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Can anyone recommend a physician for adult laser surgery for
obstructive sleep apnea. Also, was the surgery sucessful, and
what was the process like?
I had this surgery last August. It was performed by Dr. Andrew Moyce of Summit
ENT. I liked him. Still do. Felt no pain during surgery. Had tonsils, uvula and soft
palate tissue removed. (My apnea was severe and CPAP machine caused allergic
Recovery was tough for a while. Horrible sore throat for days. Very hard to eat
anything but crushed ice, popsicles, jello for days.
A week in, I sprung a leak (artery blew in throat) and had to go to Summit
emergency room at 3 am. Dr. Moyce came and sealed me up. Scary as hell, but I
made it thru. I understand leaks are not uncommon with the surgery.
No other complications.
I've had to adjust for some time. Voice box resonates differently. Have issues with
mucus drainage from nasal passages which is annoying.
OTOH. Apnea is gone! I get good nights sleep. My wife says I no longer snore...it
used to be real bad. It was unpleasnat, but worth it. I'm far more rested (and so is
my wife) and have adjusted fine to the issues I mentioned above.
I also have a good friend who had the surgery too, but he got it done at the VA
hospital in SF since he is in the Coast Guard.
My husband was diagnosed with sleep apnea in 1999. At the time we
were living in Oregon and had excellent medical care. He was seen
by specialists, had sleep evaluations done and was given a CPAP
machine. About 9 months later we moved here to the Bay Area,
meaning we had to change doctors. I was overseas when my husband
was diagnosed and did not get to ask many questions about his
care. When we left, we were given the machine to keep (not rent)
and sent on our way.
Our doctor here, who has been in practice for quite a while,
admitted to never having had a patient with sleep apnea before.
In the last three years, we have never had a follow up
appointment or even a phone call regarding how his treatment is
going. It seems to me that since this is a lifelong condition
that is potential fatal ( should he stop breathing and not start
again) that we should be receiving some kind of follow up care on
a regular basis.
At one point his CPAP machine broke and it took a month just to
get a replacement machine. The respiratory therapy company we
worked with, Apria, promptly lost our machine and then tried to
charge for a years(!) rent while they made very little effort to
find it. It took us over a year to get the machine that we owned
replaced with a compareable machine. The doctor's office was of
very little help and didn't even seem to comprehend the urgency
of needing a CPAP to ensure that my husband didn't stop breathing
at night. And in 3 years we have been unsuccessful at getting any
replacement allergen air filters for the machine.
My question is for those who are being treated for apnea. Do you
see your doctor or a specialist on a regular basis? I have a
nagging feeling that we are not getting the proper medical for
this condition. Our machine even has a smart card for usage
tracking, but no one seems interested in it. We have Cigna
insurance, but really no idea about whom in the Bay Area we
should be seeing. We appreciate any advice or helpful information!
I have heard this dentist speak on sleep apnea (his specialty)
at conferences. He is fabulous and had some interesting info on
I don't know if this was the type of information you were looking for, but I
would consider checking to see if my neurologist, Joanna Cooper,
accepts your medical insurance. I know she works with patients with
sleep apnea. I myself see her for other reasons, so I can't speak
specifically to that, but she is wonderful with me, and I would pay out of
my own pocket to see her rather than change because of my insurance.
I was diagnosed at the Stanford Sleep Disorders Clinic with a
condition related to sleep apnea. I am a Kaiser patient and I
paid for the initial evaluation out of pocket as Kaiser's
rudimentary diagnosis technique did not show a problem, but I
thought that one might exist.
Stanford's report from the evaluation- exam and history, cost
about $300- confirmed my suspicions and forced Kaiser's hand-
they then paid for a full sleep study at Stanford which confirmed
the preliminary diagnosis. I was put on CPAP which has helped a
lot- I am now rested by sleep instead of waking up still tired.
Apria provided me with the CPAP machine and initial instructions,
but I have not found them very helpful for ongoing assistance.
But since the CPAP continues to work, I have not been
None of the masks that Apria offered me were comfortable (it's a
challenge to sleep with that device anyway), and I found another
resource for other choices and replacement parts as I've needed
them. I pay out of pocket, but maybe you have different insurance
that would cover it. Jeanie Blair, a respiratory therapist, has a
business called CPAP Company in Sunnyvale, phone 408-746-9764.
she is a nice person and has been very helpful.
One word of caution about Stanford. I feel that they are too
ready to recommend surgery, some of it experimental. I wasn't
convinced that I needed it and it was very expensive (Kaiser
would not pay for this as it was experimental), and I sought
opinions from 3 doctors unaffiliated with the Sleep Clinic. None
of them felt that the surgery was warranted, and one said it
might even be harmful.
Does snoring mean Sleep Apnea?
Does anyone have experience with their children's sleep apnea? My son
(2 yrs old) snores terribly and seems to have trouble getting the breathing
technique down at night. He can't seem to breath through his nose and
sometimes will wake himself up trying to get air through. Obviously he
breathes through his mouth, but when he's not in a deep sleep, he
struggles with how to do it. It's painful for me to watch, not to mention the
loud snoring and flopping around on the bed when he wakes up. We sleep
together, so I get to participate in these events. I did see an
ear/nose/throat doctor who said he did have big tonsils and probably big
adenoids, but would need an x-ray to know for sure. We didn't really
get into the subject of surgery, but it may come to that. However, the doc
said he may outgrow it too. I really don't want to face surgery, but of
course I don't want my son to lose sleep either. Thanks.
We had the same problem with our daughter, now 3 years old. For a long
time she would wake up at night crying, and most times we (and her
thought it was a new ear infection, because she always had some fluid
behind her ears. It wasn't until she could say the word "nose" when
she woke up that we realized there was something wrong with her breathing.
She had been breathing mainly through her mouth too. She had huge tonsils
and when they did the sleep test they found several episodes of apnea. We
tried a nose spray for several months to diminish the inflammation in her
throat and nose, but it wasn't very helpful. Finally, after hesitating for
long time, she had surgery, and tonsils and adenoids were removed. We still
cannot beleive the difference. She sleeps trouth the night with no
problem, her snoring is completely gone, she breaths much more easily, she
is not cranky for being tired as she was before. And best fo all, her
frequent ear infections have disappeared, at least for the last 4 months.
The operation is really simple, and although the post-op is quite
painful, now I believe it was really worth the trouble. It was done at
Kaiser Oakland, by Dr. Byl.
Sleep apnea that results in the person awakening gasping for air, with
or with out, but usually with, loud snoring or other airway noises, in any
age group, is not okay, not normal, and should be the occasion to run, not
walk to a competent doctor who will perform a sleep study. The common
reason for awakening is that the oxygen saturation level in the blood gets
so low that the person jerks into consciousness to get more air: they
are suffocating, in a sense. Not getting enough oxygen is not good
for your body! that is why you wake up, to open the half-closed
airway! in adults, this condition increases risk for heart attacks
& sudden death. The person may need to use a CPAP machine: a mask
fits over the face while (usually) he sleeps, thru which pressurized air
is blow n into the airway to force open the air passages so that the person
person gets enough oxygen while sleeping. Some people have their
throats/airway remodeling surgically for this condition. Merrill
Nissam in Marin is one surgeon who does the procedure. If it were
happeneing to my kid I would not hang out & wait for him/her to
outgrow it, I would get right on it, do a lit search, go to Children's
Hosptial, UCSF or Stanford & not to a small pediatric office.
Kaiser has classes on sleep apnea, and a doctor whose speciality it
is to deal with it. How come I pontificate on this? I am an ER
nurse & diagnosed my partner's sleep apnea (he was awakening gasping
gasping from low O2 many times per night & felt tired all the time
& was a monster loud snorer) & hauled him in for help. He now sleeps
with a CPAP, feels much better. This is a common, oft-undiagnosed
condition that is a serious health hazard for some people! It should be
part of routine screening, especially in adult men, but it is not! Oh well.
Now you know! Save your family members!
Is daughter's lack of growth due to sleep apnea?
My daughter is 3.8 years old, but she is shorter than the average 2
year old. I was concerned about her growth, so her pediatrician gave
her some blood tests (what, I don't know) These came back normal. His
explanation for her lack of growth is one I've heard before: Her tonsils
are enormous (they squeeze up against each other). This causes sleep
apnea which interferes with deep sleep needed for growth. (Evidently
there is research to support this idea.) He believes that after we remove
her tonsils, all will be fine.
She does act like a child whose sleep is being disrupted:
She is relatively lethargic, inattentive, and constantly stares off
into space. I would love to think that many of these problems could be
fixed with a tonsillectomy. However, I am not convinced.
One, I haven't really witnessed this sleep apnea.
She does snore when she's sick, and her breathing is always
audible, but only a few times (when she was very congested)
did I hear her stop breathing for a few seconds. She
sleeps in the same room with me and I listen a lot. Is sleep
apnea so subtle that I miss it? Have other parents had their
children's tonsils removed just because they were large or the child
Which brings me to two: If she is so sleepy then why does she sleep
far less than average for her age? In each of her 4
child cares, she was the ONE child who refused to sleep, and
actually stopped napping regularly at 26 months. Are sleep apnea
children sometimes non nappers? Have people seen their children go to
sleep more easily after their tonsils were removed? Do they become
less fidgety at bedtime?
Question three: Could a child have the growth and grogginess symptoms
of sleep apnea, but have the problem really be some sort of childhood
insomnia? I sometimes wonder about our family bed situation.
(especially when I lie awake in bed at 3 am after being woken up by someone,
for the hundredth night in a row). This girl takes so long to fall asleep
and sometimes announces: " I'm not going to sleep tonight." Has anyone
every heard of chronic insomnia for a child so young?
You have a really good pediatrician. Sleep apnea often goes
unrecognized. Your description of her symptoms is exactly that of an
affected child. If you want a 2nd opinion, I'd suggest calling Rafael
Pelayo MD at the sleep disorders clinic at Stanford. You'll get state
of the art advice and probably some good articles or references.
How about renting an apnea monitor? A sleep study at home? At least
that way you could rule out apnea if that's not the culprit. Maybe your
insurance would cover it, it's certainly worth testing before having a
tonsillectomy. Good luck.
My son had his tonsils removed when he was almost five. He was also
diagnosed as having sleep apnea. In his case, I could see it happening
many times during the night and it wasn't something that was hardly
He snored very loudly when sleeping, and sometimes, would just stop
breathing for a few seconds (maybe 6 or 7 sec) and then, he would start
again very loudly, as if he was drowning before.
He was always tired, specially in the morning, even though he slept long
hours at night. He also didn't have much appetite and was very skinny,
to the point that really started worrying me. I had talked to his
many times about how he snored and was tired and the pediatrician would
always tell me that he would grow out of it. Just after changing
pediatricians, for other reasons, I found out that he actually had sleep
apnea. I was very reluctant about having the surgery and did a lot of
research about it, but finally decided about doing it.
Today, I can tell you that the only thing that upsets me is not having
done it before. My son is another child. He doesn't snore anymore, wakes up
every day in a good mood, grew up and gained weight, and his teachers at
school keep telling me that he really flourished after the surgery.
This is my experience, I hope the information helps you a little bit in
deciding what is the best in your case.
I would suggest you talk to an ear, nose and throat specialist about
this problem (didn't your doctor refer you?). My two-yr old had huge
tonsils. and adenoids (3x larger than normal) which were detected by an
x-ray. Dr. Wesman at Children's Hospital was his doctor, and although he
recommended surgery, he never pressured us and let us decide when or if we
wanted to have the tonsils and adenoids out. My son did not sleep well--he
would snore loudly and at times, stop breathing for up to 15 seconds. I
could see his chest heaving, but no air was going in. Then all of a sudden
he would snort and gasp and breath through his mouth. All of this
noise usually woke him up as well, so there was much flopping around on
the bed. We sleep together and of course I was getting no sleep either
as I waited for each breath. We finally decided it was time and had the
surgery. The results were dramatic. Not only did he sleep and quietly
at that, he began to eat better, too. I don't know why, but it was always
a struggle to feed my son since he was 1 year old. He has always been in
the lower percentile of weight and height. However, he gained two pounds in
the month after his surgery and he continues to eat like a "normal"
picky eater. As for sleep habits, my son still wakes up 2-3 times per night
and doesn''t seem to need more than 10 hours at night (two hour nap at
midday though). He has plenty of energy throughout the day. From what you
describe, it doesn't sound like your daughter has sleep apnea as I know
it. But perhaps it comes in different forms. Follow your gut
feelings--- do get more information on insomnia. Sounds like you're on the
right track... Good luck.
My older son, Benjamin, went through this when he was a toddler. He had
a terrible snore and suffered from noticeable sleep apnea, which resulted
in his being kind of spaced-out during the day. The obviousness of the
sleep apnea developed over time--I'm sure he was experiencing interruptions
underneath the snoring before the interruptions became prolonged enough
to be distinguished from snoring. His growth flattened out entirely for a
long period. The problem was identified when he was about 20 months
old, but the doctors wanted to wait until he was 2 before operating (I never
did ask for details about the need for the wait). Anyway, his tonsils
and adenoids were removed shortly after his 2nd birthday and the change
(after he recovered, of course!) was remarkable: quiet, restful sleep;
increased alertness during the day; increased appetite; growth spurt;
Even though it was hard to subject a 2-year-old to surgery (Benjamin's
father was traumatized for life when the surgical resident took Benjamin
in his arms and walked off down the hallway with him---Benjamin reached his
little arms back over the resident's shoulders and said "Papa, Papa"), I
am convinced that having those swollen glands removed was absolutely the
right thing to do. Good luck with whatever you decide to do.
To the parents of the child with very large tonsils and possible sleep
apnea. My "child" is my almost 40 year old husband who always had the
exact same symptoms you all mentioned since he was a very small child.
It became a bit of a family joke that when he shared a room with his older
brother the brother would realize he wasn't snoring (therefore not
breathing) and just as he would get out of bed my husband would snort
and breath again.
After about 10 years of marriage the snoring became so pronounced and
the other symptoms so debilitating that I encouraged him to see a doctor
about it. The doctor did a sleep study along with many other tests and
referred him to a specialist. At that time he was found to be so
seriously apneic that they did major surgery and removed his uvula, part of
his soft palate, tonsils and adnoids. They said that if we had not caught it
he would have died in his sleep. Once your blood oxygen drops to a
certain level long enough it will stop your heart. Much like drowning.
After his surgery a second sleep study found that because it had gone on
so long his brain no longer knew when to tell him to breath when he was
asleep. He uses something called a nasal cpap machine to help him breath
at night by blowing air into his nose to stimulate his lungs to inflate.
I can understand your concern about having your child undergo any kind
of surgery, but if your pediatrician does not refer you DO IT YOURSELF. Do
not let this go on until he is an adult.
I will ask for my name not to be used in this but in an adult male
another side effect is impotence which they tell me is the LAST thing to
go!! We have since had 2 more children and my husband can't believe the
difference in his life! He will graduate from graduate school in May
after 7 years of school which he would never have had the energy to do
Apnea in adults and CPAP mask
I have just been diagnosed with moderate sleep apnea,
and have been told that I need a CPAP mask to wear
while sleeping. I'm totally new to this, so any
information you'd like to share I'd appreciate.
I don't know much about apnea myself, but I came across a site on sleep
disorders on the internet that may be helpful to you. They also have a sleep clinic in
Oakland. There are sleep disorder centers at UCSF and Stanford as well.
I was initially diagnosed with moderate sleep apnea. I tried the usual
mask that fits over the nose and I found it difficult to fall asleep. I
felt like I was suffocating, and it was very noisy. My respiratory
therapist recommended I try nasal pillows that fit under the nose. Go to
this site for a picture:
I found the nasal pillows much less invasive and quieter. Also, I went
to an ENT for an evaluation after the first sleep test, and it was
discovered that I had nasal polyps. I had an operation to remove the
polyps and fix a deviated septum. I had another sleep study and my sleep
apnea improved to mild. And I continue to use the nasal pillows. There's
a variety of masks, CPAP machines, etc. If something doesn't work for
you, push to try something else. Good luck.
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