Sleep Study Follow-Up

Took Walker yesterday to see the ENT (ears, nose and throat dr.) to follow up with his sleep study. He was crazy behind schedule...like 90 minutes behind. We were gone for 3 hours! :( 

We did get a lot of information though. He checked Walker out, went over the test results and discussed options. 

First off, he DOES have sleep apnea! He's having 1 episode every 3 minutes. So basically he's never able to go through the entire sleep cycle. His body isn't able to rest and restore. It's definitely affecting his sleep and his quality of life during the day. 

After examining him he doesn't think his tonsils or adenoids are playing any part in this issue. The adenoids are still a little enlarged but nothing significant. He has a deviated septum as well. The left side is much smaller than the right. He noticed the lining of the nasal passage is inflamed and suggested we try Afrin. The current allergy spray he's on isn't helping at all. However, Afrin is addictive, so if it does help significantly then he will give him an RX for two different sprays. One is a steroid and one is an antihistamine that are really strong and do pretty much what Afrin does...with out becoming addicted to it. If the sprays don't really help then he will go in and burn the tissue inside the nose. 

The doctor feels that his biggest issue is his jaw. His jaw is too small for his tongue. Most people with sleep apnea are over weight. Clearly Walker isn't over weight. Over weight people actually have fat tongues. That's what makes them snore. The tongue becomes too big and an obstruction when they lay down. With Walker, his jaw doesn't have enough room to allow the tongue to fit, so in effect it's pushing his tongue too far back into the back of his mouth/throat causing the loud snoring and obstructing his breathing. 

If the nasal spray and nasal procedure aren't helping enough he wants to send him to an oral surgeon to discuss options. He said that they could give him a mouth appliance that would push his lower jaw forward giving the tongue enough space inside the mouth when he sleeps. This should help with the snoring. If the appliance doesn't seem to help then he recommends having surgery. 

The surgery sounds super crazy to me though!!! 

It's called Maxillo-Mandibular Advancement (MMA) Surgery. They basically have to break his upper and lower jaw. They place plates and screws inside and enlarge the jaw. This should fix the problem permanently. I read that people have a 90% reduction in symptoms from having this surgery. 

Since the jaw is broken, it has to be rubber banded shut for a few weeks. It would require an all liquid/smoothie type diet. Weight loss is common during recovery. One patient's story I read today said he actually was able to return to school after two weeks. The jaw was still banded but was able to talk enough to get by. He was still pretty swollen but it was manageable. We'd most likely wait until summer to do it. 

He also said a CPAP machine might be beneficial. But since he's only 16 he doesn't feel this is the best option long term. He'd basically have to use it for the rest of his life. We could use it now though until we decide on the surgery. It would give him the quickest relief and help. 

We've decided our first step is to see if this nasal spray helps and we'll go from there.