Posted by Whitty on May 06, 2008 at 18:30:48:In Reply to: Re: To UPPP or not to UPPP... posted by shogun on April 29, 2008 at 07:20:47:
Shogun, have you made a decision?
I appreciate the opinions of others on this forum, but I think you and I were in unusual -- though similar -- situations. After all, choosing between tonsillectomy and UPPP is like choosing between a ton of pain and a ton of pain. It's not like we really had the choice of no painful surgery at all. Believe me, if I had that choice, I totally would have chosen no surgery. I actually liked my CPAP, especially compared to the lousy quality sleep I was getting before I used it. But since I had to get the tonsils out anyway and I was having difficulty with regular CPAP use, I thought: well, how likely am I to regret the loss of the uvula? I know that there is a small chance of speech disorders, but I had also read that there was at least a 50/50 shot that my OSA would be reduced or eliminated. I figured those were good odds. I was willing to take the chance.
I will say this: we all know that surgeons have a certain inherent bias. They are surgeons; they tend to look more favorably on surgery in general. But what bias does your well qualified surgeon have that would make him more likely to recommend UPPP than tonsillectomy? Will he make considerably more from UPPP than tonsillectomy? Even if he makes an extra $500, do you think he really needs that money? I felt comfortable with my doctor's recommendation partially because I know he's the chief of otolaryngology at a couple of local hospitals and he's also the inventor of some medical equipment, and I figured: there's no way this guy needs whatever extra money a UPPP would give him over a tonsillectomy...
But I would encourage you to consider a couple of other things. As one other respondent mentioned, it may be possible that we rarely hear from those with positive UPPP experiences because they've gotten on with their lives. In addition, I'd like to add that you consider what kind of people frequent online medical sites. I'd wager to suggest that a relatively large percentage of them are sort of "do it yourself" types when it comes to medicine. Just as surgeons have an inherent bias FOR surgery, a lot of these types of folks tend to distrust traditional Western surgical techniques. Now, I want to be clear: I am by no means suggesting that this even constitutes a majority of the people on this or other sites. But still, I suspect that there are a higher percentage of those types of folks on this and other medical blog sites than the percentage you'd find in the general population. And a lot of these people are very vocal about their opinions...
By the way, I say this because I definitely used to be one of those types of people. Life has led me to moderate my views, but I'm still the type who likes to be well informed and appreciates non-Western techniques (in fact, my father-in-law is both an MD and a homeopath). And even with my background, I still chose to have the UPPP, which in many ways is a very old-fashioned kind of surgery: no lasers or scopes, just a simple cutting out of the part that we think is bugging you. Again, since I had long put off the tonsillectomy anyway, it just seemed like lopping off the uvula was a good bet for me. It's only been six weeks, but I'm still glad I did it. We'll see what the long-term results are.
And that's the thing: you can't really know beforehand. I for one am prepared to take further action if the UPPP was not successful, whether that's trying the CPAP again with another mask, or perhaps another surgery. In a lot of ways, I think OSA is like a heart condition. I think most patients with heart ailments know that it may not take only one medication or one surgery to make it better. But the condition is critical enough that you'll continue to follow up. If a procedure is not effective -- or is only temporarily effective -- then you have to be on top of it and consider something else. I think OSA is similar, and if the UPPP is not successful over the long term, then I'll consider my other options. But I knew I had to go in for a painful surgery anyway, so I thought it was best to give it a try.
Finally, I'd just like to pass along a little simple advice, though it sort of struck me as profound at the time. When my ENT first recommended the surgery, I got three second opinions, but I was still worried. I had read sites like these and I knew that lots of people railed against UPPP. I told a friend about my worries and he said, "You'll never know for sure, and in the end, you have to be the expert on your own body." The more I thought about it, the more I realized he was right. I wanted certainty, and...well, does that really come with anything in life? So I came home, got out my flashlight, and looked back at those gigantic tonsils and that long, stiff, fibrous uvula, and I thought: let's get that crap out of me. In the end, I think you'll have to make that same decision about your own body...
- Re: To UPPP or not to UPPP... shogun 12:21 5/09/08 (0)