FME 1 month update
<See photos at the bottom.>
Background
25 year old male, normal BMI, otherwise healthy. Starting ~4 years back, I've felt that something is off. I would wake feeling more fatigued, feeling like my mind isn't as sharp, and I thought maybe it's stress or just random fluctuations. But I didn't really know what it was. About 2 years ago I thought it could possibly be related to sleep apnea and I felt that my nasal breathing wasn't very good; so I went to a local doctor who gave me a WatchPAT sleep study and allergy meds and allergy testing. The WatchPAT study didn't pick up anything, allergy meds didn't really help, and allergy testing was negative. So at that point I assumed it's not my sleep. I even went to get an ADHD eval to try the meds but those also didn't really help.
Finding UARS
Over time the issue didn't seem to resolve and if anything seemed to be getting worse. About a year ago I got a Fitbit to track my sleep. I wasn't too happy with what I saw, for example it seemed like my heart rate was all over the place. I figured I may as well try a CPAP. Got a BIPAP on Craigslist and spent a while trying to tune it with different settings/masks etc and got help with it. But even after tuning it didn't seem to make a significant difference, especially not enough to justify the downsides. But that's when I found out about UARS, and using the data from the machine combined with my past complaints about nasal congestion, I realized I probably have an issue with my nose.
Finding FME
At that point is when I started finding the Jawhacks space and understanding the airway, nose palate connection, etc. I got an in lab sleep study (this one also didn't pick up much), saw Kasey Li (recommended EASE, and a CBCT found that I have a septal spur, but I didn't find the consult to be very helpful), and finally spoke with Dr Newaz who gave a very detailed analysis of my CBCT. I was definitely impressed by Dr Newaz's attention to detail.
I found that my nasal aperture is ~20mm, minimum cross section in throat ~116mm2 (could be off due to head positioning in CBCT), and IMW is ~35mm (but could be inflated due to tipped molar compensation). Reading Shuikai's post on structural abnormalities of UARS, I realized that my nasal aperture is extremely out of norm, which really helped me to understand that I was on the right track.
I went to see Dr Anil Rama, who is also a great doctor and helped me understand my situation. I did rhinomanometry there as well.
I decided to proceed with Dr Newaz for FME. My reasoning was that Dr Newaz is very experienced in expansion, from a physics perspective the device made a lot of sense, didn't risk my teeth at all, didn't need anesthesia or surgery, and would be ~3x cheaper than EASE.
FME process
I had my FME installed in early July by Dr Newaz and Dr Jaffari at Team Dental NYC. From the install to today I would say that personally I've had no pain at all. At most just some discomfort. I took a flight home a few hours after the install. I didn't even take any pain meds after the install.
In the days after the install I noticed slight changes to speech, somewhat worse sleep which I believe is due to reduced tongue space because of the device, and lots of food getting stuck in between the device and my palate. But over time all of these have gotten better.
Very soon into the turning process I noticed my nasal breathing was already slightly better, and since then there have been several jumps where it seems to get noticeably better. There was still significant variation day to day, and on "bad" days it seemed to almost be back to baseline, but as I continue turning the trend seems to be positive and the "bad" days less frequent. As of now, I rarely feel congested, and nasal breathing feels quite easy. My sleep seems to be on a slight but noticeable upwards trajectory as well, but it's still early to be certain.
Bottom line is that I'm happy with the decision I made. :)
I first noticed a diastema at 15 turns of the FME. I've now turned 18 times which is 3 revolutions of the nut which is about 3mm. My diastema is ~1mm. The photos are respectively at 3, 2.5, 2, 1, 0 revolutions, and FME install. Also see the photo of my very thin palatal bone, hence why I got FME 10.
Big thanks to everyone who helped along the way, and to the community and Shuikai in particular for making this space possible.
