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The Snoring & Sleep Apnoea Forums

Trials of a convicted snorer

If you have a story of success (or failure), then post it here for others to read.
peterf

Trials of a convicted snorer

Post by peterf » Tue Oct 14, 2008 4:42 pm

I have snored for a long time and being 46, fit, within ideal bmi, never smoked, drink moderately only once/week do not fit a lot of the classic patterns. 6 years ago my wife got completely fed up with this (my snoring, not my being a fit and housetrained husband) and I went to my GP who referred me to the local NHS ENT surgeon.

He identified my snoring as palatal flutter (which this site states is main reason if normal weight) and Epworth sleepiness scale scored only 2 so no concerns re apnoea. He said he could do a LAUP, however, he did state that it was painful and not always successful and I should consider it. He was not pushy and he gave me an open invite to get back in touch directly rather than going through GP when I had decided.

I then found this site and bought a mandibular advancement device (MAD) which really helped to reduce my snoring well but it did not hold in my mouth very well, often falling out while I slept. Now, I know a MAD is not the best solution for palatal flutter but it did work when it stayed in. I tried some of that denture fixative to hold it in at night but that was not very successful as the plastic was the wrong type. As it worked I called the ENT surgeon and asked him for referral to the orthodontist in the same hospital to get a proper one made. The orthodontist said I had a wide jaw which was why the off the shelf one was not fitting well, he even had to dig around to find an extra wide mould to take my impression in.

Anyway, the custom MAD he made up did not work as well as the one from BSSAA and after looking at the differences the custom one had a large frontal opening and allowed a lot higher air flow. I went back to the orthodontist and asked for a second one to be made up with a smaller opening like the one from BSSAA, where the opening was only a small slit about 2mm x 15mm for the wooden stick to hold the MAD whilst moulding it. At first he was not willing to cooperate at first stating "this is how we make them, do not know why it does not work for you". I showed him the one from BSSAA and showed him the differences and said that it worked very well so he eventually gave in.

This second custom one (my third by now) was brilliant and I have been using it successfully for 5 years. I think experientially that as I snore due to palatal flutter that pulling jaw forward has helped open my throat up but that on its own is not enough but the airflow restriction with a small frontal opening gave it an extra help. I sometimes wake up with achy jaw and teeth that do not mesh until after breakfast. I am also worried longer term, if I wear this for another 35 years, it is essentially putting force on teeth such as by braces which can move teeth although the forces are lower perhaps. I am just fed up with using it and sometimes if I do not fall to sleep quickly it bugs me and I end up taking it out to get to sleep. Then I snore and wake my wife and she wakes me etc.

Recently I have started snoring when wearing the MAD and also keep feeling that I have something stuck in my throat making me try and cough it up. I went back to GP and ENT and saw a different surgeon but he confirmed the same as last time. I have a larger than average uvula, which is what is probably tickling my throat and keeps making me feel something is stuck. Other than that he said airways in nose were OK and I have no problems with enlarged tonsils. Therefore, this time I have decided I will have the LAUP, no trimming of pallate so should avoid some of the problems associated with UPPP and hopefully get some improvement so I do not have to use the MAD for the next 25 years.

I believe that I have been through this in enough of structured approach rather than going straight for surgery that it is a considered decision. I am still anxious about the procedure and the recovery but after 5 years of using a MAD I am willing to take the pain in the hope that I can sleep without it in the future. I am happy to have seen a surgeon who was not pushy and willing to help me try alternatives rather than going direct to surgery. I know there are some negative re the surgery route but pinning hopes on not having other underlying factos such as weight or smoking that the chances of success are higher.

snoozer240

Re: Trials of a convicted snorer

Post by snoozer240 » Tue Oct 28, 2008 11:44 am

Hi Peterf,

When are you going for your surgery? Is it available on the NHS or are you having to go private? Keep posting as I will be interested in following your story. I had LAUP in August but I wish I had done the research like you first instead of having the surgery and only then discovering this site which is sooo helpful. On the day of the surgery the ENT specialist told me that my snoring was 60% palatel, 20%nasal and 20% tongue based so the surgery would only improve my snoring. I now also wear a nasal dilator at night which stops my nasal passages from collapsing during the night. My husband says that my snoring has improved and he doesnt here me anymore. I am aware of slight snoring in the early hours of the morning - but I also think that I have become hypervigilant of any noise I make because of all the attention that was brought to my snoring. I wont kid you that for me, the surgery was not pleasant, i dont want to put you off as everyone is different, I just want to be honest. I have a very strong gag reflex and retched constantly during the procedure. Thankfully the procedure itself only lasts a few minutes. Afterwards it took me about ten minutes before I could swallow my own saliva as the back of my throat was numb.

The pain afterwards for me, was consisderable but with medication I was back at work the next day. I had difficulty swallowing fluids (not food?) for the first few days - you know like when things go down the wrong way. On a positve note the pain and swallowing issues cleared up after about 7 days and I have no problems now. I hope that I havnt put you off I just wish someone had told me what to expect. I wish you good luck! and keep me posted on you progress.

Gail

peterf

Re: Trials of a convicted snorer

Post by peterf » Wed Nov 05, 2008 5:57 pm

Gail,

Thanks for your reponse, always interesting to see how others have tackled this. Also it is good to hear you have had success with this surgery. There always seems to be some very vociferous posts that it is a waste of time and few that espouse the successes.

Sorry no reply till now as have been away on busines for a while.

I am due to go in for surgery on the 17th, 1½ weeks and I am now getting a little nervous. Even though this has been I believe on my part a well researched and an informed decision, I still find myself lying awake occaisonally worrying myself. I am getting this done on the NHS, I live near Middlesbrough, I guess it may be one of those postcode lottery things as I know other people report having to go private. I also got my MAD made by the orthodontic service on the NHS and I have had 2 of them.

I have continued investigating this further over the past weeks even running up to the surgery because I was apprehensive about it. I bought some Rhynil on 14th Oct when I made my initial post - I had not tried this before but wish I had. I used it for 7 days while still using the MAD to allow the effect to build up and then slept without the MAD and I did not wake my wife up once in over a week. The Rhynil stiffens the palate so that was good evidence confirming the surgeon's and BSSAA tests that it is only palatal flutter in my case. This then left me in a quandry, do I cancel the surgery and use the Rhynil. However, for me the rhynil stung quite a lot and was not pleasant to use. After thinking about it I have decided to continue with the surgery because the rhynil was not a long term solution for me but having used it successfully to stop palatal flutter suggests that the surgery which should achieve the same end should also work.

I have since also spoken to the surgeon again, and he said he will be trimming the uvula and scarring the soft pallate with the laser to stiffen it but he will not be trimming off any of the soft pallate. Thus I will not get the full LAUP but an LPP in his jargon. This has reassured me because the information I was given at the pre surgery medical listed several possible side effects that could occur such as dry throat and nasal regurgitation. I then spoke to the surgeon and he said that was a general leaflet for all anti snooring including the much more radical UVPPP surgery and the side effects can occur if the soft pallate is trimmed and can no longer seal effectively. Several medical papers that I have been able to find abstracts for state that laser scarring without trimming only has very low incidence of side effects.

Re the pain etc, I am having my op under general so no issue with gag reflex. However, everyone has been very up front with the pain issue so I know to expect it. My GP said it was painful, the surgeon said it was painful, the nurse of the pre assessment said it was painful and so did the leaflet I got given at the pre assessment. When I went back to my GP a couple of months ago saying things had deteriorated and could I now get the surgery he told me it was painful. His quote was "after someone has been for this I never hear from them again, but I am not sure if this is because of the success or because even if it was not successful they do not want to go through with it again". Therefore, you have not put me off by being honest, it just backs up what I have been told by the health care professionals I have dealt with over the past 2 months.

I have also been told that on average it is not always successful, perhaps 85% short terms declining to perhaps 65% long term. I am hopeful that in my case it will be successful because of no other underlying causes and the fact that the rhynil stopped my snoring and the surgery should have the same effect, and on this basis I am willing to contemplate the pain.

I will post after the surgery.

Cheers,

PeterF

snoozer240

Re: Trials of a convicted snorer

Post by snoozer240 » Wed Nov 05, 2008 7:23 pm

good luck :)

At least you will be having a general - if you were to ask me which was worse; being awake during the procedure or the pain, I would definately say being awake during the procedure, so at least you wont have to go through that.

After having my LAUP I started the singing for snorers exercises (which Ken posts about under the general snoring products forum). Im in my third month and can reach notes which I havent been able to reach for years. My thinking is that after going through with the surgery to improve things im going to keep things toned with these exercises - and therefore increase the chances of improvement for the long term.

Good luck with your procedure :D Gail

peterf

Re: Trials of a convicted snorer

Post by peterf » Tue Nov 18, 2008 7:42 am

Well I had the surgery yesterday and this went well, no issue with general anasthaetic or pain afterwards, the largest issue is the swollen uvula which makes me keep wanting to cough. It is funny seeing other posts stating back to work after 1-2 days, I have been given a sick note for 2 weeks and told to avoid crowded places in the interim to avoid infection. Can not complain as liuckily I can have the time off without any consequences.

The op was done by a different surgeon than the one I saw in my consults. He was ging to do a full LAUP, which if you read my previous post was not what was agreed at my consults, I was going to have scarring and trimming of the uvula only. I had to correct him on this and he said he would revise his procedure so I still have some uvula left but he has cut out some soft pallate away. This is causing me some concern and I slept poorly the first night worrying about this. I will have to wait and see as it heals and hope he has the balance right. My job means I have to fly long haul a lot and there is no way I want to suffer from a dry throat as a normal state and then spend 12+ hours in a plane.

Peterf

snoozer240

Re: Trials of a convicted snorer

Post by snoozer240 » Sun Dec 07, 2008 11:20 am

Hi Peter, was wondering how you are getting on post op? Have you noticed any difference in your snoring yet?

Gail

peterf

Re: Trials of a convicted snorer

Post by peterf » Wed Dec 10, 2008 3:48 am

Hi Gail,

3 weeks since op and the stub of my uvual and edge of pallete has healed, think it is still a bit swollen and still aches a bit. I did not sleep with my wife until 1½ weeks after the op and in last 1½ weeks I have not woken her with my snoring at all. Therefore, this seems to have been a great success from that respect. I am getting a little bit of leakage into my nose, particularly with fizzy drinks, but the worst has been with beer as the flavour of it travelling above the pallete is not too pleasant. I stayed off these for the 3 weeks so only now finding this. Hopefully this will be a transient effect and will go away over the coming weeks. Other good news is that I have just travelled to Australia and although this has made the site of the op a little sore I have not suffered unduly from a dry throat or other problems so it was certainly worthwhile talking to the surgeons and getting a non standard procedure. Luckily in my case, they could actually stop the snoring without removing too much tissue, from memory the 1st consultant said I had an open passage without any restrictions and it was all down to elongated / floppy uvula and pallate.

Peter.

snoozer240

Re: Trials of a convicted snorer

Post by snoozer240 » Mon Dec 15, 2008 10:51 am

Hi Peter glad youre getting on so well. The thing with the fizzy drinks should pass - if I remember I spent the first two weeks consciously thinking about how to swallow. Some fluid would try and 'go down the wrong way' but over time this has righted itself and I no longer have problems with swallowing and Im sure this will be the same for you.

Gail

marcodamb

Re: Trials of a convicted snorer

Post by marcodamb » Fri Jan 09, 2009 5:13 pm

Dear Peter,

Thank you for posting your experience. I'm in your very same position and I'm 'only' 32 yo. I've snored since I was 25!!! Yesterday I went through the sleep test and it showed that I have no apneas, so I'm going through surgery (LAUP) on Monday (a bit of a rush, I know). My worry is that my voice would change. Is this unfounded or a real problem? What was your experience? Have you noticed any change in yours? If so, what kind of? I'm simply scared to end up with a 'more female' voice and I'm not sure whether I could cope with it. Your experience either positive or negative could help me in a better decision (although everything is set, I can still step back at the last moment without regrets). Of course, I would also be very interested in knowing whether the snoring has reduced or disappeared. I really hope so :-)

Thank you a lot,

Marco

peterf

Re: Trials of a convicted snorer

Post by peterf » Mon Jan 12, 2009 2:41 pm

Hi Marco,

Sorry I did not check this till Monday so you may have had your op by now. I have had no changes to my voice, but then as noted above I did decide with the original consultant to have the minimum amount of work done, i.e. no remove of the pallate, just uvula and scarring of the edge of the palate. I noted previously that I was having some trouble with fizzy liquids and this has almost completely stopped now as all the swelling has gone down.

This has totally cured my snoring, and I have not woken my wife once since the op. However, others report less success, in my case snoring was identified completely as pallatal flutter with no nose or tongue snoring and open airways in nasal cavity and throat.

I hope this goes / has gone well for you.

Peterf.

marcodamb

Re: Trials of a convicted snorer

Post by marcodamb » Mon Jan 12, 2009 6:49 pm

Hi Peter,

I'm glad that your snoring problem is gone. I think our partners should be really nice at us, shouldn't they ? ;-)

Thank you for your answer. I read it just after I came home from the hospital and it is reassuring.

My operation went well, part of the uvula and part of the soft pallate are now gone and the scarring is done. The surgeon assured me that he did the minimum indispensable so to avoid any damage. Good news but it might result in a second session, with which, by the way, I am ok given the fact that this operation was not painful and that also now I feel quite ok (well, I had better days, but this is certainly not the worst).

Actually, I am a bit concerned by the fact that I feel little pain right now, just wondering whether the operation will bring any results...We will see. I'll keep posting.

Thank you for your help.

All the best,

Marco

peterf

Re: Trials of a convicted snorer

Post by peterf » Mon Jan 12, 2009 11:41 pm

Marco,

Glad it went well and I completely agree with minimal approach, you can always go back for more but if it is too much then too late. I have also recalled that if there is an effect to the voice it can make it a little mroe nasal for a few weeks until the soft pallate can seal the nose off properly again.

I had little pain on the first day and had no trouble to start with. The pain did kick in 4-5 days later, not sure why but I was eating porridge / soup and other very soft foods for a few days.

Re partners - couldn't agree more.

Cheers,

Peter.

Jamz34

Re: Trials of a convicted snorer

Post by Jamz34 » Tue Jan 27, 2009 8:21 pm

Marco,

How is your throat healing now? Hopefully you are doing well. I am curious as to the continued recovery and any side effects you are noticeing. My Uvula swells for no apparent reason every month or so, drives me nuts. Some kind of allergy they think. I have seen 2 ENT's and 2 different allergists, to no avail. Basically it is down to if it really bothers me both ENTS have recommended removing part or all of the UVULA. I dont think they are going to remove other tissue, though maybe they should..

So i guess i am just curious how the whole Uvula healing process has been and has it drove you crazy, or is it just painful. Any major side effects? Do you notice it gone everyday in remorse or, hopefully, you are pleased with the procedure, progress and results?

Your response is appreciated.

Thanks,

james

marcodamb

Re: Trials of a convicted snorer

Post by marcodamb » Tue Jan 27, 2009 10:58 pm

James,

Today is my 15th day after the operation. So far (almost) so good. Only drawback:it was very painful, much more painful than what I thought (the surgeon only granted me 3 days sick leave after the operation but it was IMPOSSIBLE for me to get back to work as I was in deep pain and had to ask for 2 more days). A part for that, and a slow recovery, I don't see for now any major side-effect. The uvula (or the little part left) stays where it has to and has not swollen. Pain has decreased to zero. Only points are some sort of difficulties in swallowing when something gets stuck in the throat (or at least when I have the feeling that something has got stuck). My voice didn't change, but I'm now unable to pronounce the French 'r' (which is basically made through a vibration of the uvula and the throat), not a big deal apart from the fact that I live in Brussels which is French speaking.

I'll keep posting to tell whether I get problems with the uvula in the next months.

I use the opportunity of this message to thank Peter for his kind support and for sharing his experience.

Take care,

Marco

Jamz34

Re: Trials of a convicted snorer

Post by Jamz34 » Wed Jan 28, 2009 4:27 pm

Marco,

Thank you for taking the time to reply. Sounds like you are working through it. From some of the other posts i have read it appears the swollowing thing gets better with time. Were you able to tell if most of the pain was from the soft palate removal or the Uvula? I am guessing it just all hurt like @&!!.

Did you have your procedure as a result of snoring or sleep apnea? I dont think i have a problem with either, maybe more allergy related the docs dont know. I dont know but drives me nuts and cutting it out would seam to at least alleviate the swelling of the Uvula issue. However, as i am worried about life without Uvula, as i am sure you were.

One side effect many have mentioned is increased phlem and the constant clearing of throat. Have you noticed that?

I will look forward to your update, progress and speedy recovery.

Many thanks,

James

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