07-14-2020, 09:09 PM
RE: Any way to tackle the remaining CAs?(AutoSet for Her)
ChinaMan,
I see you have been at this a while. These people are all very knowledgeable and very helpful. I concur with everything I see on this page of this thread. If you still want to chase down the remaining CA's you should only need three items.
Pictures will help me communicate the assembly without me waxing very, very verbose, something I am very prone to.
Another concern might be that the Corr-A-Flex tubing might fit but because the port is so short the tubing may not stay connected after a bit of distortion, i.e., it might easily slip off. Be gentle with the tubing to avoid stretching it and bringing this problem on or exasperating it. If this happens you might be able to obtain some kind of a clamp to hold the hose on the port. A clamp I used to use in the laboratory is known as a Keck Clip and designed to keep standard taper glassware joints joined. They are also available at Amazon, but you would be on your own to investigate whether they are needed and/or would work. Also, you can just renew the Corr-A-Flex tubing as needed.
You will plug the vents on the front of the Bleep interface using the silicone ear plugs. This material is very pliable and long lasting. Try to be neat and remove excess so that the appearance of you equipment does not become less pleasing, but completely plug those vents. Test how successful you were with this effort by attaching the mask as if for a nights sleep and temporarily plug the far end of the hose before you connect it to the CPAP supply hose, probably using just the flat of your hand. Pressurize the line with air from your lungs through your nose with your mouth closed and see if it leaks. Move on quickly to attaching you pump to get a supply of fresh air from your pump after this test. Don't pass out on your own carbon dioxide.
The vent in the Whisper Swivel II will substitute for these vents, but at a greater distance from you face forcing you to "Re breathe" about 58 CC of used air for each 6 inch section of Corr-A-Flex tubing you insert in your line. Your tidal volume is probably on the order of 600 CC. If so, you will be reducing the amount of fresh air you breathe in each breath by about 10% for each length of tubing. Nothing I've ever seen in print used any more than 18 inches of tubing. I can't support using anything greater for that reason and because even at 18 inches I was less comfortable.
Note that your tidal volume will go up. I've never seen a good explanation of this phenomenon or any warnings that it is dangerous. Mine went up from the low to mid 600's to the low 800's. After months of using the 12 inches of re breathing space, my tidal volumes run in the mid 700's. So, my body has adjusted to the EERS. I've been using it since early February and experimented before that starting in November of last year.
Rainout is another problem I encountered. That is moisture in my warm, exhaled breaths condensed on the cold inside surfaces of my EERS. It could actually make my face get wet. I solved this by wrapping my EERS in a small rectangular piece of quilted flannel cut to the length of the EERS and sufficiently wide to wrap the tubing about two times. My wife made this for me. She mounted Velcro strips to make it easy to secure the wrapping.
You can eliminate the section of tubing you are currently using between the Bleep Interface and the CPAP supply hose, as the Whisper Swivel II can connect directly to the latter. This will bring that supply hose closer to your face and you might find that arrangement less comfortable just because of the change in weight on your face. And it might be more difficult to manage the hose. It is your choice as eliminating that section of tubing is not necessary to make this modification work.
If your CA's are treatment induced you might, per the theory of how the EERS operates, experience fewer of them. I certainly do. I was having erratic CAI's that sometimes went above 25. I rarely go above a CAI of 1 now. I do use greater pressure support, too. I can discuss that further in other posts if you are interested.
Flow-pressure graphs available at Dreamport.com for the Bleep mask and at Respironics for the Whisper Swivel II vent are very similar. Without offering a lot of explanation I think this is a good indication that your CPAP pump will perform essentially the same with the Whisper Swivel II as it does with the open vents on the Bleep mask. Again we can discuss this at a high cut (because I don't pretend to fully understand it) in another post.
Finally, note that you will NOT be creating a new asphyxiation hazard with this arrangement. I understand that nasal masks do not include an anti asphyxiation valve anyway. Full face masks do include anti asphyxiation valves. My AirTouch F20 full face mask does. Your Bleep mask doesn't. All you have done with this arrangement is to move the vent further from your face. You will survive an electrical power loss with the new arrangement the same way you would have without the new arrangement.
I look forward to hearing of your success (or failure). I'm delighted with my use of the EERS.
To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.
I see you have been at this a while. These people are all very knowledgeable and very helpful. I concur with everything I see on this page of this thread. If you still want to chase down the remaining CA's you should only need three items.
- Some [commercial link removed] Search Amazon for, 'Carefusion-55001452-Airlife-Corrugated-Segmented". It comes in rather long lengths but is very inexpensive. The link will take you to [commercial link removed]
where you can buy 4 feet of the tubing for less than $7. It is molded in a manner that makes it easy to cut it into lengths that are in increments of 6 inches, that is 6, 12, 18, 24, and so on. You probably should start with a 6 inch length: I use 12 inches now, but did experiment with both 6 and 18 inches. I found it a bit more work to breathe with the latter. Also, you can buy this material many places on the web. I saw one source where you can buy 6-inches for $0.49, but the shipping would probably be prohibitive.
- Some [commercial link removed]Search Walmart for, "Mack-s-Pillow-Soft-Silicone-Putty-Earplugs". This link is for a Walmart source, but these are readily available at most any drugstore. You'll only need one package as just one plug will suffice to plug the vents on you Bleep Mask interface. If you are creative you will probably only have to do it once.
- A[commercial link removed] Search Amazon for ,"respironics+whisper+swivel"
valve or vent. I think of it as a vent, because it does not have a "closed" position. It is always open. Air escapes between two concentric surfaces that are about 1 mm different in diameter. See picture attached. This is the most expensive item you need costing about $27 at the [commercial link removed]
. Note that as of tonight that web page reports only 2 left in stock. [commercial link removed] Search Walmart for, "Mack-s-Pillow-Soft-Silicone-Putty-Earplugs"
Pictures will help me communicate the assembly without me waxing very, very verbose, something I am very prone to.
- Picture from Dreamport.com of the Bleep interface.
- My attempt to arrange pictorially the tubing and Whisper Swivel II between the Bleep interface and supply hose (the same as was shown in Picture 1).
- Picture of Whisper Swivel II taken apart to explain how it vents.
Another concern might be that the Corr-A-Flex tubing might fit but because the port is so short the tubing may not stay connected after a bit of distortion, i.e., it might easily slip off. Be gentle with the tubing to avoid stretching it and bringing this problem on or exasperating it. If this happens you might be able to obtain some kind of a clamp to hold the hose on the port. A clamp I used to use in the laboratory is known as a Keck Clip and designed to keep standard taper glassware joints joined. They are also available at Amazon, but you would be on your own to investigate whether they are needed and/or would work. Also, you can just renew the Corr-A-Flex tubing as needed.
You will plug the vents on the front of the Bleep interface using the silicone ear plugs. This material is very pliable and long lasting. Try to be neat and remove excess so that the appearance of you equipment does not become less pleasing, but completely plug those vents. Test how successful you were with this effort by attaching the mask as if for a nights sleep and temporarily plug the far end of the hose before you connect it to the CPAP supply hose, probably using just the flat of your hand. Pressurize the line with air from your lungs through your nose with your mouth closed and see if it leaks. Move on quickly to attaching you pump to get a supply of fresh air from your pump after this test. Don't pass out on your own carbon dioxide.
The vent in the Whisper Swivel II will substitute for these vents, but at a greater distance from you face forcing you to "Re breathe" about 58 CC of used air for each 6 inch section of Corr-A-Flex tubing you insert in your line. Your tidal volume is probably on the order of 600 CC. If so, you will be reducing the amount of fresh air you breathe in each breath by about 10% for each length of tubing. Nothing I've ever seen in print used any more than 18 inches of tubing. I can't support using anything greater for that reason and because even at 18 inches I was less comfortable.
Note that your tidal volume will go up. I've never seen a good explanation of this phenomenon or any warnings that it is dangerous. Mine went up from the low to mid 600's to the low 800's. After months of using the 12 inches of re breathing space, my tidal volumes run in the mid 700's. So, my body has adjusted to the EERS. I've been using it since early February and experimented before that starting in November of last year.
Rainout is another problem I encountered. That is moisture in my warm, exhaled breaths condensed on the cold inside surfaces of my EERS. It could actually make my face get wet. I solved this by wrapping my EERS in a small rectangular piece of quilted flannel cut to the length of the EERS and sufficiently wide to wrap the tubing about two times. My wife made this for me. She mounted Velcro strips to make it easy to secure the wrapping.
You can eliminate the section of tubing you are currently using between the Bleep Interface and the CPAP supply hose, as the Whisper Swivel II can connect directly to the latter. This will bring that supply hose closer to your face and you might find that arrangement less comfortable just because of the change in weight on your face. And it might be more difficult to manage the hose. It is your choice as eliminating that section of tubing is not necessary to make this modification work.
If your CA's are treatment induced you might, per the theory of how the EERS operates, experience fewer of them. I certainly do. I was having erratic CAI's that sometimes went above 25. I rarely go above a CAI of 1 now. I do use greater pressure support, too. I can discuss that further in other posts if you are interested.
Flow-pressure graphs available at Dreamport.com for the Bleep mask and at Respironics for the Whisper Swivel II vent are very similar. Without offering a lot of explanation I think this is a good indication that your CPAP pump will perform essentially the same with the Whisper Swivel II as it does with the open vents on the Bleep mask. Again we can discuss this at a high cut (because I don't pretend to fully understand it) in another post.
Finally, note that you will NOT be creating a new asphyxiation hazard with this arrangement. I understand that nasal masks do not include an anti asphyxiation valve anyway. Full face masks do include anti asphyxiation valves. My AirTouch F20 full face mask does. Your Bleep mask doesn't. All you have done with this arrangement is to move the vent further from your face. You will survive an electrical power loss with the new arrangement the same way you would have without the new arrangement.
I look forward to hearing of your success (or failure). I'm delighted with my use of the EERS.
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Moderator Action: Commercial Link Removed
Moderator Action: Commercial Link Removed
To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.
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