Just had UPPP, Tonsil, Septoplasty, and Turbinate Reduction

[Guest]

Was that pain in specific reference to having your stents pulled out of your sinuses ?

Glad to hear you are otherwise doing well.

Give your dod a big belly rub for me !

Bill (Bill in Seattle)

[artroo]

can i say WOW! i feel like a different person...don't have the formal results yet in terms of a sleep study but i'm no longer getting headaches/pain from getting up in the morning nor am i crashing in the afternoon...i'm actually sleeping about 8-10 hours a night this week (usually only sleep 5-7 as i've beena light sleeper in the past) and am feeling very rested when i get up. i know it's still early but i know i'm breathing better...no longer breathing from my mouth. i'm going in for my follow up in a couple of weeks will keep you guys posted.

[Billinseattle]

Excellent,

It sounds like you've had the desired result ! That is what not having OSA feels like !

Best wishes,

Bill

[artroo]

and i feel great...went in to see the doc and he said everything has healed properly and tightened up. i'm going to do another sleep study in about 2 months but he said that he's very encouraged that we were successful based on the fact that i'm well rested in the mornings and my girlfriend says that it doesn't sound like i'm choking when i'm sleeping anymore. anyway, thanks again for the support and i'll be around.

[Guest]

hey artroo,
any updates? how about your steep study? i'm very interested to know.
i'm chinese also.

Ray writing from HK

[dizzy]

first successful UPPP I've read in several years here. Sounds like the nose job to fix the deviated septum was even more successful. I know it was a relief after I had mine. Glad it worked out for you, but you don't know the results of your post PSG do you.

That will be an interesting read even if it cut it by 50%.

[FordPrefect]

Hey artoo - congratulations! Curious - was the tonsil surgery "cold steel" or one of the alternate ablation/coblation methods?

What was your total recovery time?

Will be going to an ENT abot the tomatoes in the back of my throat, this is all great info for me, thanks for posting your experience!

[Billinseattle]

Ray,

My MMA surgeon from Stanford (who is also Asian) and I had interesting discussions about Asian anatomical predispositions to have OSA. He has actually published several papers a few years ago about this topic. Basically, Asian people have anatomical predispositions to have OSA without being overweight. Fortunately, (or maybe unfortunately) this lends itself better to a surgical "cure." Most typically, the surgical cure doesn't stop with a UPPP...which for most people doesn't address the tongue base...and therfore either is incomplete, or doesn't last very long.

If you are curious search for K. Li and MMA surgery on pubMed, MedSearch or even Google.

Ford Perfect,

From what I've read from Art's posts , it was not an ablation. A tonsillectomy done at the time of UPPP is most certainly done with blade and cautery. A tonsillectomy as an adult hurts more than as a child. If the capsule is spared, there is less pain and less potential for bleeding. Removing the tonsils will help OSA as an adult...but likely not be a "cure." For pediatric patients it can be a cure though. Removing the tonsils will also eliminate them as a step that will always be revisted when considering any future procedures (or even devices).

The recovery time is flexible depending on individual tolerances...usually linked withe UPPP recovery...but generally 2-3 weeks of acute recovery followed by 4-6 weeks to feel normal.

Dizzy,

I'd like to hear back from Artroo as well. I think he had an exceptional experience and hope he is doing well.

As you can see from the posts, we had a debate about my pessimism regarding the UPPP. I'm afraid I'll stick by my caveats about this procedure. But I do concede that most people who do well from a UPPP (or any other procedure) don't hang out too long and post. Therefore, we might not see another important segment of the story...the successes and how long they last.

Bill

[DJL]

After reading all of these replies, plus read other on this website. It seems that UPPP is not as successful as MMA. I have also read that some insurance companies will only pay for the MMA after other options have been tried, is this correct.
If I fail on CPAP and Auto PAP, which at present is not working to well after 3 months. I was thinking about the next option, and if MMA is 95% successful it would be worth going for that operation.
Any recommendations on a good path forward.

Dave

[Less Sleepy]

DJL, based on your other posts, I think your CPAP may not be working because your pressure might have been too low. Not everyone does well on AutoPAP. I certainly did not. I do quite well on Bi-level PAP. Until you have tried Bi-level at the appropriate pressure, you have not tried every avenue. Also, if your pressure needs are fairly low (like less than 10), you might want to try the Palatal Pillar/Dental device combination before you go to the big operations like UPPP and MMA/GA

[Billinseattle]

DJL,

I concur with Less Sleepy. Research and exhaust all options before embarking on the MMA.

It works...but it is a big hairy deal !

Insurance companies and surgeons won't do it until you've demonstrated failure in trying other procedures and devices !

The UPPP doesn't work nearly as well as the MMA...but it may contribute to the success of the MMA (get it ?). As most people get a UPPP first, then get an MMA...which then works...but may not have worked as well if the UPPP hadn't been done initially. On the other hand, there is research being done to support doing the MMA/GA primarily instead of the UPPP as the "gold standard" big surgery to fix OSA. We'll see...

Bill

[Sleepy Stoboy]

As someone who represents the pillar implant/dental device group, let me say that while I understand why some people would pursue an MMA, I don't understand why it would be done as a first step immediately after xPAP.

After 12 months, I'm sleeping as well as I would with an MMA, and with a far less invasive operation. The implants are a 90 minute out patient procedure, and the dental device that I wear every night is very comfortable. The only downside with this is that you'll probably be about $2000 out of pocket as insurance companies resist paying for either.

There are several paths toward successful treatment which is the goal. Most find it with compliance on xPAP, a small minority find it with dental devices, and some with MMA. Once you know the different treatment options, it seems to make sense to pursue the least invasive and permanent treatments first.

Anyone interested in the "combo" treatment of pillar implants/dental devices, should visit the dental forum and post any questions you have there.

As for the UPPP surgery, after 3 consultations with ENTs and a lot of research, I walked away (wait, ran away) from that as a treatment option. The risks of side effects were very high, the reward of positive (long lasting) results were very low, and the medical community continues to back away from this as a primary treatment option. To date, there are no major clinical studies that show that this is effective. And yet, the surgery has been around for what, 20 years?

[Guest]

Still pushing that snake oil Stoboy?

Give it up the guy had a UPPP, no need to waste his money on your unproven stents.

[Less Sleepy]

That's uncalled for, Guest. The treatment of Stoboy's OSA has been confirmed with a sleep study. What more do you want? The confirmation of adequate treatment with UPPP should also be routinely confirmed with sleep study.

[Billinseattle]

I agree, if you don't have anything productive to say...then don't say it. Tell us why something is snake-oil...or don't bother posting.

Pillar + dental device provides a viable, less invasive option that may work for a segment of the population here as an alternative to other PAP devices or surgical procedures.

The UPPP, not that great for most people. Poor medical data to substantiate it. However, it may be worthwhile for some folks. I just feel that everyone needs to know the score....the odds of success before doing it....so if it doesn't work they won't be broken hearted and give up.

I also believe that the community really should be aware of more aggressive options or alternatives. Pillar + dental device is an important alternative to PAP treatment and coventional surgeries. The MMA/GA has an important role in cases of severe OSA refractory to other forms of treatment...or in cases of anatomically appropriate (micronapthia or bradycephalia) situations. No one should look at any major surgery unless they've exhausted other options first. That being said...the MMA/GA has medical data to support its efficacy (and it darn well should , as it is a major undertaking).

Bill