Electric Muscle Stimulation?

[Galactus]

To me this is almost as bad as the argument for weight loss surgery. The only difference being that weight loss surgery for all its 20% complications, still having to watch what you eat after the surgery, plus a complete diet change after the surgery, and the list goes on, it is still 100% effective in so far that people lose weight 100% of the time. Before I would have considered apnea surgery I would have considered weight loss surgery.

Add that to a lot of people out here on this board who have had poor experiences, and painful results and then still need cpap and I think it's a pass till they can prove it works like they did with weight loss surgery. And even then who knows what the list of complications will be?

[DocWils]

To me this is almost as bad as the argument for weight loss surgery. The only difference being that weight loss surgery for all its 20% complications, still having to watch what you eat after the surgery, plus a complete diet change after the surgery, and the list goes on, it is still 100% effective in so far that people lose weight 100% of the time.

Completely untrue. I had a patient who had bariatric surgery four years ago, and in the first year had lost considerable weight, it is true. However, for reasons we cannot yet fathom, he showed up in my office with a full two thirds of his weight regained - mostly, I suspect from not taking the vitamins he would have to take the rest of his life and having gone off his diet, which he would also have to follow the rest of his life. After examining the op records and ensuring that nothing had burst or torn inside, I turfed him up to the GI dept. to get a full work up, and was informed that although in general the numbers are good in terms of keeping weight down post op, he is hardly the first they have seen with a return of weight or other, far more life threatening post op complications over a 5 year period post-op, and even more over a 20 year period post op.

In short, yes, you lose weight initially, but no, you may not always keep it off. In fact, the GI dept. informs me, there is considerable evidence that in the end, the positive results from the bariatric surgery itself is short term, and it is the continued discipline of maintaining a strict diet and a vitamin regime that maintains the weight loss 5 years post op.

Ergo, the reason one stays on a diet to maintain the correct weight is the discipline imposed by the ordeal (and perhaps the fear instilled by) the operation, and not nearly so much the operation itself, which only works to trigger the initial weight loss - in this view, bariatric surgery is no more effective than, say, gastric banding, except, unlike gastric banding, the patient has no motivator to maintain the strict diet post op, since there is no, and let's be frank in defining it, fear of death instilled in the patient as there is implied to to the patient by the surgeon (and oh, yes, we really lay it on, trust me) should they fail to take their vitamins and maintain the strict diet post bariatric surgery.

It is the very real fear of death or failure of the procedure that helps keep the weight down, not the operation in itself, which only serves to limit the caloric intake for a short time, six months at most, before the new stomach expands enough to take in larger proportions of food. However, not everyone can maintain the diet, even in the face of dire consequences should they return to their old ways, as the fear of death has receded and the quotidian discipline becomes onerous for them.

In addition, we have found that one of the primary effective aspects of the surgery, the changing of the hormonal signals from the stomach to the brain, returning the saity trigger that is missing in many people of greater girth, does not always happen, which is partly why these people lose the "fear factor" and break dietary discipline after a few years.

[DocWils]

It totaly depends on the medical proffessional you find.
A surgeon's hammer is a scalpel you are a nail.

I saw a device on the news last night. It is implanted in the chest with a wired probe to detect breathing and an electrical stimulator wired under the skin to the throat to treat apnea.

I am not ready to be a guinea pig, but someone saw this thread and went out and invented the thing. It is currently be tested on actual people.

Naw, that sure as heck didn't come from this thread - I have heard of this one being bandied about for quite a few years, actually, a sort of breathing pacemaker. Pretty old, in fact. I first read about this idea thirty years ago, at least, along with all sorts of other ideas back when pacemakers were getting popular and above all, smaller. Sort of a "gee, that works, here just neat-o! Where else can we use this neat little toy?". Doesn't really work, at least so far, and still in testing phases. If it did work, I would guess it would only be for CA events, as it would still be hard to make it work on OA problems - how would an electric current open up a blocked throat passage caused by loose tissue? This isn't a muscle issue, and flab doesn't contract if you pass a current through it.....

BTW, as a surgeon (former) I sort of resent the analogy about the hammer and nail. No one I know thinks that way, and I sure as hell didn't - we were in a business that we would be happy to be out of, but when we had to, at least we knew that the patient was in good hands (or the good hands were in the patient, more correctly). While cut happy surgeons exist, especially in the US where there is a business motive for them, they are far rarer than you think. Sooner than later, the Medical Licensing Associations tend to winnow out any who engage on unnecessary or excessive surgery. And at least in all hospital operations, the records of the surgeon are under continual review. Private clinics less so, but if something is noticed, then it gets reported and looked into.

[Galactus]

To me this is almost as bad as the argument for weight loss surgery. The only difference being that weight loss surgery for all its 20% complications, still having to watch what you eat after the surgery, plus a complete diet change after the surgery, and the list goes on, it is still 100% effective in so far that people lose weight 100% of the time.

Completely untrue. I had a patient who had bariatric surgery four years ago, and in the first year had lost considerable weight, it is true. However, for reasons we cannot yet fathom, he showed up in my office with a full two thirds of his weight regained - mostly, I suspect from not taking the vitamins he would have to take the rest of his life and having gone off his diet, which he would also have to follow the rest of his life. After examining the op records and ensuring that nothing had burst or torn inside, I turfed him up to the GI dept. to get a full work up, and was informed that although in general the numbers are good in terms of keeping weight down post op, he is hardly the first they have seen with a return of weight or other, far more life threatening post op complications over a 5 year period post-op, and even more over a 20 year period post op.

In short, yes, you lose weight initially, but no, you may not always keep it off. In fact, the GI dept. informs me, there is considerable evidence that in the end, the positive results from the bariatric surgery itself is short term, and it is the continued discipline of maintaining a strict diet and a vitamin regime that maintains the weight loss 5 years post op.

Ergo, the reason one stays on a diet to maintain the correct weight is the discipline imposed by the ordeal (and perhaps the fear instilled by) the operation, and not nearly so much the operation itself, which only works to trigger the initial weight loss - in this view, bariatric surgery is no more effective than, say, gastric banding, except, unlike gastric banding, the patient has no motivator to maintain the strict diet post op, since there is no, and let's be frank in defining it, fear of death instilled in the patient as there is implied to to the patient by the surgeon (and oh, yes, we really lay it on, trust me) should they fail to take their vitamins and maintain the strict diet post bariatric surgery.

It is the very real fear of death or failure of the procedure that helps keep the weight down, not the operation in itself, which only serves to limit the caloric intake for a short time, six months at most, before the new stomach expands enough to take in larger proportions of food. However, not everyone can maintain the diet, even in the face of dire consequences should they return to their old ways, as the fear of death has receded and the quotidian discipline becomes onerous for them.

In addition, we have found that one of the primary effective aspects of the surgery, the changing of the hormonal signals from the stomach to the brain, returning the saity trigger that is missing in many people of greater girth, does not always happen, which is partly why these people lose the "fear factor" and break dietary discipline after a few years.

I agree with all that you said. All I was trying to say was that there is evidence that virtually 100% of weight loss patients lose weight vs much less percentages of "curing" sleep apnea. I am not a fan of the weight loss surgery, nor did I go for it for many of the reasons you state and some others I found in my research for it. Whether or not they regain the weight eventually isn't my issue, as the surgery did in fact work, and they did lose the weight vs the apnea surgery being almost ineffective from jump street let alone whether it would return later or still need cpap treatment. And again I totally agree surgery should be a last resort for all you have said and many other reasons.

[archangle]

In short, yes, you lose weight initially, but no, you may not always keep it off. In fact, the GI dept. informs me, there is considerable evidence that in the end, the positive results from the bariatric surgery itself is short term, and it is the continued discipline of maintaining a strict diet and a vitamin regime that maintains the weight loss 5 years post op.

I've heard the theory that some patients with the surgery tend to develop the habit of "grazing," i.e. nibbling all the time, which defeats the effect of the smaller stomach. I suspect your brain and your body chemistry adapt to the feedback from the full stomach after a while.

[DocWils]

Archangle, I would not doubt that idea at all. The more I think about it, the more it lines up with some things I have observed over the years.

[Galactus]

The funny part of that, well for me personally anyway, is that when I was a teenager and in school and people didn't have any money we always referred to "grazing" as what a person would do walking through one of the giant supermarkets. Have a grape here, a small fruit taste there, take a cheese sample, a deli sample of some cold cuts, and generally walk through the store on a grazing expedition. When I saw it here I had to chuckle.

[archangle]

I was always disturbed by the idea of drastically modifying the digestive tract to begin with. It seems to me to involve a lot of hubris to tinker with something as basic to the human body as that. Seems like you need to have history of what it does over a lifetime to think it's safe to do something like that. It really sounds like playing God to me.

It seems they're figuring out now that there are problems with the band surgery after some years as well.

I lost a dear friend to bariatric surgery. She had complications of some kind and it killed her over a period of a year or so. We get way too casual about the risks of surgery these days. It's marketed like it's like getting your hair done.

Side note: Spell check didn't like "bariatric." It suggested "barbaric" as the right spelling. Sometimes I think there's some hidden wisdom in the computer.

I'll have to look up to see if there is good data on long term success. I know the artificial "full" feedback you get helps suppress the appetite, but I wonder if the demons deep in your brain don't eventually learn to adjust to the feedback and trigger hunger despite the full feeling and give you cravings to browse when your blood sugar drops back.

Heck, I haven't had any surgery, but if I eat a small meal, I often find myself craving to browse a little while later after the food has passed out of my stomach.

Of course, it is a treatment for a life destroying condition. It's probably worth it for some. I just think the benefits may be overemphasized, and the risks are underestimated.

[Galactus]

I'll have to look up to see if there is good data on long term success. I know the artificial "full" feedback you get helps suppress the appetite, but I wonder if the demons deep in your brain don't eventually learn to adjust to the feedback and trigger hunger despite the full feeling and give you cravings to browse when your blood sugar drops back.

Of course, it is a treatment for a life destroying condition. It's probably worth it for some. I just think the benefits may be overemphasized, and the risks are underestimated.

I don't want to post my weight here, but I shall say in regards to this issue that I did extensive research into almost all of these types of surgeries. I went and spoke with many people that have had the surgery done, from new patients to patients that had the surgery 5 or more years ago. I found IMHO than at the end of the day everything you knew about food and eating were going to have to change in order to succeed in not only losing the weight but in keeping it off, and to be healthy. Frankly it appears that it will take the same amount of effort to lose the weight surgically as it will to lose it naturally. The only difference I could see was whether you could control yourself or if you needed the surgery to force your control. I say this because almost everyone I spoke to had issues eating after the surgery and when they didn't do as they should they were basically vomiting all the time. So at the end of the day it was a choice between taking on a surgery that literally by measure has a 20% or better complication rate with varying severity levels, with the possibility of death as an outcome, or just trying my hardest to lose weight and control myself. I am currently down about 85 pounds, and though it hasn't been easy I have learned a lot and I am continuing on my journey. I would not recommend this surgery as any type of shortcut. Around these parts we have an expression that says sometimes the cheap comes out expensive, and by the same token maybe the easy path actually turns out to be the hard road.

[Eleong2]

Hi, I'm a newbie on the board, and feel like I'm suffering from apnea, since my sleep is frequently interrupted by my airway passages closing (I'm quite obese).

I've started reading up on the whole apnea phenomenon, and since it seems to be caused by airways collapsing during sleep relaxation (doesn't seem to happen to me while I'm awake), then I wanted to know if any kind of electrical muscle stimulation would be capable of keeping the airway muscles from going slack and collapsing.

You know, just like with those gimmicky electrical-muscle-stimulation weight-loss devices, could it be possible to keep the relevant muscles stimulated and firmed up during sleep, to keep airways from collapsing?

I have been on CPAP for nearly a year now and after reading many of the postings on this site. I can assume that a large number of the folks have an issue with weight. I have a good friend whose nephew has sleep apnea and is a “hosehead” until he lost weight, his SA went away. But regained that weight over a two year period and is now back using his CPAP machine.
I am on the other end of the spectrum I am (just) over 60, my height is 5’ 10’’ and weight 175 lbs and I have moderate to severe sleep apnea. I had a discussion with my sleep doctor during a follow up and I asked him if this is for life, he said yes since I am not overweight. I have grown accustomed and have no problems with the treatment and now rely on it to “rock me” to sleep. I have no other option except surgery, if any, to treat my condition. If there is any option with a knife, I would prefer it being me using it on a steak. I look at this as way of ensuring that I can look forward to a long healthy retirement.
Looking for an easy way out may be the wrong way out. You have a long ways before retirement age; you could jeopardize that by your action or inaction. My advice is to take the safe path first, get the sleep study and decide what to do next. Not jump into decision because you think it’s the quick and easy way.
Ed