Inspire Implant : My Journey

[Malloc]

Minor update at about three weeks into recovery: I’m back to life as mostly normal though there is still a decent amount of tenderness at the incision sites. The biggest limitation is reaching for things or sudden movements on implant side will quickly remind you that there’s no such thing as a “minor” implant surgery.

I still have ten days until activation and I have to admit it’s becoming mentally challenging even though I’ve always considered myself a very patient person. Every time I wake up gasping or with a headache I have to remind myself how close I am to the next step all the while trying not to get my hopes too high that this will be a light switch difference miracle cure. As a footnote for the annals of history I’m *very* glad that I got the surgery before the global events of early 2020 started impacting the healthcare system as a whole.

[OcalaSleeper]

Thank you for the update. I have researched a doctor in my area to see about the surgery. May your discomfort keep getting less.

[Big Guy]

My younger brother (age 60) recently had a pace maker implanted. He's experiencing a lot of the same discomfort as you have described. 

I spoke to him a few nights ago, and he was surprised at just how much tenderness there still is. He can't lift anything 10 lbs. or heavier. He was complaining about how some of his chest muscles are behaving. They are literally jerking so much that you can see it occur. He has to place his right on over them and press to calm them. 

He did see his cardiologist and was told that all is fine and he simply must deal with the discomfort for a while.

[Malloc]

Exciting update time since it's activation day!

The activation appointment went very smoothly and consisted of holding the physician programmer probe near the implant site while my sleep specialist played with some settings. He was thrilled at both the tongue movement direction (straight out) and that I could feel the stimulation at a very low setting. Both are indicators that the nerve cuff placement was basically perfect. Time to send my surgeon a thank you card for being awesome.

I will admit, the stimulation feels *very* strange the first few times it triggers. It's difficult to even describe, but at low intensities it's more of a tingling that I might compare it to putting a 9V battery on your tongue except at the base of the tongue. At actual therapy intensities it feels more like when you're cold enough to start involuntarily tensing up without the associated spasming. That is to say the whole tongue just feels tight while therapy is active. I would not describe it as painful or alarming so I guess that's a good sign for my long term tolerance of the therapy.

My next step is to acclimate by slowly ramping up the intensity over a few weeks and he said I shouldn't expect to necessarily see daytime improvement right away. Thanks to the current global pandemic all our sleep labs are closed until further notice so here's to hoping they'll be open again in ~3 months when I need a titration study.

[OcalaSleeper]

Thanks for sharing. My appointment with my doctor to discuss Inspire has been pushed back due to current situations. Look forward to hearing about your progress. Also hoping that we get a death grip on the corona virus very soon.

[Malloc]

First night was somewhat hit and miss. I was pleasantly surprised at how tolerable the therapy was and even bumped it up one setting already. I actually waited out the initial timer just to see what it was like and didn't have any problem initiating sleep even with the therapy actively on. However, my overall sleep quality wasn't that great since my sleep specialist had advised me to discontinue any other therapies (currently MAD) while I adjust. Obviously Inspire isn't an effective AHI reducer at the lowest stimulation levels, but I'm hopeful to achieve some reduction in the coming weeks. The other thing I totally did not expect was that I can *hear* the therapy activating as this low level humming that perfectly coincides with the tongue stimulation. It seems like I can only hear it with earplugs in (my usual sleep state) and doesn't bother me any more than the sound of a CPAP did, but it was very strange at first.

[Malloc]

One month from activation update: it's taken longer than expected adjusting to a stimulation level that provides noticeable benefit, but I finally feel like it's as effective or better than my previous MAD. For me that has meant level 6 out of 10 and it took me more than the recommended three days per setting to get there. I had this strange non-linear adjustment where I couldn't get past level 4 for over a week without it waking me up then suddenly the next level was no big deal and I'm back to increasing it.

So far my tongue has adjusted to the stimulation fine without next day pain or roughness from contact with the teeth and I haven't felt the need to get any additional mouth guard. The only adjustment I'd suggest to consider out the gate is upping the on and pause delays. 15 minutes is definitely not enough to get back asleep if I have to pause it and 30 minutes is sometimes not enough to fall asleep initially (at least for me). Overall I'm hopeful that this will work out for me since I can tolerate the stimulation and am feeling some benefits early on.

[Sleeprider]

Still don't miss CPAP?

[Big Guy]

Thanks for the updates! Keep um coming, I'm curious as to how well it works out for you in the long run.

[Malloc]

Still don't miss CPAP?  

I'll admit I had a few days of cold feet after activation like, "Did I *really* need to do this?" or "Should I have tried another round of CPAP first?"

I definitely don't have any love lost for the actual therapy and maintenance though.