I put this together just in case anyone else is considering or is booked in for surgery. I have written a condensed version of my story below – it is still long.
Type of surgery: UPPP, Turbinate reduction, tongue base reduction (called a multilevel surgery)
If you want to see a before, immediately after surgery and recovery throat picture click here NSFW.
Outcome: No side effects. Sleep good. Drs feel CPAP not required.
My sleep apnea story is a little odd in that I didn’t appear to have severe symptoms, in that I had no daytime sleepiness. What I did have was a lack of refreshment on a morning. This however did not impact on my daily functioning. I have for all of my life been a LOUD snorer. People in bedrooms in the other end of the home could hear me. It was my lovely wife, who first raised concerns as she observed apnea events. I went to see my GP, who referred me to a respiratory (thoracic) specialist, who instantly noted that my airway wasn’t great (specifically noting large tonsils), organised a sleep study and referral to an ENT. I guessed that given my lack of breakthrough symptoms and reasonable weight it would be mild at best. I was surprised that I was diagnosed with severe sleep apnoea (AHI 40).
At my ENT consultation I was informed I had a triple whammy of physiological concerns, a nose that was no good for breathing, a tongue that was too big for the container it was in (his words) and a compromised palate which he described as the combination of my soft palate, tonsils, adenoids and uvula all being massive and crowding my airway. So he booked me in for surgery, expressing that my physiology made me an idea candidate for successful surgery. He was up front that it may not cure it but he was confident in a positive outcome.
I was booked in for a multilevel surgery:
Sinoscopy, BILATERAL Inferior Turbinoplasty (Turbinate Reduction), Uvulopalatopharyngoplasty (UPPP), Radiofrequency Tongue (Tongue reduction)
Because I was in the public system, this took months. Between diagnosis, seeing ENT and then the wait for surgery was 18-24 months in total. In the meantime I tried CPAP. I was excited as this is the gold standard, unfortunately for me I didn’t get the kind of response others had. In fact I had the opposite, despite trying different machines, pressures, masks, tape etc, I slept worse with the CPAP in that I started to get daytime sleepiness and increased sleep disturbance. I persisted for about 16 months then stopped, happily my sleep improved so I simply waited for the surgery.
The surgery wasn’t bad at all; I had read the horror stories so was prepared. I had the surgery and stayed overnight in a high dependency unit (HDU). The surgeon (ENT) was very happy with the result and interestingly snoring stopped day one, which was surprising as they told me that due to swelling I would initially snore more. The recovery was rough but not horrible. I believe this was down to a good regime of pain medication (list here), gentle exercise (walks) and rest. The worst part of it was the narcotic medication, it zombifies you. I was able to reduce and stop the hard medication after about 10 days and managed comfortably on paracetamol. I expected to lose weight as I read that I would struggle to eat, so we made lots of slow cooked stews and soups which I ate luke warm and while this was uncomfortable, it was certainly tolerable, and indeed during the recovery I gained weight. The recovery was going very well, but I had a bleed from the tonsil bed on day 10 and had to present to the emergency department, if the bleeding hadn’t stopped I would have needed surgery to cauterise it, however it stopped but I had to stay overnight. After 4 weeks I was back at work and feeling OK, but I wouldn’t say and I was 100% until about 3 months post-surgery (i.e. back training regularly etc). Additionally, 9 months post-surgery I have had no side effects, other than a sinus infection at about 3 months.
So now the exciting part, 6 months post-surgery had a sleep study – I was concerned as I had just finished a heavy cold. I persisted with the sleep study as the wait times are horrendous. The follow up sleep study showed a reduction to 6.5 AHI which from 40 AHI is a significant drop so I was delighted. I am sleeping well, waking up less to urinate during the night, my wife hasn’t observed any apneas and she is delighted that I don’t know and describes me as a silent sleeper. Due to lack of symptoms respiratory specialist and ENT don’t feel I require further treatment with CPAP and I agree. So unless I significantly gain weight they feel that no further treatment is required and I don’t need to worry about the apnea. My ENT is going to follow me up for the next 24 months, but after being disheartened by my poor response to CPAP I am delighted with the surgery results.
In short I am happy with the outcome. Happy to answer any questions about the surgery and recovery. I do want to stress that while it didn’t work for me, CPAP is non-invasive and is the gold standard of treatment and should be tried before you consider surgery.
EDIT: Fixed links