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reverend
Unread post  Post subject: Can I get your input?  |  Posted: Wed Oct 26, 2016 2:55 pm

Joined: Wed Oct 26, 2016 2:22 pm
Posts: 3

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So last year I went to an ENT to get my nose cauterized for bloody nose problems. My dad did the same thing, so it's just a hereditary thing. All was fine, nose doesn't bleed anymore (yay), but on the followup I mentioned snoring was a problem and my wife wanted me to ask him why I'd stop breathing at night sometimes... You know what that sounds like? ;)

So I did 2 sleep studies which determined I have mixed apnea of a mild-ish variety (AHI of 9 and 12 from each test). My tritation study revealed 9cmh20 was optimal for my pressure setting, so I've been on that since. The first couple months were rough, but I don't mind the therapy now. Aside from fighting with my mask that I seem to love some nights and detest others (Amara view), the therapy has gone well for me... but I have some AHI/tiredness fluctuations that seem to come and go. And I think my nose is the main culprit.

For example, I'll go months and vary from 1.5 to 4.0. Which is all fine and dandy. However, this past week, I haven't been under 5 AHI. My 7 day average is 6.5, and my high was 15 one night (haven't seen that since I started on the machine!!). In reviewing my data (of which I'll happily paste for anyone who wants), it seems I sleep pretty well when I do sleep, but I have a lot of Apnea events when I get woken and have to go back to sleep, which happens all the time in my crazy house (cats, dogs, children, wife, and I'm such a light sleeper these days).


But the thing that bothers me the most is my right nostril, and it's the reason I'm posting in this board. I went back to the ENT and explained these deviations to him about 6 months ago, and he gave me a good looking at in my nose, and determined my turbinates are oversized and I have a leaning septum he wants to fix with surgery. So he scheduled me... but hey guess what, the insurance declined it (so they have a battery of things I need to go through to approve it). I kind of just ditched the idea and figured I'd stick with the therapy a bit longer and see if life got better, but here I am now with high AHI and a nose that WILL. NOT. WORK.

My nose just plugs. I do rinses/netipots, take allergy medicine, blow my nose 50 times before bed, tried saline, tried everything... Soon as my head hits the pillow, my right nostril stops working. There's one position I can get it to clear, but I move a lot in my sleep, so when I move ever so slightly out of that one position... it plugs up again. When my nose is clear and I can breathe fine while awake (it has a mind of its own, but cold season seems to be the worst), my AHI goes back to 1.5-4.0 range. Like literally, sometimes, my nose is just stopped up and it's completely empty. It's infuriating.

So my question is to anyone who has a similar nasal problems as me... Turbinate shrinking surgery? Yay, nay? Should I pursue the septum deviation surgery (and the battery of tests for insurance) to see if it leads me in the right direction? I just don't know if it's worth it, and I'm himmin and hawin if I should look elsewhere first before getting the knife.

I personally don't care if I have to use CPAP for the rest of my life, it isn't about that, nor do I expect to be off it as a result of the surgery. I just want sleep, dangit. :( I'm foggy and a zombie all the time. And life shouldn't be like this! O.o


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trish6hundred
Unread post  Post subject: Re: Can I get your input?  |  Posted: Wed Oct 26, 2016 7:13 pm

Joined: Tue Apr 14, 2015 12:10 pm
Posts: 736
PAP Mask: Fisher & Paykel Simplus
PAP Machine: Resmed S9AutoSet for Her
Humidifier: H5I
Pressure Setting: Titrated Pressure is 10 CM-H2O, I use a range of 7/20 CM-H2O.

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Hi reverend,
WELCOME! to the forum.!
Hang in there for answers to your questions from the more experienced at this type of thing.
Good luck to you as you continue your CPAP therapy and also on your surgery decision.


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TheLankyLefty
Unread post  Post subject: Re: Can I get your input?  |  Posted: Sun Oct 30, 2016 2:18 pm
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Site Admin

Joined: Mon Aug 15, 2011 10:22 am
Posts: 4649
PAP Mask: Practically tried them all.
PAP Machine: Use Phillips Respironics System One APAP with Aflex for mask testing
Humidifier: None
Pressure Setting: When testing, I use APAP with a range of 5-10

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reverend wrote:
Should I pursue the septum deviation surgery (and the battery of tests for insurance) to see if it leads me in the right direction? I just don't know if it's worth it, and I'm himmin and hawin if I should look elsewhere first before getting the knife.
I've never had it, but I know several patients that have. Sometimes it helps with the problem altogether, and sometimes it helps to make the use of PAP therapy easier or more effective.

I don't know that it's ever made anything worse. Several patients that I've worked with as well as several family members. It's not fun, as surgery never really is.

Best of luck to you. I would recommend having another sleep study after you are healed up (if you go that route) to see if you still have sleep apnea, and if so what your new pressure needs may be.

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kb2qqm
Unread post  Post subject: Re: Can I get your input?  |  Posted: Sat Apr 08, 2017 11:07 pm

Joined: Sun Nov 15, 2015 10:29 pm
Posts: 2
Location: Racine, WI
PAP Mask: Resmed Mirage FX, Resmed F10.
PAP Machine: Resmed Apap Autosense 10 w/heated humidifer
Humidifier: Heated Humidifier
Pressure Setting: 5-9cm

Offline
Well to the original poster. After being on Cpap for about 6 months and having trouble with a deviated septum, and not getting over 3 hours of sleep per night for 6 months....I was a wreck !! So I went to an ENT and set up a Septoplasty... turns out my left nostil was blocked about 90%. So I would go to bed and be breathing out of my right nostril and then the Nasal Cycle would kick in and I would wake up in the morning with the mask on the floor feeling like crap. enough was enough. I tried everything. nasal sprays, those nasal strips. Honestly I was just a big wimp and didn't want to get surgery.... but I was worried over nothing. They wheeled me in the the OR...I breathed some funny stuff... counted backwards from 10...at 8 and I was gone and next thing I knew some dude kept touching me to wake up. lol. Wife drove me home...and then I was back on the doctors office having the stents removed in 5 days. Advil and Vicodin worked really well. About the 4th night you will spit out a giant bloody nose gummy bear..but thats normal. They dont pack your nose anymore with gauze...they used these foam straw things... it never hurt honestly getting them out....and I am a giant wimp. After the surgery, I could not use the cpap for like 5 or 6 weeks. during that time I slept without cpap in my recliner..and I could breathe great and got great sleep for that recovery time. That surgery was the best thing I have ever done for my breathing issues. If you have not done it yet, make the arrangements. It is completely worth it. I sleep now about 7 to 9 hours per night. I got the surgery and for the first time in about 40 years I could smell and taste again. I had no idea that flowers had fragrance. Good Luck to you.... let us know how it goes..

Greg


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