Diagnosis, Doctors, and Decisions

At this point, I'm wondering if the rest of my life is going to be lived in a sleep-deprived haze. Even with the better CPAP and mask, I can only tolerate them for so long before I wake up and I can't get back to sleep with them. By the spring of 2012, I'm averaging only 4-6 hours of sleep a night--might be enough for some but definitely isn't for me--and it's starting to seriously affect me. I do more research, and start looking at other, more radical procedures--none of which seem available around me. I then arrange an overnight trip to UCSF hospital, which is reputed to have one of the best sleep centers in the country, seeking an authoritative diagnosis and treatment options...

Understand, I live on the east coast, so this is not a small or cheap deal--just to get out there for a nght came out to $500 round trip. I make my reservations online, then literally fly out Monday following work to a city I've never been to before, rent a car with a GPS, drive to my hotel, and go directly to bed--and yes, my CPAP is with me; it goes everywhere I travel at that point, which is a huge drag.

UC-San Fran

Following my GPS directions on a seventeen-mile drive into the city, I eventually find the building and pay an arm and a leg to use a nearby parking lot. Inside, I meet the ENT, a well-regarded sleep apnea specialist named Doctor Eric J. Kezirian. We talked for a while. He was impressed and flattered I came all that way, and pretty much gave me an hour of his time for free--nice guy. So nice, in fact, that he numbed up my nose so he could put a camera tube up it and thread it down to see my throat.

It's a slightly freaky thing to watch the video feed of your own throat in front of you, but also educational. He put me through some jaw movements, made me sing the letter E a few times, and his eventual recommendation was a lingual tonsillectomy and at least one form of tongue reduction. He gave it a 60% chance of working--certainly better odds than I'd had before. To my surprise, instead of insisting I come back, he gave me the names of two specialists he knew in Charlotte who could do the procedures, a mere three-hour drive from my home near Raleigh.

Wonderful! Local options... or at least a lot more local than having to fly cross-country for each appointment would be.

Charlotte

So I made arrangements to head out one Monday, staying overnight this time so I could do morning appointments and then head back and only miss half a day of work--being a contractor, I only get paid for time I work, after all.

The Charlotte ENT wasn't bad... nice guy, listened, and told me that basically, I had a BOT--a 'big old tongue', in his own parlance--and he concurred on the UCSF doctor's diagnosis. Next came the other guy, who turned out to be an maxillofacial surgeon. He was the first to recommend an outright MMA for me, saying it was only thing that more or less certain to work. I listened, but to be honest, I didn't much like the guy--had a very coarse manner and felt like he was trying to sell me something instead of working with me; he didn't really even take a look at me. Needless to say, I didn't see him again, but he did get me thinking, and my research showed that he was right about this much--an MMA gave the best chance for success.

One Thing I've Learned...

...about doctors and surgeons by now--they're going to try and sell you their particular specialty. An ENT is going to try to convince you to have soft tissue procedures, while a maxillofacial surgeon will basically want to do something a little more... invasive. It falls to you to do your homework and make an informed decision as to what you want. But in my case, dissatisfied with my choices, I looked for any local options...

And much to my surprise, I found one.