Posted by milron on August 17, 2007 at 10:24:31:

In Reply to: Trach or Maxillomandibular Advancem posted by johnv100 on August 14, 2007 at 09:39:03:

John,

Your problem sounds very similar to mine, with the CPAP causing air to come through your nose and out your mouth. I believe this was caused by the UPPP I had. I used to post here about five or six years ago. Unfortunately I had already had my UPPP a month or two before I learned of this site. I also suffer from breathing obstruction in the daytime, a problem I've had years before I was diagnosed with sleep apnea. I eventually had a Multi Latency Sleep Test (MLST) in which indicated abnormal daytime sleep patterns and possible narcolespy. After CPAP and surgery failed, I decided to lose weight, which helped me feel better, but didn't stop my symptoms. My job became very insensitve, because they couldn't beleive I was medically sick, since I was working out and looking very healthy physically, so they blamed the sleepiness on laziness. When I showed the medical evidence, which was very extreme, my job laid me off, claming they didn't want to be sued if something happened to me on the job. But so far I made the best of it because it forced me to discover the cost of living was much cheaper in the south. So I applied for disability retirement based on sleep apnea, GERD, and chronic bronchitis. I sold my home in the D.C. area and moved to the Atlanta area with a lot of cash to pay for a home in full and pay off all debts. However my disability case is going to need a lawyer because I wasn't seeing a doctor and I wasn't getting treated constantly during these five years I've been gone from this site. The brightside is I don't need that $80,000 a year Information Technology job anymore to pay my house note, car note, and credit card bills. I'm not trying to school you on life or crowd you with my personal business, but whatever you do, keep seeing a doctor and keep getting treated. You never know when the world is going to collaspe on you. When the job laid me off last summer, I gained weight and developed highblood pressure, plus the right side of my heart has grown slightly larger (The other sign of untreated apnea), but nothing to be alarmed about according to my cardiologist. The blood pressure is back to normal thanks to the medication. I must admit the diet got a little bad off and on for a while there. I'm back on CPAP, which I think has helped me including my heart, however I'm still having the same problem you're having with air blowing through the nose and out the mouth causing my cheeks to puff up with air, which is one of the reasons I stopped using CPAP in the first place. I also get congestion sometimes, even with the heated humidifier. The humidifier sometimes make my joints ache if I don't turn it down (possible arthritis), but then I risk getting congested again if I turn it down to low. I too considered a trache over the years or a MMA. I keep getting talked out of the trache because I understand there could be more to it than thought, (infections, trouble swallowing, daily maintenance, whether your body will except a trache, relearning how to speak, ect...). So the trache will be the last resort. As for future surgeries, I found a very good doctor down here in Atlanta, thanks to this site. However I don't think I can mention his name. But I did a search on this sites search engine and found him. So I'm not to clear on that. However he is supposed to be one of the top five ENT/Sleep Doctors in the country. He did a test by sticking a camera tube in my nostrils and down near my adams apple to take pictures to locate the obstuction. He had me blow through each nostril. He then had me lie on my back. He discovered that my tongue falls backward when I lay down. This may be causing the daytime breathing obstruction I've felt over the last twenty-six years. He wants to do a Hyoid Advancement to move my tongue forward, which has about a 65 percent chance of working. If that doesn't cure my sleep apnea, than he will try the next surgery, which could be a MMA, depending on the results of the previous surgery. One way or another, this may help my daytime breathing problem at least. Like Sandman said, you will need to be examined first to see what surgery would best work for you. This should determine how effective the MMA would be.

milron

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