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Operation on turbinates question that Kath asked me to post after having trouble posting it herself:

I am on APAP and still having between 5-10 AHI. I was referred to an ENT Surgeon (thank to advice Dr Parks gave me personally). The ENT surgeon said my nasal breathing will be restricted due to large/swollen turbinates. I'm on the list for what the surgeon described as SMD surgery - to reduce the size of the turbinates. Has anyone had this surgery as I'm hoping it will improve my CPAP therapy when it's done? I'm due the operation within the next 12 weeks, but have been told I need to stay overnight on the High Dependency Unit (am in the UK so am not sure if you call it that there). It means I have to stay overnight and have one-to-one care due to having OSA. They said they daren't take any chances with the anaesthetic. Is this normal too? I'd appreciate any help anyone has to offer.

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This type of surgery can certainly improve your nasal breathing and make life much better. It is a common surgery because people like the results.

I had a similar surgery and am enjoying the new "freeway" in my nasal passages every day and night.

The surgery is not likely to cure anyone of sleep apnea. With sleep apnea, the blockage is usually in the area of the back of the tongue and the soft palate.

It is good that they will give you one-on-one care during recovery. The attendant will closely monitor your breathing and is there to prevent oxygen desaturations and pulse spikes.

Relax and look forward to the good results after the healing.
Thanks Rooster. It would be great if I could experience the new 'freeway' you describe. I've been a mouth breather all of my life, and even if/when my nasal passages are clear I doubt if I could re-train my body to keep my mouth shut lol, in order to change to a nasal mask. It might help me be able to use my favourite Hybrid mask though more often. I'm not expecting a cure from apnea though, as they think the cause for my OSA in due to my large soft palate.
Thanks for the quick response - I feel better already :)
Yikes - got a call today to say operation's on the 5th Aug. So much for 12 weeks, so I'd better get my 'head around it.' LOL! Will report back to let you all know if it's successful and makes the CPAP treatment better.
Yes, I shall report back on here to you all. I've been watching the discussion you've contributed to on the REM one and am hoping that with clearer nasal passages (hopefully) the pressure on my apap won't have to be so high. I've had to put a cap of 15 on it, as it blows to maximum at whatever I set it at, and it's not my machine as I've tried 2 others - the Resmed S9 and the Fisher Paykel Icon. I don't have many leaks so that's not my issue! Fingers crossed to see the difference after the op!

j n k said:
That is one of the very few surgeries I would actually consider for myself. Looking forward to hearing how it goes for you.
Sorry for the delay in getting back to you 'j n k' but I've had a very busy few days. However, I appreciate your comments and agree with you. I got the APAP thinking it would be a good way to test the products I sell to see if they actually improved things. Getting the APAP was when I realized something was wrong and the hospital were concerned at my AHI and especially the high pressures. They gave me a Titration Study and discovered snoring was coming from the upper airways, which is when I was sent off to the ENT doc. I set the minimum + maximum pressures closer together to help, as strangely the pressures were going sky-high even before I was asleep. They're hoping this turbinates op might help things. I shall definitely report back, and it might encourage you (if the news is good) to stop being a chicken - LOL. (Says me who's already nervous!).
Oh crikey, you've just reminded me. He did tell me to try that on a short-term basis - I've just found it on a piece of paper he'd scribbled it down on. So much for CPAP restoring brain tissue....or maybe it's because I'm juggling too many balls in the air LOL. Thanks for the prod!!

He did also tell me that a lot of dr's go for the deviated septum operaton (which my own daughter had, and she still has dreadful nasal stuffiness). He pointed out that a lot of people have deviated septums with no problems. Interesting....

j n k said:
I do not want to misquote the good doctor, but recently I believe I heard a highly respected ENT surgeon say that part of his way of telling if a patient is likely to benefit from turbinate surgery is to have him or her use Afrin (or something like it) for a few days to see if that helps, since that would basically show (temporarily) what turbinate surgery is meant to accomplish for the patient (permanently). In other words, short-term Afrin can be a diagnostic tool to tell what turbinate surgery would accomplish for the patient.

I am just a patient, myself, though, so I may have misunderstood his point.

I will always be a big chicken, but your experience may convince me, so be sure to report it.
Wow, thanks for this reminder too. I remember watching this a while ago from Dr Parks (my hero). Do you want a job as my secretary? Lol! Seems like him and my ENT are on the same thinking wavelength too. By the way I have everything the video talks about, as well as a large soft palate. No weight problem though, and I'll be pleased when people stop blaming weight for OSA. Of course it's a factor, but so are many other things! Besides - which came first, the chicken or the egg?

j n k said:
Again, I'm just going from memory, but I belive the ENT surgeon I heard speak made the point that many factors come into play as far as which patients might benefit most from septum surgery. One factor, for example, may be whether the nostrils tend to collapse.

http://doctorstevenpark.com/the-deviated-septum-myth-2
LOL! Be back to this discussion after D Day - 5th August - Yikes!!

j n k said:
Kath Hope www.hope2Sleep.co.uk said:
. . . Do you want a job as my secretary? Lol! . . .

I had assumed you had already hired me on. I'll be watching the post for my cheque. ;-)
Hi All - I'm Back after the surgery. Firstly, a message to j n k: - "you don't need to be a chicken (lol) as there was nothing to the operation - it's 3 days after the surgery now + I have absolutely no pain whatsoever."

It was SMD performed via laser. The only pain I experienced was a couple of hours later when I felt the general anaesthetic leave my body, but a couple of painkillers + anti-inflammatories sorted that, and I didn't need any more. There was only a bit of blood for the first 2 days when I carefully blew my nose.

Early observations are that for the past 2 mornings I've woken up with the CPAP on with NO nasal blockages, which in itself is rare. I find this remarkable, bearing in mind the surgeon said I may not notice the difference for about a month. I'll report back in a month, just in case it helps anyone else considering this surgery. I was also told by the surgeon that sometimes the problem can return, and if that was the case, then I'd need the next stage surgery (I think he said to cut out the turbinates).

The only problems I had was that the hospital didn't know how to deal with a patient on CPAP on the first night when I tried to use it, but that's another story....... they did take me off the CPAP and put me back on the monitor, but my SATS levels kept dropping everytime I went to sleep or even dozed, triggering the alarm. Due to this, I'm now having another sleep test tomorrow to check that I haven't got central apnea as well.

Hope this helps someone :)
Kath, I'm glad everything went well with the operation, and hope you continue to have the lack of nasal conjestion. When you feel up to it please give us a blow by blow account from admission to discharge for those who are scared of any surgery, especially regarding the nose though which we have to breathe.

May those turbinates not grow back! LOL.
Mary Z.

Kath Hope www.hope2Sleep.co.uk said:
Hi All - I'm Back after the surgery.

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