Comments on: Physical Exam: The Dangly Thingy http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/ Thoughts of a moderately strange (yet not harmful) primary care physician. Thu, 11 Mar 2010 23:22:34 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Clinton http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-4103 Clinton Mon, 25 May 2009 10:10:57 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-4103 "Most of my patients worry about sleep apnea causing a person to stop breathing and die in their sleep. But it just doesn’t happen that way; people don’t just stop breathing." Ondine's curse -- Ondine was a water nymph to whom a man swore his true love with every waking breath. He cheated on her and she cursed him: he would breath as long as he was awake. Eventually, he sucuumbed to exhaustion and passed away. http://en.wikipedia.org/wiki/Ondine%27s_curse “Most of my patients worry about sleep apnea causing a person to stop breathing and die in their sleep. But it just doesn’t happen that way; people don’t just stop breathing.”

Ondine’s curse — Ondine was a water nymph to whom a man swore his true love with every waking breath. He cheated on her and she cursed him: he would breath as long as he was awake. Eventually, he sucuumbed to exhaustion and passed away.

http://en.wikipedia.org/wiki/Ondine%27s_curse

]]> By: Dr. Kranky http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-394 Dr. Kranky Tue, 16 Oct 2007 23:57:08 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-394 Dr. Rob, Thanks for your ongoing "trip through the body" series. I will have to take exception to your contention that a UPP is "generally effective" for treatment of Obstructive Sleep Apnea. It may be generally effective for managing the snoring (though even there it will not help in severe sleep apneics), but it is decidedly NOT a generally effective alternative to CPAP. The real danger is that in essence one has "turned off " the fire alarm in a sleep apneic by stopping the noxious snoring. I regularly see patients who either insisted upon or were aggressively offered this operation, only to find that it had done little or nothing to help with the sleep apnea per se. There are also some significant potential downsides to this surgery, with the tendency among surgeons to under-report the complications. Since this blog is read by lay people, they might walk away form this with the distinct impression that a UPP is an equivalent alternative to CPAP. It is not. Dr. Rob, Thanks for your ongoing “trip through the body” series. I will have to take exception to your contention that a UPP is “generally effective” for treatment of Obstructive Sleep Apnea. It may be generally effective for managing the snoring (though even there it will not help in severe sleep apneics), but it is decidedly NOT a generally effective alternative to CPAP. The real danger is that in essence one has “turned off ” the fire alarm in a sleep apneic by stopping the noxious snoring. I regularly see patients who either insisted upon or were aggressively offered this operation, only to find that it had done little or nothing to help with the sleep apnea per se. There are also some significant potential downsides to this surgery, with the tendency among surgeons to under-report the complications. Since this blog is read by lay people, they might walk away form this with the distinct impression that a UPP is an equivalent alternative to CPAP. It is not.

]]> By: Rob http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-389 Rob Tue, 16 Oct 2007 17:39:45 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-389 Here is what Ed's Comment went to: Babs' Uvula Sister.....Laraine Newman Babs.....Gilda Radner Doctor.....Chvy Chase [ open on National Uvula association flash card ] Announcer: And now, a public service dramatization from the National Uvula Association. [ dissolve to Babs and her sister sitting in their living room ] Sister: Gee, Babs, you look like something the cat just dragged in. Babs: I know. I feel crummy. But I just can't seem to put my finger on what's wrong. Sister: That's too bad, Babs. Has it ever dawned on you that it just may be your uvula? Babs: Gee, no, Sis.. I must have stupidly glossed right over my uvula. Sister: I had a hunch you might've. That's why I made an appointment for you with a top uvula specialist. [ doorbell rings ] Who makes house calls! Right now! [ Doctor enters the living room ] Doctor: Hello, I'm the doctor. Sister: Hi. Babs: That must be him! [ coughs ] [ Doctor sits next to Babs on the couch ] Doctor: I won't beat around the bush, Babs. Babs: Is it bad? Doctor: In a nutshell, your uvula is on the fritz. Which reminds me of a little joke. Knock knock! Babs: Who's there? Doctor: Babs' uvula. Babs: Babs' uvula who? Doctor: I don't know, Babs. But I do know this - you've really let your uvula go to the dogs. Babs: Yes.. I have.. Sister: I'd like to share this with you, Sis. [ opens a greeting card ] "To Babs: It'll behoove ya', to care for your uvula! Love, Sis." Babs: Boy, do I hear ya', Sis! From now on, it's strictly good, clean fun. For me and my uvula! Doctor: That reminds me of a little joke. Knock knock! Announcer: Who's there? [ Doctor, Babs and her sister laugh at the surprise interruption ] Announcer: The preceding dramatization was brought to you by the National Uvula Association. Thanks, Ed! Sid - just wait for my next post! Here is what Ed’s Comment went to:

Babs’ Uvula

Sister…..Laraine Newman
Babs…..Gilda Radner
Doctor…..Chvy Chase

[ open on National Uvula association flash card ]

Announcer: And now, a public service dramatization from the National Uvula Association.

[ dissolve to Babs and her sister sitting in their living room ]

Sister: Gee, Babs, you look like something the cat just dragged in.

Babs: I know. I feel crummy. But I just can’t seem to put my finger on what’s wrong.

Sister: That’s too bad, Babs. Has it ever dawned on you that it just may be your uvula?

Babs: Gee, no, Sis.. I must have stupidly glossed right over my uvula.

Sister: I had a hunch you might’ve. That’s why I made an appointment for you with a top uvula specialist. [ doorbell rings ] Who makes house calls! Right now!

[ Doctor enters the living room ]

Doctor: Hello, I’m the doctor.

Sister: Hi.

Babs: That must be him! [ coughs ]

[ Doctor sits next to Babs on the couch ]

Doctor: I won’t beat around the bush, Babs.

Babs: Is it bad?

Doctor: In a nutshell, your uvula is on the fritz. Which reminds me of a little joke. Knock knock!

Babs: Who’s there?

Doctor: Babs’ uvula.

Babs: Babs’ uvula who?

Doctor: I don’t know, Babs. But I do know this – you’ve really let your uvula go to the dogs.

Babs: Yes.. I have..

Sister: I’d like to share this with you, Sis. [ opens a greeting card ] “To Babs: It’ll behoove ya’, to care for your uvula! Love, Sis.”

Babs: Boy, do I hear ya’, Sis! From now on, it’s strictly good, clean fun. For me and my uvula!

Doctor: That reminds me of a little joke. Knock knock!

Announcer: Who’s there?

[ Doctor, Babs and her sister laugh at the surprise interruption ]

Announcer: The preceding dramatization was brought to you by the National Uvula Association.

Thanks, Ed!

Sid – just wait for my next post!

]]> By: Sid Schwab http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-388 Sid Schwab Tue, 16 Oct 2007 17:35:14 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-388 Frankly, I don't much care, as long as it's uvula and not mevula. Frankly, I don’t much care, as long as it’s uvula and not mevula.

]]> By: Ed Flinn http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-387 Ed Flinn Tue, 16 Oct 2007 16:39:59 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-387 <a href="http://snltranscripts.jt.org/75/75vuvula.phtml" rel="nofollow">from the National Uvula Association</a>. from the National Uvula Association.

]]> By: Ellie http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-385 Ellie Mon, 15 Oct 2007 13:59:33 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-385 Oy. Does it make me a bad person that I still tell my husband that he's going to die if he doesn't get his sleep apnea looked at? Our nights consist of *Snore...silence, silence, silence, long silence, POKE POKE, "BREATHE ALREADY!!!" Gasp, Snore, snore, snore.* and repeat until I'm ready to put a pillow over his head and finish the job myself. Oy. Does it make me a bad person that I still tell my husband that he’s going to die if he doesn’t get his sleep apnea looked at?

Our nights consist of *Snore…silence, silence, silence, long silence, POKE POKE, “BREATHE ALREADY!!!” Gasp, Snore, snore, snore.* and repeat until I’m ready to put a pillow over his head and finish the job myself.

]]> By: rlbates http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/comment-page-1/#comment-381 rlbates Mon, 15 Oct 2007 12:00:08 +0000 http://distractible.org/2007/10/15/physical-exam-the-dangly-thingy/#comment-381 My husband accidently burned his uvula several years ago with a bite of really hot fish. It resulted in a uvuloplasty, tightening his soft palate attachment (the sling). He doesn't snore like he used to do. Wouldn't recommend it, as he says it was painful. I thought he was joking and laughed at him (uncaring wife, huh?). My husband accidently burned his uvula several years ago with a bite of really hot fish. It resulted in a uvuloplasty, tightening his soft palate attachment (the sling). He doesn’t snore like he used to do. Wouldn’t recommend it, as he says it was painful. I thought he was joking and laughed at him (uncaring wife, huh?).

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