Posted by Senn on March 11, 2008 at 07:19:22:In Reply to: Re: How severe is this?? posted by Michael_needs_sleep on March 11, 2008 at 05:13:20:
Hi Michael,
Westernjoe said some really good things, so I won't try to repeat what's already been said.You mentioned that you tried really hard to make the CPAP work for 6 months, but it didn't help. You then had another titration and the CPAP didn't help there. In THEORY the CPAP should help at least a little. It should force open the obstructions, but it doesn't seem to be doing it properly. This was exactly my problem for the past several years as well. Didn't get much relief when I forced myself to use it. So it made me wonder about the possibility of whether you might also have Laryngeal-level Obstructions as well. A small percentage of apneiacs (perhaps 10%) might have this problem as well and this makes the CPAP ineffective. (Not sure if you had the chance to read my post below, "Epiglottis & Sleep Apnea". www.sleepnet.com/noncpap23/messages/103.html).
A sleep endoscopy would be ideal because the doctor is seeing exactly what your problem is when you're asleep. He's able to see your obstructions in action. He can also rule out (or find out) whether you have Laryngeal obstructions or not and determine whether this is the reason why the CPAP isn't effective. (Ofcourse, even IF the CPAP was effective, alot of us just can't tolerate the thing and opt for surgery. But that's a different story).
As for the idea of trying to go the Stanford, I would at least try hard to get BCBS to try to cover it if it ever comes to that (i.e. having to do a GA or an MMA. I met a maxillo-facial surgeon in L.A. and told him how I had the GA/MMA but it only helped for several weeks. Then my apnea started to return again. He told me I should have gone to Stanford. (I didn't go to Stanford due to insurance reasons). I asked him why, ofcourse. He said if he, or anybody else, performed the MMA, they probabaly won't get the same success rates as Stanford. Most maxillo-facial surgeons don't specialize in sleep apnea. They may perform it a few times an year, but they specialize in orthognatic dental problems. Totally different animal. He said that surgical success rates for sleep apnea mostly has to do with EXPERIENCE in doing alot of these MMA procedures for sleep apnea.
But that was a few years back. I do hear that nowadays there are more and more MMA surgeons throughout the country (and I'm guessing some docs in Chicago)who have been performing the MMA on a fairly frequent basis for treating sleep apnea. (Especially in the last several years where there's been greater awareness of this problem called sleep apnea, and I'm guessing more patients who therefore have gone in and had this procedure done). So at the very least, if there's no way you can make it to Stanford, then by all means try to find someone who's done quite a bit of MMA surgeries for apnea.