[tri-med] Re: Tonsils/Adenoids and Obstructive Apnea

Soleah has had several sleep studies--always concluding that her brain is 
"normally abnormal" . . . that always makes me laugh.  These doctors should be 
politicians.
Loren Warnemuende <lorenwarn@xxxxxxxxx> wrote:
On Monday, March 21, 2005, at 10:54 AM, Wright wrote:

> {How many kids on the list who have obstructive apnea have had either
>> tonsils, adenoids or both removed? }
> I'm curious about this too. Nicholas' ENT suggested tonsils, 
> adenoids, and trimming the uvula without a sleep study first.

It's mind-boggling how many approaches doctors take! Keren's ENT 
started off immediately with the sleep-study, but has shied from 
surgery. He did, however, check out Keren's ears, nose and throat with 
a CT scan. That factored into his feelings about surgery.

> His neurologist and his pediatrician both suggested a sleep study 
> before doing any surgery. What can a sleep study actually tell you? 
> His ENT said there are no guarantees that his apnea will improve after 
> surgery, so I'm wondering if it's worth it. The ENT said he would 
> benefit from a larger opening. He doesn't have breathing problems all 
> the time, just sometimes at night.

The sleep study tells a lot about what kind of apneas and breathing 
patterns the patient has. It's really pretty amazing what all they can 
observe. When you go in for it, the techs hook you up (I'm jumping to 
second person here, though I realize we're talking about the patient :) 
) to all sorts of leads. There are straps that go around the chest and 
abdomen that monitor regularity of breathing there (and I think the 
"depth" of breaths?). Then there is the monitor that goes under the 
nose that monitors CO2 output. A pulse-ox is connected to measure 
oxygen levels and dips. And then various leads go on different parts 
of the head and face to monitor REM sleep patterns and a few other 
things ( I forget what all!). They also check how much you're moving 
around in sleep, etc. All the info is fed to a computer that charts 
everything out. They can evaluate whether the apnea is central or 
obstructive, and also hypopnia (shallow breathing). And they can 
determine how much "real" sleep you're getting. For instance, my 
grandmother was recently tested and the tech said she was in Level 1 
sleep (the very lightest, least refreshing level) for about 90% of the 
night--yikes!

Anyway, in a nutshell that's what a sleep study determines. 
Obstructive apnea can than be dealt with in whatever method seems best 
(that's where my questions about tonsils and adenoids come in). For 
many, the best solution is the cpap or bipap machine, but it sounds 
like removing the cause of obstruction works for many, too. I just 
don't know if that would really help Keren as part of the problem is 
tiny openings and lax muscles. The cpap has been a great solution, 
fortunately!

Hope that helps!

Loren (wife to Kraig, mom to Keren, T18, two years old (9/27/02), and 
new little one due 7/13/05)
Southeast Michigan
http://webpages.eng.wayne.edu/~ad6075

Building ___ooOOoo__ Rainbows
www.trisomyonline.org
Families Helping Families On-line




Nanci - Wife to Mike, the ever patient one . . . Alicia, 20, nursing student . 
. . Shani, 14, homeschooler, biggest helper . . . Soleah, 10, Trisomy 
18M--always teaching me . . . Corey, 2, my boy-wonder!


Romans 5:3  . . . but we also glory in tribulations, knowing that tribulation 
produces perserverance; and perserverance, character; and character, hope.

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

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