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 Surgery
Author: theclarinetguy 
Date:   2010-05-08 20:42

Hello everyone,

I'm wondering if there is anybody out there who has had surgery to fix sleep apnea? Removal of the tonsils and shaving of the pallet in the back of your throat. I'm getting this done in a few weeks along with fixing some blockage in my nose. I know it'll hurt like hell and I'll be out for at least 2 weeks just to heal but am wondering if anybody who's had this surgery can tell me if they experience any problems when returning to practicing. I'm afraid that changing the back of my mouth might cause some issues.

Micheal

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 Re: Surgery
Author: Ken Shaw 2017
Date:   2010-05-08 21:50

Michael -

I considered the surgery -- I have obstructive sleep apnea and keep my wife (and the rest of the apartment building) awake with snoring, not to mention falling asleep during the day.

My cousin had the surgery and now says he can't blow up a balloon because air leaks out through his nose.

At the very least, get a consult with a surgeon who treats wind players to make sure you'll be able to create enough air pressure to play clarinet.

Stick with a CPAP if you can. The newer ones are computer-controlled and much easier to adjust to. I'm very happy with mine.

Ken Shaw

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 Re: Surgery
Author: Ralph Katz 
Date:   2010-05-09 01:21

I am not a doctor, so don't take this as medical advice. But there are plenty of people in the medical field who are just out to make money, and they only recommend things that make them money.

Surgery can't be backed out, and as such it should only be the last resort. But surgeons do surgery, so this is what they recommend.

Pick your surgeon based on other people's results, rather than "reputation". You can't be too careful about this. I am put off by clinics who only do one kind of treatment. "We don't do that here" makes me march the other way.

My dad had a CPAP and it gave him a sinus infection each time he used it. I have been through a round of this and had the same thing happen. This may be because we had lousy CPAP's - my brother has one and seems to be surviving it well.

Choose a sleep clinic that prescribes more than one make of machine. If you have the sleep tests, is your sleeping room completely dark? Is it quiet? Does the doctor ask about your facial hair and the CPAP's mask? These are mistakes that might help to identify "diagnosis mills" as opposed to clinics that can help you.

In my case, other medical issues have now forced me to do what I have been avoiding all these years - I have lost weight, am much more selective about what I eat, go to bed earlier, and am on a regular exercise program. As a result of these essentially "free" things, I am sleeping better, in spite of my mother's burgular alarm company calling me at 4:30AM this morning (high-wind events set off a motion sensor.)

There are other things that can help you sleep better. Such as, make sure you are managing allergies well. Keep dust down in your sleeping area. Use hyperallergenic bedding. Use a mattress cover. Think about putting a HEPA filter in your bedroom.

Manage your blood sugar. If it is low or high, what you eat before going to bed can adversely effect your sleep.

Manage light and noise. Do you really need your alarm clock that bright? Will room-darkening shades block out a street light? Can you hear traffic? When I really need to sleep outside of normal hours, an eye shield and ear plugs really help. Mind you, a CPAP machine or HEPA filter can make significant noise.

If you have done all this, and have narcolepsy, then the surgery may be your only hope. But you need to be disciplined about all this other stuff first.



Post Edited (2010-05-09 01:22)

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 Re: Surgery
Author: DavidBlumberg 
Date:   2010-05-09 02:17

My father had Surgery for Sleep Apnea, it not only didn't fix the Apnea, but ever since then he feels like he has something stuck in the back of his throat. Imagine if you had a sliver of Onion that got stuck, or a pea - that's what it feels like in his throat.

His surgery was about 13 years ago so probably there are better/different surgical techniques, but not sure if the end result is vastly different or not.

I have Sleep Apnea and am fine with the CPAP.

http://www.SkypeClarinetLessons.com


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 Re: Surgery
Author: CarlT 
Date:   2010-05-09 02:40

I used to think sleep apnea was something only over-weight people had. I am 5'-10" and weigh 160. Guess what...I have sleep apnea. Had it diagnosed last fall and been using CPAP since. I get up feeling so much more rested now, and the wife has stopped complaining, as I do not snore any more.

I read and heard about too many horror stories about the surgery, so I will stick with the CPAP. It's true that it takes a while to get used to the mask, and if you go this route, be sure to try out the several types (similar to buying a clarinet I suppose) of masks before you settle on the best for you. There are several basic types ranging from a simple nostril type, to a full face mask, so be careful in choosing one if you go this way.

Regarding the possible sinus problem with CPAP, you should follow all the directions about cleaning the apparatus, and you'll probably do fine. So far, I have not had any problem with sinus infections.

CarlT

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 Re: Surgery
Author: EEBaum 
Date:   2010-05-09 03:42

Could learn to play the didgeridoo... http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393/?tool=pmcentrez

Or, might I ponder, would learning to circular breathe on clarinet have similar effects?

-Alex
www.mostlydifferent.com

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 Re: Surgery
Author: alanporter 
Date:   2010-05-09 17:00

I am a retired medical doctor (general practice) and I can remember a trumpet player who was no longer able to play after having the surgery. More air came down his nose than through his mouth.
I am impressed with Ralph Katz post above, he's got it just right.
Alan

tiaroa@shaw.ca

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 Re: Surgery
Author: JJAlbrecht 
Date:   2010-05-09 22:52

If you do a search on this site, I think there have been posts from other users who have had the surgery done, and have not been able to play properly afterward. It's been a couple of years, if I recall correctly.

I use a CPAP with no trouble at all.

Jeff

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 Re: Surgery
Author: kdk 2017
Date:   2010-05-10 01:56

I didn't have the pallet shaving done, but I did have a tonsillectomy when I was 21 years old (because of chronic tonsillitis) and actively involved as an undergrad clarinet major. Based on my experience with that, I'd say it's going to be a good deal more than 2 weeks before you can play after the surgery has been done. It took me many weeks - air escaped through my nose and wouldn't go through the mouthpiece. I'd never had a problem with that before the tonsillectomy. I've had trouble with it ever since as I tire after lots of playing, although it tends now to happen only when I've been laying off for a few days.

This was over 40 years ago, and the surgical techniques may have improved a good deal since then, but the other responses to your question suggest the outcome hasn't improved where clarinet playing is concerned.

Karl

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 Re: Surgery
Author: Rusty 
Date:   2010-05-10 08:21

Well I was set up with expesive CPAP gear because after doing the sleep tests I was told this is what I will need in future. I wasn`t falling asleep during the day so at which degree of sleep apnea do you need the mask etc. The Doc could`nt tell me but of course had all this gear for sale. So I bought it, used it for about 6months then thru` it in the bin and apart from a bit of snoring if I`m on my back, I have no problem.
I guess the message here is get many opininions, I find it amazing how many differ from the experts.

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 Re: Surgery
Author: theclarinetguy 
Date:   2010-05-10 16:52

Thank you for the feedback. Couple of reasons why I was considering the surgery:

1. I have 85% blockage on the left side of my nose from getting hit in the face with a bat. Had plastic surgery to fix my nose but they just moved it back into place. This does explain why circular breathing has been basically impossible for me.

2. Because of my age, the severity of my sleep apnea could cut my life short by quite a few years. It's already cut short because of diabetes.

3. Wife can't sleep...She's also pregnant so it's depressing not having her next to me some nights.

4. Tired in the mornings. Can't stay awake in class or at performances. Felt awful when I started snoring during Hamlet.

It sounds like the CPAP machine is something to try first. The doctor is well respected and has had success with this surgery in the pass but he did say there was only a 60% chance of success.

Micheal

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 Re: Surgery
Author: DavidBlumberg 
Date:   2010-05-10 17:03

Michael, with your obstruction, you might have trouble with an apnea mask unless it's a full face mask so that you could breathe with your mouth. So try both (regular mask, nasal pillow type, and the full face mask. That's 3 styles to give a test of.

I'd do that before surgery for sure.

http://www.SkypeClarinetLessons.com


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 Re: Surgery
Author: JJAlbrecht 
Date:   2010-05-10 17:28

I agree with David. You can always swap to a different type of mask, but once someone removes tissue from your airway, it's irreversable. Many insurance policies will cover the sleep testing and CPAP/mask setup. It's cheaper by far than a hospitas stay and surgery!

Good luck,

Jeff

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 Re: Surgery
Author: BartHx 
Date:   2010-05-10 20:08

Wow, who would have guessed there are so many clarinetists with sleep apnea? I use a BiPAP without significant problems.

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