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Journal vrmlguy's Journal: My Tonsillectomy

It's almost 4am, Monday morming, and the jury is still out on the success of my tonsillectomy last Wednesday. Not for the first time, I hope that I haven't made a terrible mistake.

This all started about four years ago. In mid-1999, I started showing the classic symptoms of sleep apnea: I began falling asleep at work. At first, I thought that it was due to life-style, so I tried going to bed earlier, but that just got me up earlier. Finally, two events happened within a couple of days of each other that convinced me that something had to be done. The second trigger was my boss telling me that he had received inquiries from clients who wanted to know "if they had to pay for the time that I was asleep". I hadn't realized that things had been so noticable, and promptly told him about the other, primary trigger. As I was pulling into the office park where I worked, I had dozed off for just a couple of seconds and run over the stop sign for a pedestrial cross-walk. There wasn't any damage to the car, or much to the stop sign, but I thank God that there wasn't someone crossing the street at that preciese moment. As soon as I got into the office, I started looking for someplace where I could have a sleep study performed. The warning from my employer kicked things into high gear, and on August 15, I spent the night at Barnes Hospital in St. Peters, MO. To make a long story short, I was diagnosed with sleep apnea and wound up with a CPAP machine on September 1st.

Some people have trouble adjusting to a CPAP, but I didn't. In fact, I loved it: Suddenly, I had my life back.

Well, life wasn't all roses. I found that I was tied to a 110 volt outlet whenever I wanted to go to sleep. This meant that I had to drag the thing along on business trips. It also meant that I largely gave up trying to sleep on airplanes, but that wasn't such a big deal, since I was never more that a couple of hours away from anyplace I needed to go. But it also meant that I had to give up camping out, and that was a real annoyance. Starting in college over twenty years before, I had gone on week-end camping trips at least twice a year. That now seemed out of the question. More importantly, two years earlier I had fulfilled a life's ambition and hiked a small section of the Appalachian Trail. The experience left me wanting to do it again, and that, too, seemed unlikely while I was teathered to the nation's power grid.

On the other hand, my wife liked to point out that for her, growing up on a farm had destroyed any mystique that might be attached to "roughing it". She saw no point in sleeping anywhere except in a bed in a house. I was allowed my hobbies, but once our daughter was born in 1998, I had given up camping and hiking, at least until she was old enough to accompany me. Besides, I thought, this was mostly my own fault anyway. I'd put on a fair bit of weight since college, and weight-gain was a leading cause of sleep apnea. Let's face it: I needed to spend some time losing weight before doing any more camping, and that might cause the apnea to reverse itself.

So things sat for two years. In early 2001, I realized that I had been gaining weight, not losing it, so I started to make some noises about getting my tonsils removed. I had gone so far as to make a doctor's appointment, when I lost my job in the general economic downturn. I canceled the appointment and spent the next couple of months looking for work. I found a job soon enought, but my new employer was small, only 75 or so employees, and I was much too busy trying to help them stay in business to think about surgery for a while. And just when I did start to think about it, they laid off half of their employees, and I lost that job, too!

This time around, I did things "right". First, I went to work for a Fortune 500 company. Both of my previous jobs had been with small companies, and I had always worried that getting the surgery could seriously impact their operations. Second, I decided not to delay. As soon as I had been working for six months, I made the appointment. I didn't want to have things all set up and ready to go, and then lose my job yet again for some reason. And, there was another reason to do things quickly.

Back on my previous job, my wife and I had decided to adopt a Russian orphan or two, because it appeared that we weren't going to be having any more children of our own. The adoption process would obviously require a lot of travel outside the US, and I didn't want to lug the CPAP along. I knew that I couldn't fly for two weeks following the surgery, and as the first adoption trip looked like it would be in May, April 9th was quickly established that the best date to do it.

Of course, the Russians surprised us. Since we were willing to adopt a toddler, we wound up starting our first trip on Monday, March 31st, returning the following Monday. I decided to wait until we were in Russia to decide what to do about the surgery. It wasn't an easy decision. On the one hand, the CPAP worked just fine in Russia, and I seemed to hold up just fine skipping two nights of sleep while on airplanes. On the other hand, checking the CPAP as carry-on luggage was at least as much of a hassle on international flights as on domestic, and for our second trip I'd need extra room in my luggage for children's clothes and toys. I decided to go for it.

Now, it's been four days since the surgery, I feel like hell, and I haven't been able to sleep for more than a couple of hours at a time. I've been saying "tonsillectomy", but I really got three procedures done at once. First, there was the tonsillectomy proper. Second, I also had a uvulopalatopharyngoplasty (UPPP) peformed. In this procedure, excess tissue is removed from the back of the throat. Supposedly, UPPP is successful in curing sleep apnea approximately 30 to 50 percent of the time. Lastly, I had a turbinectomy, which is a surgical procedure that opens up the nasal passages by removing bone and soft tissue. The idea is that they all have similar, but independent, chances of success and they all have similar recovery periods, so why not do them all at once?

This evening, I tried hooking up the CPAP, and quickly discovered that it's too strong for me to use in my current state of recovery. On the other hand, what's left of my soft palette seems to still flop around like before, making me wonder if I'm in that part of the population for whom a UPPP is not a success.

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