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[CPAP] Beyond ASV with Overlap Syndrome!
RE: Beyond ASV with Overlap Syndrome!
Curiouser and curiouser. I got the new machine today at Lincare Hanover. It's an AirCurve 10 ASV just like what I have. I was issued a new mask, a F&P Vitera in a sealed bag for Large cushion as that was all they had in stock, but the RT sent along a Medium cushion. The RT knew who I was because it stuck with her that I knew more about this machine than docs she's had to work with for CA issues. The RT asked if I remembered how to get into the clinical mode and that it seemed odd to her the settings on the script, and that she's thinking with COPD on my charts that AVAPS is needed too.

Of course still no timing or manual backup rate. I'll try it, but it's the same as my current ASV. I did get a new SD, so I will put the data there for the new one.

I do see that OSCAR data seems fine and I feel OK with the lowered settings, but I still wake up and kill therapy about 2-3 hours in. I'm still convinced it's a timing issue of some sort.

OK Hanover is safe as I'm home, but I think it's going to lead to a call to the nurse assigned my pulmonary case tomorrow, as I'm not one to wait any longer to nudge the therapy in the right direction. I will give it a go tonight, but same machines are going to mean same results.

It was a nice day to take the old car for a drive. Coffee

PS there's a new design for the ResMed carry bag and the power brick has a molded 90 degree bend at the brick's round machine cord end.
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!
Just adding to the stack of stuff
Cap'n log stardate 112020

New ASV does the same as the other, no surprise it's the same but newer ASV. Called for phone visit with pulmonary nurse Tuesday. I am convinced the pattern will be ongoing, admitted the new lower pressures are more comfortable, but disruptive wakening at 2-3 hours continues. Talked with the RT at Lincare to see what she had to say. Person with COPD and apnea goes on NIV vent. She issues Trilogy and now that Respironics has a new Trilogy Evo, they issue that but they also issue ResMed Astral. RT says the breath patterns on ResMed vs Respironics carry on from CPAP all the way up to NIVs. The Astral does a unique thing that if 4 breaths in a row don't match the normal pattern, it assists breath 5 to match historical. Apparently Respironics is slower to react even in an NIV. RT also states that most docs in this area are conservative in machine progression, as in slow to advance treatment to more powerful machines like ASV or NIV. She said she has to coach patients to push for what is needed.

Then after I'd called the RT to discuss same ole pattern of disruption at 2 hr mark, she called back. The Lincare manager of my office wants to be prepared to hit the go button on the NIV as soon as the order comes in, and he wanted to know definitively who I was having the appointment with Tuesday. So anyway this Lincare office seems to be very good for me. This is the same manager that erased a debt with my hospital bed when old insurance reversed an approval after the bed was issued. He just started the claim over with Medicare. Commendable action.

Anyway, Happy Friday y'all.

Cap'n Quirk out. Coffee

PS the F&P Simplus and Vitera are excellent. I like both and they are a bit different but RollFit is applicable to both.
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!
BTW I thought this was interesting, but I forgot to mention it with the rest of the stuff. The RT at Lincare asked if I'd heard of an item in a brochure she held up, one for SoClean. I did admit I'd heard of it and that I thought it was not needed, and that manufacturers warranty would be in jeopardy of being dropped. She was not attempting a hard sale of it, but said to do what I thought best, as it appears she guides all patients to use best judgement on things of this sort. I said I'd be fine without.
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 it was me, I'd tell her that SoClean is an ozone generator - (partial taken from the dictionary "Ozone - a colorless unstable toxic gas with a pungent odor and powerful oxidizing properties...").  Yeah! I want that coursing through a device that will soon be inflating my lungs.

Don't get offended anyone.  I'm sure they are fine as long as you follow the manufacturer's directions for proper usage.  But how many people throw away the instructions and don't read them because they, well, just do.

Also, they may do a good job disinfecting your PAP system, but do nothing to clean out the schmutz that accumulates over time.  Kinda gross unless you do some sort of schmutz-cleaning in addition to SoClean.  Hmmm... So-soClean???

Fingers are crossed for you Dave. Sounds like you are on the road to success.

Eat-popcorn
RayBee

  
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RE: Beyond ASV with Overlap Syndrome!
Thanks RayBee. BTW the RT was about to suggest not considering SoClean, but I wasn't interested anyway. She knows I adjust my own settings and is quite fine with it. She said she knows I have a lot more knowledge about therapy than any other patient she deals with.

OK so onward to a new battle with doc. I have the RT stating AVAPS is necessary, and the nurse is a ditto. According to the RT the AVAPS she's meaning is in the NIV like Respironics Trilogy and Trilogy Evo, and the ResMed Astral. Notably not the ST-A or Stellar. Just need to get doc to see it too. I think it won't be too long after Tuesday's phone visit.
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!
Just a friendly warning East coast. I'm having a phone office visit 1430 with my doc that the RT at Lincare believes is my best bet at WellSpan Chambersburg on trying for the ventilator/NIV. The ASV experiment is over, I'll make that clear, as I'll also state I need the ResMed Astral 150. Despite good looking OSCAR data, I can only get 1-3 hours mask on. Then I'd sleep x number more hours. Setting changes did nothing to my need for breath time controls, which I'm not at all surprised by this not being solved.

The nurse at this pulmonary office told me a very funny joke. "Some Apnea patients just must accept 7, 10, 20 AHI even while on the PAP as the best it can get". Oh really? I told her I'll reject any result other than AHI of under 5 on therapy as not treated according to the "how do I feel" factor and the medical accepted threshold.

I've gotten a Contec CMS50F and report software and plan on attaching reports if I see anything interesting. First use showed just 2.2 minutes at or below 88%. Pulse is all over the chart, from 40ish - 135ish. The "exercise" was me going to various rooms of the house or sitting. That's the PVC aspect.
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!
BTW any feedback with this CMS50F first night oxy only report? I had some time at below 89% but surprising is that it was only 2.2 min. My PVCs heart condition can be seen in up/down pulse.

And to answer where's the ASV data, I cannot use it. New or old and newer lowered settings still result in 1-3 hour mask on and feeling worse for using than without.


   
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!
Sorry you have found the ASV intolerable as time went on. Good luck on getting the Astral. On your SpO2 chart, it may help to add a dotted line at a target value like 88%, or whatever threshold is significant for your results.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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!
Thanks Sleeprider. I saw a red line on the report on PC. I'll add one if I find the option.

Let's say my ASV therapy is EPIC fail

PS can OSCAR add that redline to my oxy chart?
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!
I found that surprise surprise OSCAR does add lines to my oxy and pulse. Great job Fred and co.

Do the lines help Sleeprider?

   
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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