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  • #1

    what to do next

    Hi,
    I have mild osa and have been using an a/pap for 2 years now.
    I went to the hospital yesterday and and showed them my printouts from my machine and the results from using my Oximeter.
    I have tried 1 night of sleeping with no a/pap and the Oximeter showed very clearly that the a/pap does a good job.
    I told the doctor that although the a/pap does a good job I am still having apnea's and I would like to have a sleep nasendoscopy and if it showed clearly what is causing the apnea's I would like to have surgery for that.
    He said this hospital does not do that because surgery has a high failure rate and think's i should look at using a c/pap as the a/pap is failing me.
    he is talking about setting the pressure to 20! I said isn't that an overkill and he said we will start at that and see if apnea's stop and then monitor it.
    I do not look forward to a set pressure of 20 and feel i should be going down the sleep nasendoscopy route.
    i would be very interested to hear your thoughts on this.

    Regards Joe
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  • #2
    My personal thoughts are that surgery should be a last resort.

    What's your APAP set at? Is it wide open (4-20) in which case some tweaking may be helpful (other than just setting it at 20!)

    Comment

    • #3
      Why on earth are you so decided that you want lumps cut out of your throat, especially as your APAP is doing a "good job"?

      As for the CPAP: makes a lot of sense to me because that is what I have done except I did it by increasing from a lower pressure rather than decreasing from the maximum pressure a machine will give.

      "Does a good job" does not tell us a great deal technically. What is your AHI on APAP? What is your 90% pressure? How much leakage do you record? How many times do you wake per night? Are you well hydrated? Use a humidifier?

      TF
      Respironics REMstar 'M' Series APAP.
      Resmed Mirage 'Quattro FX' Full Face Mask with a 'Quattro' headgear.

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      • #4
        Hi Joe,

        You should dismiss from your mind any ideas of having surgery: it has a very poor rate of success, and, if yours goes wrong, there is no way of restoring what has been removed.

        I would think you are probably thinking of using private medicine for this procedure because someone has tried persuading you to go down this path. There are people whose surgical intervention has left them in a much worse state than before: unable to eat properly, unable to taste or swallow. But a CPAP would have solved their problem.

        A pressure of 20cm.H2O is not that great: I have a pressure of 37cm.H2O and that gives me a good night's sleep every night.

        Instead of toying with the idea of surgery, why not treat yourself to a nice APAP machine instead?

        Richard

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        • #5
          Thank you all for your help.
          I looks like surgery is the wrong road to go on.
          I will obviously have to think again on this.

          Richard what do you mean get a nice a/pap?

          At present I have a Remstar auto m series with a flex and a humidifier.


          thanks Joe

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          • #6
            [QUOTE=Richard;17600 I have a pressure of 37cm.H2O and that gives me a good night's sleep every night.[/QUOTE]

            37?!?!

            Really?

            ....................

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            • #7
              Yes, really.

              My apnoeas are not the OSA type. It's the lungs, dear boy, they don't work as they should.

              At best, I have around 25% lung capacity, which means getting about is a pain. My default blood-sats without supplementary O2 are around 85% and with O2 the best I can reach is c.94%. Overnight ventilation for 8-10 hours with a line of O2 prevents the sats. from dropping below 90%; in essence, the vent. breathes for me.

              The respiratory consultant cranks up the pressure a notch or two every year! Five years ago it was 28cms.; my BREAS ventilator has a max. of 40.

              What I have is the collateral damage from having TB when I was a student, although the TB was cured, the damage was already done. Unfortunately, we see nowadays that TB is on the rise, ever more reason for children to be vaccinated. Ironically, I had the BCG vaccination when I was at school.

              Richard

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              • #8
                Ouch - that's not good!

                So when you get to 40hPa is that move-to-another-ventilator time or just crank up the oxygen?!

                Comment

                • #9
                  I'll let you know when I get that far! If I get that far.

                  Richard

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