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Looking For Info on Upcoming Surgical Procedures ...

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GBerger +0 points · over 7 years ago Original Poster

Well, I had my follow up visit with the ENT who performed my sleep endoscopy on 5/18. Based on his finding, he is suggesting that I have the following procedures performed:

  • Nasal Turbinate Reduction
  • Possible Septoplasty
  • Palatopharyngoplasty
  • Hyoid Suspension

I've given my doctor the okay to apply for approval by my insurance company (Anthem BC) but I am in the process of doing some research & asking a lot of questions before I make my final decision. My doctor has told me that the likelihood of achieving the goals of these procedures is "Good".

I would welcome any information that anyone can provided me on any of these procedures, especially if you've had had one performed on you in the past.

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

If you insurance will foot the bill, ask for a second opinion. I am thinking there won't be a lot of response as all of those procedures are pretty technical. Take the results to another doc and see if he is on the same page as the one already visited. I know this is a good idea based on my own medical history. Good luck and keep us up to date on the outcome.

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Sherry +0 points · over 7 years ago Sleep Commentator

I would agree with getting a second opinion! I had two most painful surgeries that did not work. There are those who are making recommendations for $$ vs making recommendations in he best interest of the patient. Choose clinicians wisely and check their reviews carefully!

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KindPinkGuanaco9781 +0 points · over 7 years ago

Also strongly recommend you receive another opinion. Depending on the surgery, some of these procedures rate of success is only around 40% and they can be extremely painful. Advocate for yourself and get more information from another professional. Good luck!

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GBerger +0 points · over 7 years ago Original Poster

First off I'd like to thank everyone who responded to my request for input. I have good news & bad news. The bad news is my insurance company denied my claim for sleep endoscopy that I had done on 5/18/2016. It turns out that even though the ENT told me that he was in my network & that he took my insurance, it turns out that they coded the request to my insurance company incorrectly & they are not "in network". Neither is the facility where the procedure was performed. I explained that I had been misled by the ENT & my insurance company rep. recommended that I file an appeal so I did that. However, the good news is since the ENT that performed my sleep endoscopy was out of my network, I had to find an "in network" ENT, which I have an appointment with this Monday. He is being provided all of my records and will be providing me with his opinion on the recommended procedures. If he convinces me that surgery is the best option, I will probably have him perform the procedures. I've been reading a lot of data on all of the procedures and based on the findings from my sleep endoscopy, the risk vs. benefit analysis, a careful consideration of any alternative options for treatment ... the decision to move forward looks like the right one. However, I want my new ENT to give me his opinion after carefully reviewing my records.

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

The magic of insurance companies! Geesh, seems like this should be something the industry could check on without confusion. In any case, you will have the benefit of a 2nd opinion even though you got there on a winding path. Good luck and let us know how this turns out!

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GBerger +0 points · over 7 years ago Original Poster

Oh I almost forgot. After finding out about the issues with the ENT that did my sleep endoscopy (not being "in network"), I was talking to my cardiologist. He's a great cardiologist ... he treated my mother for her heart problems before she passed away, he runs the cardiology department at the top cardiology hospital in my area & he's so well known in the field that people come from great distances (including celebrities, who can afford the best care) to get his services. Any way ... I was talking to him at my appointment about my sleep apnea issues & he told me that his brother was a great ENT who specializes in sleep apnea. I called my insurance company & had them verify (in writing) that he is in my network (as well as the facility he works out of) and he is the ENT that I have my appointment with on Monday. So I'm pretty pumped about making the change & getting a new perspective on my condition & his recommendations on treatment (my second opinion).

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

Wow... positive convergence here that could really help you get through the medical issues. You really need to follow up as this is starting to become a great thread.

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GBerger +0 points · over 7 years ago Original Poster

Well, it's been about a month since I originally posted this topic to the forums. Since that time, I had an appointment with my new ENT (who also happens to be the brother of my cardiologist). He examined me, looked over the recommendations from the ENT who performed my sleep endoscopy and suggested the following: he felt like (2) of the (4) procedures that were recommended (in his opinion) have the promise to provide me enough relief to be worthwhile getting done. They were the Palatopharyngoplasty or UPPP & the Septoplasty. The Palatopharyngoplasty or UPPP is the surgical removal of the uvula & additional adjacent tissue in the throat to widen the airway. It takes 30-60 minutes & is done with a general anesthesia. A short time is spent in the recovery room but patients typically spend the night at the hospital for observation. A Septoplasty is a procedure designed to improve a patient's nasal airway. Nasal obstruction is usually caused by bone or cartilage which blocks the nasal airway. This procedure also requires a general anesthesia & typically requires a short time in recovery following the procedure. I gave him the initial go ahead to secure approval from my insurance company & the insurance company has already responded with a request for additional information. The tentative date for the surgery is Tuesday, July 25th. I had my pre-op appointment with my family physician which he is faxing to the ENT. I've sent inquiries to both my cardiologist and my endocrinologist asking them for a recommendation on my medications.

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wiredgeorge +0 points · over 7 years ago Sleep Enthusiast

Things are moving along. Can't comment on medical issues (lack of expertise) but hopefully the two procedures will bring some relief. Guess a second opinion was of value.

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Rirob +0 points · about 7 years ago

My doctor highly recommends that people don't try surgery as the likely hood that surgery will solve your sleep apnea issues are slim to none! I'm at my last resort trying a bipap machine with nasal pillows hoping it will eventually help or help cure my sleep apnea?

This is my third try with a machine. I've also tried a periodontist made orthotic device and to date nothing has helped due to my severe claustrophobia. I've had my new machine only a few days now with the nasal pillows and I still can't wear it all night, but do wear it for a few hours before I take it off.

Not sure if you want to go through all the trouble of those surgeries if only to find it doesn't help your sleep apnea? My doctors have told me that the surgeries are hard on you and the recovery is "very rough"!

As the others have said, get a second opinion and maybe even a third before you go the surgical route.

Good luck to you.

Rob

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PracticalAzureFalcon0046 +0 points · about 7 years ago

I just recently had the turbinate surgery and removal of my tonsils. So my experience is not exactly like yours will be, but it's recent and it is throat surgery. First the recovery from the surgery is very painful, especially the tonsils. I lost 20 pound in 12 days, no exaggeration.

I was out of work 8 days total. The Thursday of the surgery, then Friday, Mon-Fri the following week and the next Monday. I went to work that Tuesday and made it through to 3:00pm and through to 4:00pm the next day. Anyway make sure you check on the length of the recovery. I am 53, btw.

Results, I definitely feel better than I ever did with the CPAP an bipap. But I am still tired. My wife says am no longer snoring and my breathing is not as labored.

I just went back for the sleep study. My doctor says he sees no difference, and that I do still have sleep apnea. I probably still do, but I feel better and even though it was an ordeal it is the ONLY thing that has made me feel better at all.

This might be too late for you, but thought I would provide some input from my somewhat similar situation.

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DesertHorses +1 point · about 7 years ago

Being prepared for the aftermath of surgery helps any recovery go more smoothly. After thyroid surgery, gelato, sherbet, ice cream and protein shakes were my friends - great excuse to indulge. When that gets boring, move on to soups, etc. Plan on sleeping with your head elevated either with pillows or in a recliner - this helps drainage and reduces swelling. Get ice packs ahead of time - either flexible gel ice packs from the drug store or several bags of frozen peas you can rotate. Ice melts and gets messy. Ask about a prescription for "miracle mouth wash" - a combination of numbing and pain meds. This can make the difference in being able to swallow at all. Even if you don't normally have acid reflux - a bout of it after throats surgery can be excruciating. Taking some cimetidine or Pepsid OTC ( or ask your doc for a prescription) can keep this from happening. And don't be afraid of pain meds or getting lots of sleep especially the first few days. Pain inhibits your body's ability to heal and there's nothing to be gained by avoiding pain meds when you need them. Rest is a large component of early healing and it can take general anesthesia up to 72 hours to clear your system. It can be a shock for some of this that after surgery we can't just pop up out of bed and resume where we left off

Patti in AZ

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HonestTurquoiseRhinoceros6898 +0 points · about 7 years ago

Dear all, I recently diagnosed as mild OSA with UARS. My main complain is daytime fogginess and sleepiness. After DISE (drug induced sleep endoscopy) my doctor , who is an ENT surgeon suggested modified expansion sphincteroplasty along with nasal deviation sx. According to him as my site of obstruction is velum and DNS (nose) these sx may improve my condition.I am little nervous about it. I hope your (GBeregr)surgery gone well and you are doing better than ever. Oh, I am 40 and with BMI of 28.

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