| |
You are here: Experts > Health/Fitness > Medical Specialists > Anesthesiology > 4mm Airway
Expert: Dr Ian Jackson - please note UK based
Date: 9/12/2008
Subject: 4mm Airway
Question
QUESTION: I was diagnosed with a 4mm airway by Dr. Larry Wolford in Dallas, Texas. I am curious to know what dangers/risks does a decreased airway have especially undergoing anesthesia and is this a dangerous situation if not corrected? Right now the insurance company is denying surgery to correct this condition stating they only see cosmetic reasons for correcting my condition.
ANSWER: Karen
I would really need to have some more information about this. Where is your airway only 4mm in size? Trachea? Over how big an area is it this size? How old are you? Is there any background as to why your airway is this size?
Sorry many questions but I need a bit more to go on. From info so far if your trachea is only 4mm wide and you are a full grown adult then that is a significant reduction on normal and I would not regard repair as cosmetic (or simple for that matter)
Kind regards
Dr Ian Jackson
---------- FOLLOW-UP ----------
QUESTION: Dr. Jackson,
My airway is decreased due to my lower jaw pushing back against the airway. Hopefully that gives you and idea of the location and how big an area the size is. I am 43 and suffer from underdeveloped upper/lower jaw, non-union of jawbone, 4mm transverse deficiency, a 5mm overjet which all adds to the problem. Dr. Wolford proposes to move the upper/lower jaw forward by about 6 to 7mm and widen my upper palate. Hopefully this helps you to understand a little better of what is going on. I just received a letter today from Aetna Insurance stating they are denying me again. Dr. Wolford stands strong that this is a dangerous situation and needs to be corrected immediately because this is a life threatening situation.
Karen
ANSWER: Hi Karen
This is difficult and I cannot provide you with any info that will help you with your insurance. I am UK based and so have no influence over your company.
I can only suggest you discuss with them the need for a second opinion - even if it is a specialist appointed by them.
Now for a reality check.
You are 43 so this is something you have had all your life. I therefore have some difficulty accepting that this is life threatening and I suspect suggesting this will not help you with your insurance company.
Your issues all surround your upper airway/palate and so have nothing to do with your trachea (the idea of a 4mm trachea was very worrying)
I can only assume that 4mm is the distance from from back of your soft palate to the posterior pharyngeal wall. Given the width of this inlet then I suspect this is not as serious as may have been suggested.
However I finish as I started. Seek a second opinion and use your company. This is the only way that both you and your company can reach agreement.
Sorry I can't be more helpful.
kind regards
Dr Ian Jackson
---------- FOLLOW-UP ----------
QUESTION: Dr. Jackson,
The decreased airway is not something I had all my life. It is a result of a jaw relapse from a Lefort surgery in 2005. The situation is dangerous because I have an increased heart rate due to the breathing issues. As you are aware 11mm is a normal airway and mine is less than half of this. I am having problems breathing while attempting any form of exercises, laying down, etc. Restricted airway increases chances of a heart attack and stroke. My blood pressure has also increased which I have always had low blood pressure until the restricted airway began. I do appreciate your input and advice regarding this matter.
Karen
Answer
So gradually we are teasiong out the information. As I stated in my first response it is difficult to give comment with only part of the story. I am sure there is still more but the end point must be that you need to work with your Insurance Company to solve this situation. However to do this you need to suggest a second opinion by someone they appoint. I suggest you avoid making staements about the risks of your condition as they do not help your case. This is because if your airway is restricted enough to cause a large increase in your effort of breathing then this may well have an effect on your longterm health. Also if you are experiencing obstructive sleep apnoea then this would have an effect on your heart. This can lead to pulmonary hypertension and so increased risk of heart attack. I have no expertise outside of this as to why the problem you describe could have given you a fast heart rate and be at increased risk of stroke or heart attack.
I don't believe I can help much further than this but I am sorry you are in this situation. As I work in the UK we do not have situations like this.
Kind regards
Dr Ian Jackson
Add to this Answer
Ask a Question
|
|
