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[Treatment] Surgery in Ontario/Canada?
#1
Sad 
Surgery in Ontario/Canada?
Hi everyone! I'm a 29 year old athletic male who got diagnosed with sleep apnea 2 years ago. My AHI is 32 when sleeping on my back and 5 when I'm on my side. I've tried CPAP (various masks), dentures, and positional therapy, but none of them worked. After talking to my doctor, I've decided to get surgery. I've read over 30 pages of this forum and other scientific papers, so I understand its risks.

I live in Toronto, so the doctor referred me to a ENT who deals with sleep apnea. The surgeon told me to get a septoplasty & turbinates reduction, as well as a UVPP. Looking at ratemd, the surgeon doesn't exactly have good reviews, and I haven't found a person who mentioned he got that surgery from this doctor, so I'm not sure. However, I'm asian, and the surgeon has wrote a study about how different races sometimes respond differently with surgery: http://wmcntr.com/ws/download/CSS%202015...urgery.pdf

I'm looking to get a second opinion. Does anyone know of a good sleep apnea surgeon in Ontario or know of someone who got one in Ontario/Canada? I can travel!

Thank you!!!
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#2
RE: Surgery in Ontario/Canada?
You say you tried CPAP. I think I'd give that another go before going through the pain and agony of surgery with only a 25% success rate. You posted a cpap pressure of 7cm. I'm guessing you didn't have close monitoring of your treatment and finally gave up. If you were to try again with the help of this Board I think you could find a fix for your problems. One other thing to consider is many people here have had surgery and ended up on CPAP anyway. Avoid the pain and go back to CPAP.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#3
RE: Surgery in Ontario/Canada?
(02-21-2018, 07:41 AM)Walla Walla Wrote: You say you tried CPAP. I think I'd give that another go before going through the pain and agony of surgery with only a 25% success rate. You posted a cpap pressure of 7cm. I'm guessing you didn't have close monitoring of your treatment and finally gave up. If you were to try again with the help of this Board I think you could find a fix for your problems. One other thing to consider is many people here have had surgery and ended up on CPAP anyway. Avoid the pain and go back to CPAP.

I've had close monitoring, had several sleep studies done, a titration, and tried it for over a year. 

I understand the risks and the success rate (though, in my case, is different; I have a 48% - 70% success rate according to the paper above) - I've read over 30 pages of this forum and more scientific papers than I can count!

If anyone in Ontario knows of a good ENT surgeon, would love to get a referral Smile
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#4
RE: Surgery in Ontario/Canada?
Just because you tried it for over a year does not mean that you were given good advice during that time. There are many people on this forum that have not been able to get good help from their equipment supplier (I would be willing to say the majority of people on here) or even their sleep doctor when it came to adjusting their machine and picking the right mask for effectiveness AND comfort.

Everyone wants a quick and easy solution to everything these days but the truth is surgery has a very, very low success rate. Especially long term. The odds of you eventually being on a CPAP machine is very high at some point. Even if the surgery works initially. But in the meantime you will definitely go through a lot of pain and inconvenience with doing the surgery.

It's your body and your call ultimately of course but I would advise you to do a lot more reading on the success rates and long term outcomes of these surgeries for Sleep Apnea and I would urge you to re-consider. I would suspect a large reason why your CPAP therapy was not successful is because it was not comfortable for you and you had trouble adapting to it. I would submit that with the combined knowledge on this forum you would get the help you need to make your therapy comfortable and effective. It was so for me and I sleep way, way better using my machine and the mask I eventually settled on than I ever did without it. I would not go back to sleeping without my machine anymore. That's a fact.

Your decision...
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#5
RE: Surgery in Ontario/Canada?
(02-21-2018, 01:14 PM)Marillion Wrote: Just because you tried it for over a year does not mean that you were given good advice during that time.  There are many people on this forum that have not been able to get good help from their equipment supplier (I would be willing to say the majority of people on here) or even their sleep doctor when it came to adjusting their machine and picking the right mask for effectiveness AND comfort.  

Everyone wants a quick and easy solution to everything these days but the truth is surgery has a very, very low success rate.  Especially long term.  The odds of you eventually being on a CPAP machine is very high at some point.  Even if the surgery works initially.  But in the meantime you will definitely go through a lot of pain and inconvenience with doing the surgery.

It's your body and your call ultimately of course but I would advise you to do a lot more reading on the success rates and long term outcomes of these surgeries for Sleep Apnea and I would urge you to re-consider.  I would suspect a large reason why your CPAP therapy was not successful is because it was not comfortable for you and you had trouble adapting to it.  I would submit that with the combined knowledge on this forum you would get the help you need to make your therapy comfortable and effective.  It was so for me and I sleep way, way better using my machine and the mask I eventually settled on than I ever did without it.  I would not go back to sleeping without my machine anymore.  That's a fact.

Your decision...

I understand and appreciate everything you wrote, but I pursued multiple avenues before deciding on surgery. I've read this forum, read multiple scientific papers, talked to multiple suppliers + sleep doctor, and even talked to people who had surgery 5-10 years ago and relapsed.
I also have a science degree in biochemistry with a minor in statistics, and I understand the risks.
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#6
RE: Surgery in Ontario/Canada?
Best of luck to you. Make sure to keep in touch. We'll be here when it's time to start the CPAP again.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#7
RE: Surgery in Ontario/Canada?
(02-21-2018, 01:39 PM)Walla Walla Wrote: Best of luck to you. Make sure to keep in touch. We'll be be here when it's time to start the CPAP again.

Thank you! Although I've met plenty of people who had surgery and never needed CPAP again, even after 10 years (one of the issues with some of the studies is that they treats all apnea patient the same as long as they have the same AHI, without looking at age, genetic disposition, whether they are overweight or not, etc. After talking to a number of people who would have been similar to me 5-10 years ago, surgery looks effective!)
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#8
RE: Surgery in Ontario/Canada?
I had turbinate reduction, septoplasty, AND a uveloplasty (UPPP) back in 1997, I was NOT overweight back then. They didn't fix my need for a cpap, and I still use one to today, for 20 years now. I get much better airflow, and I no longer tend to snore to "bring the house down", but realize that surgery is not usually a cure for sleep apnea, though it can help you better tolerate cpap therapy. If you go into with that mindset and NOT that it's a guaranteed cure, you should do ok.
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#9
RE: Surgery in Ontario/Canada?
(02-21-2018, 02:37 PM)MikeBear Wrote: I had turbinate reduction, septoplasty, AND a uveloplasty (UPPP) back in 1997, I was NOT overweight back then. They didn't fix my need for a cpap, and I still use one to today, for 20 years now. I get much better airflow, and I no longer tend to snore to "bring the house down", but realize that surgery is not usually a cure for sleep apnea, though it can help you better tolerate cpap therapy. If you go into with that mindset and NOT that it's a guaranteed cure, you should do ok.

Yep! This is similar to what I heard from others who relapsed, that it still helped with their breathing - thanks!
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#10
RE: Surgery in Ontario/Canada?
Best of luck to you! Like Walla Walla said. We'll be here.
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