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Q. How long does the laser procedure
take?
A. On the average, this procedure takes less than an hour but
including pre-operative preparation; you can expect to be in our center for
approximately 2 hours. The procedure is simple done right in our
state-of-the-art Bala Cynwyd center. In general, most patients prefer to be
sedated during the procedure. Experience of the surgeon has a lot to do not
only with how fast the procedure could be done but how well and how precise.
We have performed thousands of laser surgery case since 1992. With our
changing technology, Dr. Madani has significantly modified the procedure to
be performed in a single visit.
Q. How do I know if I have sleep apnea?
A. Normally, patients with sleep apnea may have certain signs and
symptoms such as: day time sleepiness, loud snoring, stopped breathing at
night, restless sleep, morning headaches, memory loss and nighttime
disturbances. However, you may not be aware of your problem, so a sleep
study will confirm the presence or absence of apnea. Most sleep studies are
done in a sleep center and patients spend the night in a private room. Many
large hospitals are equipped with sleep centers. During the study, special
sensors record the activity of your heart, lungs and brain; the movements of
your muscles; airflow from your nose and mouth; and the oxygen level in your
blood. In addition, your body movements may be videotaped while snoring;
talking or other noises are recorded. A technician watches the recording on
the monitors all night to observe you and make sure there are no problems
with the equipment. If you have severe sleep apnea, the technician may
provide a device called CPAP (a device that forces room air into your body)
that keeps your air passage open and helps you breathe. CPAP must be used
all the time and your compliance in that regard is crucial in the
effectiveness of it.
Q. Do I need a sleep study prior to the procedure?
A. Not everyone is required to have a sleep study prior to the procedure.
However, a post-operative sleep study is recommended for all patients.
During your consultation, in addition to a detailed review of your medical
history, a head, neck and oral examination will be done and all of your
options will be discussed. Please remember that our procedures will not cure
sleep apnea but are designed to reduce the intensity of snoring.
Q. How long is the recovery period?
A. Recovery is incredibly fast. Patients are able to and encouraged to
return to work and resume normal activity the day after the procedure.
Patients are expected to have a sore throat for 12-14 days after the
surgery. In addition, a soft food diet is recommended during recovery and we
would provide a list of soft menu items.
Q. What are the benefits of laser surgery?
A. The benefits of our LA-UPPP procedures are outstanding compared to
conventional surgical methods. The procedure is handled on an outpatient
basis under a light sedation and local anesthesia. Each treatment is quick
and patients are able to return to normal activities the following day. All
of this adds up to less discomfort and more convenience for the patient. In
addition and most importantly are the results. Thousands of patients treated
since 1992 have reported stable results several years later after surgery.
Q. What are the side effects of the laser treatment for snoring?
A. Following the procedure, patients can expect to have a moderate to severe
sore throat for 12-14 days. Pain medication is prescribed to help alleviate
the discomfort. For the first day and a half, patients should be on a full
liquid diet. The second week after surgery, a soft food diet is recommended
(fish, oatmeal, potatoes, pasta, eggs, etc.). We will provide a menu for
soft food suggestions. When patients feel ready, they can slowly resume
eating regular meals. Dryness of the back of the throat is very common after
the procedure indicating an easier airflow in the nasopharynx. Feeling of
lumpiness also may occur in few patients, however both the dryness and
lumpiness feeling could be significantly reduced if you chew gum or swallow
pushing your tongue to the roof of your mouth as often as you can for a
period of four weeks after surgery. Generally these complications are
temporary in nature but may last for several years. Due to the soft food
diet, weight loss may occur.
Q. Does this procedure affect the voice in any way?
A. There has not been any report of voice change with our patients. The
uvula and soft tissue, which is removed, does not have an impact on the
vocal cords. The main purpose of the uvula is to act as a swinging door and
protect liquid or food from entering the nasal passage. However the soft
palate is the reflective device that allows the voice to project outward
from the mouth. Traditional UPPP was reportedly associated with over 5%
voice changes. In thousands of cases treated in our center no one has had a
voice change directly related to our procedures.
Q. What is the function of the uvula and soft palate?
A. The uvula and soft palate work as a single unit to seal off the nasal
passage when you drink or eat. The other function of these two structures is
to reflect the sound of your voice out of your mouth rather than your nose.
Additionally, they direct food and liquid into your pharynx and esophagus.
Patients who have severe post-nasal drip use their tongue and uvula to bring
the postnasal phlegm forward to expectorate. This function will be restored
by the swallowing exercise explained in last question. Our extensive
experience with laser surgery and the experience of other practitioners with
laser surgery have proven that removal of the uvula in patients who suffer
from severe snoring would have minimal effect. Once again, the experience of
the surgeon is crucial in avoiding complications.
Q. Do any insurance companies cover this procedure?
A. This procedure is performed to treat snoring. Therefore, it is considered
cosmetic in nature and not covered by insurance plans. It is just the same
if you were to have any other cosmetic procedure (tummy tuck, breast
augmentation). We cannot bill your insurance company for this procedure. If
the issue is sleep apnea, then your insurance company should cover
alternative treatment plans (i.e., a CPAP machine).
Q. What is the cost of the laser procedure?
A. The cost of the laser procedure is $2100. If you require the nasal Coblation procedure, there is an additional charge of $900(A total charge of
$3000). Keep in mind that the source of snoring could be from the enlarged
uvula, elongated soft palate, tonsils, adenoids, and voice box, base of the
tongue, narrow airway and/or enlarged nasal passages. In many cases, we can
perform both the nasal radiofrequency
and the palatal laser surgery (LA-UPPP)
and tonsillar radioablation on the same visit. Once we examine you we would
determine which procedure is best for you. The charge for the nasal
radiofrequency is separate from the laser treatment charge.
Q. I do not live near Philadelphia. Can I still have this procedure done at
your center?
A. Luckily, Philadelphia is a place worth visiting if you've never been to
this historic and beautiful city. Fortunately, the laser procedure can be
done in our office and within fifteen minutes. A traveler can easily plan a
two-day trip, have the surgery, and head home the next day. We usually
recommend that traveling patients spend the night following their surgery in
a local hotel so we can take a post-operative look at them the following
morning before going home. If you decide to travel to our center for your
surgery, call our office so we can help with your accommodations.
Q. I am a great sleeper, when I put my head on the pillow I fall sleep in
minutes, but I wake up tired. Why?
A. When you snore, the airway in the back of your throat could be blocked by
your tongue or the uvula and cause you to stop breathing. You may toss and
turn all night not even knowing anything about that. You then miss the
crucial REM sleep and wake up tired.
There are other causes besides snoring that causes you to loose sleep.
Excitability, anxiety, nervousness, or the inability to fully relax has
caused many people to lose valuable sleep. When sleep is lost, the next day
is spent drinking many cups of coffee while stumbling through the day.
Consider this vicious cycle. You lose sleep because of interrupted sleep,
you're tired, wake up fatigued and not rested and don't do the things that
need to get done. Then at night you feel sleepy while driving, come home and
eat dinner and fall sleep right away after half an hour you snore again and
having interrupted sleep. So being a so-called great sleeper may mean that
you actually suffer from an illness of sleep apnea.
Q. Who is affected by snoring?
A. Almost all of us snore one time or other in our lives, but for some it
can be much more problematic. This habitual snoring (a person who snores all
the times) is more common in males, overweight persons, and usually becomes
worse with age. Not only is it disruptive for the snorer, who can actually
awaken him or herself, but also for the spouse or bed partner. They too are
disturbed by the noise and sleepless nights.
- 20% of the
population experiences snoring problems.
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Males and obese people have more problems with snoring.
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Snoring tends to be louder when a person sleeps on their back.
There are more than 350 devices registered in the U.S. Patent and Trademark
Office to help cure snoring.
Q. How much sleep do I need?
A. The amount of sleep an individual requires varies from person to person,
but most adults average eight hours of sleep. Sleep plays a vital role in
our daily regimen, as during this dormant period, it recharges and
rejuvenates weary body organs and tissues, and restores the body to an alert
state. Interruptions of sleep patterns will prevent this process. A person's
lifestyle is another variable in the amount of time he needs to achieve this
healthy balance, and to feel well rested upon awakening.
The quality of a person's sleep also factors into the sleep equation. When
we drift off to sleep, we either fall into a deep, restful sleep, or into a
shallow, light sleep. One who normally requires eight hours of sleep, but
sleeps shallowly, will most likely awaken feeling tired. In contrast, if the
same individual sleeps fewer hours, but lapses into a state of deep sleep,
he may well awaken refreshed and invigorated.
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