Double the Surgery - Double the Fun!

Okay, I'm warning you right off that this is one of those medical update blog posts that turn a lot of readers off. If that's you, please click someplace else before going any further, I don't mind. I do these medical posts because when people are thinking of having a procedure done, or are having a problem, they often search out answers from other patients instead of always getting all their information from the doctor's point-of-view. This post is for those readers.

For those who have read my blog, or have known me, for any length of time, you know that I've been diagnosed with severe Obstructive Sleep Apnea or "OSA" (see my posts on the subject here). OSA is far more than just loud snoring; it's a health endangering condition wherein I actually stop breathing for several seconds at a time throughout the night, depleting the oxygen in the brain, disrupting sleep patterns, putting extra strain on my heart and lungs, and annoying the hell out of my wife.

For the last few years I've been using a CPAP device - a machine that basically forces you to keep breathing by putting a continuous flow of air into your nose by way of a face mask. I like to call it my "hose hat." The nickname is the most fun part about it.

While the CPAP has been effective at reducing my symptoms by about 75-80%, it's uncomfortable, I can only sleep in two positions without dislodging it (flat on back or at just the right angle on my right side), it's a damn nuisance if I want to get up in the night to pee, a damn nuisance to carry through an airport when traveling, and, frankly, being attached to an air hose while in bed inhibits intimacy with my wife.

The surgical options originally presented to me by my sleep doctor were not very enticing. I was told they could basically break my jaw and rebuild my entire windpipe and nasal system, giving me at least six months of the most excruciating pain imaginable and a lower success rate than the CPAP. I passed on that. But I also could not imagine strapping the hose hat to my head every night for the rest of my life. I kept my eyes open for other options.

But recently I heard of a new, minimally invasive option called the Pillar Procedure. The procedure, done in the doctor's office (not a surgical center), is the insertion of three to five small plastic pillars, each about the size of a match stick, into the soft palate at the back of the mouth. As tissue regrows over the pillars, over several months, this stiffens the palate, reducing the vibration that is the cause of most snoring.

After some additional research, I signed up for it and had it done yesterday.

Here's what the procedure looks like (warning: graphic video):



My procedure went pretty much as in the video above. Five pillars inserted in fairly quick time. Unlike the video above, mine was not completely painless. While I didn't feel the first one, the second one hurt like hell, but only for a minute. I felt the others go in, but it was bearable. This did not surprise me, as when dentists work on me I always require additional drugs before I'm numb.

In addition to the pillars, I had a second procedure done at the same time: Turbinate Coblation, which is a procedure to reduce the swelling of tissue in the nasal passages as a result of allergies. While it was technically for my allergies, having a chronic stuffy nose also contributes to the snoring problem.

Here's a the Coblation procedure looks like:



Mine was much as the above. Very easy and quick. Altogether, I think I was in the chair in the examination room for a total of 35 minutes for both procedures, including signing the release forms, getting prepped, and going over my instructions for follow-up.

Yesterday I had a bad sore throat, not so much pain as discomfort in a place I wasn't used to. Also there was some bloody, mucus discharge from my nose (expected). I only ate soft, mild foods: a smoothie, yogurt, scrambled eggs. I did take Tylenol for pain, although I wasn't even sure if I needed it past the first hour or so.

Today I'm already feeling much better and haven't needed the Tylenol at all, and my nose is already clearer. Still some roughness to the throat so I'm not talking much, but definitely no pain or severe discomfort.

Now comes the waiting. Right now there's scar tissue in both palate and nose which will last for the next week or so before I start noticing the real benefits of the procedures. The full effect of the coblation should be known in a few weeks. The full effect of the pillars should be known in a few months.

And you know I'll post again letting you know if it was all worth it.

(BTW: The article links and videos are NOT the doctors I used, they're just informative links.)

A visit to the sleep clinic...

This lovely picture is how I looked as I got ready to go to bed last night at the sleep disorders clinic for my polysomnogram (an overnight sleep study). There are 28 sensors attached to me, including two on each leg, one on my left index finger, several on my chest and back, and a whole bunch all over my head.

Among the measures they were checking were brain waves, breathing patterns, blood oxygen levels, and leg movement. The reason for the visit is many years of disruptive snoring, lack of "rested feeling" in the morning, and likely Sleep Apnea.

I arrived at the clinic at 8 PM and immediately changed into my sleep clothes. From about 8:30 - 9:30 the technician hooked me up. She was very good and professional, and it's not really as uncomfortable as it looks. A little stifling, but not at all painful. The little control box you see hanging around my neck gets hung by the bed post when I finally get into the bed.

It's a private room, with a TV, so once I was hooked up and plugged into the bed I watched Heroes and Studio 60 till lights out just after 11 PM. Falling asleep was a bit difficult, as that's when I had the only real discomfort with the sensors behind my ears pinching just a bit.

I did not sleep well. Even worse than normal. But, that's really not too surprising. It's also not really a problem, as they wouldn't really get the data they need if I had had a "good" night.

The technician woke me up at 6:30 and it took about 1/2 hour to get everything un-hooked before I could get showered and dressed.

I will go in on Thursday to discuss the detailed results and diagnosis with the Doctor, but the technician's "unofficial" observations were that I did stop breathing several times during the night (Apnea) which caused my blood oxygen to dip. There was also some leg movement that might indicate RLS (Restless Leg Syndrome).

I'll post again when the next course of action is determined. Most likely it will be another sleepover to test out using a C-PAP machine, which is basically a mask and pump that forces air into my lungs and forcing me to breath through the night.

(NOTE: I sometimes question posting these personal, medical issues on the blog. I do it because over time, these are the posts that end up being most popular. While the political stuff looses its relevance very quickly, people are always looking for information on health problems and looking for other people who've been through it. These posts aren't for everybody, but they are important.)