Back when I was the guy who stood at Gold’s Gym at 05:00 hours.  That’s 5 am for anyone who is not familiar with the 24-hour time clock. Then one day I was driving home, and it was a dark and rainy night (sounds like a good beginning to a horror story, and as it turns out, it was). There was a jaywalker in the middle of the road, so I hit the brakes hard and stopped, but so did the bus to my right. Unfortunately, the guy behind me did not stop and slammed hard into the back of my car, doing around 40 mph. My neck snapped pretty hard, and my beautiful car was crunched up quite badly. (Sure, it was already 15 years old, but it was my baby :)). I took down the name of the guy who nailed me, went home and went to bed. The next morning my neck hurt so bad I could not move, could not get out of bed and could only call for help.

This was the beginning of a 20-year nightmare of neck pain and back pain that would never cease. I felt like I was living on Advil. My neck, traps, back, shoulders, everything had been in pain for so long that it felt like there was no solution. And then, I slowly began to notice that I was having difficulty swallowing my vitamins and eventually even food was tough to get down my throat. It was like I had to really ‘work it’ to force down my food and people were noticing that I had lots of issues, they actually asked if I was choking. Well, it turns out that I was indeed having swallowing problems sounding like choking!

As the years progressed, I sought countless physical therapy appointments, osteopath visits and any other doctor to help with the pain.  Some of them were really good, others not so much. The problem with all this treatment was that nothing would really alleviate the pain or swallowing problems for any length of time. It was all ‘palliative’ treatment, as they call it.

So, I already knew that I had a severely deviated nasal septum that would greatly affect breathing and healing, obviously. As a member of the ALF Academy, I learned more about my own problems. I learned that when the body incurs trauma, like I did, the ligaments that exist from the mastoid bone behind the ear and go to the hyoid in the throat will often calcify into bone. This calcification is our body’s way to help open up the airway and reduce spinal compression, both of which I had going for me. If you can imagine having long pieces of bone stuck in your throat on both sides and these darned things are blocking both your airway and your ability to swallow, then you can understand what I have been through, and many of my patients have experienced. Was this diagnosed as Eagle’s Syndrome? No, not really, but some of my doctors did suggest it. And what do you do about Eagle’s? You generally watch it and keep an eye on it. So that’s what I did until recently.

In my practice, we have always watched for this, and appliance therapy slows down the calcification process tremendously. To be clear it does not get rid of the problem.  The concern is the compromised airway and continued pressure placed on the carotid artery. Obviously, this is a concern that can lead to a stroke. This is why we have a CBCT X-ray completed from the neck up.

Now, back to my story. There came a time in middle to late 2022 when I was choking on most foods and literally gave up on all the vitamins and supplements that my doctor wanted me to take. I knew my hyoid ligaments were very calcified at this time. I took a good long look at my own X-rays and said, ‘That’s enough XXXX’, I need to deal with this problem. I made the call to the most wonderful ENT doctor that I have known for years. He and I discussed treatment and he explained he has dealt with these issues for many years now and knew exactly what to do. Needless to say, I knew I had to deal with this, so I scheduled a surgical intervention. His surgery involved correcting the deviated septum and removing the calcification from either side of my throat.

The next three days of my life were really rough. All I could do was to choke down the oxycontin and cry for the next five minutes or so. The oxy would kick in for a while and it was three days later before I could even think of consuming chicken broth or anything similar. So, for the next week, I would choke down my broth, and sometimes there was a bit of noodle in there as well.

At 12 days post-surgery, I am at the computer typing away with a very sore throat and just taking Tylenol as needed for the pain. Last night, I was able to choke down some noodles and sauce and it was a bit less difficult than the night before. No more oxycontin is needed. My nasal passages are also popping out lots of scabs these days and if I blow my nose, lots of junk comes out. Overall, it is getting better, but ever so slowly. I have been sleeping up to 12 hours each day; not sure if this is recuperative sleep from losing so much sleep over the years or just from the lack of sleep post-surgery. I am still having problems with swallowing, but the throat is still quite swollen, so I guess that’s par for the course.

So, how would I rate doing this surgery? The jury is still out. I do admit that I believe I can breathe a little better through the nose and hope this continues to improve. Also, when I take Tylenol, it does not get stuck in my throat nearly as much. The neck pain is still there – I had no expectations about curing that. Sleep is much better and definitely more restful. My main reason for writing this very long blog was to set expectations if one ends up doing such a surgery. Expect a lot of pain. Expect difficult days and rough nights. But in the end, as long as it helps, it was worth it!

The post The Case of the Calcification and the Correction or How I Handled Eagle’s Syndrome first appeared on Sleep & TMJ Therapy.

There are so many issues involved with SDB that it would take pages to explain, so in this short blog, we will review some of the major players in the equation.

The symptoms of SDB include morning headaches, night terrors, teeth grinding, polyuria (lots of bathroom visits at night), mood changes (irritability during the day), cognitive difficulties, restless sleep, gasping/snorting while asleep, and periods of outright cessation of breathing. As you can see, SDB is a very serious matter and needs to be addressed.

Let’s start with how to measure SDB. To get somewhat of a handle on the problem, a fairly simple test called the PSG (Polysomnogram) can be done. The PSG produces a number that allows an assessment of how serious sleep apnea might be. It’s sort of similar to getting a blood pressure number. For sleep apnea, if the number goes above 5-15, the apnea is considered to be moderate. Anything over 15 is generally considered severe apnea and needs to be addressed right away. A CPAP is usually the first course of treatment, and if a patient cannot handle wearing the CPAP, a dental sleep appliance usually works quite well.

As part of a good sleep analysis, the Vitamin D3 level should be analyzed carefully. The reason for this is that D3 is not really a vitamin, it is actually a hormone that regulates your sleep. If the D3 number is around 30 ng/ml or below, you are running really low and should address the problem. The proper number for good healing and good sleep is around 60-80 ng/ml. If you maintain a very low D3 level over time, eventually your body stops the ability to process D3 and you will have lots of problems with sleep later in life.

Snoring is another SDB issue that is very common in our society. Snoring is created by a harsh sound that occurs when the tissue is vibrating as you breath. This can turn into a chronic problem causing a vibration of the carotid artery, and this can cause damage to the artery to the point where your body sends plaque to fill in the damaged areas. If a plaque loosens and goes to your heart, then a cardiovascular event, even death, can occur. Snoring can be caused by a condition having fat deposition in the throat and tongue, nasal congestion, deviated septum, or even enlarged tonsils and adenoids. These factors can lead to snoring and prevent a good night’s sleep.

Another important aspect of good sleep is a very much ignored thing called sleep hygiene. That’s right; how clean, how good is your sleep pattern? What this means is that if you can program your body into going to bed at a regular time each night, your body will get used to that pattern and sleep more effectively and efficiently. Good sleep can be prevented by other factors such as:

-Sleep Disturbance: This is mostly caused by stress, insomnia and even excessive screen time.

-Poor Diet: Food is obviously a very important part of fuel for our body. With a poor diet, nutritional deficiencies become present, like the vitamins and minerals your body needs.

-Dehydration: This affects the function of your body’s organs and blood volume. The effect makes you feel tired.

-Psychological: This could be stress from work or a traumatic event causing a considerable degree of uneasiness leading to your mental health and exhaustion.

As you can see, when sleep is poor, you will be tired. It’s as simple as that.

If you are experiencing any of these symptoms, Dr. Jeffrey Brown and our team are here to help. We offer sleep apnea therapy in Falls Church, VA. Please give us a call if you would like to learn more, or to schedule a consultation. Just call our office at 703-821-1103. Better sleep awaits you!

The post Why am I Always Tired? first appeared on Sleep & TMJ Therapy.