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Hi,
I had a nasal sleep endoscopy which involves having a camera put down my nose and then sent to sleep
and then waiting for an apnea to happen and then they can see what is causing it.
I was told that I had three things was causing them.
1/large tongue 2/ soft palate 3/ throat
they said they would not touch the throat but could probable help correct the tongue and the soft palate.
I am due to return for a consultation and have it fully explained to me in the next few week.
Is there any specific questions I should have and have you any other comments on this.
Thanks for any help
Regards joe
Views: 651
Replies to This Discussion
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Permalink Reply by Gillean on
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Since they won't touch the throat, are you still going to have apnea events or will the selected operations open everything up enough?
I am sure you would ask this, but I am honestly curious. Make sure to post what information they share.
Interested in CPAP mask information? Check out this website http://cpapmaskhq.com
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If you are anywhere near Stanford/Palo Alto, Ca see Dr Robert Riley or Dr Powell. They pioneered some of the sleep surgeries, and they are very good. They did several surgeries on me.
The first surgery most get is the UPPP which cures 1/3 of the people, helps 1/3 of the people, and doesn't help 1/3 of the people who get it, or at least that's what I last heard. It helped me.
I had my tongue microwaved six times which didn't help and the seventh time a newbie doctor in the clinic actually paralyzed some muscles on the seventh try causing my pressure to go from 8 to 16. He was fired.
And, then they surgically removed a portion of my tongue down the midline. This made matters worse. A sleep surgeon form Singapore told me that never helps because it makes the tongue slide down the throat more easily.
Drs Riley and Powell are everywhere in the literature. They are "gods" in the apnea field as one sleep doc here in Kansas told me years later.
Get the UPPP for sure, and after that make sure you get very experience surgeons to do any of the other surgeries. My doctors pioneered the big one, the maxillio-mandibular advancement moving the mouth forward. The nurse there told me they do a lot of revisions of other surgeon's work because the advancements weren't aggressive enough. I'm glad I had Dr Riley do mine even though I didn't get optimum results especially because I was the rare bleeder (complicating matters), and sometimes people don't wake up from that. I was already at 911 my cousin's dentist told me when it happened so he may have saved my life.
A man does what a man has to do, so if you need the advancement do it. There is a very high success rate for it.
Always ask how many surgeries the surgeon has done and the results for any surgery he proposes.
Best,
Mike
Regarding your apnea treatment, Before you do anything else ever check this out: http://www.youtube.com/watch?v=h7cbBB1c0IM. Watch all 5 parts. I am fascinated with this. I ran onto it a few months ago. It Could be a game changer in the treatment of sleep apnea (see part 5 of 5 for recommendations). It may already be covered here on sleepguide. I don't keep up.
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Permalink Reply by jim allAn on
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I have the same three problems, but I doubt medicare would cover the surgery. There escape would be it is cosmetic and thus not covered.
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I have heard that the improvement rate for such invasive surgery is not very high. If you cannot simply use CPAP, then you might try oral devices. Most folks who have surgery still end up on CPAP anyway so carefully choose what you do.
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Permalink Reply by Clueless in Redwood Shores on
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My advice: cancel the appointment and stay away from the surgery. I wish I had done so! Incidentally this is now the advice offered by the sleep docs at Stanford.
I was a patient of Drs. Riley and Powell. For me, the UPPP (palate surgery) produced no lasting results other than a significantly impaired sense of smell. The painful radio-frequency tongue ablations shrank the tongue, which led to a relatively clean sleep study afterwards; the apnea returned with a vengeance at some point in the subsequent years.
The whole experience shrank the wallet; Drs. P and R can and charge well above what any insurance company, let alone Medicare, is willing to pay. There is also a significant cost in time and stress (and regret if you enjoy tasting your food or wine).
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Permalink Reply by Jan vanNiekerk t SnoringElephant on
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Please don't go for the op. People has lost their taste.
In a few years, you are back. It is not a long term solution.
We have pictures at our South Africa office of these operations.
I beg you, please get a second opinion?
Kind Honest Regards.
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I also have an enlarged tonsil and seriously considering surgery. I am told that the success rate is average although my doctor said I will have significant improvement. Does anyone have any experience with this? Thanks.
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Permalink Reply by Mack D Jones, MD, SAAN on
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Michael W Gray said:If you are anywhere near Stanford/Palo Alto, Ca see Dr Robert Riley or Dr Powell. They pioneered some of the sleep surgeries, and they are very good. They did several surgeries on me.
The first surgery most get is the UPPP which cures 1/3 of the people, helps 1/3 of the people, and doesn't help 1/3 of the people who get it, or at least that's what I last heard. It helped me.
I had my tongue microwaved six times which didn't help and the seventh time a newbie doctor in the clinic actually paralyzed some muscles on the seventh try causing my pressure to go from 8 to 16. He was fired.
And, then they surgically removed a portion of my tongue down the midline. This made matters worse. A sleep surgeon form Singapore told me that never helps because it makes the tongue slide down the throat more easily.
Drs Riley and Powell are everywhere in the literature. They are "gods" in the apnea field as one sleep doc here in Kansas told me years later.
Get the UPPP for sure, and after that make sure you get very experience surgeons to do any of the other surgeries. My doctors pioneered the big one, the maxillio-mandibular advancement moving the mouth forward. The nurse there told me they do a lot of revisions of other surgeon's work because the advancements weren't aggressive enough. I'm glad I had Dr Riley do mine even though I didn't get optimum results especially because I was the rare bleeder (complicating matters), and sometimes people don't wake up from that. I was already at 911 my cousin's dentist told me when it happened so he may have saved my life.
A man does what a man has to do, so if you need the advancement do it. There is a very high success rate for it.
Always ask how many surgeries the surgeon has done and the results for any surgery he proposes.
Best,
Mike
Regarding your apnea treatment, Before you do anything else ever check this out: http://www.youtube.com/watch?v=h7cbBB1c0IM. Watch all 5 parts. I am fascinated with this. I ran onto it a few months ago. It Could be a game changer in the treatment of sleep apnea (see part 5 of 5 for recommendations). It may already be covered here on sleepguide. I don't keep up.
________________________________________________________________________________
Thanks for the heads up Mike!
Forget surgery and dental devices for the treatment of sleep apnea (SA). They will not and cannot get rid of your sleep apnea. Why is that? Because SA is a neurological disorder due to the malfunction of autonomic neurons within the brainstem that are responsible for maintaining an open airway during sleep.
The best that surgery or oral devices can possibly do is reduce the AHI, but they cannot and will not get rid of the problem altogether. You still have to resort to CPAP or a trach in the end. So save your money, avoid the surgical risks and playing around with the oral devices.
Now here comes Dr Gominak, a neurologist who I believe has come up with what may be worthy of the Nobel Prize in medicine, if her theory turns out to be correct. (I think it has a good chance of being the answer we've been looking for). Get a "vitamin" D blood level and a sleep study done. Begin treating your low D level and stick with CPAP until you don't need it anymore (you'll have to work with your sleep doc on this once he becomes aware of the concept that low D causes the autonomic neuronal dysfunction). How long before you can get off CPAP? Nobody knows yet. We'll have to wait on the studies to get the whole story.
Everyone should follow Mikes advice above and check out Dr Stasha Gominak's youtube discussion.
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Enlarged tonsils can be removed. I do have a problem with cutting on the tongue etc
Scooby said:I also have an enlarged tonsil and seriously considering surgery. I am told that the success rate is average although my doctor said I will have significant improvement. Does anyone have any experience with this? Thanks.
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First question to ask is, "Am I a good candidate for this surgery?" Tonsils and adenoids (when they are causing a problem) are easily removed. A UPPP is good for people who are good candidates. I was such a candidate. My surgery was very successful. However, I had to have more surgeries to correct other issues. (My other issues were in my nose and sinuses.) Eventually I was able to give up CPAP therapy. My ENT said that there was surgery to remove the lingual tonsils (tonsils on the tongue, not the tonsils that are removed in a T & A). He said he rarely recommeded this operation due to the complications. He said that a portion of the back of the tongue could also be removed. He was even more against that operation for most people. He was very much in favor of me having the UPPP. I was very happy that I had it. There are risks in any surgery. They have to be weighed very carefully. With many surgeries, some people have great outcomes and some people have poor outcomes. You have to decide for yourself.
I am thrilled with the results I experienced. Some other people are unhappy.
The two most important things to consider are how good of a candidate you are for the surgery and the surgeon's ability. Remember, any surgery has risks and at least some pain involved. People who tell you that an UPPP is extremely painful were either not the best candidates for the surgery and had less favorable outcomes or did not have reasonable expectations for pain. I did not find the UPPP to be the most pleasant experience, but it was by no means extremely painful.
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