Ask A Guy Who Just Had Sleep Apnea Surgery (UPPP + tonsilectomy) Anything.

[SKINUM]

ive worked in field and ents love the procedure (makes them a lot of $). what made sense to me was cpap if you have something more than a mild case (unless something is abnormal like an enlarged tonsil).
the mask leak for many with cpap is why it bothers them. finding the right mask and pressure for your machine is crucial. a lot of people arent set up right and end up sol and hate it.
the two masks i swear by for most if they fit right are the wisp (size large) and mirage quatro for a full face.

It sounds like you are on the high side for a complete fix all (perhaps if its not resolved all the way you could get some more relief with a dental appliance to help seal the deal).

Best of luck and hope you are of the hook!!!

That is the key for CPAP use for the majority of people. So, many people are only given one mask option while there are probably 25-35 mask options available.

I find that the Wisp nasal mask seals very well and still allows one to watch tv/read without the mask getting in the way. The only issue is if the user is a mouth breather.

The Resmed quattro is my favorite full face (covering nose & mouth) option as it tends to fit most faces properly & seals well.

Another good nasal piece is the resmed swift.

If your mask is making more noise than a ceiling fan on high then u should be refitted for a mask.

Also if your CPAP pressure is around 14 & up u would probably feel more comfortable with Bipap use.

In regards to the surgery: it has about a 50% success rate as the earlier post mentioned. It basically becomes a choice of is a 50% chance worth the pain of surgery & the 50% chance that u may still need a CPAP.

For most people the 1st month of CPAP use is the most difficult. If pressures are correct & the tech that did the fitting of the mask took the time to find a comfortable option then most people will find they can't do without the CPAP after a month of continuous use.

The patient needs to understand the treatment completely and not be rushed. There will still be a few people that just have a mental block that they can not get by (claustrophobia). However, for most people if the health care professional takes the time to treat the patient completely the success rate is high with CPAP/BIPAP use.

[induced_drag]

I have issues with apnea. My wife will tell me about it and sometimes I even feel it happening and am brought to an awake state over it. It is one thing that motivates me to stay leaner.
As soon as I start a moderate surplus and eat in the 500g of carbs range, the water that comes along with it causes it almost immediately.

I did some reading and neck size (not just fat) is a underlying cause. My neck is 18.5" and I stay close to 10%bf year round. (hitting about 12% at my upper limit) and still have it so it is not just a 'fat' guys issue.

This may be something I have to consider in the future.

Cutting right now down to sub 10%. As soon as the water drops off the apnea goes away but snoring is still pretty bad.

[ragexzero]

I have issues with apnea. My wife will tell me about it and sometimes I even feel it happening and am brought to an awake state over it. It is one thing that motivates me to stay leaner.
As soon as I start a moderate surplus and eat in the 500g of carbs range, the water that comes along with it causes it almost immediately.

I did some reading and neck size (not just fat) is a underlying cause. My neck is 18.5" and I stay close to 10%bf year round. (hitting about 12% at my upper limit) and still have it so it is not just a 'fat' guys issue.

Oh man, so you mean to tell me, that I'm trying to lose weight desperately so I can get rid of my apnea, yet when I achieve my fat loss goal, I might STILL have it? OH man, that's terrible news.

I don't remember having the feeling of drowning, during the day and at night, when I was leaner. I put on a lot of weight and that's when it started happening, so I always assumed: get leaner = no apnea.

I really hope I won't have to resort to surgery, but if that's what it will take to finally breathe and sleep better, I might just go ahead and do it. Still haven't even tried using CPAP, so yeah, that's where I'll start.

[SKINUM]

Oh man, so you mean to tell me, that I'm trying to lose weight desperately so I can get rid of my apnea, yet when I achieve my fat loss goal, I might STILL have it? OH man, that's terrible news.

I don't remember having the feeling of drowning, during the day and at night, when I was leaner. I put on a lot of weight and that's when it started happening, so I always assumed: get leaner = no apnea.

I really hope I won't have to resort to surgery, but if that's what it will take to finally breathe and sleep better, I might just go ahead and do it. Still haven't even tried using CPAP, so yeah, that's where I'll start.

Each person & scenario is different. I've seen people @ 115lbs that have apnea issues & people @ 350lbs with no issues. Most facilities will want u retested with a 30+lb weight loss. So, although neck size gives a good idea of possible issues it isn't a given that u will definitely have issues with a 17+ neck.

[Human Rocket]

Apparently I get to be one of the fun ones. Went to bed between 9-10 and am now back up with a lot of bleeding. Doesn't hurt that bad and it's getting better with ice. Don't want a trip to the ER thrown in on top of this. Will try to hold out 'til morning. It's kind of slowing down right now.

EDIT: Apparently significant after surgical bleeding happens in about 3-5% of patients with it being more likely for adult patients. Ice seems to be really helping.

[ragexzero]

Oh no. I hope you can stay away from the ER. Best of luck with your recovery and thanks a lot for starting this interesting thread. Never thought I'd run into such a thread on a bodybuilding forum. Heh. So relevant to one of my main issues.

[Human Rocket]

Got up again. Coughed up a lot of phelgm but not as much blood. It's official. If this were torture then it would be banned by the Geneva Convention. Will practically worship CPAP machines in the future.

[beachguy498]

Apparently I get to be one of the fun ones. Went to bed between 9-10 and am now back up with a lot of bleeding. Doesn't hurt that bad and it's getting better with ice. Don't want a trip to the ER thrown in on top of this. Will try to hold out 'til morning. It's kind of slowing down right now.

EDIT: Apparently significant after surgical bleeding happens in about 3-5% of patients with it being more likely for adult patients. Ice seems to be really helping.

Call your doctor's office when you get up. Don't hesitate to hit the ER if you think its excessive. This really isn't normal for this type of surgery. Good luck!

Rob

[Human Rocket]

Call your doctor's office when you get up. Don't hesitate to hit the ER if you think its excessive. This really isn't normal for this type of surgery. Good luck!

Rob

I finally figured out what was happening last night. This is really gross and I was going to try to hide it as a spoiler text but couldn't get it to work so if you are squeamish then all I can do is suggest is that you STOP READING NOW. NOT JOKING.






















NOT JOKING.






















I was coughing up scabs. Big ones. THICK ONES. I should have taken pictures because I can't believe some of the **** that came out of my throat. I can still feel a few back there but I got most of them out finally and I feel so much better. Once I got them out then sucking on ice and rinsing with salt water got the bleeding under control. And now I feel like I can breathe so much better. I feel like a million bucks compared to last night. I may go through this one more night but after that I feel like I will have turned the corner. I take it as a sign that my body is finally starting to heal.

I will keep you guys updated and when it's all said and done I will type up a summary of the best advice I have for anyone contemplating the same surgery.

Whew!

[Minotaur]

That's great.

Hey, it may be disgusting to have to do it, but it feels great to bring something up like that or the guacamole in your chest from bronchitis. I was so happy when I learned how to do that. One of life's little pleasures (simple pleasures for a simple mind ).

[beachguy498]

Yikes... I had the same surgery but without the side show acts. I really had no issues when I was healing.

Rob

[induced_drag]

Oh man, so you mean to tell me, that I'm trying to lose weight desperately so I can get rid of my apnea, yet when I achieve my fat loss goal, I might STILL have it? OH man, that's terrible news.
.

As I have said, I think it can be as much neck size as fat%. Even lean, my neck is 18"+. For a guy 5'9, that is up there. I dont do any specific neck work, but have always had a muscular neck. I think OHP and deads do build the neck and since returning to the gym a few years back, my neck has grown to where it is now.

I dont have the issue when I am eating lower carbs or cal restricting, but as soon as I switch to surplus, things get bad pretty fast. It is the main reason my wife hates when I am eating to grow. I end up sleeping in the other room about 50% of the time because I get sick of getting the elbow

[Human Rocket]

Just thought I'd give an update. Doing OK all things considered. Throat is still a little sore but I'm not on any pain meds and can pretty much eat anything I want as long as I chew it well. I don't have a scale so I can't say how much weight I've lost although I'm using notches on my belt that I haven't touched in years. I have a follow up appointment with my doctor tomorrow and will get weighed then I guess. I'm supposed to go back to work on Wednesday, the 29th.

Got thrown another curve ball when as soon as I got to the point that I could kind of take care of myself, my wife left me. Took my five year old kid and went to her parents to stay indefinitely. Says she doesn't want a divorce but I'm still sort of in shock over it. Especially considering that about a year after we first got married she had an accident and had to go through a lengthy rehab and I stood by her and supported her the whole time. When/if she decides to come back I really don't know how we're going to make things work.

My mental state isn't all that bad. Not as bad as it could be. Music helps me get through things. Here's a video of a garage punk band from the 90s called the Mummies. They're... different. Either you'll get it or you won't.

[ragexzero]

Man, that's rough. I hope things will get sorted out between you and your wife, if that's what's best for both of you. Good luck!

Thanks to this thread, I am now looking seriously into this kind of surgery and I can at least IMAGINE a day when I don't wake up feeling like I'm drowning after only four hours of light sleep. So thanks! And by all means, keep us updated!

[Human Rocket]

Yeah, I'm actually not able to sleep all through the night yet but that could be due to stress as much as anything. My energy levels during the day are pretty good so I do think what sleep I am getting is better quality sleep. I even went to the gym today and got a workout in. I've definitely lost strength from before the surgery but that's to be expected.

[Human Rocket]

Got almost a full night of sleep last night and woke up feeling great this morning. (Still dealing with some drainage issues but it's not as bad as it was earlier, or at least wasn't last night.) Going back to work today. It's been a hell of a three weeks on multiple levels.

Gonna give myself another month or so to recover and then going to start seriously hitting the weights again. Already able to piddle around in the gym some and it's about the only thing that's keeping me sane right now.

To quote Henry Rollins:

"The Iron is the best antidepressant I have ever found. There is no better way to fight weakness than with strength. Once the mind and body have been awakened to their true potential, it's impossible to turn back.

The Iron never lies to you. You can walk outside and listen to all kinds of talk, get told that you're a god or a total bastard. The Iron will always kick you the real deal. The Iron is the great reference point, the all-knowing perspective giver. Always there like a beacon in the pitch black. I have found the Iron to be my greatest friend. It never freaks out on me, never runs. Friends may come and go. But two hundred pounds is always two hundred pounds. "

Fulll essay is here:

http://www.oldtimestrongman.com/stre...-henry-rollins

As far as advice goes on recovery from sleep apnea surgery I have plenty but it may or may not help you. I tried the things that other people recommended and a lot of them just didn't work for me. So take whatever advice I give you with a grain of salt as your experience could be totally different from mine.

The best thing you can probably have is a loving and patient caregiver who is strong mentally and emotionally. I didn't have that.

About the only thing that soothed my throat in the early goings was chicken broth and vanilla almond milk. Tip for the chicken broth: Add a little extra salt and maybe a half of teaspoon of olive oil. The olive oil will help it go down easily and you need the fats. I didn't do this but liquid fish oil as a supplement would probably be a good idea.

For the first few days following the surgery just remaining hydrated is a challenge. If you can afford pedialyte and can get it down without it burning your throat then it's probably the best thing for you. Do not use Gatorade. It is too acidic. Constipation will be a problem. I would dilute a little prune juice with almond milk and add sugar (unsweetened prune juice is bitter to me) and that helped a little. For about a week or two, every time you drink anything it will likely come out your nose. I eventually got this under control although it still happens occasionally.

Now there are some things we are no longer allowed to discuss here on bb.com but let's just say any serious bodybuilder knows the importance of taking care of your liver. You will likely be prescribed some kind of corticosteroid and some liquid Tylenol 3 (hydrocodone and acetaminophen.) This stuff is hard on your liver and if you are in as much pain as I was then you will be taking way more than the recommended amounts of Tylenol 3. If nothing else I'd say have some liquid Milk Thistle on hand. Maybe even some liquid UDCA if you can afford and find it. I would avoid alcohol leading up to the surgery and while you can still take pills I'd get my liver in good shape with an all around liver supplement that includes NAC, alpha lipoic acid and such. (Actually while most people do, I never had a problem taking pills after my surgery. I took my regular blood pressure and cholesterol medicine with no problems. I just sort of chucked the pill in the back my throat to ring the hole.)

Another thing that helped me recover was drinking a meal replacement shake during the time I couldn't eat. I bought some stuff by EAS at Wal-Mart called "Complete Protein Nutrition Shake." (I searched for it here on bb.com and didn't find it.) It was too thick at first so I had to mix it half strength. I mixed it with vanilla almond milk. It was a while before I could tolerate regular milk again. And I never did eat much ice cream which is what everyone suggests when you have your tonsils out. I also mixed Bio Salud in with the shake which is kind of a little dairy drink with probiotics in it. Again, you can find it at Wal-Mart.

Pain management was a difficult thing for me. In addition to whatever your doc prescribes you, you can gargle with salt water and suck on ice. I would also put ice packs on my throat periodically. Pray to God that you don't have to sneeze before you get fully healed. Your teeth and jaws will hurt after having the surgery. You may have ear aches as well. Chewing gum helps with this a little. I also kept a pot of water boiling on the stove to humidify the winter air. I took a lot of showers too as the hot water vapor seemed soothing.

You should probably rest as much as you can but I can tell you that I did not. I would get up and wash dishes and wash clothes and take out the garbage and go check the mailbox. It wasn't a lot of activity but probably more than I should have done and I mainly did it out of boredom. You will quickly get sick of watching TV and surfing the internet. You could try reading but might have a hard time focusing early on. Towards the end I was able to start studying for some IT certifications which helped me feel productive.

Food may taste weird for a while after your surgery. This could be for a brief time or for as long as a year if the doctor accidentally cut a nerve during the surgery. Most stuff tastes normal enough right now for me so I got a break in that dept. I'm eating lots of baked chicken right now and it tastes just fine.

Well, I dunno what else to say and it's time to go to work anyway. I will monitor this thread for a few days so if you have questions then ask away. Or if you've had the surgery yourself then share your own tips for recovery.

[ragexzero]

Very useful information. Thanks a lot for taking the time to write it all down and give us the low down on your recovery. It's funny you posted today because in about two hours I will be out for an appointment with my ear/nose/throat doctor and I will bring up this surgery and see if he recommends it or not. If he says he doesn't recommend it, I will ask: "Then what do you propose I do in order to ****ing BREATHE once and for all!?". Haha.

[Human Rocket]

Very useful information. Thanks a lot for taking the time to write it all down and give us the low down on your recovery. It's funny you posted today because in about two hours I will be out for an appointment with my ear/nose/throat doctor and I will bring up this surgery and see if he recommends it or not. If he says he doesn't recommend it, I will ask: "Then what do you propose I do in order to ****ing BREATHE once and for all!?". Haha.

Have you had a sleep study yet? That will be the first thing required. Then it just depends on what your insurance will cover. They may expect you to try a CPAP machine first or they may let you jump straight to the surgery.

A lot of people are going to tell you to lose weight before trying the surgery. At my heaviest I was about 250lbs but I can tell you getting down under 210 didn't solve the problem for me. Maybe if I had dropped another 40lbs then I could have avoided surgery. I dunno. I just didn't see that happening.

I will have to have a follow up sleep study in about six weeks. That will let me know to what degree the surgery was successful. I know it has helped some but not sure how much. I may have to try CPAP again (hopefully at a lower pressure setting) or maybe one of those orthodontal devices that adjusts your jaws. The orthodontal devices are really expensive though.

[drudixon]

Why not coblation?

[Human Rocket]

Why not coblation?

I'd never heard of it before. My ENT didn't offer it as an option. I just googled it and found this.

http://people.healthsciences.ucla.ed...roup_id=104472

My reading of this is that coblation is a treatment for light snoring but for severe snoring with sleep apnea a UPPP is required.

[Foliage]

http://www.theleadsouthaustralia.com...apnoea-relief/

I've just applied for this medical trial in Adelaide, got past the screening test and now have an interview with the medical staff on monday. It is a partial UPPP and tongue coblation where they shrink your tounge volume by using a coblation wand in the rear muscle section.

The pilot trial had amazing success reducing episodes from an average of 24 AHI to 9.4 after 6 months follow up, however it had no control group.

This study is the same with 100 people, 50 get no treatment with a 6 month followup, 50 get the UPPP and coblation, you are randomly selected to get surgery or not. If the trial shows success at the end of it the 50% who were in the non-treatment group will get offered the surgery.

Side effect profile is reduced due to using a partial UPPP where they leave the dangly bit in the middle, this is as previous procedures where they removed all of it could result in food/drink going up your nose which never really resolves.

Anyone else looked into this? It looks about on par with tonsillectomy in terms of pain so it will be at least a week in bed on strong painkillers.

Here is the pilot study
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544378/
Quote:
The preoperative AHI (median and interquartile range) of 23.1 (10.4 to 36.6) was lowered to a postoperative AHI of 5.6 (1.9 to 10.4) (p < 0.05). The Epworth Sleepiness Scale score fell from 10.5 (5.5 to 13.5) to 5.0 (3.09 to 9.5) (p < 0.05). Morbidity of the surgery was low, with no long-term complications recorded.