Recovery from UPPP surgery

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Postby psrumors » Sun Apr 18, 2010 8:02 am

Allan I am sure it will be fine. Between surgery and the meds your body just has to heal but better to check and be safe.

I think you had the same issue as I, a big fat uvala. If this is in fact what was causing the issue as seems to be in my case, I don't see how it can return unless you have a uvala transplant. :lol:
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Postby AllanInPA » Sun Apr 18, 2010 5:40 pm

psrumors,

Thanks, I am greatful that the uvula and tonscils are NOT things that regenerate like the liver! :-D

Yes, I have a uvula that routinely laid on my tongue and on occasion triggered my gag reflex - always nice in a social setting! :-) I am pleases so far with the results. The incision on my neck (from the hyoid bone advancement procedure) is a little tender today (discovered this as I tried to button my shirt to put on a tie).

I am confident that all the meds I was on has had an affect and that nothing abnormal will show up on the scan. If it does, then I will deal with that and will have an excuse to use when I "forget" to do something I told my wife I would do! :-) I just hope they find a brain, my wife swears that I may have had a lobodimy, we will see...

Have a great week
Allan
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UPPP Survivor!!! 03/16/2010

Pre-surgery: AHI=47 ResPro C-Flex (12/6) + w/Humidifier (3) FlexFit 431 Full Face
Post-surgery: Stay Tuned...
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Six weeks post op

Postby AllanInPA » Sat May 01, 2010 8:26 am

Yep, it has been 6 weeks since surgery. Overall things are great, only remaining side effect is the feeling that something is stuck in my throat after eating. ENT says everything has healed perfect and what I am feeling is the scar that should gradually go away. It is not a big issue, just something different.

CT scan shows I do have a brain! Neurologist said "you have a good looking brain". She has ordered an MRI just to make sure since she finds the sudden change in vision (just before surgery I noticed this), my violent and confused reaction when waking up after surgery, and my inability to type well when I got back to work "interesting". All of these issues have since gone away, but she is saying that the meds should not have caused all of this. Just wants to be sure. Good news is I do not have alzheimers (I am only 46 and would have been the youngest patient she ever saw with that).

I continue to feel better rested (when I allow myself more than 4-5 hours sleep a night) in the morning and I am not snoring, so what I was looking for has been realized. Sleep study in a month... will be interested to see the numbers.

Allan
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UPPP Survivor!!! 03/16/2010

Pre-surgery: AHI=47 ResPro C-Flex (12/6) + w/Humidifier (3) FlexFit 431 Full Face
Post-surgery: Stay Tuned...
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New Guy

Postby xjarhead50 » Tue Jul 13, 2010 3:22 pm

Hi, everybody! Just wanted to introduce myself. I'll be going through with the UPPP, Toncilectomy, and deviated septum repair next week.
I'm glad this thread is open since the other one was closed.
I have an AHI of 9.7, so I have somewhat mild apnea. I've had a biPap machine for aver a year. Pressures of 11/21 if I remember correctly. Iv'e logged just 120 hours due to initial pressure being to high and not allowing me to geto to sleep. I can ramp it down to 4 starting, but as soon as it goes back to 11 it wakes me up.
I go under the knife on thursday 22 July. So wish me luck. If I survive I'll post my pain and suffering here. :-(

TJ
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Postby AllanInPA » Wed Jul 14, 2010 6:30 pm

Good Luck TJ...

You will hurt, but you WILL live! I just received my new set of numbers from my ENT.

DOC >> "You are apparently a success"
ME >> "Tell me something I do not already know"
{laughter....}
DOC >> "Before the surgery your AHI was 44.9 - severe OSA, after surgery it is now down to 20"

Anything more than 50% is supposed to be really good, and these numbers can be brought down further by doing something else. Gonna think about that.
Bottom line is my numbers are WAY down and my sleep is noticeably better with MUCH less snoring!

Let us know how you fare.
Allan
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UPPP Survivor!!! 03/16/2010

Pre-surgery: AHI=47 ResPro C-Flex (12/6) + w/Humidifier (3) FlexFit 431 Full Face
Post-surgery: Stay Tuned...
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Postby xjarhead50 » Thu Jul 15, 2010 10:54 pm

thanks Allen, Do you still have to use the mask? I'm hoping I can get away from the mask requirement. Any way this time next week will be day 1. Not looking forward to it

TJ
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Postby Vicki » Fri Jul 16, 2010 2:39 am

An AHI of 20 is moderate sleep apnea, so yes Allan still needs to use a CPAP . A UPPP "success" is considered a reduction in AHI of 50%. To cure moderate to severe sleep apnea, a multiphasic, surgical approach is usually required following the gold standard in U.S. sleep disorders, Stanford's, surgical protocol. Or, under the guidance of a dentist who specializes in dental sleep medicine, OSA still in the mild to moderate range might be compensated with a dental appliance.

Vicki
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Vos Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
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Postby xjarhead50 » Fri Jul 16, 2010 11:52 am

Thanks for hte reply Vicki. I've tried a couple dental devices to no avail. I've had 4 sleep studies conducted and one was to confirm the fact that I have mild apnea AHI 9. Two were to determine what type of machine I needed. I ended up getting a BiPap. Pressures of 11/21 I think. My last sleep test was conducted to see if I had any improvement with the machine. The test indicated my numbers were not improved.

I'm a military pilot, currently grounded for this condition. If I cannot find someway to improve this condition I will loose my authorization to fly in the military and my authorization to fly anything civilian.

I'm convinced this is the only chance I have to get back my career and ability to support my family. I'm not real comfortable with the having the surgery, but I feel I have no choice.


TJ
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Postby xjarhead50 » Tue Aug 10, 2010 3:45 am

Well the deed is done. Had the surgery on the 22nd at 1145. Woke up at 1300. To my surprise I had no trouble breathing through my nose. Pain wasn't bad thanks to my new friend and soon to be enemy morphine.
Spent the night in the hospital for observation. The night after the surgery was OK as far as pain, but that would soon change. the nurses came into my room around 3 am shaking the hell out of me to wake me up. Scared the !@#! out of me. They told me the cardiologist was on his way to come see me. Apparently the morphine caused my heart rate to drop to 20-30 bpm along with cardiac pauses of 2-3.5 seconds.
He changed my meds to 5-325 percosets. He told me that if the same thing happened with this drug they were going to have to consider putting a pace maker in to regulate my heart rate. They took and EKG, ECG, blood tests and a couple other test to determine if I had damaged my heart.
My new friend percoset was the ticket for pain and my strange heart rate but now I had a new problem. I couldn't sleep cause I felt I could't breath properly when I started to fall asleep. So back for new meds. this time i got Vicodin. This helped but I still only got about 30 mins of reasonable sleep per 5 hours.
The only days I had problems with pain was day 4 and 5. I got behind on meds but i twasn't as bad as I thought it was going to be.

I'm currently on day 18 post surgery. Nose is healing alright despite my best efforts to sneeze it off. Caught a cold about 3 days ago. Throat is all of a sudden starting to have more pain, been off meds for 4 days, and is also getting more white "stuff" on the wound, kinda like strep on steroids. I'm going to have to use the pain meds tonight to sleep. Hope I haven't damaged anything with the sneezing and coughing.

Anyway, the procedure was not near as bad as I thought is was going to be. Not sure if it helped yet. I have a follow up on the 20th of Aug. Then a new sleep study in a month or so. I'll come back and post my results.

My opinion the hardest thing about this procedure was the lack of good sleep and not being able to eat any food for 9 days. I lost 22 lbs and so far have kept 18 of them off.

Thanks TJ
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Postby tsheff1 » Sun Aug 15, 2010 7:24 am

Hi, I'm new too. Wednesday I'm having my UPPP. I hate sleeping and when I sleep it makes me soooo tired! I have a 'sleep related breathing disorder', not apnea. Basically I never go into a deep sleep. My throat closes, I can't remember everything and don't have my papers here. They used bipap because they said it closed both in and out. They had to keep constant pressure to keep my airway open and it seemed to make my sleep worse and I gave up on it! I found this other doctor and he said the UPPP should help gibve me my energy back. H?ate being tired allllll the time! I am very nervous about this surgery. I've had many other surgeries, but just on hands, elbow, knee, shoulder... oh my...LOL Anyway, this is the only one making me so very nervous at the thought of not getting air during and after surgry. I'm probably exaggerating but...
I'm also a juvenile diabetic but I have a pump so not eating is ok for me!
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Postby xjarhead50 » Wed Sep 29, 2010 3:55 pm

Just had my post OP sleep study. I'm not very happy either. My AHI score was a 9.7 with very mild central apnea events, this to my understanding is very mild apnea. My new score is 110 with severe central apnea events. How the hell can this happen? How can I get worse after getting the surgery? This was probably my last option to keep my military flying career. Now I'm screwed!

My wife says I don't snore any more and she doesn't notice any breathing pauses and I wake up in the morning feeling much more rested than before the surgery. Could the test be screwed up? My Dr is trying to get tricare to pay for another sleep study to confirm or dispute the results.

Does anybody have any insight into this. I sure hate to think I had this surgery only to get worse.
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Postby msla » Wed Sep 29, 2010 5:53 pm

An apnea review article I read 7 years ago did state that a reduction of symptoms by 50% was considered a success and that, as I remember it somewhere between 40-60 % of the surgeries were successful. My ENT wanted to do surgery and was somewhat put off when I replied, "No thanks." He said, ominously, I would have to use the machine always. I said "OK." The odds reminded of something similar to the house odds in Vegas. :twisted:
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Postby Pstar » Fri Oct 01, 2010 12:40 pm

xjarhead50 wrote:Just had my post OP sleep study. I'm not very happy either. My AHI score was a 9.7 with very mild central apnea events, this to my understanding is very mild apnea. My new score is 110 with severe central apnea events. How the hell can this happen? How can I get worse after getting the surgery? This was probably my last option to keep my military flying career. Now I'm screwed!

My wife says I don't snore any more and she doesn't notice any breathing pauses and I wake up in the morning feeling much more rested than before the surgery. Could the test be screwed up? My Dr is trying to get tricare to pay for another sleep study to confirm or dispute the results.

Does anybody have any insight into this. I sure hate to think I had this surgery only to get worse.


1-A month post-op is way too soon to do a follow up sleep study. You probably still have inflamation from the surgery. I was just starting to get off the cpap after a month following my surgery.

2-Did your Dr. address any air restrictions with your nose, and even more importantly, your tongue?

FYI, there is a new proticol that is being tested that EVERYONE who is undergoing apnea surgery should insist they have. In addition to having the optical scope down the nose pre-surgery, fiberoptic examination with Muller maneuver, they are now scoping the airway as they put you under before the UPPP surgery gets started. The patient authorizes the Dr. to conduct one or more tongue base surgeries depending on what they see through the scope when you are sedated and sleeping. The surgeon can see first hand what areas of the throat are causing obstructions which is much more effective than the "awake" test with the scope. I've long thought the erratic succuss rate with surgery was due in large part to the poor diagnostic procedures carried out by the Dr. I highly recommend EVERYONE who will undergo UPPP surgery pick a surgeon who will do this test in a sleep state. Further, your surgeon should have the expertise to do a tongue advancement, hyoid advancement etc and be willing to do these extra tongue base procedures depending on the outcome of the sleep induced scope. IMO, this is a very exciting new diagnostic procedure that all folks who are considering surgery should be aware of...

"...a major goal of surgical upper airway evaluation in OSA is determining the pattern of obstruction. The authors of the largest meta-analysis of surgical treatment of OSA wrote that the failure to identify and treat all levels of airway obstruction was the principal factor in not achieving optimal surgical results.1 A Cochrane Collaboration review of surgical treatment for OSA indicated that determination of the site of obstruction should be a major focus of research efforts in sleep-disordered breathing.4 Techniques that are most commonly used to characterize the pattern of obstruction utilize specific components of physical examination,2 awake fiberoptic examination with Muller maneuver,5-7 and lateral cephalometry.6 Because they are all performed on the awake patient and because most also provide a static rather than dynamic evaluation, they may not be ideal methods to assess the behavior of the upper airway during sleep.Drug-induced sleep endoscopy (DISE) avoids these drawbacks and provide a more accurate evaluation of the upper airway."
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Postby AllanInPA » Mon Dec 13, 2010 7:11 pm

Hey, I am back...

Xjarhead... have you had another sleep study yet. I agree that 1 month is way too soon, there would have been residual swelling and as my doc says "loose stuff hanging around" that will definately impact a sleep study. I am curious to see if your numbers have changed.

Eventhough my numbers were cut down to 20, I am still a candidate for other procedures. My ENT has recommended having a genioglossus advancement procedure. He says this could cut my numbers as much as another 50%, which would put me in the mild range. I have started to snore again, due to my tounge collapsing he says, which is irratating to me. I cannot make a fake snore sound, so it must be the tounge. I hope this takes care of the snoring problem.

Anybody have a genioglossus advancement procedure? I am curious about the recovery time. I have read you are not suppossed to talk for 3 days... is this true? I sometimes do not listen to my wife for days at a time, but that is another story! :) The doc also says I will not be released until the pain is managed and I can swallow... this cannot be as painful as a UPPP, can it? ANybody have real problems swallowing afterwards?

Thanks
Allan
- - - - - - - - - - - - - - - - - - -
UPPP Survivor!!! 03/16/2010

Pre-surgery: AHI=47 ResPro C-Flex (12/6) + w/Humidifier (3) FlexFit 431 Full Face
Post-surgery: Stay Tuned...
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one month after uppp surgery

Postby charles.damilola » Tue Dec 14, 2010 9:16 am

I am charles from Nigeria. I am not suffering from Apnea but I snore loudly. I met with my doctor who checked me and after some preliminary tests booked me for upppn with the tonsilictomy and a nose job.

The pain was horrible 5 days post op and went till the 8th day, its a month after now and I recorded my sleep yesterday night and to my horror, I snored. I am so depressed. Is this supposed to happen @ this stage of post op? Someone please enlighten me, I am not due to see my doctor till a few days time
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