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general/surgical advice

Posted by M3LFL on December 02, 2002 at 16:06:23:

Hi all, new to the site and the forums. Had a surgical consult today regarding treatment for apnea. Had a sleep study done and was diagnosed with severe apnea (RDI of 83, O2 saturation got down into the low 80's also). I've been trying CPAP and now BiPAP (at pressures around 16), but not having much luck. Can't seem to fall asleep, but I'm confused 'cause I know the second half of the sleep study they put a CPAP machine on me and it worked. Can't figure out why it would work there, but not at home. Dr has even tryed to put me on Ambien to help me get to sleep and stay asleep while trying the machine... hoping if I can just get past the first hurdle here it might work for me.

Then had a surgical consult today and the ENT thinks I'm a good candidate for a UPPP and if that's not sufficient he would like to repair the deviated septum in my nose as the second step rather than anything involving the tongue. He doesn't think the base of my tongue is large enough to be part of the obstruction problems.

Here are my questions: First, although I know this is a personal decision, I'm trying to figure out whether or not to have surgery or to keep trying CPAP and try to force myself to get used to it. I read a post regarding someone that had random breathing patterns of shallow and then deep breathing that seemed to cause a problem for this type of treatment due to breathing synchronization with the machine (is this a BiPAP only issue?) and I think I have the same issue. Has anyone tried this method, or been through many different machines and headgear setups before finding one that works? Or am I just one of the 50% that can't tolerate CPAP who won't ever be able to stay asleep with it and won't be able to use it as a treatment? When is enough and I just give up on CPAP?

Secondly, the surgical consult wasn't as involved as some I've heard and read about that include other things like endoscopy (?) to determine where the obstruction occurs and what surgical procedure(s) to consider as a way of treating my particular problem. Should I be concerned that the recommendation is based on an insufficient exam? Or could it be this surgeon has seen enough and done enough that he is able to make that determination with a less involved exam? I did research on the potential procedures and understood what he was saying and he seemed to know what he was doing. So my instinct tells me his diagnosis is accurate and valid, but should I be concerned about a more thorough exam? What else should I ask before moving forward with surgery if I decide to go that way?

Sorry for the extra long post, just trying to get as much info as I can.

M.

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