It has been my understanding that in the U.S., a person has to fail using CPAP in order to qualify for this implant due to insurance requirements (CPAP is cheaper...). That said, my husband has been trying to get a CPAP machine for months and has yet to get one thanks to the clinic and insurance hoops. We have no idea how much it's going to cost especially since the year ended and we now have to pay the new deductible again. We have what's considered really good medical insurance for the U.S. too. (Thank you for reading my rant about how horrible the U.S. medical system is!)
Not sure what a deducible is, but I'm glad you have cover. There are loads of steps prior to an implant so go through the options with your team. I use about 42 operations for snoring and sleep apnoea personally.
A deductible is a copayment that the holder of the insurance of any kind is responsible for while the policy pays the rest. There are also supplemental policies in healthcare that will cover the deductible so no out of pocket expense.
I'm on a Medicare Advantage Plan that will pay for Inspire although I'm not sure what my copay is yet. I have a follow up appt. In February for moderate obstructive sleep apnea. I started with the Resmed 11. I lasted about 9 months. I have a sinus issue that blocks one nostril every night. Never during the day. 5 ENTs and 2 MRIs say all is normal. Obviously not good forcing air up a blocked nostril. Still better than no machine but since I have Bruxism I decided to switch to an oral appliance and kill 2 birds with one stone😂. I am at the 9 month interval and again failing. The device is too large for my small mouth, but that is the way they are made so nothing to do about that. According to the Snorelab app I do a little bit better with it in than out. Now I also have prostate cancer and BPH. PSA is going down gradually 16 months after Viewray Mridian MRI linac radiation hypofractionated treatment. The BPH I did not treat because it did not become an issue until 6 months before radiation treatment and I couldn't postpone the RT any longer. So now on Flo max (Tamsulosin). One of the side effects is.....drum roll please! Sinus congestion! Perfect mess. So l have multiple contributing factors to sleep issues. I have improved recently by changing when and how I take flo max and and am getting up about every 3 to 4 hours at night. Not bad. When I had undiagnosed sleep apnea and no BPH 4 years ago my sleep was much worse. I should have had a sleep study 20years ago. I'm 71 tomorrow. When I went in to discuss results of the sleep study I was told I qualified for Inspire. Obviously I have exhausted other options and plan on moving forward in February when my appt. comes up. I cancelled the appt last March because I was getting the oral appliance and wanted to wait a few months to see how it was working. The next available appt was 11 MONTHS! So that is this February. Just getting over my first experience with Covid that started Dec 12. My sinuses are feeling better and not clogging as bad but still every night (that has been going on for 35 years). What I'm hoping is that the radiation treatment from 10/22 continues to shrink the prostate over the next 9 months and I can stop the medication. Otherwise it will take a Urolift or other procedure to open up a pathway. Obviously the first solution is desired. I made it 68 years with no medical issues so can't complain 😊!
Fantastic news Mr Veer !. I am one of your patients and awaiting a a DI sleep endoscopy . Hopefully it will work and be well tolerated by all 👍. Many thanks for all your hard work in this field !
I myself a medical practitioner, suffering from UARS with symptoms of mild difficulty in swallowing, often enlarged lingual tonsils. Anatomical Mallampati grade2, often a mouth breather, history of tonsillitis, pneumonia and throat infections. Came across your channel for a better understanding of UARS. I’m planning for tonsillectomy. If you’ve any recommended treatment please share. Thanks
I hadn't even heard of this procedure until now. I'm sure there will be many people that will benefit from your hard work to get this approved. I love it when you put out video's. Easy to listen to and informative. Do you know if they do this procedure in Australia?
Wow! Thank You so very much Dr. I was diagnosed with sleep apnea but couldnt get on with mask, so will get referral to come & see you. People like me, are So grateful to doctors like you who are prepared to go above & beyond, to help patients! Ive other issues linked to scar tissue in my cervical region, so Need a good ENT consultant. Look forward to meeting you & do hope i can have this procedure asap will change my life! 😊God Bless You🙏🤩
@@VikVeerENTSurgeon Have met many different types of doctor's/surgeons, over years, but you, Dr Veer, are Amazing! 🌟💯 Congratulations!!✨🎉 Your Patience, Hard Work, Committment, Professionalism & all time/energy used, in order for this implant to be available to those who meet criteria, not just in UK, but on NHS! Wow!! THANK YOU DR👏👏👏 I know, it wasnt an easy challenge, especially with all NHS red tape, but its one that has now, been given green light, Thanks to all your hard work! This says so much about you, as person & Doctor/Surgeon! Shows You Truly Care about lives of UK Patients & know/will have Proven to NHS decision makers that this implant Works! You'll hv saved/changed many peoples lives in yr career. Your great efforts, have already brought me Alot of Hope, that this procedure Will Change My Life (in Many Positive Ways) & change lives of so many patients/partners, whose lives are severely affected, on daily basis, by vast array of symptoms, from this life threatening condition. Many of whom, like myself, hv tried, but Cant get on with using cpap/ mask. A family member, (with no diagnosed health issues) passed away, during their sleep recently. They may well hv had sleep apnea undiagnosed. So my family & I who I've just told about what you've achieved), are praying I'll be suitable candidate for this implant.(meet min level during sleep study.) I speak on behalf of us All, when I say Well done & Thank You, Dr Veer Can't wait to meet with you. Feel Blessed that there's chance I could have this implant soon!😊😊😊
Good afternoon. Most interesting video, once again, thank you for your continued enthusiasm and professionalism. Enjoy the remainder of your weekend Best regards
Great news Dr Veer. Always enjoy seeing your videos. Looking forward to more videos of yours for sleep apnea and UARS Can I also say, the tonsillectomy is the WORST PAIN EVER !!!!😂
Brill news NHS has agreed this, I'm having my turbinates reduced on the 23rd Vic so see you then 😀 Also I can hear heartbeat in both my ears so need to chat about that as well-so that is called: Pulsatile Tinnitus right?? Reply when you can thanks.
I have a video on pulsatile tinnitus so have a look at that. You might have to see someone local to you however as I'm only meant to be doing snoring and sleep apnoea work at the RNENT hospital.
@@VikVeerENTSurgeon I have just phoned them up Vik, my appointment on Jan 23rd is for Sleep apnea-I didn't realise I got referred for that lol I also phoned up Queen's ENT about Turbnate Reduction you will be doing and said with waiting lists will be very early Spring 👍🏻
I am on the waiting list to see you to hopefully find out the cause of my sleep apnea. I have already seen 2 ent specialists in Birmingham following diagnosis but they gave the impression that if it wasnt due to excess weight or something obvious, it wasnt possible to find the cause. I dont get on well with the mask and was so pleased to find you on utube and discover the many possible reasons and your ability to discover which it is.😊 I am already taking Gaviscon Advance which has greatly helped with constant sneezing and hoarse voice, post nasal drip etc. Which i have suffered from for years. Thank you so much it was a light bulb moment hearing about silent reflux! I had previously been diagnosed as allergic rhinitis cause unknown. Hoping I get an appointment soon thanks again
If you get your nosed fixed and then use nasal steroids, you'll be able to handle a mask just fine. I'm sure Dr Veer here will figure out a plan of action for you. The biggest issue with cpap IMO is mask air leak. Most people need to find a way to keep their mouth sealed, otherwise you are not getting reliable therapy. If your mask leak is above what it should be for a said mask, you can't believe any of the data the machine has logged for the night.
Hello Dr Veer, very educational videos, thank you. I am using CPAP for my sleep apnoea for over 4 years now find it difficult but for peace to prevail i use it anyway for my wife's sake. I am really interested in the device Hypoglossal nerve implants. How do i get a referral to see you? Also would it be a massive surgery, inversive or just under the skin.? Thank you
I don't understand what my issues is, i have had sleep apnea but ive caught myself fall asleep but holding my breatg so im confused, i can tell the blockage wasn't at my throat but almost holding my breath. I had a sleep apnea episode once i woke up on my knees, my hands around my throat as if i was joking. I was scared for me life. It took some seconds until my airways opened. Dam! Btw im very thin, who never eats fried foods.
I follow a sleep apnea page on Facebook and alot of people in America have had these implants in the removed a year later. What are the side effects? I have osa and wore a cpap for a year with no effect! Was told by another Dr it would never work for me and sent me down the mandipula device path but I can’t use it. So suffer with terrible fatigue, high BP and Pre Diabetic from my apnoea.
I have one of those inspire devices that he talks about. Had it for about 4 years. When I used cpap, it worked great, however all of a sudden I couldn’t tolerate it. This is why I got this device. Given my experience with it, here are some things to note. After having this installed, you need to get it tuned up for your specific needs. It will take some iterations to get its effectiveness as close to the best it can be for you. After tuning it, you’ll need another sleep study to see how well the tuning has worked. This was not done too thoroughly in my case. Another thing is that when you first turn it on at night when you go to bed, it sends a test pulse to your tongue that I find uncomfortable and it wakes me up too much. After which, after 20 minutes or so before I have fallen asleep, it starts its routine and wakes me up again after which I have to reset its timer and start again. Most nights I just give up on it. So, these nuances have to be taken into account and tuned and managed properly.
Hi Vik, i have sleep apnea but in the last year i have stopped being so tired, i dont fall asleep in the day anymore, i dont fall asleep at work any more like i used to. I changed things in my life which where recommended.I have stopped using my cpap machine for 3 months and still feel fresh. How ever i still snore and have tried everything to stop. I am not sure where to turn too as i feel my gp will not have the knowledge you may have. Do you have any advice for what i should do next?
My nose needs to be chisseled & I think then that might work. Or re break my nose and that may work as cpap has no effect on me. I’ve been referred to you a year or more ago and had no answer.
Lets see some LONG TERM results after 5 or 10 years and lets see the AHI's and complications. If you have an AHI of 35 your AHI will go down to around 10 AHI. Worth it?
There have been about 40,000 implants with over 5 years data so I'll dig up the data and do a video on the results at some point. Thanks for the video idea.
I don't see that type of data provided by this public co. In the USA this co. is bombarding the population with these adverts! Missed you in NYC this holiday. Should the clinicians that do the DISE also be implanting the Inspire? A conflict of intere$t? This looks like a phenomenal idea but in reality is it long term as far as an AHI less than 5. Genioglossus advancement is easier and can be easily reversed. @@VikVeerENTSurgeon
Hi Vik, I had MMA two years ago which failed to solve my issue. I recently also had Hyoid Bone Suspension, which doesn’t seem to have worked. My obstruction is tongue based and despite my AHI being fairly low (just under 20) my ESS is always high. I’ve been hesitant to go for a hypoglossal stimulator, because looking at the data it doesn’t look very successful, and a lot of people get it removed. Would love to know what you think about the success rate of the surgery and why my surgeries trying to address anatomical issues failed.
Hi Vik, could you please do a video on nasal valve surgery with alar batten graft? I’m due to have this done in the near future as my nasal valve collapse is quite band and strips aren’t that effective due to having a large nose and the collapse occurring at the inner valve area. I also have OSA and the collapse negatively impacts my CPAP treatment. I was also offered turbinate reduction but will refuse that as I’ve decided to tackle the root cause which is dust mites. Thanks and keep the great videos coming as your channel is invaluable for people like myself 👍
It has been my understanding that in the U.S., a person has to fail using CPAP in order to qualify for this implant due to insurance requirements (CPAP is cheaper...). That said, my husband has been trying to get a CPAP machine for months and has yet to get one thanks to the clinic and insurance hoops. We have no idea how much it's going to cost especially since the year ended and we now have to pay the new deductible again. We have what's considered really good medical insurance for the U.S. too. (Thank you for reading my rant about how horrible the U.S. medical system is!)
Not sure what a deducible is, but I'm glad you have cover. There are loads of steps prior to an implant so go through the options with your team. I use about 42 operations for snoring and sleep apnoea personally.
A deductible is a copayment that the holder of the insurance of any kind is responsible for while the policy pays the rest. There are also supplemental policies in healthcare that will cover the deductible so no out of pocket expense.
I'm on a Medicare Advantage Plan that will pay for Inspire although I'm not sure what my copay is yet. I have a follow up appt. In February for moderate obstructive sleep apnea. I started with the Resmed 11. I lasted about 9 months. I have a sinus issue that blocks one nostril every night. Never during the day. 5 ENTs and 2 MRIs say all is normal. Obviously not good forcing air up a blocked nostril. Still better than no machine but since I have Bruxism I decided to switch to an oral appliance and kill 2 birds with one stone😂. I am at the 9 month interval and again failing. The device is too large for my small mouth, but that is the way they are made so nothing to do about that. According to the Snorelab app I do a little bit better with it in than out. Now I also have prostate cancer and BPH. PSA is going down gradually 16 months after Viewray Mridian MRI linac radiation hypofractionated treatment. The BPH I did not treat because it did not become an issue until 6 months before radiation treatment and I couldn't postpone the RT any longer. So now on Flo max (Tamsulosin). One of the side effects is.....drum roll please! Sinus congestion! Perfect mess. So l have multiple contributing factors to sleep issues. I have improved recently by changing when and how I take flo max and and am getting up about every 3 to 4 hours at night. Not bad. When I had undiagnosed sleep apnea and no BPH 4 years ago my sleep was much worse. I should have had a sleep study 20years ago. I'm 71 tomorrow. When I went in to discuss results of the sleep study I was told I qualified for Inspire. Obviously I have exhausted other options and plan on moving forward in February when my appt. comes up. I cancelled the appt last March because I was getting the oral appliance and wanted to wait a few months to see how it was working. The next available appt was 11 MONTHS! So that is this February. Just getting over my first experience with Covid that started Dec 12. My sinuses are feeling better and not clogging as bad but still every night (that has been going on for 35 years). What I'm hoping is that the radiation treatment from 10/22 continues to shrink the prostate over the next 9 months and I can stop the medication. Otherwise it will take a Urolift or other procedure to open up a pathway. Obviously the first solution is desired. I made it 68 years with no medical issues so can't complain 😊!
Fantastic news Mr Veer !. I am one of your patients and awaiting a a DI sleep endoscopy . Hopefully it will work and be well tolerated by all 👍. Many thanks for all your hard work in this field !
Look forward to it. Fingers crossed for you
I myself a medical practitioner, suffering from UARS with symptoms of mild difficulty in
swallowing, often enlarged lingual tonsils. Anatomical Mallampati grade2, often a mouth breather, history of tonsillitis, pneumonia and throat infections. Came across your channel for a better understanding of UARS. I’m planning for tonsillectomy.
If you’ve any recommended treatment please share. Thanks
I hadn't even heard of this procedure until now. I'm sure there will be many people that will benefit from your hard work to get this approved.
I love it when you put out video's. Easy to listen to and informative.
Do you know if they do this procedure in Australia?
I'm pretty sure that they do. They are certainly doing research into implants (as we are working on this together for a different company).
They definitely use them in Australia. There are surgeons who have a particular interest in implanting these devices. And yes they work quite well.
Wow! Thank You so very much Dr. I was diagnosed with sleep apnea but couldnt get on with mask, so will get referral to come & see you.
People like me, are So grateful to doctors like you who are prepared to go above & beyond, to help patients!
Ive other issues linked to scar tissue in my cervical region, so Need a good ENT consultant. Look forward to meeting you & do hope i can have this procedure asap will change my life! 😊God Bless You🙏🤩
I'll do my best to help. Speak to your GP, I'll see you soon.
@@VikVeerENTSurgeon
Have met many different types of doctor's/surgeons, over years, but you, Dr Veer, are Amazing! 🌟💯 Congratulations!!✨🎉
Your Patience, Hard Work, Committment, Professionalism & all time/energy used, in order for this implant to be available to those who meet criteria, not just in UK, but on NHS! Wow!! THANK YOU DR👏👏👏
I know, it wasnt an easy challenge, especially with all NHS red tape, but its one that has now, been given green light, Thanks to all your hard work!
This says so much about you, as person & Doctor/Surgeon! Shows You Truly Care about lives of UK Patients & know/will have Proven to NHS decision makers that this implant Works! You'll hv saved/changed many peoples lives in yr career.
Your great efforts, have already brought me Alot of Hope, that this procedure Will Change My Life (in Many Positive Ways) & change lives of so many patients/partners, whose lives are severely affected, on daily basis, by vast array of symptoms, from this life threatening condition. Many of whom, like myself, hv tried, but Cant get on with using cpap/ mask.
A family member, (with no diagnosed health issues) passed away, during their sleep recently. They may well hv had sleep apnea undiagnosed. So my family & I who I've just told about what you've achieved), are praying I'll be suitable candidate for this implant.(meet min level during sleep study.)
I speak on behalf of us All, when I say Well done & Thank You, Dr Veer
Can't wait to meet with you. Feel Blessed that there's chance I could have this implant soon!😊😊😊
Good afternoon.
Most interesting video, once again, thank you for your continued enthusiasm and professionalism.
Enjoy the remainder of your weekend
Best regards
Thank you for the comment, much appreciated.
Great news Dr Veer. Always enjoy seeing your videos.
Looking forward to more videos of yours for sleep apnea and UARS
Can I also say, the tonsillectomy is the WORST PAIN EVER !!!!😂
Ask those who've had an expansion pharynoplasty.... That's next level pain...
Hunters are allowed to have guns in the UK? I thought only criminals were allowed to arm themselves there.
I honestly don't know the law. With a license you can have a gun, but no automatic guns or handguns. Sorry that's all I know.
No one can be bothered with guns generally, but I'm sure there are people out in the countryside that have them for the farm etc.
@@VikVeerENTSurgeon Sure, I'm kidding around about the guns. Seriously though, another great video, thank you for sharing all that with the world.
Brill news NHS has agreed this, I'm having my turbinates reduced on the 23rd Vic so see you then 😀
Also I can hear heartbeat in both my ears so need to chat about that as well-so that is called: Pulsatile Tinnitus right??
Reply when you can thanks.
I have a video on pulsatile tinnitus so have a look at that. You might have to see someone local to you however as I'm only meant to be doing snoring and sleep apnoea work at the RNENT hospital.
@@VikVeerENTSurgeon I have just phoned them up Vik, my appointment on Jan 23rd is for Sleep apnea-I didn't realise I got referred for that lol
I also phoned up Queen's ENT about Turbnate Reduction you will be doing and said with waiting lists will be very early Spring 👍🏻
I am on the waiting list to see you to hopefully find out the cause of my sleep apnea. I have already seen 2 ent specialists in Birmingham following diagnosis but they gave the impression that if it wasnt due to excess weight or something obvious, it wasnt possible to find the cause. I dont get on well with the mask and was so pleased to find you on utube and discover the many possible reasons and your ability to discover which it is.😊 I am already taking Gaviscon Advance which has greatly helped with constant sneezing and hoarse voice, post nasal drip etc. Which i have suffered from for years. Thank you so much it was a light bulb moment hearing about silent reflux! I had previously been diagnosed as allergic rhinitis cause unknown. Hoping I get an appointment soon thanks again
Looking forward to it. See you soon. Glad the globus video helped you.
If you get your nosed fixed and then use nasal steroids, you'll be able to handle a mask just fine.
I'm sure Dr Veer here will figure out a plan of action for you.
The biggest issue with cpap IMO is mask air leak. Most people need to find a way to keep their mouth sealed, otherwise you are not getting reliable therapy. If your mask leak is above what it should be for a said mask, you can't believe any of the data the machine has logged for the night.
I Have A Question Why Do My throat Feel like Ice Is stuck inside and feel cold in my throat?
Hello Dr Veer, very educational videos, thank you. I am using CPAP for my sleep apnoea for over 4 years now find it difficult but for peace to prevail i use it anyway for my wife's sake.
I am really interested in the device Hypoglossal nerve implants.
How do i get a referral to see you?
Also would it be a massive surgery, inversive or just under the skin.? Thank you
I don't understand what my issues is, i have had sleep apnea but ive caught myself fall asleep but holding my breatg so im confused, i can tell the blockage wasn't at my throat but almost holding my breath.
I had a sleep apnea episode once i woke up on my knees, my hands around my throat as if i was joking. I was scared for me life. It took some seconds until my airways opened. Dam!
Btw im very thin, who never eats fried foods.
I follow a sleep apnea page on Facebook and alot of people in America have had these implants in the removed a year later. What are the side effects?
I have osa and wore a cpap for a year with no effect! Was told by another Dr it would never work for me and sent me down the mandipula device path but I can’t use it. So suffer with terrible fatigue, high BP and Pre Diabetic from my apnoea.
I have one of those inspire devices that he talks about. Had it for about 4 years. When I used cpap, it worked great, however all of a sudden I couldn’t tolerate it. This is why I got this device. Given my experience with it, here are some things to note. After having this installed, you need to get it tuned up for your specific needs. It will take some iterations to get its effectiveness as close to the best it can be for you. After tuning it, you’ll need another sleep study to see how well the tuning has worked. This was not done too thoroughly in my case. Another thing is that when you first turn it on at night when you go to bed, it sends a test pulse to your tongue that I find uncomfortable and it wakes me up too much. After which, after 20 minutes or so before I have fallen asleep, it starts its routine and wakes me up again after which I have to reset its timer and start again. Most nights I just give up on it. So, these nuances have to be taken into account and tuned and managed properly.
Hi Vik, i have sleep apnea but in the last year i have stopped being so tired, i dont fall asleep in the day anymore, i dont fall asleep at work any more like i used to. I changed things in my life which where recommended.I have stopped using my cpap machine for 3 months and still feel fresh. How ever i still snore and have tried everything to stop. I am not sure where to turn too as i feel my gp will not have the knowledge you may have. Do you have any advice for what i should do next?
"Completely free" is not a term used by surgeons in the U.S.
Do youthink turbinates implant is possible?
Do you think turbinates implant is possible?
How do you get referred to maxillofacial surgeons for sleep apnea on the NHS?
Just ask your GP.
My nose needs to be chisseled & I think then that might work. Or re break my nose and that may work as cpap has no effect on me. I’ve been referred to you a year or more ago and had no answer.
Sounds like your appointment has got lost. I would chase it up with the hospital.
Very helpful
Glad it helped
Lets see some LONG TERM results after 5 or 10 years and lets see the AHI's and complications. If you have an AHI of 35 your AHI will go down to around 10 AHI. Worth it?
There have been about 40,000 implants with over 5 years data so I'll dig up the data and do a video on the results at some point. Thanks for the video idea.
I don't see that type of data provided by this public co. In the USA this co. is bombarding the population with these adverts! Missed you in NYC this holiday. Should the clinicians that do the DISE also be implanting the Inspire? A conflict of intere$t? This looks like a phenomenal idea but in reality is it long term as far as an AHI less than 5. Genioglossus advancement is easier and can be easily reversed. @@VikVeerENTSurgeon
Hi Vik, I had MMA two years ago which failed to solve my issue. I recently also had Hyoid Bone Suspension, which doesn’t seem to have worked. My obstruction is tongue based and despite my AHI being fairly low (just under 20) my ESS is always high. I’ve been hesitant to go for a hypoglossal stimulator, because looking at the data it doesn’t look very successful, and a lot of people get it removed. Would love to know what you think about the success rate of the surgery and why my surgeries trying to address anatomical issues failed.
Hi Vik, could you please do a video on nasal valve surgery with alar batten graft? I’m due to have this done in the near future as my nasal valve collapse is quite band and strips aren’t that effective due to having a large nose and the collapse occurring at the inner valve area. I also have OSA and the collapse negatively impacts my CPAP treatment. I was also offered turbinate reduction but will refuse that as I’ve decided to tackle the root cause which is dust mites. Thanks and keep the great videos coming as your channel is invaluable for people like myself 👍