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Tonsillectomy failure
#1
My son went in for a tonsillectomy and adenoidectomy a little over two weeks ago. He needed them out anyway for recurring throat infections and ear problems, doctor told us he could possibly come off BiPap as a result of the surgery. Well he's recovered from surgery and last night had to go back on BiPap as he was having fatigue and tiredness and we could still hear him snoring and gasping. He was really wanting to get off pap therapy but after I did some digging on all this leading up to surgery day I told him don't be disappointed if it doesnt work based off what I had read. So we called the doctor and told him what was going on and he said to resume pap therapy. Carter was disappointed but took it in stride. I'm thinking he may need to go back in for another titration study because with the mask on I can still hear him snore a little wheras before we heard nothing but peaceful breathing. I'm wondering if this surgery has altered his pressure needs.
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#2
Its highly likely that his pressures might have changed, but I would suggest waiting longer to re-titrate. Most likely not all of the swelling is gone from the surgery, so if you re-titrate now, in another 4-6 weeks, when all swelling is gone and everything has settled down completely, those settings may not be any good, and then you have to re-titrate all over again.
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#3
Brian, do you use Sleepyhead to check his progress and monitor for higher apnea events? I would think if you have a look at the data you can very easily see whether there are events occurring, and at what pressures they happen.

I doubt the swelling has fully stabilized for Carter, and I would think the warm humid air would be helpful during healing. There may be further improvement, but as you know, surgery does not have a high success rate in replacing CPAP. Hopefully (and likely) this will resolve the ear infections and other problems.
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#4
Yes, I use sleepyhead for him and me, and yes he has went from two to three events a night to eighteen to twenty spread throughout the nigh, but I didnt think anything about it as he has been off of it for two weeks, so I was thinking he was getting used to it again, gonna watch it more closely over the next week, i'm hoping to get him back to 100% on sleep before christmas break ends this week
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#5
I think you're wise to monitor this for the time being. He is still at an AHI less than 3, so not alarming considering the circumstances, but definitely worth watching. What type of events are being flagged? Are they a different type than what he recorded before surgery? If you're seeing OA or CA events, note the duration. They get flagged at 10 seconds, but longer events are a bigger concern.
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