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My Sleep Apnea surgery
In July of 2001 I was diagnosed with Sleep Apnea, I used a Remstar CPAP, and later a REMstar Series M CPAP from 2001 to 2008. I travel a lot by Air and it is a supreme Hassle to get your CPAP through the TSA checkpoint. They always made me feel like a terrorist. You put it in your checked baggage and you risk having it damaged (been there, done that) or missing a flight connection, not having your baggage and having to sleep without it, not a very good option. Last spring my wife and I visited friends in Italy and it was then that I grew so fed up with dragging a CPAP around the world that I vowed to explore surgical options.
On Sept 17th 2008 I underwent surgery to hopefully alleviate my severe chronic obstructive sleep Apnea. I was being operated on by Dr Ryan Stevens at Samaritan Regional Health Center in Corvallis Oregon. I discussed every one of the surgical possibilities with Dr Stevens. After an endoscopy exam he concluded that my biggest problem was the excess tissue on base of my tongue. He suggested a Lingual Tonsillectomy and a UPPP. We proceeded with the surgery and I remained in the hospital for 2 days then was released for a 2 week recovery period. Probably the roughest part was that the Dr placed a loop of suture on the underside of my tongue in case I began to choke while in the hospital recovering. The suture caused me to salivate like Niagra Falls and saliva leaked out of my mouth when I tried to sleep it would wake me up. After they removed that the following morning things improved. My pain was managed with Roxicet (liquid Oxycontin) and by syringes of a lidocane gel. The Lidocaine made everything numb and seemed to increase the salivation so I used it sparingly. The second night at the hospital was much more comfortable and by the following morning I was doing well enough to be released. I was cleared to eat solid food upon my release of the hospital, I could eat but it was a slow process and swallowing was difficult, more from the tissue stretching than from pain.
I stayed off work for 2 weeks, the second week I was well enough to go on a 5 day trip to the San Francisco Bay Area to visit family. Probably the things I can say looking back on this are: It was worth it! The pain is no worse than a bad sore throat from Tonsilitis. The end definately justified the means.
During recovery I drank warm water with meals, anything hot, cold, alcoholic or carbonated was not tolerated. I slept with CPAP for 2 weeks post surgery. After the swelling was totally reduced I quit using it. I no longer have apnea episodes, I no longer gasp and I rarely snore, when I do snore it's about 90% less than before. The only thing I've notivced is that sometimes I'll cough if I have post nasal drip, that seems to be the only thing that wakes me from a sound sleep. I have to say I look and feel better, I awake rested, alert and there's no grogginess at all. My wife is very pleased, My coworkers say I'm easier to get along with and my boss has commented that I'm more productive. (I work for Hewlett Packard at a Research and Development Center)
I have had 2 post op checkups and Dr Stevens is elated with the results. I had an appt with the sleep Doctor (Dr Mark Reploeg) and he's signed me up for an another sleep study, They are going to do an overnight Oxygen saturation study at home to ensure that I'm not having apnea episodes. Personally I don't think another sleep study is needed but that's for the Docs to decide. I turned 54 on Jan 20th and this surgery made me feel 15 years younger. I highly recommend considering it.
Feel Free to contact me with Questions. Dr Stevens has performed this dual procedure several times in 2008 and his patients have had great success with getting off of CPAP.
Randy Bray,
Corvallis Oregon
On Sept 17th 2008 I underwent surgery to hopefully alleviate my severe chronic obstructive sleep Apnea. I was being operated on by Dr Ryan Stevens at Samaritan Regional Health Center in Corvallis Oregon. I discussed every one of the surgical possibilities with Dr Stevens. After an endoscopy exam he concluded that my biggest problem was the excess tissue on base of my tongue. He suggested a Lingual Tonsillectomy and a UPPP. We proceeded with the surgery and I remained in the hospital for 2 days then was released for a 2 week recovery period. Probably the roughest part was that the Dr placed a loop of suture on the underside of my tongue in case I began to choke while in the hospital recovering. The suture caused me to salivate like Niagra Falls and saliva leaked out of my mouth when I tried to sleep it would wake me up. After they removed that the following morning things improved. My pain was managed with Roxicet (liquid Oxycontin) and by syringes of a lidocane gel. The Lidocaine made everything numb and seemed to increase the salivation so I used it sparingly. The second night at the hospital was much more comfortable and by the following morning I was doing well enough to be released. I was cleared to eat solid food upon my release of the hospital, I could eat but it was a slow process and swallowing was difficult, more from the tissue stretching than from pain.
I stayed off work for 2 weeks, the second week I was well enough to go on a 5 day trip to the San Francisco Bay Area to visit family. Probably the things I can say looking back on this are: It was worth it! The pain is no worse than a bad sore throat from Tonsilitis. The end definately justified the means.
During recovery I drank warm water with meals, anything hot, cold, alcoholic or carbonated was not tolerated. I slept with CPAP for 2 weeks post surgery. After the swelling was totally reduced I quit using it. I no longer have apnea episodes, I no longer gasp and I rarely snore, when I do snore it's about 90% less than before. The only thing I've notivced is that sometimes I'll cough if I have post nasal drip, that seems to be the only thing that wakes me from a sound sleep. I have to say I look and feel better, I awake rested, alert and there's no grogginess at all. My wife is very pleased, My coworkers say I'm easier to get along with and my boss has commented that I'm more productive. (I work for Hewlett Packard at a Research and Development Center)
I have had 2 post op checkups and Dr Stevens is elated with the results. I had an appt with the sleep Doctor (Dr Mark Reploeg) and he's signed me up for an another sleep study, They are going to do an overnight Oxygen saturation study at home to ensure that I'm not having apnea episodes. Personally I don't think another sleep study is needed but that's for the Docs to decide. I turned 54 on Jan 20th and this surgery made me feel 15 years younger. I highly recommend considering it.
Feel Free to contact me with Questions. Dr Stevens has performed this dual procedure several times in 2008 and his patients have had great success with getting off of CPAP.
Randy Bray,
Corvallis Oregon
Views: 1153
Replies to This Discussion
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Permalink Reply by SomeDudeInCali on
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Hi Randy,
First off I'd like to say, thank you for your story. I'm 27 years old and I am not overweight. A couple years ago I was diagnosed with mild sleep apnea. My ENT said I'm a good candidate for UPPP. However, because of all the UPPP horror stories I have read online, I decided to just have a tonsillectomy. Two months ago, I went ahead with the surgery and yet my sleep apnea symptoms persist.
My sleep apnea symptoms are that I sleep fine for about 3-4 hours but then I wake up choking, gasping for air, and I'd have a rapid heart beat. I'm going to be seeing my ENT as well as another ENT for a second opinion and discuss UPPP because I'm seriously considering it now.
My two biggest fears of UPPP surgery is that:
1. My voice permanently changes.
2. I'd permanently have difficulty swallowing food (whether it be liquid or solids). This is because the uvula prevents food from entering in the wind pipe during eating/drinking.
Do you have any of the two above symptoms? I'm currently on BiPap and I'm dying to get off. I'm exploring both surgery and dental devices.
Thanks again,
Mike -
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Permalink Reply by Randy Bray on
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Hi Mike,
I can allay your fears on both concerns, I have experienced neither symptom. In fact I think I swallow BETTER since the surgery. I take dietary suplements as well as a couple of prescriptions daily, I use to choke on the fish oil capsules and that problem is totally gone.
Have your ENT check the base of your tongue, this was my biggest issue when I would relax in sleep my tongue would collapse against the back of my throat. I had excess tissue on the base of my tongue and the combination surgery of a modified UPPP and Lingual Tonsilextomy resolved my Severe Chronic OSA. (I have had my sleep Apnea my entire life, Looking back I can see why some things happened to me out of sheer exhaustion.
Check this page: http://homepage.mac.com/changcy/botcoblation.htm
Lingual Tonsillectomy involves removing excess tissue from the base of the tongue to help prevent obstruction of the airway when sleeping. I had concerns with the UPPP, I asked my Dr on the morning of the surgery to do a modified UPPP, remove only about 1/3rd as much of the palate as would normally be removed, he thought this was a great idea and said that, in conjuntion with the Lingual tonsillectomy that it should resolve my Severe OSA.(80%+ Success rate) So, in essence he removed my Tonsils, Adenoids, a small portion of palate and uvula and the excess tissue on the base of my tongue (where your tongue meets your throat.) I just had my 3rd Post op exam, this with a "Sleep Doctor" who runs the sleep lab here. He was pretty thrilled to see how effectively this dual procedure had worked. He ordered an oxygen saturation and pulse study to be done while I was sleeeping at home, a strap on sensor on my middle finger was connected to the recorder. I just got the resilts back, he said I have very slight sleep apnea, not even enough to bother with a CPAP, he advised me to try to take off 20 more pounds and check with him in 6 months.
My ENT told me his 3 biggest concerns with the surgery he did on me were: 1) The sensation of having something "stuck in my throat" 2) that my ability to taste would be affected and 3) That my tongue would be numb. I didn't experience any of these symptoms whatsoever. I no longer use CPAP,I don't gasp or cough when I sleep. I still snore slightly if I'm overtired and laying flat on my back, I tend to sleep on my sides more now. If you're still having symptoms, talk to your ENT, consider the dual procedure if he feels that this would be beneficial. I considered a dental device but with this surgery I have no need for it. See if your ENT would be willing to do a "UPPP Lite" (I just made that term up) like I had where only about 1/3rd of the usual palate tissue is removed. I think the ONLY side effect I've had with this is that I will occasionally choke on saliva. This happens maybe once a month and is really very trivial, just coughing a bit mostly. As I go longer since the surgery this rarely ever happens at all and I wouldn't consider it a reason to not pursue surgical options.
If you'd like to discuss my experience by phone, send me an email at Randyincv@gmail.com and I wold be more than willing to discuss the entire sequence of events. Personally every time that I look back on 2008 the surgery and getting rid of my CPAP is definately the brightest spot.
Randy Bray -
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Permalink Reply by Leslie Scott on
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Doing a post-op study on a UPPP tonight... and it seems to have worked!! his apnea ratio is below 5 :) I know that septoplasty did take care of OSA for my daughter, granted she was 8.
I can ask my patient these questions in the am (about an hour) and see if he has these issues... and I'll ask if it's ok if I share. (the whole HIPPA thing, although I am not using a name)
Les in CO -
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Wow... thanks. I was able to get off my cpap in January since I lost weight, but since then, I have been having a bigger problem with my tongue. I have a weird allergy, and thought it would make my throat swell shut. The more I have paid attention, the more I realize it is the back of my tongue swelling. I have had trouble with pills getting stuck and even had a swallow study done.... with nothing. Yet, if I move my goiter (yes, thyroid goiter) I can feel the meds pop loose. I have not had the problem recently, mostly because I can't take very many pills anymore (we figured out that the allergy is fillers in the medications, so most of my meds are chewable or liquid). I have been wanting to go and see the ENT about my tongue though. Might have to go and get it checked. My ENT is no longer doing surgery anyway (he's next to retire, so they are phasing him out) so now would be the time to try out a new doctor.
Thanks,
Les in CO
Randy Bray said:Hi Mike,
I can allay your fears on both concerns, I have experienced neither symptom. In fact I think I swallow BETTER since the surgery. I take dietary suplements as well as a couple of prescriptions daily, I use to choke on the fish oil capsules and that problem is totally gone.
Have your ENT check the base of your tongue, this was my biggest issue when I would relax in sleep my tongue would collapse against the back of my throat. I had excess tissue on the base of my tongue and the combination surgery of a modified UPPP and Lingual Tonsilextomy resolved my Severe Chronic OSA. -
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BTW, I did talk to my patient that night after he got up. Said he didn't have any of the issues you were concerned about with his UPPP and gave me permission to share :)
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Thanks for the post. i am getting prepped to have the same procedure. (I think).
They are going to cut down the back of the tongue.
They are going to hang the ring of my esophagus over the adams apple (hyoid suspension)
They're going to remove the tonsils and adenoids
They're going to open up the nasal valve by placing small (1 mm x 1 cm) strips of cartilidge along the sides of my septum.
I can't wait for the results, but I am wary of the procedure. My mother will be driving to town to take care of me and I'm pushing for her to take me back up to my folks place, to rehab there. She doesn't think I will be able to move and will need to be here.
How long do you think it will be before I can endure a 4 hour car trip? (I didn't even realize that it reuqired overnight hospital stay until reading this).
Thakns for the post -
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I was off work for 2 weeks, after a week at home we headed for the S.F. Bay Area to visit family and friends. I tired easily, but did ok. When they work on your throat like that you can eat and swallow, it just takes awhile. They signed me off for eating solid foods before I left the hospital. My wife had a good laugh at me in San Fran when it took me 45 mins to eat a sandwich. Some things I would recommend avoiding. Ice Cream, regardless to what Bill Cosby used to talk about it hurts to swallow it. I wouuld avoid anyhting with ice in it to drink, avoid carbonated soda, alcohol. I even drank glasses of warm water with dinner and it helped immensely. Good luck with the surgery. I don't use CPAP anymore, I do use a "Snore Guard" from a Dentist which helps keep my jaw pulled forward while sleeping, it's been so good to travel without a CPAP in Airports. Best of luck with your procedure.
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Many many thanks!
What I didn't think about was that I might not be able to leave town due to the check-up process. My hopes were to get back to my folks place as soon as possible since both parents are there, dog, etc. But now that I think about it, even if I were able to put up with the 4-hour drive, I'd still need to get back for checkups.
In your case from the time you left the hospital until you got back from san fran 2 weeks later were there any check-ups where you went back in to get a review? I've got an e-mail into the doctor asking.
Thanks
Randy Bray said:I was off work for 2 weeks, after a week at home we headed for the S.F. Bay Area to visit family and friends. I tired easily, but did ok. When they work on your throat like that you can eat and swallow, it just takes awhile. They signed me off for eating solid foods before I left the hospital. My wife had a good laugh at me in San Fran when it took me 45 mins to eat a sandwich. Some things I would recommend avoiding. Ice Cream, regardless to what Bill Cosby used to talk about it hurts to swallow it. I wouuld avoid anyhting with ice in it to drink, avoid carbonated soda, alcohol. I even drank glasses of warm water with dinner and it helped immensely. Good luck with the surgery. I don't use CPAP anymore, I do use a "Snore Guard" from a Dentist which helps keep my jaw pulled forward while sleeping, it's been so good to travel without a CPAP in Airports. Best of luck with your procedure. -
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I had a checkup about 3 weeks after the surgery, everything was better by then and I was able to eat normally. On thing I would caution on is to not get overly active during your recovery. Walking, riding in a car would be ok. I would avoid anything as strenuous as riding a bike, jogging, etc. The possibility of post operative bleeding exists if you overdo it. Othe rthan that things have been great.
BC said:Many many thanks!
What I didn't think about was that I might not be able to leave town due to the check-up process. My hopes were to get back to my folks place as soon as possible since both parents are there, dog, etc. But now that I think about it, even if I were able to put up with the 4-hour drive, I'd still need to get back for checkups.
In your case from the time you left the hospital until you got back from san fran 2 weeks later were there any check-ups where you went back in to get a review? I've got an e-mail into the doctor asking.
Thanks
Randy Bray said:I was off work for 2 weeks, after a week at home we headed for the S.F. Bay Area to visit family and friends. I tired easily, but did ok. When they work on your throat like that you can eat and swallow, it just takes awhile. They signed me off for eating solid foods before I left the hospital. My wife had a good laugh at me in San Fran when it took me 45 mins to eat a sandwich. Some things I would recommend avoiding. Ice Cream, regardless to what Bill Cosby used to talk about it hurts to swallow it. I wouuld avoid anyhting with ice in it to drink, avoid carbonated soda, alcohol. I even drank glasses of warm water with dinner and it helped immensely. Good luck with the surgery. I don't use CPAP anymore, I do use a "Snore Guard" from a Dentist which helps keep my jaw pulled forward while sleeping, it's been so good to travel without a CPAP in Airports. Best of luck with your procedure. -
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