One of the nicest things about living in the 21st century is the
amount of surgical options available to more people, including
more and more people in the developing world (though, obviously,
not enough).
Quite sincerely, countless numbers of lives have been outright
saved, or inestimably improved, due to surgery. I doubt you’d
find anyone who would absolutely conclude that surgery, as a
concept, is a mistake; or that we should long for pre-surgery
days, where infections and ailments so easily morphed into
life-threatening conditions.
Are We Addicted to surgery?
Yet (and yes, there’s always a yet!), there is a bit of a cloud
attached to this surgical silver lining. We now live in a world
that is, for all intents and purposes, addicted to surgery. It
has become the first option – and in some cases, the only option
– that both doctors and patients consider when trying to remedy
a problem.
Advances in medical technology have played a role here as well;
transforming within the span of a generation a surgery that once
required 7-10 days of hospital care, to an “in by 2:00pm, out by
4:00pm” outpatient experience; and since many (enhanced) medical
insurance plans cover many types of surgery – all it needs is a
doctor’s okay – it’s not uncommon to come across people who have
had a litany of surgeries over the past few years. They might
even know the surgeons by name, and have a favorite parking spot
at the hospital.
It is in light of all this is that we look at snoring, and at
surgery. In a nutshell: the two don’t mix; and this is a bit of a
problem to people who are persuaded by medical doctors (or by
surgery-addicted colleagues, friends, and relatives) to go under
the knife to get rid of that “pesky snoring problem”. These
people may be well intentioned, but they don’t have all of the
facts. One of the things that they probably don’t (yet) know –
again, not deliberately – is that surgery is not an exact
science. It may look that way, especially when one sees the army
of hi-tech equipment that clogs many operating rooms and makes
one think that they’re at NASA Mission Control instead of a local
hospital.
However – and even surgeons will readily admit this (or their
insurance companies will if they won’t) – surgery is, always has
been, and always will be, somewhat exploratory. True, some
surgeries are better known and more ordinary than others, and the
chance of a successful outcome for, say, a quick knee surgery
might be radically more predictable than a kidney transplant. But
the bottom line is that both of these procedures are surgical,
which means that they both have risks. This, indeed, is something
of a wake-up call for people who have equated surgery with
certainty.
So how does this relate to snoring? Quite bluntly, it’s this:
whereas some surgeries are a bit more tried and tested than
others, surgery designed to stop, mitigate, or treat snoring
have been less than successful for many people. Why is this the
case? Surgery to treat snoring is designed, ultimately, to
increase the airflow in the trachea; and the most common surgical
way to do this is to cut away some of the tissue that is
clogging up that passageway. Is this a wise choice? Possibly,
yes, for some snorers this can be a remedy; but not for all, and
certainly not for most. This is because the problem of snoring
is often much deeper than a constricted trachea.
Yes, as we discussed earlier in this book that is how snoring
manifests itself as sound: air from the lungs vibrates in the
airflow. Yet for many people, this is not the ultimate cause of
snoring; that cause, like many medical ailments, is often
something of a mystery, and can change significantly from person
to person.
Let’s look at something simple and non-medical: car insurance.
Let’s take 20 people who are considered bad drivers by their
insurance companies. As a result of that dubious distinction,
all of these drivers are going to face a premium increase of $500
when they’re insurance is renewed. Now, seen at a distance, it
might appear as though all of these drivers are in the same boat
(or same car, as it were). And given that assumption, a method
to deal with this problem might be to simply give each of these
people an extra $500 in cash. Really, as strange as that sounds,
this is a way to solve this problem for each of these 20
drivers: they need to find $500 more to pay their insurance
premium, and hence, that is what this so-called solution is
going to do. Yet is this wise? No!
Some of those drivers – probably more than a few of them – are
not going to actually correct why they might be classified as a
“bad driver” by their insurance company. They simply won’t know
why they’re bad drivers, and hence, some of them will likely
remain a “bad driver”, and face higher insurance premiums next
year – but this time after a few more accidents or tickets.
As you can easily see, the real cause of the so-called “bad
driving” isn’t solved when each person is given a nice gift of
$500 with which to pay his or her increased insurance premium.
And since the problem isn’t really solved, the bad driving can
crop up again, and cause financial problems and even worse, it
can endanger health and safety.
So when people readily turn to trachea tissue-cutting surgery to
cure their snoring, they may quite easily be overlooking the real
root cause of the snoring; something that may be related to
diet, sleep position, jaw or tongue dysfunction, lifestyle,
genetics, or be an indication of an even more serious health
problem; an indication that could be dangerously suppressed
(temporarily, at least), after a seemingly successful surgery.
Going to surgery as an easy, off-the cuff solution for snoring,
is like giving these bad drivers $500 in cash. It may seem to
solve their problem, but for many, it will just be a temporary
fix; masking even deeper problems that can lead to severe
consequences down the road, including Sleep apnea.
Again, we return to the unfortunately familiar theme that surgery
has become an easy first option for many physicians who, for a
variety of reasons (including, sometimes, financial ones) find
themselves recommending surgery as an almost off the cuff
solution to a serious snoring problem. Sometimes, what is lost
in this snoring surgical-obsession are some very basic and
established risks. For those who are not immediately familiar
with such risks, they include:
·post-operative medical conditions, including aesthetic and
cosmetic concerns
·infection from hospitals (including the emerging
antibiotic-resistant “superbugs”
·scarring of tissues that can lead to painful inflammation
·expensive follow-up to surgery
·time consuming follow-up which may cause extended periods of
leave from work (potentially adding to the overall cost of the
salary in lost wages/salary)
·expensive medications to control swelling
·possible damage to speech, including changing voice
·possible problems with swallowing
·possible hemorrhaging
·possible uncomfortable and distracting dry mouth
·possible intense ear pain
It’s necessary and well-worth repeating (sorry, but it is…) that,
overall, surgery is often a truly wondrous means of solving, or
at least alleviating, some serious health problems. Nobody wants
to return to a pre-surgical world, where procedures that are
swiftly addressed today would otherwise render a sufferer in
agony for years; or perhaps even hasten an early death.
So it should not be surmised that the view is that surgery is
inherently bad; because it’s not. But surgery is simply a tool,
and one that should be used only when necessary (not unlike any
other tool). The problem is that some people rely on surgery as
an automatic fix. What’s that old saying: if all you have is a
hammer in your hand, then everything looks like a nail? For some
people, this is regrettably true when it comes to surgery; every
health ailment that they see is worthy of surgery.
Yet these same people would probably seriously reconsider their
views when faced with the substantiated evidence that surgery is
not often working for snorers (and their loved ones).
Overall, then, while snoring surgery can be useful and effective
for some sufferers (and their families, roommates, neighbors,
heck, even their pets!), it’s clear that surgery has not proven
to a panacea, offering risk-free cures for this dangerous, and
potentially life-affecting condition.
Emanuele Accenti is the owner of the stop snoring website.
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