My Sleep Apnea Story, Part 2: You Down With UPPP?

Sleep ApneaIn Part 1 of My Sleep Apnea Story, I covered the process of getting diagnosed with obstructive sleep apnea and the various treatment option paths that I went down in my effort to alleviate my symptoms in a quest to improve the quality of my sleep.

 

After unsuccessfully using the CPAP mask, the mouthguard and of course changing my diet and watching my weight, I was not satisfied and inevitably found myself getting closer to the invasive UPPP/Tonsillectomy procedure.

 

Quite honestly, this was an option that I wasn’t really excited about and for a number of reasons.  First and foremost, it’s surgery and it’s not something to take too lightly. Secondly, I was concerned with the time off required during the recovery process. This too was something, that I don’t take lightly at all.  I am a financial adviser and my livelihood is comprised of meeting with clients and prospective clients, working with my team and keeping all the balls of our business in the air and making certain that we are paying attention to the key metrics of my business.   Finally, pain and recovery was a concern as well. Basically, I’m a wimp when it comes to dealing with any sort of pain and I wasn’t looking forward to the part of the procedure.  Sure, I’ll have strong drugs to get me through the toughest times, but I was still a little – well, a lot – nervous.

 

TonsilsA few months back, I was speaking with a very good friend from high school and mentioned to him that I was thinking about doing the “Cleanout” to help me resolve my Sleep Apnea once and for all.  That’s when he told me he had the procedure done on himself 5 years ago!  I was like, what?  Wait. You did? Tell me more.  What’s your experience?  He has been so helpful to me throughout the process and I was motivated to go through with the “cleanout” based on his recommendation.

 

Let me describe what the “cleanout” is all about.  Take a look at the picture above of the open mouth and picture someone (the evil doctor) taking aluminum foil and scrunching it into a ball and taking cooking tongs and shoving that aluminum foil ball into the back of your throat and giving it two or three quick and aggressive turns and for good measure, moving that rough foil ball back and forth in your throat.  Yeah!  That’s the “cleanout” and that’s not an exaggeration of how it really felt post surgery.

 

One thing I found strange was that nobody ever pulled punches about how painful this surgery would be and that I was going to be miserable for two weeks from the day of surgery.  Not my friend, not the Doctor, not the nurses, not anybody on the message boards.  Every single person was brutally honest that I would be extremely miserable and in pain for two weeks and don’t even think about doing anything else in life during that time.

 

I’m not going to lie.  The recover hurt like hell!  Swallowing my own saliva brought tears to my eyes and a severe pain in my throat.  Being forewarned about the pain to follow, I went into the surgery with my eyes wide open, along with my throat, of course.  If you are reading this to learn more about this surgery and the recovery, be very prepared and go in knowing what you’re about to deal with and also know that there is a light at the end of the tunnel and everyday you are one day closer to recovering fully.

 

August 31, 2015

Day 1:  Surgery

My surgery was to be performed by Dr. Joseph Campanelli who is the Otolaryngologist at Kaiser Hawaii. Dr. Campanelli first introduced himself as the guy that is going to cause me severe discomfort and pain and apologized in advance.  He has done this procedure hundreds of times and was very confidant and assuring about what to expect and how things should progress.  The surgery took a little over an hour. My time in the recovery room took about two hours.

 

The UPPP procedure basically removes the excess tissue in the throat to make the airway wider.  This allows air to move through the throat easier when you breath and reduces the obstructive sleep apnea and the snoring that comes with this problem.  My tonsils and uvula were removed.  The uvula is the finger-shaped tissue that hangs in the back of the throat (I mistakenly thought that was my tonsils).  The tonsils are located on both sides of the back of your throat in the back of your mouth and is excess lymph tissue whose job is to produce antibodies to help prevent infections.  Back in the 1970’s, kids were getting their tonsils removed all the time and the story was that you got to eat a lot of ice cream, Popsicles and juices to aid in your recovery.  That may have worked for little kids that seem to bounce back quicker from the removal of tonsils.  For adults, this is utter bullshit.  Anything frozen, like ice cream hitting the area where my tonsils once were caused immediate fucking, shocking pain!

 

Referring to the Universal Pain Assessment Scale, which by the way only goes from 1 (no pain at all) through 10 (severe pain, I need to lie down in a fetal position and quietly cry). Most of the times during the first 4 days I was hovering between a 6 “Moderate Pain” through a 10 “Severe Pain”.  As I write this, I just got through what I can only describe as an 11 “OMG FML mama” level of pain.

 

September 1 – 5

Day 2-5:  Recovery at home

Oh my God!  This hurts!  I cannot think of eating at all.  Drinking anything causes severe pain and just the reflexive act of swallowing takes my pain level up to a 9-10 on the pain scale.  Oh God this sucks!

 

I’m living for my pain medication every 3-4 hours.  I’ve been prescribed a huge bottle of liquid morphine (10 MG and a dosage of 5 ML orally) and that doesn’t seem to be helping at all, but it’s all I got.  The nurse warned me to not to try and be a hero about the pain.  Even though the prescription was for a 5 ML taken orally every 4 hours, she and the Doctor, both suggested that I take the medication as needed for pain.  By the second day of recovery, I was taking a dose every 2-3 hours and that really helped.

 

I had some bleeding and on Day 2 and started spitting out streams of blood and blood clots.  This was a huge concern.  We called Dr. Campanelli’s office and left word about this development and expressed our concern.  I later learned that this was normal and I simply needed to gargle some cold water to stop the bleeding and lie down with my head elevated.  It worked.  Thank you Jesus!  The last thing I needed was complications.  Because that might require another journey under the knife and that would really suck!

 

The day prior to my surgery, my wife and I prepared by getting all types of ingredients for juicing, yogurt, ice cream, Popsicles, Gatorade, etc.  Great intentions, but I barely touched anything during week one.  I just couldn’t do it.  Just looking at things caused a reactive pain in my throat and my brain.

 

Of course, this was a real concern.  I had to force myself to attempt to consume liquids to prevent dehydration. My urine was showing all signs of dehydration – it was sporadic and limited, it was concentrated, the color was amber, and I just didn’t have much to dispense.  I was also weak and dizzy at times.  This is common but the conditions were made worse due to the extremely humid and hot weather we were experiencing in Hawaii at the time because of the very active hurricane season.  I must point out how instrumental my brother Mike Kai and his family were in my recovery during this first week.  Living in Kailua, Oahu is beautiful and a blessing, but his home can get extremely uncomfortable during the summer.  My brother purchased a portable air conditioning unit and had it installed in the guest room for my comfort.  Without realizing it, this step did so much to prevent me from suffering from a more extreme case of dehydration.  What a blessing!

 

Another problem that I needed to be concerned with during my recovery was the potential for constipation.  The fact the morphine is an opiate doesn’t help with the body functioning properly, it slows down your metabolism and body mechanics and this prevented me from being able to take a healthy dump for the first 6 days!  I was literally “backing up” even though I was taking the stool softener pills (who was the genius that prescribed pills to a guy that can’t swallow?)  Finally!  On the sixth day I had a glorious, satisfying dump that brought tears to my eyes. Not from straining mind you.  Last thing I want to do is tear up my throat again because I was straining to take a crap. But tears of joy, because I would avoid the humiliation of having a nurse dig it out of me.  Seriously, they sometimes have to do that.  Talk about a crappy job.

 

During this phase of the recovery, I started to formulate a routine to handle the pain that was coming in 4 hour waves.  Here is my routine.  Give it a try and work on your own variations to help you cope with the pain.

 

  1. Get the blood flowing.  The first thing I needed to do was get the blood flowing in the area of pain, so I would gently massage under my throat and under my ears.
  2. Salt Water Gargle.  Mix some Hawaiian salt in a small cup of warm water.  Rinse your mouth thoroughly and gently gargle to help rid some of the mucus and blood build up.  Initially, this will sting like a mutha, but it will get easier as the days pass.
  3. Tap Water Gargle.  Do the same thing with warm water and no salt.  Simply to rinse your mouth.
  4. Take your meds.  Your palate and throat is now ready to receive the medicine and you’ll be nice and ready to absorb it directly into your bloodstream.
  5. Drink something.  Force yourself to drink something.  At the early stages of your recovery, you will need to replenish your body with electrolytes, so your favorite flavor of Gatorade will do the trick.
  6. Eat something.  At this stage you can probably only handle yogurt or ice cream.  Something, anything will help.
  7. Go for a walk.  This helps to get your blood flowing all over your body and to help with digesting and disseminating anything and everything that you’ve tried to consume.
  8. Drink again.  The walk will help you to build up a need for a drink.  This is also the time to take any stool softener pills and any other type of medication that you may need as part of your regiment.
  9. Rest.  Prepare your resting spot.  Make sure to elevate your head above your heart and at least at a 30 degree angle to remove any pressure on your neck and throat.
  10. Sleep.  Let the morphine and pain medication seep through your body and go to sleep.  You body will recover best in a resting state.  You need this.  Don’t try to fight it and don’t try to be a he-man.

September 6 – 11

Day 6-11:  Recovery in Hilo

I flew back home to Hilo on Sunday, September 6th.  I was going stir crazy and as much as I loved and appreciated the care and attention that my brother and his family provided me during my stay in Kailua, I longed for the care from my wife.  Lori accompanied me to Honolulu for my surgery but had to return to Hilo earlier than me.

 

She was very concerned and worried about me while we were apart.  I was instructed to stay on Oahu for a week after surgery to make sure I didn’t suffer from any complications like infections, excessive bleeding or anything else that Dr. Campanelli might have to handle as my surgeon.  I had a post-op appointment scheduled for Friday, September 4th and since the 7th was Labor Day, I had planned on staying on Oahu through Tuesday, September 8th.  I couldn’t wait any longer once and I just wanted to get home to my own bed, so after the post-op appointment on Friday, I flew home on that Sunday.

 

One upshot of this surgery and not being able to eat or drink is the weight loss.  I started this surgery process with my weight at 189 lbs.  On Sunday, Day 7, I had lost 12 lbs and was down to 177!  Winning!  I could sell this weight loss plan as a simple way to lose 12 lbs in a week with no excercise, no sweating at a gym, no special diets or counting calories, very simple and it is guaranteed to work.  The only catch is severe pain but that is just a small price to pay for the weight loss.  Stop complaining you loser!

 

September 12 – 15

Day 12 – 15:  Feeling Better!

By Saturday, September 12th, I was feeling a lot better.   I was actually able to eat my first real meal and drink a full bottle of Gatorade without too much pain.  My throat still hurt a little from swallowing, but the pudding, ice cream, jello, apple sauce, yogurt and iced teas really helped me gain some energy and get hydrated.

 

I tried to drink a beer.  Couldn’t do it.  Taste buds are not back and the beer carbonation didn’t help.  Switched to a glass of red wine and the same results, no real taste or desire to have that drink.

 

On Sunday, we attended church and I was doing great.  No real pain at all.  I’m still taking morphine (pill form) for the pain, but really only about half the dosage that I’m prescribed.  I’m supposed to take 1 10-mg pill every 6 hours, I’m really taking about 2 per day.  I have to also remember to continue to take a stool softener every 4 hours to help with the constipation.

 

Monday, Day 14, September 14.  I’m back at work!  Took meds in the morning, ate breakfast that was basically a smoothie, had a yogurt and lots of liquids.  Worked for about 6 hours and left for home at around 1 pm.  Don’t want to push too hard.  Fortunately, my assistants, Brandy and Jeanine, held down the fort in my absence and prepared the office for our annual compliance audit conducted by our Broker/Dealer that was scheduled for Tuesday, Sept. 15th.

 

Tuesday, Day 15, September 15.  Audit day at the office.  Fairly routine and nothing out of the ordinary.  Brandy did a terrific job in preparing in advance for our in-office audit.  It all went well.  The auditor had a lot of questions for me regarding my sleep apnea story.  He thinks he may have Obstructive Sleep Apnea because of his heavy snoring history.  I strongly suggested that he have a sleep study done to learn more and to connect with me if he has any more questions.  Today, I also attended a YMCA board meeting and once the meeting was over, I shared my surgery story with the other board members.  Lot’s of questions regarding sleep apnea, the results of my surgery and my feedback on the recovery and operation.

 

Bottom Line:

  • Was it worth it?  Hell yeah!  Two weeks of discomfort for potentially a lifetime of better sleep, with less snoring and actual REM sleep.  Absolutely!
  • What has the results been so far?  My wife says that I am no longer snoring!  Amazing!  I’ve been a wicked snorer since I was a teenager and this is unreal.
  • What about your quality of sleep?  To be honest, I can’t tell as of yet.  Since, it’s only been two weeks and a day since the operation and I’m not completely off of the pain medication, I’m not sure if I’m getting a better quality of sleep.  But, If I’m not snoring, then I must be sleeping more soundly.
  • Would you recommend this procedure to others?  I would first determine if you have Obstructive Sleep Apnea by doing a sleep study.  Describe your sleep issues with your primary physician and request that you do a sleep study.  The results will either alarm you or calm you down to take another course of action.  Keep in mind that surgery is not a top choice of recommended solutions.  Some people swear by the CPAP therapy and are good with that option, so only you can decide if this is what step you need to take to improve the quality of your life.
  • Final thoughts?  I did my sleep study five years ago and first learned that I had Obstructive Sleep Apnea.  The treatment options were all presented to me after consulting and reviewing the results with my physician and the Ear, Nose and Throat specialist.  This included the CPAP Therapy, lifestyle adjustments (quit smoking cigars, reduce alcohol intake, lose weight, etc.) and the “Cleanout”.  I knew that I wanted to do something to improve the quality of my life and that of my dear wife, who has had to live with me snoring in her ear for the past 27+ years.  After giving the CPAP therapy a good try (2 times!) and not getting results, I owed it to myself and my wife to go under the knife and do the UPPP/Tonsillectomy procedure.  I knew full well what I was getting into and once I made the decision, there was no turning back.  I needed to do this.  I am glad I did this!

 

I am excited to experience life with a full night’s rest and quality sleep.  I was considered a high energy, intelligent, creative, dynamic, enthusiastic guy before this procedure.  What sort of improvements will I experience now that I’m able to get a great night’s sleep?  I am grateful and super excited about the second half of my life.  Starting now!