Re: [ACEsthetics] Re: finally happened

I would not be quick to say that the nasal surgery is unrelated to the apnea, if that is what you meant. Insufficient nasal patency is one of the predictors for non-responders to MAD therapy.

Kent Smith DDS
Sent from my smokin 64GB 4G iPad3

On Jun 30, 2013, at 5:38 AM, "Guy Moorman" <gmoor@windstream.net> wrote:

Thanks, Kent.  As I told Mark, I looked at the scanned report on his sister and we dropped her to a five from 81 so maybe we can get lucky and get him down there also.  Man, I did a consult yesterday for an ENT's patient and someone in Atlanta had done surgery.  That is some damned radical mess and it worked for only about a year.  She's back with a CPAP which she does not wear often enough.  He's doing unrelated surgery on her nose and sinuses and we'll make her an appliance after she finishes that.

 

Guy W. Moorman, Jr., D.D.S.

The Swamp

Douglas, GA 31533

912-384-7400

 

 

 

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From: acesthetics@googlegroups.com [mailto:acesthetics@googlegroups.com] On Behalf Of Kent Smith
Sent: Saturday, June 29, 2013 11:06 AM
To: Guy Moorman
Cc: <Acesthetics@googlegroups.com>
Subject: [ACEsthetics] Re: finally happened

 

All MADs effectively do the same thing, Guy, so if you are more comfortable with Tap, that's what I would use.

Kent Smith DDS

 

Sent from my iPhone


On Jun 29, 2013, at 6:03 AM, "Guy Moorman" <gmoor@windstream.net> wrote:

Kent et al, I have made quite a few Tap 3 Elites for patients who snore.  I require an ambulatory sleep test on all unless they have recently had a test and report in hand.  None have had particularly bad scores and the Tap 3 has dropped them to below 5 AHI with minimal desaturations and no snoring.  I made a Tap 3 for a lady who had an original score of 55 and snored to the point that her husband had threatened to move out of the room.  She had a sleep test done and had a CPAP but was totally intolerant.

 

Her brother came in last week because he snored just as badly as his sister did and was also threatened by his wife with moving out of the bed.  The Somnodent is above their financial threshold even though the brother is self-pay. 

 

He is coming in Monday for impressions for a TAP 3 Elite.  But we got his sleep study scores back and he blows is sister away…AHI of 88, multiple desats to as low as 81%...everything bad.  He informed me on the consult visit that he did not give a damn what the sleep study showed.  He was not wearing a mask because he could not stand for someone to put their hand over his face…anything and he'd just have to die before he wore one of those damned masks.

 

I'm going to have him sign a release and retest him with the appliance.  His sister dropped below AHI of 5 with the TAP 3 Elite and has completely quit wearing the mask, which she never finished a night with it on. 

On questioning them both I get the feeling that they suffer for an anxiety disorder and that is at the root of their CPAP intolerance. 

 

My question is basic.  I know he is not going to go to a physician.  I know he is not going to wear a CPAP.  I personally know this guy.  He is not overweight but muscular with a very thick neck from high school football, which he has maintained…physique.  Should I stick with the TAP 3 which I have quoted or should I try to talk him into paying the higher fee for a Somnodent appliance.  The results for his sister with the TAP 3 were amazing so I'm inclined to stay there with him.  I have patients that have bought both the TAP 3 Elite and the Somnodent type appliance and almost all find the TAP 3 more comfortable.  As soon as I get these damned implant crowns on, I'm having a TAP 3 made for meself.  Any advice from all this BS???? Thanks, Guy

 

Guy W. Moorman, Jr., D.D.S.

The Swamp

Douglas, GA 31533

912-384-7400

 

 

 

This email message and any attached files are confidential and are intended solely for the use of the addressee(s) named above.  This communication may contain material protected by patient rights, work product, or other privileges.  If you are not an intended recipient, you have received this communication in error and any review, use, dissemination, forwarding, printing, copying, or other distribution of this email message and any attached files is strictly prohibited.  If you have received the confidential message in error, please notify the sender immediately by reply email message and permanently delete the original message. 

 

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Unknown ● Sunday, June 30, 2013

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