2] http://www.atsjournals.org/doi/abs/10.1 ... 2IGGaZ3_FW

[10] Fletcher EC, author. Recurrence of sleep apnea syndrome following tracheostomy. A shift from obstructive to central apnea. Chest. 1989;96:206-9

[11] Guilleminault C, Simmons FB, Motta J, et al., authors. Obstructive sleep apnea syndrome and tracheostomy. Long term follow-up experience. Arch Intern Med. 1981;141:985-8

Hi everyone - I am posting this message to THANK ALL OF YOU who replied to my original post ? concerning surgery to fix OSA - I have spent many hours reading hundreds of past posts on the forum concerning people who had surgery to try and cure the OSA and the conclusion is they all failed they may have had some relief from OSA for some years following surgery but their OSA all returned just as bad as ever to bite them on the bum and they were forced back to cpap treatment to cope with their OSA only NOW they had terrible complications from having half their mouth removed which made returning to cpap treatment very difficult indeed - thank you so much you kind people for pointing me in the right direction and making the FATAL MISTAKE of pursuing surgery options to cure my OSA - in a nutshell surgery methods simply do not work in the long run and leave you with more problems than ever postsurgery and returing back to cpap to cope with OSA.

I have finally reaialsed that cpap is the GOLD STANDARD in fixing OSA in my case since the the three and a half years since using cpap my health and energy returned to such a degree that I was able to ride my bike for 40km a day and use a 1200 kal diet for nine months to lose 112 lbs pound of excess fat I lost 40 % of my total body weight how ever this huge lose of weight did not cure my OSA but I am sure it lowered my nightly AHI events plus I feel fantastic in body mind and sprit from my weight loss all due to cpap therapy so I now confess I will NOT be going ahead with my $5600.00 surgery to try and cure my OSA infact I can afford to buy a s9autoset cpap machine and several new masks and still have $2600.00 left over in my bank account once again thankkkkkkkk you so very much for guiding me to sanity and seeing the TRUTH - I think I must have been suffering from a large dose of wishful thinking and total ignorance of the facts I am quite sure now that my ENT surgeon was outright lying to me when he said he could cure my OSA with an operation which by the way is very painful to recover from - god bless you all here on this forum for helping me see the light - I WISH you ALL a very happy day and a peaceful nights sleep on your hose and cpap - much love from Peter from Australia

bavinck wrote:

Pugsy wrote:But maybe as a younger person the risk is worth it. Not my place to judge a person's perceived quality of life and if "cpapless" would GREATLY increase their perception and they think the reward is worth the risk......

I would suggest that younger people need "older" folks to call them on risky, vain pursuits by providing wisdom of experience. I think, as a self professed "older" CPAP user it is exactly your place to warn so called "younger" suffers of what wisdom and experience has taught you!

Sorry but that's not my job or my calling or my whatever to make out like my personal opinions, whatever they might be, are the gospel. They aren't the gospel according to Pugsy. Actually I do understand why a person would want to go cpapless. I myself would really rather be cpapless so I fully understand one's desire to try to "fix" things so they don't have to use the cpap. Just because I understand the desire doesn't mean that I would do it myself though.

Surgery of any kind scares the hell out of me because I know the risks. I have a really good friend whose grandson died at the age of 8 from a plain old tonsillectomy. Died at home in his own bed....bled to death. We all know the risks but we think it would never happen to us or someone we know and love. It's so rare...couldn't happen to me.

I don't like telling anyone that they should do this or that. I prefer that when pointed to proper educational materials that they make their own educated decisions about anything.
Just like I have never appreciated anyone telling me what I had to do...let me make my own decisions about my own life. Right or wrong...my decision.

Pugsy wrote:

bavinck wrote:

Pugsy wrote:But maybe as a younger person the risk is worth it. Not my place to judge a person's perceived quality of life and if "cpapless" would GREATLY increase their perception and they think the reward is worth the risk......

I would suggest that younger people need "older" folks to call them on risky, vain pursuits by providing wisdom of experience. I think, as a self professed "older" CPAP user it is exactly your place to warn so called "younger" suffers of what wisdom and experience has taught you!

Sorry but that's not my job or my calling or my whatever to make out like my personal opinions, whatever they might be, are the gospel. They aren't the gospel according to Pugsy. Actually I do understand why a person would want to go cpapless. I myself would really rather be cpapless so I fully understand one's desire to try to "fix" things so they don't have to use the cpap. Just because I understand the desire doesn't mean that I would do it myself though.

I don't like telling anyone that they should do this or that. I prefer that when pointed to proper educational materials that they make their own educated decisions about anything.
Just like I have never appreciated anyone telling me what I had to do...let me make my own decisions about my own life. Right or wrong...my decision.

I must have been unclear in what I was trying to get at. Wisdom does not "tell people what to do" but rather offers advice based on personal experience, points people to information (like you say) that they can learn from and is available to continue offering advice. Our culture is so afraid of being "told what to do" that we are almost completely missing the fact that experience breeds wisdom, and wisdom breeds understanding. I was not trying to encourage you to tell people what to think, but rather encourage you that in apnea land you have valuable experience that many can benefit from. Please share your wisdom, in this case it was accepted! I was certainly not trying to promote a "gospel according to Pugsy" mindset, as we are all self educated people figuring it out as we go in cpap land, even you:-)

Coblation channelling of the tongue is far less ablative than it sounds, using saline and radiofrequency to in effect stiffen the tongue. This means that the tongue loses minimal volume but is less inclined to fall back and occlude the throat when sleeping. An ENT surgeon skilled in its use will always favour conservative intervention. In addition, modified UPPP as performed in modern surgery is more reconstructive than ablative with less scarring and better results. Operations are now tailored to individuals based on careful anatomical assessment and staged to address each level of collapse. As someone who works in the field of Sleep Medicine, I would not hesitate to have this operation providing an ENT surgeon experienced in the techniques was available. To claim that tracheostomy is in some way preferable reveals out-dated biases towards a technique that still carries stigma from the early developmental days of UPPP. These latest approaches offer a viable alternative for those unwilling or unable to tolerate CPAP or MAS devices for OSA, despite scare mongering in circles with a vested interest in ensuring device use is ongoing.

What do you call the person who graduated medical school at the very bottom of the class?
----Doctor!
In my doctor's office are posted certificates and diplomas--but never a transcript!
What constitutes a passing grade? Hmmm?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544378/

I'm not lining up until they do some followup studies to this one to see how people who've had this and improved fare over a period of time. Even then, I'm not big on the risks of surgery, and cpap works okay for me, so it would take a lot more information for me to be persuaded to take the risks.

Also not a big fan of surgery, unproven in particular.

chunkyfrog wrote:Also not a big fan of surgery, unproven in particular.

I am not a fan of surgery either. But all jokes aside, if someone has not succeeded with pap therapy or a dental device in spite of their best efforts, it is the only game left in town. Our "friend", Dr. Steven Park, has a document on his site called "truthsboutsurgery" that is a good read for anyone considering surgery.

chunkyfrog wrote:What do you call the person who graduated medical school at the very bottom of the class?
----Doctor!
In my doctor's office are posted certificates and diplomas--but never a transcript!
What constitutes a passing grade? Hmmm?

most of the vict... er, patients survived before graduation?

chunkyfrog wrote:What do you call the person who graduated medical school at the very bottom of the class?
----Doctor!
In my doctor's office are posted certificates and diplomas--but never a transcript!
What constitutes a passing grade? Hmmm?

I not sure what your point is CF. As we all know, just because you have excellent grades in school doesn't mean you are going to be at the top of your profession.

By the way, I will bet ENT number one whom I saw was probably at the top of his class in medical school. But when he said I wouldn't die after being off of cpap for two weeks after a septoplasty, i felt it was time to move on for obvious reasons.
Anyway, the issue is again how does the person who is now down to surgery as an option to relieve their sleep apnea make the best possible choice so that their odds of success are maximized as much as possible.

This is the most important part of aux scientist's post.

Operations are now tailored to individuals based on careful anatomical assessment and staged to address each level of collapse

Any surgeon who does not do this should be ditched in a heartbeat.