my tale: 8 months start to mma
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my tale: 8 months start to mma

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Posted by sleeping-in-SF on September 30, 2010 at 12:53:32:

My sleep apnea tale: first sleep study to mma surgery in 8 months

[Sorry this terse but here goes...]

46 year old male professor in technical discipline. Tall/thin build. Swim 2-3 times / week.

Poor sleep for 10 years (since 2000) but thought it was anxiety from overwork at a startup before professorship. I've been 8 hours a night guy my whole life. Finally during middle of 1 year sabbatical Dec 2009, I realized I was totally relaxed and still couldn't sleep. Something must be wrong. Scoured internet and apnea was a possibility. I snore loud enough to wake myself up and my brother has bad apnea.

No one believed I had it since I'm a "pencil neck". I digitally recorded my sleep with laptop and looked at waveform. I snored every 5 seconds but would stop for 15 seconds; sounds of choking as well. I read later in journal paper that waking yourself up and a partner saying you choke is like a 93% indicator of apnea. Jan 2010, sleep study at stanford confirmed severe apnea 44 hypopneas / hour on back and light/moderate of 14 on side; no apneas. Had surgical consult with Dr. L. He said MMA was only thing that would help me. I have huge tongue and small jaw. Tongue falls back and corks me at night. Thought he was crazy to want to break my jaw. He told me 45 was cut off for good success rate but figured I'd have 90% chance of success.

Started CPAP but couldn't get even decent improvement. 2nd titration study in May showed I needed 18 pressure but couldn't tolerate. Tried bipap which kept me awake. No love from CPAP. I systematically adjusted parameters but no luck. Had to shave, wash face, tape mouth, use tight chin strap, *then* mask to get any benefit. 3 months recovery from mma vs 30 more years of that started sounding pretty good.

When to Dr L and to Dr P in July 2010. Xray showed 4mm airway (smaller than average) but big issue is small jaw / big tongue. Preferred Dr L's demeanor. Dr P gave pretty old school doc/patient relationship. At only 50, Dr L's physical skills would also be at their peak. Also, he does both sides of jaw whereas most do one side with a partner doing other. Talked to 3 surgeons and 5 medical docs. Consensus: mma surgery good option since cpap failing and I have no surplus soft tissue to remove.

I sit quietly at desk most of the day and must be mentally 100% to do my job successfully. Being even a little tired makes it impossible to compete in my world. Had no choice but to do surgery. Found 2 friends of friends that had MMA *and* with Dr L; amazing. All said it was tough but worth it. I made appt for Oct 5 surgery and got med leave from university. Then decided to move up to earliest possible date given my duties: Sept 15.

Had surgery Wed Sept 15 at Stanford Hospital. First day in ICU was brutal (nausea mainly). I mean really bad. Thu moved to regular room. Pain and general malaise. Went home Fri AM. I walked a bit in hospital 2nd day and have increased since. A bit light headed. It's been steady slow progress since. After about 10 days, I lost the dizzy/light-headed feeling and went to ibuprofen/tylenol during day. Was able to read / watch TV more easily. Talking even a little kept my pain up so I've stopped that. Stitches starting dropping out at about day 13. Day 16 and most swelling is gone and i don't need much tylenol during day. About 1.5 percocet 5-325 at night with a wee bit of ambien. I wake up 3x each night still.

I'm dreaming like mad but don't get good sleep at night (even at 11 hours); likely due to pain and narcotics. Naps seem to leave me refreshed so I'm hopeful I'm not choking anymore. (Just switched at Day 16 to flat bed from 15 degree incline.) Dr L moved my lower jaw 15mm forward and 8mm for top. Bite is perfect still. Friends say difference in facial structure is subtle but a nice one. My chin was a tad "weak" and now is "normal."

The worst parts of experience were for me:

* waiting for the operation d-day
* ICU / nausea
* the liquid diet!

Pain is manageable with meds, more or less. I went to work on Day 15 for a bit just to get out of house. I feel strong mentally but weak physically. Climbing stairs tires me out. I've gone from 196 lbs to 187 in first two weeks. I'm eating creamy soups and grinding up chicken curry but still lose weight. Ice cream is hard to cram in through front teeth. All food goes thru blender and is then drunk. Oh, I discovered that you can, in fact, drink sausage gravy! woot!

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