Had pillar today

[Sleepy Bear]

I went to get the pillar implants surgery today. Procedure was almost painless (except for the anesthesia shots which hurt a little).
Another good thing is that I did not have to pay a dime. The company that commercialize the pillar implants fully covered my ENT expenses. The reason they are doing this is to get as many good ENT to prescribe the surgery to patient suffering from apnea (as long as the palate is a source of the apnea obvsiously). By covereing the expenses of the first couple of patients they get to put the name of the ENT in their website (restoremedical) and get more business this way.
I only have mild sleep apnea and my palate is the main source of obstruction according to my ENT so I am hopping for good results.
I will keep the forum informed of my progress.

[Jpnasty95]

how were you able to get the company to pay for it. did u ask them for any doctocs offering it?

i'm curious because i sent then an e-mail on the subject

[sleepy bear]

I spoke to my ENT (who had previously done my nose septoplasmy) about Pillar and told him I was considering having the procedure done as long as he thought I would be a good condidate for it (i.e. mostly palatal obstruction).

He told me that he had been contacted in the past (sometime end of 2004) by the company and they had proposed him to pay for his first couple of patients. At the time, the procedure just came out and he decided to do more research before agreeing.

Then early 2005, I spoke to my ENT about pillar and he said he would contact Restore Medical back and see if the offer was still valid. He basically did the job for me. I think after that my ENT went to a conference/traning program for 1 day or two to learn more about pillar and get to practice on cadavres (sorry, i know it sounds morbid).

Finally, on surgery day, we were a couple of guys having the procedures done and a team from restore medical was also there.


DAY 2: Throat is still a little sore but pain is very bearable.

[Jpnasty95]

I had IT DONE YESTERDAY ALSO. the worst part about the procedure was the novacaine shots.
i too, am still a little sore today.... but its not that bad.


good job on getting it done for free. i'm a little upset because i contacted restore and thru e-mail asked if they knew of any doctors that are new at preforming the procedure, where i could get it done at a discounted price or even for free. they told me they didn't know of any.

oh well, i did manage to find someone who charged a little less at $1100

[Sleepy Bear]

So it has been 1 week an 1 day since I had the pillar procedure.
Pain is all gone, actually it's been gone 3 days post op and was really not that bad anyway.

My ENt told me that the full effect of pillar is 3 months after the surgery. However, I think i can see already a small improvement. NOthing scientifically proven as I have not taken a sleep study and will not do so until at least 3 month post op.

My wife told me that my snoring is still here but much less noisy than usual. She also have not heard any sleep apnea; but she tends to fall asleep before me and wake after me so I am not too sure how much trust I can put in her observation!

One funny thing: I have had the craziest dream for the past few days and I usually very rarely remember my dream. In other post, people who had their sleep apea reduced also mention this similar experience.

I also fell a little more energetic during the day but that might be a placebo effect. ONly a sleep study will determine that.

[Sleepy Stoboy]

Hi Sleepy Bear,

Don't be surprised if you get some regression after initially feeling good. In my case, I slept great for about 3 weeks after the implants, then regressed to sleeping poorly for another 4-6 weeks. Then it got better, but not as good as it was in those first 3 weeks. A 90 day sleep study confirmed a 50% reduction (36 to 1, and sleep was better than before, but still not very good. I then added a dental device and that gave me the first great sleep in about 20 years.

So don't get discouraged if you regress somewhat. I think there is some effect of the post surgery swelling that may limit the palate's movement and gives you better sleep at first. But that's just a theory...

[Jpnasty95]

afetr a week i also had no pain

congrats on your improved slepp

i haven't really noticed an improvment yet... my ent told me at least 2 months before i may see an improvement

[Sleepy Bear]

[Sleepy Stoboy]

Wishing you the best of luck with all of it.

I do think something happens post surgery that swells your palate and gives you relief for a few weeks. Perhaps I could just take a dozen novacaine shots to my palate once a month? Crikey...

Consider adding a dental device if you don't feel better at the 90 day mark. I used my waiting period to go ahead and have the mold made so that if pillar didn't work I could order up a dental device in a flash. It also gave me time to get a good dental consult so I could better understand what they did to the jaw and tongue.

Hang in there. The process does suck, but in my case the implants made a nice, significant reduction in my RDI without the permanence of a UPPP. Unfortunately, my problem is more than just the palate.

[dizzy]

has anyone checked the success of these Pillar Implants with their own Autopap reports?

Personally, I don't think a one-night follow-up study at a lab will give you any kind of a good reading as a several nights on your own Autopap will in your own bed under familar conditions.

Now if one had this procedure then to see if it was working went back on autopap for a week and autopap usage reports showed reduced # of events and/or no responses to events, then I would consider that to be successful.

I would think improvement would be seen as:

1. Machine records fewer events than before.
2. Pressure stays at minumum and/or lower pressure throughout the night than before.
3. IF the autopap was a Remstar, the number of snores seen would be seen minimized.

I'm sure there would be exceptions to this since we all have a "bad" night every now and then even under ideal conditions. But you could go back to a lab 3 different nights and get 3 different results.

I have done Remstar Auto reports for nearly 3 years now and out of a typical 13-page report I'll get some nights with nearly zero events (hey I'm cured! yeah right) and other nights like therapy wasn't working at all,. I've had several PSG's and gotten different results with each one I've done. I know we all can't go in for several PSG's, that would be foolish which is why I think if you were on Autopap before the Pillars and stayed on it for a week afterward that would give you the ideal picture and true success of this procedure.

[Sleepy Stoboy]

Well perhaps,but I think you're being overly critical of a typical PSG.

At it's simplest level, you're looking for the number of sleep disordered breathing episodes, and regardless of whether you sleep well or not, you can get a good baseline in seven hours of sleep. While I may not have had my best night of sleep in the lab, I did sleep, and retrieved pretty good data from both a pre and post pillar study. PaulY, who was used in Restore's clinical study also used pre and post PSG data.

The data is pretty consistent. Generally, about a 40-60% reduction in RDI from pre to post pillar implantation. This is across about 40 different data sets I've seen.

Perhaps you can get a little higher precision in the data if you surveyed over several days using autopap, but then you'd need to ensure that the testing conditions were equivalent for all nights surveyed.

The good news is that after about a year, the data on pillar is coming in pretty solidly. For those profiled with a long soft palate, the procedure is effective at lowering RDI to a significant degree. In most cases seen, this does not allow it to be the only treatment needed. But it can be an effective treatment side by side with treatments or surgeries that address the tongue base.

[rested gal]

One of the big reasons a person has the pillar procedure done is to try to get away from having to use an xpap machine.

I think the person would do better having their outcome checked by a full PSG study at a sleep clinic...all wired up, but not having to use a mask...having everything looked at, including desats.

If they tried to check it at home via autopap, they'd have to not only have (or rent) an autopap, but they'd also be fighting the same issues with mask and machine that drove them to try Pillar and perhaps a dental device.

They might not get all that much sleep at home testing themselves with the things that made them uncomfortable -- mask and a machine -- and maybe with mouth/mask leaks all over the place.

[dizzy]

Overcritical of PSG's? don't think so, I've had 4 of them, all different results depending on the tech administering it. How many have you had? and how long were you on cpap before having the pillar procedure? Like most I've read about, probably not long if at all.

this procedure may work for some, but I think the whole story on these implants is not yet out, half the posts I've seen on it seem to be from trolls. I think Rick was the only one here I've read about that had been a visitor to TAS for sometime before having the procedure. Why is it that the people that claim this procedure is such a success have all the answers, I guess if I got the procedure for free I'd do the same thing but then I would be a troll also now wouldn't I.

But the fact remains we have no idea how long these surgical stents will stay in place in the palate. As for the surgical stents themselves they have been used for years. The procedure is still experimental and reason your insurance won't yet pay for it (they have to prove that it works).

Reducing snoring is one thing, reducing and curing OSA is something else. Adverse side effects, stents coming out etc. all have to be reported to the FDA just as medical device failures do, but that is pretty hard to police. Snoring alone is NOT considered a medical condition and no insurance will pay for a procedure that stops snoring.

Some of us however know that these snores can lead to other events such as flow limitations, hypoapneas and worse. We've also delt with this problem for years on end not just months and I don't care what anyone says cpap is hard to tolerate, it's uncomfortable and sometimes it don't work either. But for the most part it works.

I'm pesimestic because I don't see how stiffening up the palate is going to be any better off than a UPPP procedure where the uuvala is nearly all but removed amungst other items, yet they come back here one after another seeking help a few years down the road.

A person with a full upper denture or even a retainer is going to nearly hide the palate impacted by these implants, so I wonder why no sleep dentist has done any study on that? The avg. cost for a full upper dental retainer is what $300 (just had to buy one for my daughter who lost hers). All the lab has to do is add a bit more plastic to the posterior side forming sort of a tail to cover more of the palate. They normally don't because of some people having a sensitive gag reflex usually found when taking impressions. But there are many that don't.

Now I've caught myself dozing off on the couch many times and hear myself actually begin to snore (think it was what woke me up) but the snoring appeared not to be coming from the palate as my mouth is fully closed breathing through my nose with my toungue in the palate yet the noise/vibrations seems to be coming from deep down in the nasal passage not the palate.

So if the flabby palate was the true cause of the snores, it was happening with NO air flowing over the palate, and the tongue firmly in place in the pocket covering the palate. This is why I haven't run down to have this procedure done, the $1,100-$1500 cost is no big deal and a drop in the bucket to what I've spent already on this SDB over the past 4 years and before that the 2 strokes, all the drugs, tests etc.,etc.

I'm just tired of wasting hard earned money on so called gimmics only to find out later it also didn't work.

[humaliens]

Dizzy, I suppose your level of suffering doesn't warrant the need for an unproven procedure. But for myself, the Pillar vs U3 makes for an easy decision.

Every case is different. I've been on this board for over a year now and there are success stories with Pillar and MRD. For me using the MRD alone didn't fully treat and the next choice is Pillar.

After trying CPAP for a few months and getting nowhere, the Pillar/MRD combo is a viable option that makes nights without a mask a happier occassion. Getting fully treated is everybody's goal. The Pillar has proven already it can work in many cases, and that's all I need to know going in.

Well, I'll let everyone know if Rick, Paul, Sleepy, and some of the rest will have a new member of the 0 RDI club with Pillar/MRD combo for treatment.

Rick Humaliens

[Sleepy Stoboy]

Dizzy,

You certainly feel strongly about your position, and that's certainly your right. But I question whether you've read the strong library of posts here and on the dental forum that are strongly supporting that pillar does indeed work, in most cases combined with a dental device.

To address your many opinions:
1) I've had three PSGs. I found the process at my sleep lab remarkably consistent. Same techs in a smaller clinic each time. Many of the factors are near impossible to duplicate, but one thing is near certain- it will tell you if you are having sleep disordered breathing episodes, and on average, how many per hour. That is the critical gauge I've used to determine the effectiveness of my treatments.

2) I wasn't on CPAP prior to the pillar implants. I don't see what this has to do with anything. I made a choice out of the box to try an alternative treatment. For those that are happy with CPAP, why criticize the choice for alternates? Isn't this a game where we all try and find a comfortable working solution?

3) The story on the implants is not yet out. Of course it isn't. I'm not sure the story is completely out yet on plasma TVs. Any new product, procedure has to go through this phase. But it's only "new" for apnea. It's been approved for snoring for several years. So while there is a lack of long term effects of these implantations, there are thousands of people who have had them for snoring long before it was approved for apnea. So far, no silicone breast implant horror stories.

4) I'd love to see the evidence that most of the pro-pillar support has been from trolls. You're really missing something here. PaulY, Rick, and myself have posted numerous times all through our journeys. With data. Pre and post. Perhaps you haven't read the dental board as well.

5) Why would you be a troll if you received the treatment for free? PaulY did get the procedure for free, and his posts are grounded in as much sincerity as you can get. He honestly tells you that it resolved only 40% of his apnea, and that he needs to use an MRD for the rest. Not exactly a shill for the company.

6) "The fact remains that we have no idea how long these will stay in place". Absolutely correct. There is significant evidence that this is a safe material, used in many other surgical operations, and there is a strong belief that they will only harden in this tissue and in fact become more firm and secure over a long period of time. The fear of possible extrusion of the implants is much more pronounced at the time of, or shortly after the surgery. But life is full of risks and rewards. Your risk for not having this done is missing out on years of an alternative treatment that could buy you better sleep. Your reward is not having to have implants removed at a later date. But these implants can be removed in about 45 minutes after a couple of numbing shots. Not exactly a long, grueling procedure.

7) "Your insurance won't pay for it". They did. All of it. I know that's not the norm, but they did on the first shot. I also had an ENT who was willing to charge me cost for the procedure if they didn't.

8) "Reducing snoring is one thing, reducing and curing OSA is something else". Not in my case. I had a 50% reduction in RDI 90 days after the procedure. No, it's not a cure, but no single surgery on the palate is ever going to be. I knew that going in.

9) "I don't see how stiffening the palate is going to be any better than a UPPP". They are two very different procedures both attempting to do the same thing. There is a common belief that the reason UPPP's regress is that the scar tissue that regrows around the removed area essentially sags back into the airway. There is no need to remove tissue if stiffening it will accomplish the goal in the first place. In addition, some people experience nasal regurgitation and other unpleasant side effects after a UPPP. Do we really think the uvula has no known purpose?

10) I know my gag reflex is strong and could never tolerate such an upper retainer. But have you really seen how far the implants go back? I'm not sure how long your daughter's palate is, but mine is long and soft (thus the profile for the procedure). I doubt anyone could tolerate a retainer driving this far back to their throat without gagging.

Dizzy, my goal here isn't to be argumentative. But some of us have invested a lot of time, money and effort to get to the REAL facts about pillar implants. And we've spent time posting these results here, but much of it goes unread. Some people just start laying out their opinions and fears without reading any of the background that has already been laid down. And this background is full of facts, PSG data, and lots of subjective concerns and thoughts along the way. We've tried to present the good, the bad, and the ugly so others can make an informed decision. I've never knocked CPAP, just said I was more willing to go down this road than the road to CPAP compliance. CPAP does work, and for a whole lot of people. But there is a very real likelihood that CPAP won't be the treatment of choice in 20 years. You refer to the gimmicks you've dealt with. Just remember that buried amidst all of these gimmicks may be some very real and effective treatments that are emerging.