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TRACHEOSTOMY BY A QUALIFIED SLEEP DR. JUST FOR SEVERE SA.

I have gone through the gammit with drs. I have had this beast for most of my life, but as I get older (51) everything else is catching up to me , HBP , Deppression, cholesterol, borderline diebetic, overweight. I have tried all the cpap machine with all the different masks. I could not handle it. Then I had a septoplasty. that made things worse. Then came the UPPP with rf tongue, and turbinate reduction. Now it is even worse .( AHI 99 ) All the mucous in the back of the throat, swallowing, etc. I have tried every pill / spray, nothing works. I do use Ambien to help with the insomnia . It just keeps me from staring at the walls. I was consdering an MMA , but after reding more about it I think a thrach might be the best option. I'm getting desperate. If anyone has any names of drs.who are experts in sleep disorders , that understand all aspects of treatment . please let me know. Or have had a trach. let me know the results.

Thanks,
Dave

To add to the UPPP problems. I just got back from the university of Maryland for a consult. I picked up a bug of some kind . I went to the emergency room after returing home for fear I had another epoglotis problem. Now I have bronchitis. With the UPPP it just makes it twice as bad.


Dave

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Perhaps you should try one of the major sleep clinics with worldwide reputations. I'm familiar with Stanford, but there's the Cleveland Clinic and the Mayo Clinic.
Good for you for considering this option. It's the only 100% cure for sleep apnea.

Here are a couple of good places to start.

Dr. Mack Jones is a doctor who has a situation which is very similar to yours. He ended up getting a trach, and is very grateful for having had it done. You can post a message to his "wall" by going to his profile page (you can and should also read everything he has written here about his experiences): http://www.sleepguide.com/profile/MackDJonesMDSAAN

Here's an article I wrote on this as an option that is too often overlooked: Tracheostomy for Severe Sleep Apnea article
Dr. Kasey Li works here in the Bay Area and is one of the most prominent surgeons for sleep apnea in the world. that said, i'm no surgeon, but i bet a trach is a simple surgical procedure. going to someone like Dr. Li for a trach would be like taking a sledgehammer to a nail. then again, he's certainly very familiar with surgical options generally and can advise you well.
A tracheotomy is one of the most basic operations that any ENT / head & neck surgeon can do. In training, this is the first operation that you are taught to perform. There' s no surgeon that specializes in tracheotomy. I'm sure that even Dr. Li doesn't do it that often, since it's not done for this purpose that often. Your ENT should be able to do it, since the technique is straight forward. You just have to get a low profile tube that can be plugged easily. As Mike mentioned, listen to Dr. Jones, the neurologist, whom I interviewed about his views on OSA and Alzheimer's, as he himself underwent a tracheotomy.
Steven Y. Park, MD said:
A tracheotomy is one of the most basic operations that any ENT / head & neck surgeon can do. In training, this is the first operation that you are taught to perform. There' s no surgeon that specializes in tracheotomy. I'm sure that even Dr. Li doesn't do it that often, since it's not done for this purpose that often. Your ENT should be able to do it, since the technique is straight forward. You just have to get a low profile tube that can be plugged easily. As Mike mentioned, listen to Dr. Jones, the neurologist, whom I interviewed about his views on OSA and Alzheimer's, as he himself underwent a tracheotomy.
What about this tubeless trach I read about on some post's . They were nine years ago mentioning a doctor who has since retired , and some one said his student named Dr. Robert Lorenzo took over, but a search turned up he is in the middle east with no mention of the procedure. Did it turn out to never be a viable option? Do you or anyone know any recent info on it.

Thanks,
Dave
j n k said:
I enjoy PAP therapy and highly recommend it.

What is it about it that you "could not handle," as you put it, if you don't mind my asking?

The same reasons many have given. I ended up jerking it off, Always had a hard time breathing out, nose would always clog up, then mouth would dry out. To put it simply, I hated it.
When I started pap therapy I knew that I had to have a positive frame of mind. My mindset is that I will not let anything beat me -- it is something that needs conquered and I will come out on top.

With that mindset I have gotten where I can not sleep without my apap!!

Much easier and much less invasive than a trach.

Good luck in your quest with getting one done. My brother-in-law had one (not because of sleep apnea but other chronic conditions) and I know personally I wouldn't want to go there if other options were available.
Can I ask you why your brother does not like the trach, and does he need it during the day as well?

I think I have done as much as I can with my cpap machine. When I am 100% convinced I will never use it again. I would love to find someone to give it to that may not have insurance , and can't afford one. Of course if I go with the trach That decision will be made.

I am glad it worked for you. Anytime you can avoid surgery is great.

Dave
Dave, your story sounds a lot like Dr. Mack Jones' story. I personally would go with the trach over the MMA myself, if i were in your shoes. After all, my understanding is that the trach is 100% reversible. Given your options, it seems like the best one to me.

Dave Post said:
Can I ask you why your brother does not like the trach, and does he need it during the day as well?

I think I have done as much as I can with my cpap machine. When I am 100% convinced I will never use it again. I would love to find someone to give it to that may not have insurance , and can't afford one. Of course if I go with the trach That decision will be made.

I am glad it worked for you. Anytime you can avoid surgery is great.

Dave
My brother-in-law had one due to other chronic conditions -- not sleep apnea. He had muscular dystrophy and after a bout with pneumonia he had to have one as he was left in a weakened state. He passed away about ten years ago due to the musclar dystrophy, but lived with the trac probably 4 or 5 years. Mother-in-law was constantly on guard for infections, suctioning, etc. He didn't have a choice if he wanted to come home. He would complain that the stoma (I think that is what it is called, but could be wrong) would get sore and irritated at times.

I know from my experience being around him, I would opt for that as only a last ditch resort. Things might have changed in the years since his, but my memories are still strong of his and the associated problems encountered over the course of his last few years.
I would hate much worse having a hole permantly in my throat.

Dave Post said:
j n k said:
I enjoy PAP therapy and highly recommend it.

What is it about it that you "could not handle," as you put it, if you don't mind my asking?

The same reasons many have given. I ended up jerking it off, Always had a hard time breathing out, nose would always clog up, then mouth would dry out. To put it simply, I hated it.

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