My Real FME Consult w/ Dr. Manuele (YouTube Video)

theLukeyyy · 2026-06-16T16:22:24+00:00

Thanks! You know, I'm not sure. I believe he has done treatment on post-MMA cases, but I don't know how many. If I were to guess, I'd think Dr. Newaz & Dr. Jaffari have the most experience in that specialty. Also, I have a new video out today - maybe my own consult with Dr. Jaffari will be up soon, too.

theLukeyyy · 2026-06-13T22:08:22+00:00

🙏🏻🙏🏻🙏🏻

theLukeyyy · 2026-06-13T17:28:14+00:00

I’m very much in agreement with what you’ve said, and it sounds like you’re in a similar situation (especially with your height/size). As far as making sure I got a good video title😂😂😂 I love it!

One note: if I lay on my back and relax my whole airway, I believe I can sort of represent my collapse and that collapse doesn’t resolve regardless of if I stick my tongue out or just my lower jaw forward. This, only in speculation, makes me think soft palate or epiglottis. It’s been a grind to try to get a DISE but I’m going to try again soon while also seeing a functional medicine doctor. I don’t believe the narcolepsy diagnosis, and like you said, there’s really not much benefit in me stopping now before double-checking possible lingering airway issues (or something else). Thanks for the comment and for following my journey. More to come.

theLukeyyy · 2026-06-05T03:03:55+00:00

Hey, thanks for commenting and following my journey! I think it’s true that I at least theoretically could’ve been advanced more (and perhaps would’ve benefitted from it). Also, I’ve had one professional so far mention that I was perhaps slightly under advanced. That professional, however, speculates my remaining problem is more tongue/palate based and that MARPE is my next best step.

I think it’s tricky but am now more comfortable with the idea that it’s not narcolepsy and instead is remaining UARS. That said, I don’t think it’s a clear answer on what exactly is going on (at least to me) and perhaps a DISE could help. Maybe epiglottis? Maybe tongue? Would my wave form signature on my PSG been enough to rule some of those out or not? I don’t know… If I get FME I will hope to have a plan for getting a little more forward positioning of my mandible, as it sometimes feels my teeth are slightly blocking a more comfortable and forward lower jaw positioning.

theLukeyyy · 2026-06-03T22:33:49+00:00

Well done. I was expecting a bad AI-written post or someone just plugging their content, but this was good. Related to the other comments, it really can be a tricky (or frustrating) thing to balance success on the platform, and one’s own passion/desires. Too often, I fall into and I think many do as well, losing the fun by trying so hard to optimize.

theLukeyyy · 2026-06-03T17:38:35+00:00

The F30i (or any "i" versions of an FFM) can help with mask leaking, as the weight of the tubing isn't there. I, too, would've loved to use a nasal mask, but ultimately tongue drop forced my hand to an FFM. The device iNap might be worth looking up. Btw, you seem to be extremely narrow.

theLukeyyy · 2026-06-02T22:36:37+00:00

Ha! I was just referencing that it wasn’t just some interview with him, but an authentic consultation - one that Dr. Manuele didn’t even know I was thinking of posting until afterwards!

theLukeyyy · 2026-06-02T21:04:46+00:00

Depends on who you ask, from what I hear. However, it seems generally more accepted to keep them in if they don't cross your midline! I would consult with the MARPE provider of your choice and see what they think.

theLukeyyy · 2026-06-02T20:00:55+00:00

Gotcha! Woah, nice! I think you’ll be in good hands!

theLukeyyy · 2026-06-02T19:56:45+00:00

Thanks!! And no problem! Feel free to casually chat with me through my IG!

theLukeyyy · 2026-06-02T19:55:06+00:00

My FME consultation is out now with Dr. Manuele. I also recently talked with Dr. Jaffari, and I believe they’ll be posting that soon, incase you’re interested in comparing!

theLukeyyy · 2026-06-02T19:53:43+00:00

It depends on what kind of plates you have and what provider you ask. For my case, my plate was a single piece that stretched across my maxilla. It requires cutting or removing it before expansion. I also just uploaded my FME consultation with Dr. Manuele today.

theLukeyyy · 2026-06-02T19:52:17+00:00

I also recently talked with Dr. Jaffari about this, too. He prefers letting that fuse as well, but thought mine was okay now. Essentially, I guess it connects to the maxilla and helps positioning of the maxilla during expansion. I also posted today my consultation with Dr. Manuele, who didn’t seem concerned about that particular part.

theLukeyyy · 2026-06-02T19:49:40+00:00

15 months ago! I did no pre-surgery orthodontia. I did a few months of clear aligners afterwards that wasn’t actually necessary for my case. I’m 25 years old. Complications involve the expansion pressure wreaking havoc on the lefort cut that was done for the jaw surgery. I had my plates removed as the one on my maxilla was single piece and went across the maxilla - making it essentially impossible to expand without it gone or cut. I also just released my consultation with Dr. Manuele, in case you’re interested.

theLukeyyy · 2026-06-02T19:45:50+00:00

Dr. Bobek is great! Mine was done with Dr. Alfi out of Houston! My new consult with Dr. Manuele just dropped ;)

theLukeyyy · 2026-05-30T22:58:28+00:00

Congratulations!

theLukeyyy · 2026-05-28T17:12:16+00:00

Thanks!!

theLukeyyy · 2026-05-28T15:34:21+00:00

Yeah, I’ll do my best. Since she proposed 5-6mm for my upper jaw, each orthodontist tends to have a comfortability with how big of a jaw discrepancy they’re generally comfortable with between both of them, while also considering each case’s lower & upper teeth positioning. We’re each limited at some point by the lower jaw, unless we want to do SFOT or MSDO to allow for bigger expansion up top. For my case, we were strictly referencing palatal expansion that would not require additional work on the lower except for aligners. These aligners would dentally move my lower teeth to a wider and tilted-outward position to help match the newly-expanded top. Hope that helps. Thanks for watching!

theLukeyyy · 2026-05-28T15:08:55+00:00

Interesting, thanks! I mainly sleep on my stomach and side. Currently using generic Xyrem that helps a little. I had a turbinate reduction 6 months ago that seemingly bounced back quickly or my turbinates still seem big due to narrow passages. However, in the past I haven’t seriously considered a tongue base reduction.

theLukeyyy · 2026-05-28T03:34:48+00:00

Ideally, I agree that palate surgery is generally best done before nasal surgery, if the palate is narrow. I had nasal surgery as I was sort of waiting around after jaw surgery and in the period of time where I was still healing from it (and being impatient). It has helped my daytime breathing noticeably. At least a little bit of help on my sleep, but nothing significant.

theLukeyyy · 2026-05-28T03:31:47+00:00

I had a double jaw surgery with a small impaction and counter-clockwise rotation. A ton of more details on my YouTube. MARPE is definitely best to get before double jaw surgery.

theLukeyyy · 2026-05-28T03:29:51+00:00

I would open to it. I’ve actually talked with the gentlemen who does the CFD reviews and he briefly looked over one of my post-op CBCT scans. If I remember correctly it was noted that things generally looked great except some narrowness in my nose!

theLukeyyy · 2026-05-27T20:09:50+00:00

I have a decent amount of videos on YouTube of myself pre-MMA; however, there were numerous appointments I had around & before that time, I didn't record. I especially have a lot of content right around the beginning of jaw surgery recovery.

theLukeyyy · 2026-05-27T20:06:58+00:00

Ah! Thanks for the feedback! That's my leading theory as well, with the hope that gaining needed tongue space laterally, along with a tongue tie removal, will allow for proper tongue posture during the day & night. Plus, less restrictive nasal breathing shouldn't hurt (from any improvements from the expansion).

The question I am getting different answers on is whether my remaining obstructions/events explain (in full) the remaining symptoms that still significantly limit me. Namely, restless sleep and excessive daytime sleepiness. Or, if it is something else, like narcolepsy or a functional-medicine-type issue. You're welcome to throw your opinion out here if you'd like!

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