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[CPAP] Beyond ASV with Overlap Syndrome!
RE: Beyond ASV with Overlap Syndrome!
Here's today's not quite 3 hr OSCAR. Low doctor concocted therapy pressures give me Zeros! My ASV cannot give EPAP range the doc scripted of 4-17 as my EPAP Max stops at 15 with Min 4. Even so, my ASV with what I consider less than ideal pressures still gets that zero when their lab Respironics gets an AHI of 7. Hmm so even Respironics test machines do less than ResMeds.

Low use hours still are attributed to some aspect that increases sleep disruption by hour 3 of use. I'm still of a stubborn mindset that timing is off. Rogue Guinea Pig subject 2468 signing off.

Pertinent pressure settings are EPAP 4-15 PS 3-10

No update what ASV the new DME has on order and no call that it's arrived, but the image in the coffee grounds is a DreamStation SV Auto as if I'm correct that it does have timing controls. If/when I do get that one, I'll have quite the mini-DME collection. I hope I can give solid evidence with poor settings on the current ASV that pressures aren't the issue and timing is missing and is the fatal flaw for me. I guess I'd need to accept the other SV Auto/ASV, assuming it has the timing controls to see the differences in therapy results. I don't like the accepting a new machine when the nurse I'd talked with on initial new patient consult believes strongly my COPD/Apnea needs AVAPS.

   
Dave

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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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RE: Beyond ASV with Overlap Syndrome!
Well it's interesting that your EPAP pressure stays very low, and only goes to 7.0 at the end of the night. Your PS varies as expected, but results look great. How does the tidal volume, and minute vent compare to previous experience at higher pressures? In your case, we can visualize the variability of respiration by also posting the Advanced View graph.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
Here's last night's TV, MV and one that's back in 9-19 as one of the more recent MV TV shots. I attempted an Advanced chart but it didn't seem to change it. I can send more differing shots if needed. The wheels have been knocked off the therapy for quite a few months as time flies by quick it seems. Be back a bit later, gotta go visit Sheriff Andy to renew my carry license.

TV & MV last night 11/11 and older 9/19. Looks like on the older one I'd edited PS Min to 4 instead of 3, and EPAP Min was up to 9 instead of normal 8. I was trying various pressures at that time to try to fix the therapy that had lost its wheels. I think I may have had the bronchitis episode in Sept. last year. I do know soon after the 7/19 pneumonia is when the wheels seemed to fall off, with doors, hood, and seats going about then as well.

If it is in fact timing, oh the horror if I had to run with a Respironics SV Auto. I am kidding of course.

Should show as last night then 9/19's
       
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Beyond ASV with Overlap Syndrome!
You are maintaining much more consistency with the lower pressure. Congrats.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
Interesting. It does feel a bit better, although I still like a bit higher min EPAP. It is the breathing through a straw. I am only maintaining it as is to create data for doc and the nurse. I think if it is deemed necessary, this nurse will have sway in whatever is needed. She really does understand the overlap status, and included a nebulizer to address COPD issues. Old docs office thought I was too stubborn to listen, and that may be true sometimes but in the presentation of overlap of COPD and Complex Apnea they were snowblind.

Thanks for looking at it Sleeprider.

We'll see what shiny new thing the DME has an order for. The one I last talked to said the machine was on its way to their office and the RT would call for me to visit. I don't bet, but if I did, it's likely to be a square wave Respironics Flex-O-Matic. No not really, because I already stated to the doc I'd not accept less than what the ASV could do.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Beyond ASV with Overlap Syndrome!
If you feel you need something more, I would not mess with the EPAP min, but might increase PS min a bit. There is no suggestion here that EPAP is an issue. If nothing else, congrats on having a doctor that is interested enough to make useful suggestions and enough concern that your needs are met.
Sleeprider
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____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
Copy that. True it may be PS that I'm missing. Not that I dare not adjust things, but I'm needing to see a trend if there's one to be seen, so I'll run with settings as is for the weekend. Thanks again for looking.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Beyond ASV with Overlap Syndrome!
FWIW I got the call from Lincare Hanover, PA to come in Thursday afternoon to get the new ASV. The woman at Lincare couldn't verify brand, but since doc scripts a backup breath rate of 10 and breath timing controls, I am guessing the DreamStation SVAuto. I did verify it's scripted to contain a humidifier and heated hose along with a mask of patient choice. I'm opting for an F&P Vitera Medium. I've already got the Simplus from the most recent sleep study. I really like these F&P masks. They are more comfortable than the ResMed F20 despite the forehead bar thinger. I'm in for RollFit.

BTW Lincare Hanover is next to Utz chip factory. Eat-popcorn
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Beyond ASV with Overlap Syndrome!
Well if it's the Philips you can certainly use data to demonstrate what works for you. It could be interesting, and I would not rule out the possibility of exchange if the results are demonstrably worse. Personally I would not rule out the possibility that Duke Nukem might raise a ruckus if they are.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
I am going into this as unbiased as possible. I am result and comfort oriented for this process. If this is in fact a Respironics, I will give it a real try. If it works to solve what I believe is timing issues, so be it and I'll call it a wrap. If however it doesn't solve it, I will then keep on pushing for a better answer. I do feel I have an advocate at this new to me WellSpan Pulmonary in the nurse that I did the initial new patient consult. She's the one that sent a script for a nebulizer within 24 hrs after that initial visit. I am sure if things are still "off" with therapy, 1) I'm giving feedback right away and 2) make sure the nurse has input to persuade doc it ain't right if it does in fact go there.

Oh that reminds me, the current ASV settings are not doing bad. Could have been I set it less than ideally, but it's in the past. New F&P Simplus mask is excellent and helps a lot. After the wheels fell off therapy many coffee mugs ago, things revert to pre-PAP surprisingly fast. I'm feeling I'm back at PAP 101 in making sure I mask up before I drop off to sleep. Eh no biggie, I'll get it straightened out ASAP.

Do not worry folks, Dave will not Nuke any innocent chip factories, so Utz factories won't be harmed. I can't comment yet about the new pulmonary doc.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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