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Bipap bloating stomach questions
#1
Bipap bloating stomach questions
Hi Everyone,

Hope you all are doing well. I have been diagnosed with sleep apnea for over a year now. I got a CPAP machine but even though events were less than 5 i did not feel i had good sleep quality. I went for a titration study 2 weeks ago and was told I need to be on BiPap machine.

I got my Bipap machine yesterday (Resmed and mode was Bipap ST) i was told my settings which best helped me in the sleep study were 19 Ipap/14 Epap with 10 as res back up. Trying it for first night i felt it was much more aggressive than what i had with CPAP i ended up waking up within 2 hours with extreme bloat that i was sort of vomitting air it was so uncomfortable, never felt that with CPAP. Going into bipap i had thought this was a problem of the past but apparently not. I am now confused on what to do, clearly the settings are aggressive as i had never ever felt uncomfortable on cpap nor i recall that feeling in sleep study but perhaps thats because they try different things that they never actually tested it for long time, which sucks.

What can i do ? (I am using Nasal pillows for what it is worth with chin strap) I know i should keep them ipap and epap 5 apart (maybe more?) I do want to sleep well but i am scared to have a similar experience like yesterday, what can i ideally lower settings to to avoid this feeling? and should i immediately call up my doctor on monday to let him know settings are not working for me?

I am looking for advise on how best to utlize the bipap machine i have and what i can ask of my doctor as i slept yesterday thinking all my problems are gone to find i have worst feeling i ever had

Appreciate your advise and insight and patience with me and i will be happy to follow suggestions.

Thanks alot
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#2
RE: Bipap bloating stomach questions
Is there some reasoning to have put you on the ST instead of a VAuto or some other ResMed BPAP? Both are BPAP machines, with the ST being basic spontaneous timed breathing, but it's static as in 2 exact pressures. Whereas the VAuto can vary pressures between minimum and maximum settings. Now, if it's a backup rate that's required, an ST-A might be called for, but the ST is a stupid device that is normally unfit to give good therapy to anyone.

As is, you are experiencing aerophagia/air swallowing. To correct it, we'd consider turning down the pressures. Do you have OSCAR data to show or the detailed, redacted sleep study report? Both would be helpful, and in the US you are legally permitted to request the sleep study and the titration in full according to HIPAA rules. Still, I'd want to know why you were given the old tech not very smart ST instead of better machines.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Bipap bloating stomach questions
Nope, i only did a sleep study and that's what i was given i did not know there are other machines, i don't know if i can even ask for different machines. The pressures are definitely way too high i can barely even tolerate 10/5 not even sure how I got and i quote "The most optimal settings were as follows: 19 cm / 14 cm with a rate of 10 breaths per minute. " during the sleep study. 

I can request the data by Monday, not sure they would even replace the device given the data they have. Should they have given me the ST-A or Auto and is there a way for me to request a swap? And for now what can i do as i am in terrible pain and can't even consider using device again.

I will setup an oscar today \ tomorrow i hope, but looking for advice on what i can discuss with my doctor as i feel bad right now that i did not get proper device nor settings that i feel i trust
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#4
RE: Bipap bloating stomach questions
(11-07-2020, 04:50 PM)SarcasticDave94 Wrote: Is there some reasoning to have put you on the ST instead of a VAuto or some other ResMed BPAP? Both are BPAP machines, with the ST being basic spontaneous timed breathing, but it's static as in 2 exact pressures. Whereas the VAuto can vary pressures between minimum and maximum settings. Now, if it's a backup rate that's required, an ST-A might be called for, but the ST is a stupid device that is normally unfit to give good therapy to anyone.

As is, you are experiencing aerophagia/air swallowing. To correct it, we'd consider turning down the pressures. Do you have  data to show or the detailed, redacted sleep study report? Both would be helpful, and in the US you are legally permitted to request the sleep study and the titration in full according to HIPAA rules. Still, I'd want to know why you were given the old tech not very smart ST instead of better machines.

Reading more it definitely doesn't sound like ST is the right device for me? I am so upset on why they would prescribe me something that is not for my case as i was told i suffer from Centrals. I don't know if i can ask them to return the device i have and ask for new one without yet another set of tests as i don't see myself using the current device until told why.

Any insights on what i can do to push my doctor to give me information as it seems it is gonna be a long back and forth process if i cannot trust my doctor to do right things on my behalf! and they are supposed to be reputable where i live. I presently sent him asking why he believes ST is best option when i was not told i suffer from respiratory disease. Also sent my company issuing health devices to ask why they gave it to me based on the data they have. Due to covid not sure if i can even return the device after less than 3 day use and whether i will have to pay for it fully then

Thank you for any help you can give or advice
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#5
RE: Bipap bloating stomach questions
OK the titration 2 weeks ago is the study you slept somewhere and was hooked to a test PAP machine. The tech doing the test varies the pressure settings and records the results. That would be a good test result to get and post. They decided you needed ST, but ST is not given to treat CA, so they got it wrong badly in my opinion. Call the doc that scripted it and ask why they're treating the CA they said you had with archaic ST. If they said you have CA to be treated, you need a ResMed AirCurve 10 ASV. But you need the sleep study and titration as well to point out the CA and tell them to change the script to ASV. No matter what, you need those detailed studies as you may need a different doctor to see the results and actually see CA and connect that to ASV for treatment.

And treatment such as what you're getting is very common for apnea treatment. So many others have been issued the wrong machine as well, not all get an ST, but most everyone is issued a CPAP and sent on their way hoping the CPAP magically takes care of everything. Docs rarely follow up with apnea patients other than that required to keep insurance coverage going. But here's the thing, that is why Apnea Board exists, to help patients like you get the treatment you need. OK stick with us, not me alone though. AB members will ask questions, you get answers. And we will answer your questions too. We will train you on how to get treated properly and fairly. So again, try getting the detailed results of both sleep study and titration, detailed multiple pages. Scan them to your PC and post redacted/blackened out personal info here. Tell the docs office you have HIPAA rights to your copies. And you want to know why they put you on ST to treat Central Apnea. Be polite and nice, but be firm and demand to have an understandable answer. Just because doc said is not nearly good enough.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Bipap bloating stomach questions
(11-07-2020, 06:55 PM)SarcasticDave94 Wrote: OK the titration 2 weeks ago is the study you slept somewhere and was hooked to a test PAP machine. The tech doing the test varies the pressure settings and records the results. That would be a good test result to get and post. They decided you needed ST, but ST is not given to treat CA, so they got it wrong badly in my opinion. Call the doc that scripted it and ask why they're treating the CA they said you had with archaic ST. If they said you have CA to be treated, you need a ResMed AirCurve 10 ASV. But you need the sleep study and titration as well to point out the CA and tell them to change the script to ASV. No matter what, you need those detailed studies as you may need a different doctor to see the results and actually see CA and connect that to ASV for treatment.

And treatment such as what you're getting is very common for apnea treatment. So many others have been issued the wrong machine as well, not all get an ST, but most everyone is issued a CPAP and sent on their way hoping the CPAP magically takes care of everything. Docs rarely follow up with apnea patients other than that required to keep insurance coverage going. But here's the thing, that is why Apnea Board exists, to help patients like you get the treatment you need. OK stick with us, not me alone though. AB members will ask questions, you get answers. And we will answer your questions too. We will train you on how to get treated properly and fairly. So again, try getting the detailed results of both sleep study and titration, detailed multiple pages. Scan them to your PC and post redacted/blackened out personal info here. Tell the docs office you have HIPAA rights to your copies. And you want to know why they put you on ST to treat Central Apnea. Be polite and nice, but be firm and demand to have an understandable answer. Just because doc said is not nearly good enough.

Thanks to you and other members for all the good you do to educate us those who pay and receive little to no knowledge and help \ care by those who are supposed to have your best interest.

For now, do you recommend I not use the device until talking to doctors or try lowest settings i can tolerate and work my way up till then. And ST machines will not help Centrals at all? so should i go back to CPAP device for now or there is a slight hope bipap can help somewhat until i get my paperwork from them?

Thank you!
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#7
RE: Bipap bloating stomach questions
    Hi Dave,

I know it is only 1 day worth of info and as you can clearly see a day full of uncomfort, but i attached my chart so that you can guide me what i need to provide next time. I will try to use lower settings today e.g. 9 IPAP and 5 EPAP unless you suggest higher and provide data tomorrow as well. But given the current details i attached anything stands out?

Thanks alot


Attached Files Thumbnail(s)
   
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#8
RE: Bipap bloating stomach questions
I don't see how to edit threads, and found the Oscar guide and adding data let me know what else i can do and how to best help members here help me. Thanks everyone.


Attached Files Thumbnail(s)
   
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#9
RE: Bipap bloating stomach questions
By the treatment numbers in OSCAR the ST is tackling apnea events for the most part. I'd say given your feedback it is not comfortable for you to use as it is.

Try this, unless it is so uncomfortable that you'd decide not to use it at all, change your pressures to 7/12.
Your ST looks something like this? If yes, hold Home button and click the Dial in at the same time. You're now in the Clinical Menu. Look for your pressure settings, use the dial to move up or down to the setting you need to change like the low pressure, click it and turn the dial to move the number down to 7 click dial again to lock 7 in, repeat this for the high pressure number but make it 12. After you're done with the edits, click home to jump to the top setting and report area with return at the top, click return after highlighting it with the dial. You're ready to run it tonight on lower pressure. Report back if it helps and with OSCAR. If it becomes too difficult to use because of discomfort or pain, pull the mask off and stop the ST. Call the doc tomorrow to state you cannot use it because of pain and discomfort feelings. Then soon request the detailed reports, and also make the doc aware that ResMed states ASV is for treating CA.

[attachment=27964]
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Bipap bloating stomach questions
(11-07-2020, 09:32 PM)SarcasticDave94 Wrote: By the treatment numbers in OSCAR the ST is tackling apnea events for the most part. I'd say given your feedback it is not comfortable for you to use as it is.

Try this, unless it is so uncomfortable that you'd decide not to use it at all, change your pressures to 7/12.
Your ST looks something like this? If yes, hold Home button and click the Dial in at the same time. You're now in the Clinical Menu. Look for your pressure settings, use the dial to move up or down to the setting you need to change like the low pressure, click it and turn the dial to move the number down to 7 click dial again to lock 7 in, repeat this for the high pressure number but make it 12. After you're done with the edits, click home to jump to the top setting and report area with return at the top, click return after highlighting it with the dial. You're ready to run it tonight on lower pressure. Report back if it helps and with OSCAR. If it becomes too difficult to use because of discomfort or pain, pull the mask off and stop the ST. Call the doc tomorrow to state you cannot use it because of pain and discomfort feelings. Then soon request the detailed reports, and also make the doc aware that ResMed states ASV is for treating CA.

You are correct that's my device but black in color. I will adjust settings as you said although had been thinking to make it even lower. Assuming i feel somewhat better and report back tomorrow and numbers look okay \ good. I think i still have to follow up with my doctor and get results and if it is central he is treating switch to ASV

My final question for the day would be, assuming somehow the doctor refuses to switch me to ASV and he states he is treating central apnea. What can I legally do aside from switching doctors, can I call my insurance and let them know i am not being treated for right issues and they would then refuse to pay for my BiPap device and i wouldn't have to? or i am stuck now with this machine and paying for it? I don't want to shoot myself in the foot given I am now more conscious about how poorly they are treating me
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