Lefort 1, BSSO, and Genio. Advancement for Sleep Apnea

[Guest guest]

Welcome Shirley, it's nice to hear from a fellow apneac! Did you ever

try the nasal pillows? I found them much more tolerable than the mask.

I ended up tossing the whole thing and opted for something more

permanent. I had an 8mm upper,lower,genio last may. Being a mouth

breather all my life it was easy to adjust to the stuffiness after

surgery but the first thing I noticed when I awoke was how easy it was

to breathe through my mouth with the airway opened up like it should

be. They gave me liquid meds but I found I could also swallow pills if

needed so not to worry. You will have to sleep on your back for a

while, I found the recliner works good or maybe buy one of those

incline pillows. I also had BCBS and had no problems. good luck with

your surgery and I hope you will breathing better. Remember the

success rate for this surgery to cure apnea is around 95%. I'm just

waiting to stabalize so I can get my follow-up sleep test but i'm sure

i'm cured. eric

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for 18

> mos. I had braces as teenager, but it never solved the problem with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley

[Guest guest]

Welcome Shirley, it's nice to hear from a fellow apneac! Did you ever

try the nasal pillows? I found them much more tolerable than the mask.

I ended up tossing the whole thing and opted for something more

permanent. I had an 8mm upper,lower,genio last may. Being a mouth

breather all my life it was easy to adjust to the stuffiness after

surgery but the first thing I noticed when I awoke was how easy it was

to breathe through my mouth with the airway opened up like it should

be. They gave me liquid meds but I found I could also swallow pills if

needed so not to worry. You will have to sleep on your back for a

while, I found the recliner works good or maybe buy one of those

incline pillows. I also had BCBS and had no problems. good luck with

your surgery and I hope you will breathing better. Remember the

success rate for this surgery to cure apnea is around 95%. I'm just

waiting to stabalize so I can get my follow-up sleep test but i'm sure

i'm cured. eric

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for 18

> mos. I had braces as teenager, but it never solved the problem with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley

[Guest guest]

Hi Shirley,

Wow, I congratulate you on being cancer free!

Well, my only $.02 worth is regarding nutrition: I am not lactose

intolerant per se, but I had a sinus infection after my surgery and

drinking Boost made my mucus thicker---reading the label, I

discovered that it contained milk protein, which I needed but didn't

do my sinuses any good. Ensure is lactose free, plus there are other

nutritional shakes that are lactose-free...be sure to read the

labels. It helps to go to your local health food store ahead of time

to further your options. Good luck!

Bea

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for

18

> mos. I had braces as teenager, but it never solved the problem

with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I

have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done

for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also

going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley

[Guest guest]

Hi Shirley,

Wow, I congratulate you on being cancer free!

Well, my only $.02 worth is regarding nutrition: I am not lactose

intolerant per se, but I had a sinus infection after my surgery and

drinking Boost made my mucus thicker---reading the label, I

discovered that it contained milk protein, which I needed but didn't

do my sinuses any good. Ensure is lactose free, plus there are other

nutritional shakes that are lactose-free...be sure to read the

labels. It helps to go to your local health food store ahead of time

to further your options. Good luck!

Bea

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for

18

> mos. I had braces as teenager, but it never solved the problem

with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I

have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done

for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also

going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley

[Guest guest]

Dear Shirley (bizegrammatx)

Have you considered the " phased surgical protocal " for dealing with

your sleep apnea? This is the approach advocated by and

Riley (sleep apnea experts) from Standford. The jaw advancement

surgery/s are the second (and last) phase of the approach. The

first phase may involve one or many of the following procedures:

1) Nasal: Correct nasal obstruction depending on anatomical

deformity (septum, turbinates or nasal valve deformities)

2) Pharyngeal: UPPP or equivalent and tonsillectomy if tonsils

present

3) Hypopharyngeal: Inferior sagittal mandibular osteotomy and

genioglossus advancement, hyoid myotomy and suspension, or laser

midline glossectomy and lingualplasty, or partial glossectomy.

*** After phase one is completed a period of 4-6 months is allowed

for sufficient healing, weight stabilization and neurologic

equilibration. Then a repeat polysomnogram accompanied with a sleep

assessment and clinical examination is done to assess the clinical

outcomes. Those patients who are unchanged or incompletely treated

are offered either further surgery (Phase two) or medical management

(CPAP).

Definition of Phase Two: (-Riley) If our protocol was used

previously, the only region that should be left incompletely treated

is the hypopharynx ( base of tongue ). A choice now is made among

the remaining methods:

1) maxillomandibular advancement surgery, tracheotomy or nasal CPAP.

NOTE: I believe the the Hypopharyngeal procedures noted in phase 1

can be done with or without aesthetic changes.

I would be curious if you considered this alternative. The jaw

procedures seem particularly challenging.

I also have sleep apnea and I am considering alterantive options to

the jaw surgery. The upper jaw surgery worries me most because I

already have sinus issues due to a deviated septum. It worries me

because the upper jaw surgery seems to affect the nasal area?

Just some food for thought. I am just a layperson that is also

seeking the correct appropriate treatment.

Good luck, PMD

[Guest guest]

Dear Shirley (bizegrammatx)

Have you considered the " phased surgical protocal " for dealing with

your sleep apnea? This is the approach advocated by and

Riley (sleep apnea experts) from Standford. The jaw advancement

surgery/s are the second (and last) phase of the approach. The

first phase may involve one or many of the following procedures:

1) Nasal: Correct nasal obstruction depending on anatomical

deformity (septum, turbinates or nasal valve deformities)

2) Pharyngeal: UPPP or equivalent and tonsillectomy if tonsils

present

3) Hypopharyngeal: Inferior sagittal mandibular osteotomy and

genioglossus advancement, hyoid myotomy and suspension, or laser

midline glossectomy and lingualplasty, or partial glossectomy.

*** After phase one is completed a period of 4-6 months is allowed

for sufficient healing, weight stabilization and neurologic

equilibration. Then a repeat polysomnogram accompanied with a sleep

assessment and clinical examination is done to assess the clinical

outcomes. Those patients who are unchanged or incompletely treated

are offered either further surgery (Phase two) or medical management

(CPAP).

Definition of Phase Two: (-Riley) If our protocol was used

previously, the only region that should be left incompletely treated

is the hypopharynx ( base of tongue ). A choice now is made among

the remaining methods:

1) maxillomandibular advancement surgery, tracheotomy or nasal CPAP.

NOTE: I believe the the Hypopharyngeal procedures noted in phase 1

can be done with or without aesthetic changes.

I would be curious if you considered this alternative. The jaw

procedures seem particularly challenging.

I also have sleep apnea and I am considering alterantive options to

the jaw surgery. The upper jaw surgery worries me most because I

already have sinus issues due to a deviated septum. It worries me

because the upper jaw surgery seems to affect the nasal area?

Just some food for thought. I am just a layperson that is also

seeking the correct appropriate treatment.

Good luck, PMD

[Guest guest]

Hi Shirley

I had upper and lower jaw advancement 5 days ago to treat severe

sleep apnea (also not overweight}. I can breath well through my nose

and just use saline and afrin to keep it clear. However I noticed you

mentioned that you may have the turbonate reduction at the same time

as your jaw surgery, is that what your Dr recommended. I had that 2

years ago with UVP, somnoplasty and septoplasty. My nose was plugged

up completely, maybe that was because of the septoplasty? Check to

see if they will plug up your nose, if they will I would suggest not

doing the 2 together as it is hard to breath through your mouth when

you are banded shut.

I can already get pills though my teeth as I didnt like the liquid

meds and it has only been 5 days. There is no pain opening your jaw,

not as much as you would think, so dont worry about that it is just

the effort of opening against the bands.

I lie a little on my side, but try to stay on my back propped up.

I wont know if this has worked for my sleep apnea for a while. I sure

hope it does as I too tried CPAP and suffered many sleepless nights

with ill fitting face masks! I Cant bear to go back to that.

Let me know if you have any more questions, it is good to chat to

someone in the same boat.

Hilary

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for

18

> mos. I had braces as teenager, but it never solved the problem

with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I

have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done

for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also

going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley

[Guest guest]

Hi Shirley

I had upper and lower jaw advancement 5 days ago to treat severe

sleep apnea (also not overweight}. I can breath well through my nose

and just use saline and afrin to keep it clear. However I noticed you

mentioned that you may have the turbonate reduction at the same time

as your jaw surgery, is that what your Dr recommended. I had that 2

years ago with UVP, somnoplasty and septoplasty. My nose was plugged

up completely, maybe that was because of the septoplasty? Check to

see if they will plug up your nose, if they will I would suggest not

doing the 2 together as it is hard to breath through your mouth when

you are banded shut.

I can already get pills though my teeth as I didnt like the liquid

meds and it has only been 5 days. There is no pain opening your jaw,

not as much as you would think, so dont worry about that it is just

the effort of opening against the bands.

I lie a little on my side, but try to stay on my back propped up.

I wont know if this has worked for my sleep apnea for a while. I sure

hope it does as I too tried CPAP and suffered many sleepless nights

with ill fitting face masks! I Cant bear to go back to that.

Let me know if you have any more questions, it is good to chat to

someone in the same boat.

Hilary

>

> Hi All,

>

> I'm new to this list. I've been reading the past posts and have

> found them very helpful.

>

> I am scheduled to have surgery on Dec 2. I've been in braces for

18

> mos. I had braces as teenager, but it never solved the problem

with

> the retrognathic lower jaw. As adult I now have severe sleep apnea

> (not overweight) for which I have been unable to find a full face

> mask to fit properly. So after months of frustration, I was

> referred by pulmonologist to the OS to the OD. I will have the

> LeFort I, BSSO, genio advancement and possibly turbinectomy. I

have

> been told I will not be wired, but rubber banded. These procedures

> will be to open up the airway which is much narrower than it should

> be.

>

> Since I'm no " spring chicken " (61), had major surgery for cancer 14

> years ago & reconstructive surgery 8 years ago ( I remain cancer

> free), I didn't make this decision for orthognathic surgery without

> a lot of contemplation. If any one has had these procedure done

for

> sleep apnea or not sleep apnea, I had appreciate some insight on

> these:

>

> 1) Medications - Can you take oral meds or must I find a liquid

> alternative? (I am on some daily meds such as Sythroid, Zocor, etc)

>

> 2) Any recommendations for non-lactose smoothies? I am going to

> try the rice milk. I'm severely lactose intolerant. I'm also

going

> to consult with a dietician. I'll have to Boost, etc. too.

>

> 3) One of my main concerns is breathing. I have a very reactive

> airway and asthma (been well controlled). Did any of you have any

> problems with breathing straight of surgery?

>

> 4) How long before you can lay down on your side? I would imagine

> they don't want a lot of pressure on the jaws for a while.

>

> 5) Did any one have BCBS Federal Employees insurance for the

> surgery and did you have any problems with them? My OS is not a

> participating doctor so anticipate my portion will be larger.

>

> Thanks for any insight. Many questions to ask the surgeons when I

> see them next.

>

> Thanks, Shirley