Palatal Prolapse and Velumount

[Sleeprider]

The Velumont palatal device consists of a small, plastic-coated wire customized to the individual anatomy. The middle section lies in the retropalatal region, applying traction to the soft palate. Its main effect is stenting the lateral pharyngeal wall to prevent velar collapse. The wire's ends are passed through the retromolar and alveolar regions, securing it with the lips.3 Arthur Wyss of Berne invented the Velumount® palatal device with subsequent design modifications by several companies. To date, over 40,000 patients have been treated with palatal devices, predominantly for habitual snoring and mild obstructive sleep apnea.
Source: Treatment of Residual Palatal Collapse in Hypoglossal Nerve Stimulation Using a Palatal Device
Source:  Therapy of Snoring and Obstructive Sleep Apnea Using the Velumount Palatal Device

[G. Szabo]

Thanks, Sleeprider, for the details.
Do they have providers in NA?

[Sleeprider]

I have not seen a North American provider, and given the custom fitting, I suspect it is a training issue as well as FDA approval. We have several members using the Alaxo Stent, and this looks a little more tolerable and more directly supports the pharyngeal velum. The research excerpt quoted above indicates these are used for snoring and mild OSA, but the O.P. is using this in combination with positive pressure to treat the palatal prolapse the positive pressure does not really address.

[Nitrous]

I’m brand new on the forum and am looking for an approach to mask noise problems.
I read the post with some interest but thought I’d share an observation about my limited personal experience with OSA and its treatment.

For the record, my wife and I are both retired MD’s (me an anesthesiologist and my wife a much more useful family doctor).  I’m well versed in the pathophysiology and treatment of OSA.  But I have to say, the most important aspect of my care is a competent respirologist/sleep physician and an excellent respiratory technician.  Beyond that, we both try and get out of the way to let them use their experience and objectivity to give me optimum care.

This doesn’t mean we abdicate our care, without thought or the occasional challenging question or two, but the diagnosis and treatment decisions are largely made by these two.

So, if the OP is managing this problem without professional oversight, I’d strongly suggest that would be my first step.  It’s hard to sue yourself for professional misconduct ?

If this post is completely out line, I Hope the mods will delete it… no disrespect intended.  Thanks
Nitrous

[40plus]

I think the main problem is that sleep apnea treatment seem to more and more be a case of a simple home study. If sleep apnea is present then give apap machine like resmed 11 set to 5-15 or 5-20, fit a mask and bye bye.

This seems fairly true both in America and here in Europe (sweden). If you complain they say your AHI is low so your fine, you just need time to adjust. And you are left to figure things out yourself.

Some get lucky and get a really good doctor but most of us seem to get the generic standard settings on an apap machine and thats it.

[G. Szabo]

This seems fairly true both in America and here in Europe (sweden). ... Some get lucky and get a really good doctor but....

Based on my experience in the EU, USA, and Canada under different insurance or finance models, the more direct the connection between the patient and the payment for medical services, the more chance the patient has to select better services and obtain better treatments. In fully covered insurance models, especially in government-financied systems, there is a mentality that the patient gets everything for "free." And the quality drops accordingly. Some doctors even become ignorant. 

This is true for any medical service.

[Nitrous]

Based on my experience in the EU, USA, and Canada under different insurance or finance models, the more direct the connection between the patient and the payment for medical services, the more chance the patient has to select better services and obtain better treatments. In fully covered insurance models, especially in government-financied systems, there is a mentality that the patient gets everything for "free." And the quality drops accordingly. Some doctors even become ignorant. 

This is true for any medical service.

I'd appreciate some context here.  I've been in the Canadian System all my life (including professional life) and wonder about the declining life expectancy in the premier "for profit/insurance-based" system in the world - America ( or at least we would be lead to believe that with single payor systems are inferior. 

The for profit system does not yield the level of care that many believe. Too many hands reaching in to get paid before any service is rendered. 

But that's off the topic.  I was merely asking if a majority of users on this board are 'figuring it out' for themselves?

[Crimson Nape]

I would speculate that most members here are doing it on their own.  It appears that the medical profession has been only taught the high points of sleep apnea and not the more granular aspects of treatment.  Many members have joined Apnea Board after becoming dissatisfied or disillusioned with professional care. This in itself could be a leading factor in the failure rate of therapy or CPAP usage.  With almost 500,000 members here, I would be inclined to believe that this lack of proper care exists worldwide.
- Red

[BoxcarPete]

But that's off the topic.  I was merely asking if a majority of users on this board are 'figuring it out' for themselves?

That is the explicitly stated purpose of the forum's existence, so I'd say yes. 

I talked to my doctor about whether I should make CPAP work or look for alternatives and he literally shrugged his shoulders and told me to go talk to someone at the sleep center. They're hardly any better. This forum allows people to share experiences gained from hard-won trial and error, and although not medically rigorous nor peer-reviewed by the establishment system, the volunteers who take time to work with struggling CPAP users get good results and heartfelt thank-yous the vast majority of the time.

[G. Szabo]

I'd appreciate some context here. ... The for profit system does not yield the level of care that many believe.

I can provide some context Nitrous wanted:
On Apnea 
In Canada:  My family physician referred me to a sleep specialist (medical doctor) working for a leading and one of the best-financed hospitals in the country because he was convinced that I had sleep apnea, and he wanted to be sure that no CA was involved. He explained to me that they could test that in the hospital. When I saw this specialist, he asked me, "Have you gained weight lately?" When he learned my answer was No, he decided I did not need further investigation and wanted me to leave his office. When I insisted and repeated what my family physician told me about possible CA, he answered, "If your family physician knows this so well, he should do this investigation himself," and I was discharged. After some rough time, I got a ResMed device from a small Canadian service provider for a home test, which confirmed that I have sleep apnea. No sleep report was generated. I bought a CPAP device and a nasal mask from this service provider. When I complained that I blew out the air through my mouth, which was pumped into my nose,  the sleep tech responded that it was anatomically impossible. 
In the USA: When I moved to Texas, I had no problem completing a sleep study at one of the hospitals. They prescribed me a full-face mask to deal with the issue I had in Canada. I still use that report when there is a demand for instrument purchases.

On eye problems:
In the USA: One of my close family members was diagnosed with high eye pressure in Texas,  and an eye drop was prescribed to prevent the development of glaucoma. 
In Canada: When we moved back to Canada, a local and well-known specialist in one of the major cities (a medical doctor) declared that she did not need the eye drops, and he declined its prescription. A severe vision loss (later diagnosed as glaucoma) was developed within three years. The specialist, who denied the eye drop earlier, said, "It is weird; I have no clue what is going on; let's wait and see what happens." At this point, we searched for the best eye specialist in Canada and requested a referral to him from this doctor via mail. After this, this eye specialist wanted to refer her to a glaucoma specialist of his choice. When we insisted on the referral to the best specialist, the eye doctor discharged my family member and documented in her medical record that she rejected the offered referral. This unfair comment in the medical record had severe consequences later on when additional medical intervention was needed. 

In which system do you want to be treated?