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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.

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Does anyone have the success rates for this surgery regarding apnea?
If you need braces as well as surgery, they no longer wire your jaw shut. they rubberband it together at that point. This of course is a lot more comfotable and easier to deal w/ if you need to cut the rubberbands.
Oh my god, I also had perfectly healthy teeth pulled when I was 12 thinking I had "too many teeth", then braces to fill in the gaps. It completely changed my jaw, by pushing my teeth back, and by 20 years old, I was hurting badly. I also had a highly stressful event in my life about 12 years old as well, so that added to the jaw clenching and pain. Add to the event, I stopped sleeping due to anxiety, about 2-4 hours of sleep/night. All adolescents must have lots of sleep to grow and repair their major changes in life at this age. I have not, since that time, 40 years ago. I am experiencing much damage to my body, with painful joints and connective tissue pain, tight muscles and cramping. I have lost a long time marriage to the love of my life because of this. Struggling with depression and anxiety, little sleep and all that that causes, all the different meds and their side effects, plus diagnosed with not only the above but bipolar, and ADHD too, and those meds, and side effects. Now those cause anxiety and depression! Poor memory, difficulty in learning new information, concentration, disorder, creativity non existent, you name it. On top of it all, I was told I had TMJ, of course, and had braces for 6 years, yes 6, to get ready for the jaw surgery. The four spaces where my teeth were removed was opened up, so the teeth were pulled forward, getting ready for the surgery. I had my suspicions that this was not a resolution, but I was also going through the loss of my marriage, so I could not think straight, of course, I wasn't sleeping and filled with anxieties! I was also told I would get implants to replace the teeth that should never have been pulled in the first place. I was told right before surgery that I may experience some problems of nerve damage, etc, two full pages of potential problems. I was so frightened and didn't listen to my gut reaction screaming to not go through with the surgery because I worked with the surgeon for years by then. I wanted to throw up. I also had insurance coverage and with a divorce I didn't know what was to happen in that department. It didn't occur to me that I could cancel the surgery. Now that is stress. Upon awakening from surgery I had severe nerve damage, that is only partially alleviated, and the lower teeth/jaw is pulled too far forward, or, should never have been done at all. Now I have the opposite problem, lower teeth jamming into my upper teeth from behind, causing so much pain in my face all over. And still, only about 4 hours of sleep, with sleep medication, and the side effects. And, because of long term braces, I have not only loss of bone and can no longer have implants (!) I have these gaps, with false teeth on my retainer, AND I have loss of gum as well. I broke my jaw during the few months after surgery too, so that caused further problems. On top of that, my orthodontist told me after surgery that he thinks he could have solved the TMJ with orthodontia alone! OMG! Why didn't that team tell me? If they did, I sure didn't hear it, as I was distressed with divorce. What a mess, and I am miserable in pain, little sleep, heart broken, crazy feeling, suicidal half the time, even though I have a genius IQ, one would never ever know! I cannot get or hold a job because of this. I do not know what to do now, I am desperate for sleep, and to have a good bite, without pain. My entire face hurts now, not only the jaw, again, but my teeth, cheekbones, and eye sockets. It is like the entire face is nauseous in pain, and it is a barrier separating me from the world. Depressing, and with anxiety, again. What can be done? I am exhausted and cannot get much done. I live in the SF north bay area, and have health insurance, a good one, with cobra, through the end of the year, then I don't know what I am going to do. Debilitating in every way. Any ideas? Much too much to deal with, and I never succumbed to drink or drugs, thank god. I just want to be a good member of society, with a somewhat normal life! Thank you so much for any help or suggestions.

sandman said:
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.
Oh my god, I also had perfectly healthy teeth pulled when I was 12 thinking I had "too many teeth", then braces to fill in the gaps. It completely changed my jaw, by pushing my teeth back, and by 20 years old, I was hurting badly. I also had a highly stressful event in my life about 12 years old as well, so that added to the jaw clenching and pain. Add to the event, I stopped sleeping due to anxiety, about 2-4 hours of sleep/night. All adolescents must have lots of sleep to grow and repair their major changes in life at this age. I have not, since that time, 40 years ago. I am experiencing much damage to my body, with painful joints and connective tissue pain, tight muscles and cramping. I have lost a long time marriage to the love of my life because of this. Struggling with depression and anxiety, little sleep and all that that causes, all the different meds and their side effects, plus diagnosed with not only the above but bipolar, and ADHD too, and those meds, and side effects. Now those cause anxiety and depression! Poor memory, difficulty in learning new information, concentration, disorder, creativity non existent, you name it. On top of it all, I was told I had TMJ, of course, and had braces for 6 years, yes 6, to get ready for the jaw surgery. The four spaces where my teeth were removed was opened up, so the teeth were pulled forward, getting ready for the surgery. I had my suspicions that this was not a resolution, but I was also going through the loss of my marriage, so I could not think straight, of course, I wasn't sleeping and filled with anxieties! I was also told I would get implants to replace the teeth that should never have been pulled in the first place. I was told right before surgery that I may experience some problems of nerve damage, etc, two full pages of potential problems. I was so frightened and didn't listen to my gut reaction screaming to not go through with the surgery because I worked with the surgeon for years by then. I wanted to throw up. I also had insurance coverage and with a divorce I didn't know what was to happen in that department. It didn't occur to me that I could cancel the surgery. Now that is stress. Upon awakening from surgery I had severe nerve damage, that is only partially alleviated, and the lower teeth/jaw is pulled too far forward, or, should never have been done at all. Now I have the opposite problem, lower teeth jamming into my upper teeth from behind, causing so much pain in my face all over. And still, only about 4 hours of sleep, with sleep medication, and the side effects. And, because of long term braces, I have not only loss of bone and can no longer have implants (!) I have these gaps, with false teeth on my retainer, AND I have loss of gum as well. Surgery was a complete failure, and absolutely unnecessary, I don't care what the surgeon says, as he is very defensive. What a mess, and I am miserable in pain, little sleep, heart broken, crazy feeling, suicidal half the time, even though I have a genius IQ, one would never ever know! I cannot get or hold a job because of this. I do not know what to do now, I am desperate for sleep, and to have a good bite, without pain. My entire face hurts now, not only the jaw, again, but my teeth, cheekbones, and eye sockets. It is like the entire face is nauseous in pain, and it is a barrier separating me from the world. Depressing, and with anxiety, again. What can be done? I am exhausted and cannot get much done. I live in the SF north bay area, and have health insurance, a good one, with cobra, through the end of the year, then I don't know what I am going to do. Debilitating in every way. Any ideas? Thank you so much!

sandman said:
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.
If folks live in the Bay Area and are interested in talking to me face to face about questions regarding the surgery or recovery, I'd be happy to meet with you. You can also start with the blog I kept immediately before and following the surgery for an overview:

http://harddaysbite.blogspot.com/

Sha, sky_shannon@yahoo.com

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