Is surgery the only option for treating sleep apnea or snoring
I do predominantly the line share of sleep apnea surgery in our department. I collaborate closely with the pulmonologists, who are the sleep medicine s. Those are the s that help diagnose and treat sleep apnea, as well. If those patients fail their, their medical or their conservative therapy, that's typically when they get sent to see me for surgical considerations to, to look at potential cures for their apnea. It's not uncommon for me to see a lot of patients for, who come in for snoring complaints and, you know, are wondering whether or not they have sleep apnea. So sleep apnea is condition where you actually stop breathing at night.
Snoring is somewhere on that spectrum, towards the more mild, you know, milder end of that spectrum. But, you know, really the only way to determine if you have sleep apnea, the gold standard of testing, is really getting a sleep study. And that's an overnight, monitored study where patients, you know, sleep in a room that's similar to a hotel room but they're being monitored and they're hooked up, you know, for sound so to speak with different monitors and cables on them. And that's really our best test to diagnose sleep apnea. The treatment for sleep apnea is typically a nonsurgical therapy; something called CPAP,
which stands for Continuous Positive Airway Pressure. And it's the patients that don't tolerate their CPAP who end up seeing me for surgical considerations. And there's a number of reasons why patients may not tolerate their CPAP. But there are some surgeries that can be helpful in patients who are not tolerant of their medical therapy. And I offer a variety of surgeries including nasal surgery, a variety of palatal surgeries for the kind of tonsil and soft pallet region and then also a variety of tonguebased procedures, as well. But we typically see a patient back after their procedure in about three weeks to recheck everything, make sure that they're healing okay.
After that, I normally recheck a sleep study in about three months after their surgery, just to give everything a chance to heal and to scar. And we, you know, make further recommendations based on the result of their followup sleep study after their surgery. We're exploring the, a new technology now which is actually a nerve stimulator for sleep apnea. It's an implantable device, very similar to a pacemaker that goes into the patient's chest. And there's an electrode that will actually stimulate the nerve that goes to the tongue to provide the tongue with a little bit of more tone when they're sleeping at night, and thereby eliminating their sleep apnea.
You Are Two
Your brain is two brains. Two hemispheres each doing half the work of being you. Half your vision goes to each and half your movement directed by each. Right controls left and left controls right. Your two brains coordinate through a wire of nerves, but this wire can be cut, and was, for a time, used as an epilepsy treatment. After the cut, people seemed the same, though their brain was split intwain.
Except, some postsplit patients described that while selecting their morning outfit with right hand, left might come along to disagree. Actually, left hand might quite often disagree, which these splitbrain patients found frustrating. What's happeningé To investigate, remember, right brain sees and controls one half, while left brain controls and sees the other. But only left brain can speak. quot;Hello.quot;
Because that's where the speech center is located. Right brain, without this, is mute. In normal brains, this doesn't matter because each half communicates across the wire with the other. But, splitbrains can't, and thus, you can show just the right brain a word, ask the person: quot;What did you seeéquot;, and you'll hear: quot;Nothing.quot; Because, left speaking brain saw nothing. Meanwhile, right brain will use its hand to pick the object out of a pile hidden from left brain.
This is deeply creepy. Ask quot;Why are you holding the objectéquot; and speaking left brain will make up a plausible sounding, but totally wrong, reason. quot;I always wanted to learn how to solve one of these.quot; Left brain isn't lying; it's just doing what brains do: creating a story that explains its past actions to its current self, a behavior which does rather cast doubt onto the notion of free will (but that's a story for another time). Creating reasons for why it does things is just something
left brains do. It happens in normal, healthy humans all the time, and if you think about it closely, you know you've done this. Back to experiments. Give right brain an object, ask the person quot;What's in your handéquot; and they won't be able to say. quot;I'm not holding anything.quot; And, when asked to draw, a splitbrain can draw two separate objects simultaneously, with each hand, in a way unsplitbrains find challenging.
These experiments on splitbrain patients are deeply unsettling because they really point in the direction of a mute separate. intelligence. Something. Living in the skull. You can even ask questions of a splitbrain and get disagreement on the answer. So, if your brain is split, who is the 'you' in this situationé From the outside, it's tempting to think of the part of the brain that's speaking as the person, but something is hearing and answering questions.
HCPCS and CPT Codes FAQs Disc Herniation vs Disc Degeneration
Q 16: Will there be at anytime HCPCS andCPT codes togetheré A: Well, yes. I guess so. The only time youreally use HCPCS codes is if you are doing Medicare. They're the other ones that reallylike the HCPCS codes. CPT codes, well, yes they will because EM codes are CPT codes.So, right there you're going to have CPT and HCPCS codes together. HCPCS codes mightbe, if they're giving an injection for Medicare patient in the office, then you would usea HCPCS code. Q 17: Please clarify with disc herniationand disc degenerationé A: OK, well I can do that because that'slike an ICD9 thing. Herniation of a disc
is when it bulges. So, you've got your littlediscs. Think of it as little block squares set up on top of each other with a hole inthose squares, and in those squaresâ€¦ So, think of this as your vertebra, and thinkof this little pearl right here as your spinal cord. So, that's stacked up. A bunch ofthose are stacked up on top of each other. Now, around that is this meaty tissue andfluid to make sure that nothing hurts that spinal cord because it doesn't regenerateitself. So, you've got these little guys stacked up on top of each other. If you havea herniation that's when some of this goo in here pops out, OKé Think of a little balloonof goo sticking out, it's a hernia. Just
like if you have inguinal hernia or a herniain your intestines. Now, a disc degeneration is when this littleguy right here, he's falling apart. So, this starts degenerating. It starts breakingdown. It's not solid anymore. It's getting porousand they can't do the job and it's getting weak. So, they'll stack on top of each otherâ€“ two completely different things. Herniation you got a bulge right there, anddegeneration this is wearing out. Can you have bothé Absolutely, but they are two distinctthings. Q 18: What is the difference between LefortI, II, III from each procedureé Also, is Botox
injection part of the procedureé What is CPTcode for the Botox injectioné A: I don't know. Sorry. First of all betweenLefort I, II, III, I just don't even know what that is without looking it up, and Iapologize that after I said I was so intelligent andawesome that I don't know that; but this is a perfect QA forum question. So, if youwill post this in there I will make sure that it gets answered because now I want to knowwhat Lefort I, II, III, is, and what is the CPT code for a Botox injectioné Again, I'msure it has a specific injection code and we'll find it for you.