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Permalink Reply by 99 on December 19, 2009 at 10:01am

write a little note to yourself to take into the doctors
to ask what you want
use the notes as reminders i am sure the doctor would not mind you reading from your notes

Irma Hudson said:

It is a hole in the nasal septum. It feels like the flow in my nose is very turbulent, and I was wondering if that would keep the air from flowing up my nasal tubes, Like it blows in one side and out the other and little air goes into my system. Those are my subjective sensations, and I am trying to both express them clearly and if possible get an explanation. I need to prepare as well as I can for conversations with my medical people because I get very tense and nervous with doctors. Always have.

Irma

D. W. Conn said:

I may a be a bit dense here.. is it a hole in the nasal septum or ventricular septum? It is not believed that either of these should be causing an issue with CPAP.

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Permalink Reply by sleepycarol on December 19, 2009 at 10:03am

Do you have a general practioner you see? Would they be receptive if letting you try an apap for a few weeks to try to pin down your pressure needs a little better?

There are so many variables that one night in a sleep lab can give a fairly good idea of your pressure but can not give a clear picture of long term issues such as large leaks, positional apneas, etc. That is why it is essential in my opinion to only allow data capapble machines that record full data details instead of the bottom of the barrel machines such as yours. If your machine were data capable it would be so much easier to spot trends that may be effecting your therapy.

Try not using the ramp. Many find that they feel starved for air with a pressure of 4 or 5 (which maybe what your ramp is set to). I know personally after getting used to my machine I found that a pressure of 8 felt too low and found I do better with a starting pressure of 9.

Many have found fixing the septum improves therapy, but those are ones that have a deviated septum which makes breathing through both nostrils difficult.

As far as feeling tons better right away, many of us have found that it is a very gradual process and doesn't happen overnight. For me it took at least a year or longer to start noticing real changes to the way I felt. Part of the reason is we build up a sleep deficit and it takes our bodies time to heal itself from the ravages of sleep apnea.

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Permalink Reply by Irma Hudson on December 20, 2009 at 1:20am

Great idea... I will organize my questions and write them down.

Thanks, Irma

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Permalink Reply by Irma Hudson on December 20, 2009 at 1:28am

Hi SleepyCarol,

My Internist handles my blood pressure, while the sleep lab handles the sleep stuff. I would have to ask them about the
APAP.

I will try not using the ramp and see what happens.

It seems that when I have had better sleep, my blood pressure is down, and that is important. My Internist has had to increase my medication, and I was really expecting to be able to decrease it instead.

Take Care, Irma

Irma

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Permalink Reply by D. W. Conn on December 20, 2009 at 8:30am

I have had patients with Nasal septum shunting. This does cause turbulence and eddies. Areas where air is rough in transfer. I know of 2 who ended up having nasal septal repair. This is defiantly the case for consulting with your PCP.

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Permalink Reply by Irma Hudson on December 20, 2009 at 3:53pm

Thank you, D. W.! Is there anything you can suggest for me to convince them to at least take a look? I was not listened to when I suggested this possibility quite a while ago. Irma

D. W. Conn said:

I have had patients with Nasal septum shunting. This does cause turbulence and eddies. Areas where air is rough in transfer. I know of 2 who ended up having nasal septal repair. This is defiantly the case for consulting with your PCP.

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Permalink Reply by D. W. Conn on December 22, 2009 at 4:52am

This would be a time you do as trw99 said. make notes and read off to the MD. Str8 tell him/Her that this is an important issue and you must be heard. If MD will not listen then its time to find another Doc.

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Permalink Reply by Irma Hudson on December 23, 2009 at 2:16pm

Thank you, Thank you!

I now have an appointment with an ENT next Tuesday and am carefully preparing my list of questions. I appreciate all the suggestions and feel I am well prepared to ask questions that will help to get this straightened out. I will let you know what happens.

Irma

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Permalink Reply by Irma Hudson on January 3, 2010 at 10:59pm

The appointment went well and I got all my questions asked, most of them answered. :-)
He says that my main problem is dryness inside the nose. He thinks that the hole in my septum may contribute to my unusually difficult dryness problems. He suggested several things for it:
1: MUCINEX; the regular expectorant, or else the generic guaifenesin (cheaper) 12 hour tabs twice a day.
2: Neti Pot, use to rinse the nose two times a day and
3: Ayr nasal gel spray -- I couldn't find this locally and am eagerly awaiting its arrival from drugstore.com. He says it sticks better and lasts longer than the regular nasal sprays.
He doesn't recommend any prescription drugs for me. Irma

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Permalink Reply by Charles Gollott on February 11, 2010 at 7:14pm

Is the hole in the septum dangerous if it is causing no noticible problems?

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Permalink Reply by Irma Hudson on February 12, 2010 at 6:05pm

Hi, Charles,

According to my ENT, the hole in the nose had little effect, except perhaps to complicate the air flow which may have made my very dry nose problem even worse. Getting my nose moist and healed was very important. To be perfectly honest, I didn't even realize how dry and inflamed it was -- I had been using saline nasal sprays for a long time but they just weren't doing enough.

Another piece was getting the right size for my nasal pillows, I do much better with extra small than with small.

Hope this answers your question. Irma

Charles Gollott said:

Is the hole in the septum dangerous if it is causing no noticible problems?

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Permalink Reply by amott1973 on February 13, 2010 at 3:55pm

I'm so glad you got in and got some answers Irma. I was wondering how the CPAP therapy is going for you now. Improved? I don't know much about the anatomy part, but my husband had a cleft lip and palate as a baby. He has a deviated septum and a hole from his nose into his mouth, like a little tunnel between his top lip and top teeth. He found that a nasal mask didn't work because it forced air into his mouth thru that hole and messed things up. He changed to a full face mask and that solved his issue.

Not sure if that is at all related to your problem though. I am curious about the Ayr spray though. I have a chronically stuffy nose, just from inflammation, not mucus all the time. So I'm wondering if using that might help me too. Is it addictive? Do you use it every night or just as needed? Thanks!

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