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When do I consider jaw surgery to address my obstructive sleep apnea?
I am a 51 year old male and I have a long history of dealing with the symptoms of sleep apnea. Exhaustion, fatigue, persistant head aches and anxiety were my first symptoms. When misdiagnosed about 15 years ago the symptoms of anxity were treated with a benzodiazapine which over an 8 year period caused further exhaustion and depression.
It was about 7 years ago that I was finally correctly diagnosed with severe sleep apnea and it was at that time that I started on the surgery route. My first surgey UPPP, was very helpful but left me with moderate apnea. Since that time I have attempted unsuccessfully to use a CAP at every step of the way. I have tried many different masks and three types of machines. I have had deviated septum surgery and stents inserted in my nose, neither surgery providing any relief.
Over the last 6 months the depression seems to happen more frequently, my short term memory is worse and my state of exhaustion seems to fluctuate from high to moderate. I have subsequently been fitted with a 24 hour dental device to help align my jaw and a two piece night time device, which I cannot wear due to my inability to breath through my nose. The device has helped reduce my TMJ headaches. Nothing seems to be working for me. Today I have had the first of what could be 2-3 sessions of radio frequency treatments. My thought is to see how it goes for the next few months and if there is no notable improvement consider what is said to be the ultimate solution, jaw surgery.
If there is anyone out there who has been throught the surgery, I am very interested in understanding your process, success rate and any challenges that the surgery may have caused you.
It was about 7 years ago that I was finally correctly diagnosed with severe sleep apnea and it was at that time that I started on the surgery route. My first surgey UPPP, was very helpful but left me with moderate apnea. Since that time I have attempted unsuccessfully to use a CAP at every step of the way. I have tried many different masks and three types of machines. I have had deviated septum surgery and stents inserted in my nose, neither surgery providing any relief.
Over the last 6 months the depression seems to happen more frequently, my short term memory is worse and my state of exhaustion seems to fluctuate from high to moderate. I have subsequently been fitted with a 24 hour dental device to help align my jaw and a two piece night time device, which I cannot wear due to my inability to breath through my nose. The device has helped reduce my TMJ headaches. Nothing seems to be working for me. Today I have had the first of what could be 2-3 sessions of radio frequency treatments. My thought is to see how it goes for the next few months and if there is no notable improvement consider what is said to be the ultimate solution, jaw surgery.
If there is anyone out there who has been throught the surgery, I am very interested in understanding your process, success rate and any challenges that the surgery may have caused you.
Views: 1017
Replies to This Discussion
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Permalink Reply by Mike on
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check out all the photos posted by Sha -- she had the surgery and posted a number of photos.
you're right that the jaw surgery is a huge one. it freaks me out to tell you the truth, and I wouldn't do it myself. Especially since it's not terribly reliable unless performed by the best surgeons. I've heard Kasey Li at Stanford does good work with these. You should also consider a tracheotomy: http://www.sleepguide.com/profiles/blogs/tracheostomy-for-severe-sleep
let us know your thoughts...
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Permalink Reply by sandman on
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Hey Mike,
Thanks for the connection, the photos are helpful. I would definately use my doctor, Riley, at Stanford to do the proceedure since he was part of the team to first perform the operation. Li was a student of Riley, I believe.
Before making my selection to move forward I plan to exhaust what I feel are all other possibilities and will attempt to get pre-approval from my insurance company. The whole process of dealing with doctors, hospitals and the insurance companies, as you may know, is very frustrating and exhausting in itself.
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can you tell us a little more about the radio frequency treatments, either here or on a separate thread? never heard of that treatment
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Permalink Reply by Duane McDade on
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that's where your wife turns up the radio so she can't hear the snorts and gasping! sorry I couldn't help myself. Just kidding. I' m a R.F. Technician Too, and that would be something I would like to hear about, too!
Mike said:can you tell us a little more about the radio frequency treatments, either here or on a separate thread? never heard of that treatment
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Hey Sandman, it sounds like you are local in the Bay Area -- if you are too I'd be happy to meet with you in person and answer any questions you may have. Drop me a note and we can work out a time.
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PS, I used Riley and he is top notch. Even better, though, is his assistant Dr. Sesso; he has the best bedside manner of any doctor I think I've ever had, period. (Kind of unintentionally compensated for Riley who is very businesslike and busy, IMHO.) He ALWAYS has time to sit and talk with you and is ALWAYS available by email as well.
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sha said:Hey Sandman, it sounds like you are local in the Bay Area -- if you are too I'd be happy to meet with you in person and answer any questions you may have. Drop me a note and we can work out a time.
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sandman, your reply didn't come through...
sandman said:sha said:Hey Sandman, it sounds like you are local in the Bay Area -- if you are too I'd be happy to meet with you in person and answer any questions you may have. Drop me a note and we can work out a time.
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Hello Sha,
Thanks for the honest candor about your surgery and condition. I've had three surgeries with Riley, UPPP, deviated septum surgery and nasal stents. The first surgery was a success in bringing me from severe apnea to moderate. The other two surgeries did nothing. I'm considering another doctor, Arnett in Santa Barbara who is a jaw reconstruction specialist. Arnett worked on a friend who had a bad accident, and the result was favorable.
Regarding my story. Poor orthodonture is the possible cause of my condition....too many teeth were removed at a young age, causing presure on the TMJ, hyperextended arch in the roof of my mouth, a life of closed sinus passages and now colapsing flesh in my throat at night. Long term sleep deprivation had lead to memory loss, morning head aches and high anxiety and bouts of depression.
I'd just love to get a good nights sleep and am at this point ready to go to the extent of this surgey to achieve this goal. The way I see it, this condition is both debilitating and life threatening.
Yes, I am in the Bay Area and at some point it might be good for us to have a chat. My first appointment for intake is not until August. The will give me time to make a case to my insurance company. Was your surgery covered by any insurance?
Did you have to have braces prior to your surgery? Arnett uses the braces to hold the jaw in place for the surgery and the healing process.
I'm sure tht I'll have lots of questions. I have spoken to one other person who has had great results with the surgery.
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Permalink Reply by Sandra Limbach on
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After looking at the discussion below I know you must be in good hands... My son had the jaw surgery done by Dr. Li 4 yrs ago at 9. He is still the youngest person to ever have had the surgery at Stanford. It has changed his life. They expected some nerve damage and for him to loose wisdom teeth buds and possibly 12 molars. He has no nerve damage and did not loose any tooth buds. My son's case was one of a tiny lower jaw, the lower teeth were completely inside the lower jaw so eating was extreamly difficult. They did the maximum palate expansion possible then did the extension. After the surgery he had no pain and was back in school within a week. He has not needed CPAP again...Yet. as he grows he will need it again, before he has another round of surgery at about 16. The overriding factor for me as parent in making the decision to go through with the surgery was his quality of life. There comes a point where doing without the surgery is just not worth it. My insurance paid about half and the rest was enough to end up on my taxes.
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Thanks Sandra,
The same names of doctors keep coming up in all of the conversations that I have been having about my situation. The Stanford Sleep Clinic has a great reputaion. I wish your son the best of luck with future improvements. I've gotten to thepoint of realizing that the quality on my life will only decline if I do not proceed with the surgery. Your son's recovery time sound incredible, I can only wish for such a speedy recovery myself! I"ll be seeing a doctor next week for a full evaluation.
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Permalink Reply by April Reeves on
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I've had jaw surgery before--not for this same problem. The main problem is that they wire your mouth shut for 6 weeks to allow the bones to fuse properly, unless things have changed since I had mine done. The good news is that you can eat darn near anything "blender-ized" and it tastes exactly the same as otherwise. I was losing a significant amount of weight, which is why my dad finally threw a hamburger into the blender! Another challenge is brushing teeth. I just ended up cutting notches out of a straw so I could slide it in between my teeth and use my tongue to clean the backsides of all my teeth: necessity really IS the mother of invention.
After the 6-weeks was up and they clipped the wires apart, I had romantic visions of having a wonderful celebration dinner complete with salisbury steak and veggies...but it never occurred to any of us that my jaw muscles would be atrophied. Yeah-a little nerve damage too. Only on one side under the lip, about a 2-inch section.
Those are the main issues I had with my recuperation. the surgery itself was apparently a breeze--I had a really great surgeon. I hope this helped. Good luck to you!
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