Recovery from UPPP Surgery

This is the forum for off topic discussions.


Recovery from UPPP Surgery

Postby FredL » Wed Nov 22, 2006 12:51 pm

I had a sleep study done due to extreme daytime drowsiness. I was subsequently diagnosed with severe obstructive sleep apnea, and two of the resulting recommendations were CPAP and UPPP. I started out with the CPAP machine as it's obviously less invasive. However, it was so incredibly annoying I ended up not being able to use the thing (and, yes, I certainly did try!); for me, it was intolerable.

I went back to my ENT doctor, and he said that I was a good candidate for UPPP, so he scheduled me for UPPP and a tonsillectomy. My question is this: what kind of time frame should I expect for recovery, that is, not being able to return to work? I was given anywhere from 2 to 4 weeks, and I was hoping to get some feedback as to whether it might be closer to 2 weeks or 4 weeks. Thanks!
Last edited by FredL on Wed Nov 22, 2006 1:04 pm, edited 1 time in total.
FredL
 
Posts: 1
Joined: Wed Nov 22, 2006 12:34 pm

Postby BARBCCRN » Wed Nov 22, 2006 1:01 pm

Fred-do lots of research and your homework before consenting to UPPP surgery. It has a VERY LOW success rate. I personally know of 2 people who have had it done and they say it was the worst pain they ever had and the first 4 weeks were HELL! Both actually still need to use CPAP(though pressures are now lower) but both say they would never do UPPP again if they had to do all over again
EVERY SILVER LINING HAS A TOUCH OF GREY
-Grateful Dead
User avatar
BARBCCRN
 
Posts: 1480
Joined: Tue Nov 15, 2005 5:54 pm
Location: Las Vegas,baby!

Postby Bearded One » Wed Nov 22, 2006 1:15 pm

I don't recommend UPPP. I had UPPP with tonsillectomy and I was out of work for 10 calendar days; take Friday and the next week off, your mileage may vary. UPPP is usually not very effective, any improvements are not usually permanent, can have serious permanent complications, and can increase your required CPAP pressure. Ask your surgeon to explain the numbers that he uses to define successful surgeries, you may be surprised at what constitutes a "successful" UPPP surgery.
User avatar
Bearded One
 
Posts: 2961
Joined: Mon Oct 02, 2006 1:03 pm
Location: Virginia

Re: Recovery from UPPP Surgery

Postby Daniel » Wed Nov 22, 2006 1:56 pm

FredL wrote:I had a sleep study done due to extreme daytime drowsiness. I was subsequently diagnosed with severe obstructive sleep apnea, and two of the resulting recommendations were CPAP and UPPP. I started out with the CPAP machine as it's obviously less invasive. However, it was so incredibly annoying I ended up not being able to use the thing (and, yes, I certainly did try!); for me, it was intolerable.

I went back to my ENT doctor, and he said that I was a good candidate for UPPP, so he scheduled me for UPPP and a tonsillectomy. My question is this: what kind of time frame should I expect for recovery, that is, not being able to return to work? I was given anywhere from 2 to 4 weeks, and I was hoping to get some feedback as to whether it might be closer to 2 weeks or 4 weeks. Thanks!


Fred,

Just to reinforce the posts of Bearded One and Nancy, the numbers are stacked against you with the UPPP. Whatever about mild apnoea it is completely ineffective with severe apnoea.

I think all ENTs use the phrase 'a good candidate for UPPP'...........regardless. I was told that too........in Ireland, must be part of their 'bedside manner' :lol:

As you are an adult and capable of making your own decisions I won't rant on about UPPP, but please ask your ENT the following questions:

1. Is UPPP a recognised first line treatment for Severe Sleep Apnoea and is it included in the clinical guidelines of the AASM (American Academy of Sleep Medicine).
2. What constitutes a surgical success in the treatment of OSA.
3. What are the possible surgical complications and the possibility of you being affected.
4. Is the surgery reversible, and what is the probability of OSA returning within 5 years of the surgery.

If he answers you truthfully, I don't think you will bother with the procedure.

Best of luck.

Daniel.
The untreated Sleep Apnoea sufferer died quietly in his sleep..
Unlike his three passengers who died screaming !


The first 40 years of childhood are by far the hardest
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

"Limited" UPPP

Postby Danny » Thu Nov 23, 2006 10:35 am

What causes the risks in a UPPP over just tonsils? I am scheduled to have my tonsils, adenoids ( if present ) removed on the November 30th. After explaining my concerns with a UPPP to my ENT we have agreed to take out the tonsils and stitch the flap? and snip off the uvula, not going into the soft pallete. Is this less risky?
Danny
 
Posts: 64
Joined: Thu Mar 30, 2006 8:13 pm
Location: Richmond, VA

Postby painless » Thu Nov 23, 2006 1:32 pm

FredL

If you have severe OSA, then UPPP probably isn't gonna help much. There is only ONE surgery that is 100% effective - a Tracheostomy. This is not, in fact, highly recommended for treating OSA. You can understand why.

Our stand is this: List your problems to us, and we try to offer help to help you correct problems, adjust attitude, or fix whatever the problem is.

CPAP/BiPAP is actually the best treatment for OSA, some people just take longer to convince themselves they need it, it is working, and they like the difference in how they feel. This has to be your focus, it is going to help you, not "I'm inconvenienced by this machine that I hate."

Give it time, give us a challenge (we kind of like them) let us help. That's why we're here.
painless

Sleep Apnea is a Killer! Get it Tested!
Get it Treated! Use the Treatment!
painless
 
Posts: 354
Joined: Sat Aug 26, 2006 10:49 am
Location: Jackson, Mo

Postby hhopper » Thu Nov 23, 2006 1:43 pm

My doctor told me about UPPP Surgery but recommended against it because the success rate is so low.
Image

Acronyms and Often Used Forum Phrases
Respironics? M-Series Auto w/ HH & C-Flex; Flexfit? Hybrid? Mask, Encore Pro 1.8i
User avatar
hhopper
 
Posts: 1275
Joined: Wed Nov 22, 2006 1:34 pm
Location: Tarpon Springs, FL

Re: "Limited" UPPP

Postby Daniel » Thu Nov 23, 2006 5:38 pm

Danny wrote:What causes the risks in a UPPP over just tonsils? I am scheduled to have my tonsils, adenoids ( if present ) removed on the November 30th. After explaining my concerns with a UPPP to my ENT we have agreed to take out the tonsils and stitch the flap? and snip off the uvula, not going into the soft pallete. Is this less risky?


Danny,

I think the procedure being suggested is a uvulectomy along with tonsils and adenoids being removed.

Has he given you any reason for 'snipping the uvula' ? Or is it a case of it's there 'hanging', and as I'm going to be in the vicinity why not hack it out :lol:

Risks with the UPPP...........include change of voice tone/pitch, regurgitation of liquids and some foods through the nose, disimprovement in the severity of your apnoea, ongoing pain and a few more that I just can't think of at the moment.

Any surgery, whether to the upper airway, or anywhere else is very risky...........the risk of leaving the soft pallet out of the equation is minimal.............however the liklihood of success is not good. Why ENTs persist with it I do not know.

Only today I spent 45 minutes (on the phone) talking to an OSA sufferer, diagnosed moderate (AHI 28) last July. Had a UPPP with tonsillectomy and adenoidectomy in August. Had a sleep study earlier this month and is now into night 2 with CPAP. His AHI has moved to 29 within 3 months of surgery........and he is pretty pissed off. He works for a large corporation and has been off work for the last few months. He is fearful for his job. He initially went to an ENT, but is now attending a respiratory sleep specialist.............unfortunately I have been there, done that and have the T shirt :lol:

I admit to being anti surgery............but unfortunately this case is only one of many that I am involved in picking up the pieces.

Be very careful..........the surgery you propose is not reversible.

Best of luck.

Daniel.
The untreated Sleep Apnoea sufferer died quietly in his sleep..
Unlike his three passengers who died screaming !


The first 40 years of childhood are by far the hardest
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

Postby Danny » Fri Nov 24, 2006 8:49 am

Thanks for the responses

I have been 100% CPAP compliant sine February of 06 on a pressure of 18 cm

my throat is almost completely closed due to tonsils and uvula, making things difficult in the daytime as well as at night, my sinus's wont drain and I have aer problems due to fluid in the ears. I went to an ENT 9 months ago, unaware that I had OSA to get some releif from these symptoms

I have to use a full face mask because of these issues, and I have to adjust the mask all night to get it to seal, the 18cm of air really gets along well with the fluid in my ears. The last thing I need is an additional problem from a UPPP, but feel I need to do something to improve the situation. This is why I am leaning towards only the work above (leaving the soft pallet alone)

I need to have my septum and turbinate work done and the ENT feels he needs to do the throat 1st to make more room as I will not be able to use the CPAP for a while after the sinus work.

If I just get my pressure down to a reasonable level and get my head to open up me and my CPAP will be very happy

Daniel, are you saying that leaving the pallet alone decreases the food/fluid out the nose risk? or is it still a big risk with tonsils & uvula
Danny
 
Posts: 64
Joined: Thu Mar 30, 2006 8:13 pm
Location: Richmond, VA

Postby drjayii2 » Fri Nov 24, 2006 9:57 am

They wanted to do the same thing with me...tonsils, adnoids, uvula etc.

I opted for tonsils only. Less risks. Less complications. Not sure if other things would improve effectiveness anyway. Removal of tonsils will not improve effectivness unless your tonsils are big and moving causing the obstruction.

I can say...being 6 days post surgery...........It HURTS like a b@tch!... Simply having your tonsils out is extremely painful.

It is "managable" with meds...percacet or dilaudid(hydromorphone)....but dont plan on doing anything or eathing anything for about (2) full weeks. I believe my surgeon was excellent...and I am still in what I consider "major" pain.

With a less than excellent surgeon...the pain would be almost unbearable. Those are my thoughts.
drjayii2
 

Postby hhopper » Fri Nov 24, 2006 1:56 pm

drjayii2 wrote: Simply having your tonsils out is extremely painful.


I was lucky. I had my tonsils out when I was three. I remember having a sore throat and getting to eat a lot of ice cream and pop cycles. To give you an idea of how long ago that was, I remember a cloth placed over my face and the strange smell of ether! :shock:

I wonder how bad my apnea would be if I still had them in.
:-({|=
Image

Acronyms and Often Used Forum Phrases
Respironics? M-Series Auto w/ HH & C-Flex; Flexfit? Hybrid? Mask, Encore Pro 1.8i
User avatar
hhopper
 
Posts: 1275
Joined: Wed Nov 22, 2006 1:34 pm
Location: Tarpon Springs, FL

Postby Daniel » Fri Nov 24, 2006 3:13 pm

If I just get my pressure down to a reasonable level and get my head to open up me and my CPAP will be very happy


There is no guarantee that your proposed surgery will bring about a reduction in pressure. Reduction in pressure requirement has been reported post op, but it's not a 'given'.

Daniel, are you saying that leaving the pallet alone decreases the food/fluid out the nose risk? or is it still a big risk with tonsils & uvula


Not 100% sure on that one, but to look at it analytically..........the soft pallet is closer to the nose area than the uvula, so I assume that if its left alone there should be a lesser risk.............just my opinion, nothing scientific. I should also point out that it is a recognisable risk factor............doesn't always happen.

Daniel.
The untreated Sleep Apnoea sufferer died quietly in his sleep..
Unlike his three passengers who died screaming !


The first 40 years of childhood are by far the hardest
Daniel
 
Posts: 6006
Joined: Sat Jun 25, 2005 5:49 am
Location: Ireland
Machine: Philips Respironics System One Auto
Mask: ResMed Micro Nasal Mask
Humidifier: No
Year Diagnosed: 1993

UPPP

Postby Guest » Tue Nov 28, 2006 11:57 am

I am 3 weeks post op from UPPP. It was extremely painful for exactly 3 weeks regardless if you think you have a high tolerance for pain. I go back to work tomorrow, my procedure was done on Nov 7. My ENT seems to think it was very successful but I will have to have another sleep study to determine the #s. I lost 17 lbs, which was needed because I was overweight. The liquid diet sucked but it was hard to take all of that medicine on jello and popsicles. You will have to take a antibotic, a steriod and pain meds, all liquids. I cannot tell if I am sleeping better yet or not because I have still been taking hydrocodone every night but I am discontinuing it tonight since I have to return to work tomorrow. But my boyfriend says that no longer snore. Time will tell how successful from a patients point of view
Guest
 

Postby Bearded One » Tue Nov 28, 2006 3:53 pm

Tonsillectomies and sinus/nasal surgeries are pretty well known procedures, have relatively low incidents of complications, and are likely to do you some good. I have no idea what the possible complications of a uvulaectomy are. Somebody has posted a report of the effects of his tonsillectomy, adenoidectomy, and uvulectomy (uvulaectomy) at http://www.jasonplancaster.com/weblog/283.php -- it doesn't sound good.
User avatar
Bearded One
 
Posts: 2961
Joined: Mon Oct 02, 2006 1:03 pm
Location: Virginia

Postby SnickersPie » Wed Nov 29, 2006 12:45 pm

Fred,

I too couldn't tolerate CPAP, and consulted an ENT. My experience seems to be unique. My ENT actually discouraged me from the UPPP procedure. He said that the success rate was low, and most people who have the surgery still need the CPAP. Just my two cents ...
SnickersPie
SnickersPie
 
Posts: 211
Joined: Sat Nov 18, 2006 9:34 am
Location: New Hampshire

Next


  • Site Supporter

Return to Late Night With Sleep Apnea

Who is online

Users browsing this forum: No registered users and 0 guests