If You're Paying, I'll Have Top Sirloin

Patri has private health insurance. I do not. Both of us have chronic sleep apnea, both of us have had Uvulopalatopharyngoplasties in the past without much success, and both of us have had doctors recommend undergoing Maxillomandibular Advancement Surgery.

Since Patri is not an ideal candidate, his insurance may not cover the surgery. In which case, "the combination of cash discounts and tax writeoffs should bring the cost down to $30k-$40k." Ouch. That sounds even more painful than the surgery itself!

Since I do not have any kind of health insurance, the taxpayers of Georgia will be paying for my surgery, with a total out-of-pocket-cost to me of about $3. If You're Paying, I'll Have Top Sirloin.

Something is wrong here. Yes, I am somewhat of a hypocrite, but "free" $30-$40 thousand surgery is awfully tempting! I just couldn't help myself, fellow Georgia taxpayers. I'm sure you'll understand.

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I'm appalled

I'm appalled. So, how long does a person need to be a resident of Georgia to get your deal? And is it means tested?


Appalled by the health program or Micha?

I wonder what he will write if the government of Georgia comes up with a program to control illegal immigration via handsome bounties.

This shame thing of Micha's isn't working out. Congress has about the lowest approval rating ever and they are still continuing with the same behavior. If shame doesn't work on the guy who's advocating it then I guess it's hardly surprising that it doesn't work on all the tribalists*.

* - a Randian term of art used to denigrate, similar to calling a fellow worker a scab.

I'd advise against

I'd advise against maxillomandibular advancement surgery. It's an awful experience, and the people I know who have had it told me that in hindsight, they'd rather not have had it ("like having been hit by a truck, and disfigured, then eating liquid food for weeks"). It's useful for people with too short a jaw, who run the risk of prematurely wearing out the cartilage at the joint (especially those with bruxism), but the risk of permanent nerve sensitivity loss (and some partial facial paralysis !) is not negligible. And despite what the linked page says, your face does change a lot. And falling on your face, you'd maximise the damage done, beyond the reasonable IMO. And AFAIK it mainly helps breathing in people who already have trouble breathing while awake...

I'm surprised there still is no implant surgery for sleep apnea, like what they already do for correcting vision or reinforcing coronary arteries.

The people I've talked to

The people I've talked to have found that it helped their apnea enormously. If you look online you can find a half dozen blogs by people relating every detail of their experience and recovery.

I dunno about Micha, but I have a small (short and narrow) jaw. Some chance of permanent nerve sensitivity loss seems well worth it for a chance at significantly better sleep.

And AFAIK it mainly helps breathing in people who already have trouble breathing while awake...

This does not match with anything I've read about MMA. Studies show it as being 90+% effective at significantly improving sleep apnea, and I saw no mention in the studies I read about the patients having trouble breathing while awake, which is not standard for sleep apnea. Nor did my surgeon (one of the experts on the procedure) ever mention that.

(Also, I would say that I have trouble breathing through my noise even when awake. I don't get enough airflow).


p.s. I tried googling specifically for bad experiences (before I had just googled the surgery), and was unable to find any patient reports of bad experiences. I'm interested in reading writeups of bad experiences, if you know of any.

p.s. there are palate implants to stiffen the palate, but the airway is a big place, it is not easy to reinforce the whole thing. Because the position of the jaw is so key in forming the airway, moving the jaw not only increases the size of large tracts of the airway but improves muscle tone due to the new positioning. In many ways it seems to be addressing the fundamental cause of the poor airway which causes apnea.

MADs and Bruxism

Would it not be a good idea to try a Mandibular Advancement Device (MAD) before under going this procedure? I'd have thought that would give you some idea if it will help you.

Lots of sleep apnoea sufferers also have bruxism, which can slowly damage the TMJ (temporo-mandibular joint - jaw joint). I wonder what impact this surgery has on any pre-existing TMJ problems.

Is top sirloin really that

Is top sirloin really that expensive? Why not tenderloin, or lobster?

Exactly, I'll have the dry

Exactly, I'll have the dry aged Kobe tenderloin with the broiled 5lb lobster. Hummm... surf & turf.

How does accepting 'free'

How does accepting 'free' surgery make you a hypocrite?

You're welcome

Can I just send you a bill for my portion, then? I accept installment payments.

But seriously, I do hope my tax dollars cure your apnea.