This is my first time, and I don't even know if I know how to use a message board.  I'm a 51 y/o male, 5'7'' 180lbs.  Six months ago I quit smoking,  Since then I have gained 30lbs - I was 150lbs.  My symptom began after I quit, but before I had gained any weight.  My symptom: when I exhale through my nose, something that feels like it must be some kind of "flap" that acts like a flapper valve in my nasopharynx, blocks all of the air. This only happens when I exhale.  My nose is blocked completely from somewhere "way in back".  Usually, trying to exhale harder has no effect - the blockage is 100% complete.  This symptom seldom occurs during the day, unless I am lying on my back with my neck flexed.  Extending my neck usually makes the obstruction go away. The obstruction is "all or none" it is never partial. It occurs frequently while I am in bed, and I assume that I breathe through my mouth if it occurs while I'm sleeping.  This morning, lyeing in bed, I exhaled through my nose, and it was blocked. Extending my neck didn't (as it usually does) help.  I got on my feet, and it was still there, even when I extended my neck. I walked 25' to the bathroom, and it was gone when I got there.  I have seen an HEENT about this. He states that I have an extremely deviated septum, and an allergy to my cats.  He thinks a septoplasty will cure this.  I'm thinking that my septum is in the front of my nose, and this feels like it happens at the very back of my nose/throat - so would a septoplasty help?.  I always worry about the "if you're a hammer the whole world's a nail" thing when dealing with doctors. I have had no sleep studies of any kind, and have no idea if I snore.   Is this a familiar symptom?
Thanks, Peter Mayer,   cerf@pacbell.net

Peter, I have OSA (recently diagnosed) and am by no means an expert. usually with OSA, folks snore, have daytime fatigue, daytime hypersomnolance, sometimes stop breathing when they sleep and sometimes wake up gasping for breath. A deviated septum and enlarged tonsils can be indicators of a breathing disorder (OSA) but other symptoms as I mentioned above helpto confirm a diagnosis. Do you snore loudly or has anyone told you that you had stopped breathing while you were asleep? I would thnk that based on the symptoms and medical history you gave your HEENT MD, he didn't feel as though you had OSA, otherwise he would ahve recommended a sleep study to "confirM" that you had it. Relook at your symptoms and if they fit the "pattern" of OSA, you may wan tto see if your MD thinks a sleep study is in order to rule out OSA. Hope this helps somewhat. Good luck.

I agree with Doug. Think your problem is different, especially since it occurs at anytime. OSA is a sleep-related problem in which the airway partially or completely closes off and stops your breathing. This can happen hundreds of times in a night and it rarely ever wakes you all the way up, but it breaks up the sleep cycle and robs you of effective sleep. Snoring is the most common symptom and people with untreated OSA will often grow quiet then "snort" loudly when their brain wakes them up and they begin breathing again. Your exhale- only symptom seems to indicate a respiratory problem of some kind, but doesn't to me sound like OSA. With OSA, the problem is with inhaling, not exhaling. When the airway closes, you can't take air in and would suffocate if your brain didn't wake your body up. And that has happened, in severe cases.

Never hurts to get a second opinion, but I think your doc is right on this.


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Larry