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GurdBonk Starting
#21
RE: GurdBonk Starting
What I don't understand is how you concluded getting an Aircurve 10 Vauto was any kind of solution when you failed at every level of CPAP titration.  The answer to this result should have been to schedule or continue titration with ASV. We can see with CPAP pressure from 4.0 to 11.0 your AHI ranged from 38 to over 70 events per hour, and your SpO2 is low enough to qualify for supplemental oxygen through out the test.  This is just dangerous! 

Please either get supplemental oxygen or an ASV test. This is really urgent. Your Aircurve 10 Vauto will not correct this problem.  Why is your doctor not involved in this? Let me be completely honest and blunt. I have never told anyone this before. I do not think I can help you try to adapt to Vauto therapy. You need to be on ASV and/or oxygen therapy. Your health iis in danger as indicated by the oxygen saturation and heart rate seen in your titration study, and you are better off without any PAP therapy than trying to use a bilevel without backup or CPAP. Your tech was alarmed and was restricted form making an appropriate recommendation, but asked the doctor to contact him personally. You must find a competent and caring physician that understands central apnea and get treatment immediately.

[Image: attachment.php?aid=20408]
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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#22
RE: GurdBonk Starting
Sorry, this is going to be a series of posts. I'm on my phone.

Your original diagnostic study results from 2016
AHI   = 151
CAHI =  52
OAHI. = 99

In your titration study the tech quoted these numbers incorrectly much lower but still extremely bad.

These are the worst results I have seen.  
These call for an ASV and no other machine.
Continued.

Your current titration study  indicates primarily Central apnea about 2/3rds of it.  In addition he didn't have time to complete the study.

Ask your girlfriend what she would do for a patient who is consistently under 88% Oxygen?   Any one of the pressures qualify you for supplemental Oxygen 
This is you with a CPAP, APAP, or BiLevel such as the VAuto.  For what it's worth the VAuto is a great machine for most people, But NOT for you.
 
You also have heart issues on top of this, PVCs and tachycardia. Not enough info to say how bad but enough to get it investigated. 

A guarantee, the VAuto will not work for you.

As it is right now using , the same machine I'm currently using, the VAuto, be sure to save all the material because it could make a good documentary, titled after an old movie called Dead Man Walking.  
And yes, that is intended to scare you a little.

At all costs get an ASV.
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#23
RE: GurdBonk Starting
Your results are crazy   Bug-eyed

And as everyone has said, anything but ASV will not help your severe central apnea or even make it worse.
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#24
RE: GurdBonk Starting
You are also at altitude so the CA’s can also be altitude induced
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#25
RE: GurdBonk Starting
Gurdbonk, I understand your account is locked for number of posts in one day. I will try to remedy this. Meanwhile here is my reply to your PM:

First of all, we can help. You need ASV therapy, and it is extremely easy to get setup. Today, ask your doctor for a prescription for ASV. You need the prescription to open up the sources you can buy from. You can call Supplier #2 SecondwindCPAP at 1-855-263-2727 Explain you need an ASV machine, specifically a Resmed Aircurve 10 ASV. Secondwind sells that machine for $1119.00 lightly used with 1-year warranty, or $2149 new. You can return your unopened machine, or sell it lightly used to Secondwind (you will take a hit used). It is worth every penny to you to get the ASV. You can use your sleep study as documentation of your needs, and you may have to get the prescription. Your primary doctor can issue the script.

To setup the ASV thre are very few settings. Set it to EPAP min 4.0, EPAP max 15.0 PS min 3.0 and PS max 15.0. DONE! You can start therapy immediately, and you will eliminate close to 100% of the problem immediately! Call your doctor first and explain your needs. If he agrees to issue the script, call Secondwind, give them your doctor's phone and fax, and you will have a machine by Monday.

Here is suggested script:
ASV therapy Resmed Aircurve 10 ASV HCPCS code E0471
Mode: ASV Auto
EPAP Min 4.0
EPAP Max 15.0
PS Min 3.0
PS Max 15.0

YOU DO NOT NEED YOUR SPECIALIST TO WRITE THIS SCRIPT
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
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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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#26
RE: GurdBonk Starting
What Sleeprider said above. I'll add that ANY talk or action that does not include an ASV is not worth the time or money. And you want the ResMed ASV. There are a lot of users here that switched and prefer the ResMed.
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#27
RE: GurdBonk Starting
One more piece of possible help for your doctor to issue the script.  Here is the recommended titration protocol for ASV and ASV Auto as issued by Resmed.  You can provide this to your doctor to let him see that the settings in the recommended script are the default recommendations for new users by Resmed.

[Image: attachment.php?aid=4210]
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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#28
RE: GurdBonk Starting
Just to give you a bit more info.  I highlight what the VAuto and ASV treats, this text was taken from the ResMed Sleep Lab Titration Guide


This info is from the ResMed Sleep Lab Titration Guide

  • CPAP (continuous positive airway pressure) Fixed pressure delivered with optional expiratory pressure relief (EPR). It Treats OSA

  • AutoSet/APAP (automatic positive airway pressure) Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas. It treats OSA

  • AutoSet for Her/APAP Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas along with an increased sensitivity to each flow-limited breath, providing a more comfortable therapy for women. Increases sensitivity to each flow-limited breath, providing a more comfortable therapy for women (OK for men too). It Treats OSA
  • VAuto Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas; Pressure Support (PS) is fixed throughout the night and can be set by the clinician. It Treats OSA, non-compliant OSA

  • S (Spontaneous) Senses when the patient is inhaling and exhaling, and supplies appropriate pressures accordingly. Both treatment pressures are preset: inspiration (IPAP) and expiration (EPAP). It treats Non-compliant OSA and COPD

  • ST (Spontaneous/Timed) Augments any breaths initiated by the patient, but also supplies additional breaths if the breath rate falls below the clinician’s set “backup” respiratory rate. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions

  • T (Timed) Supplies a clinician-set respiratory rate and inspiratory/expiratory time, regardless of patient effort. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions

  • iVAPS (intelligent Volume-Assured Pressure Support) Maintains a preset target alveolar minute ventilation by monitoring delivered ventilation, adjusting the pressure support and automatically providing an intelligent backup breath. It Treats COPD, Neuromuscular disease (NMD), Obesity Hypoventilation Syndrome (OHS) and other respiratory conditions

  • ASV (adaptive servo-ventilation) Targets the patient’s minute ventilation, continually learning the patient’s breathing pattern and instantly responding to any changes. It treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
  • ASVAuto Provides an ASV algorithm plus expiratory positive airway pressure (EPAP) that automatically responds on the patient’s next breath to flow limitation, snore and obstructive sleep apneas. It Treats Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)

  • PAC (Pressure Assist Control, also known as Pressure Control) The inspiration time is preset in the PAC mode; there is no spontaneous/flow cycling. Inspiration can be triggered by the patient when respiratory rate is above a preset value, or delivered at a set time at the backup rate. It Treats Neuromuscular disease (NMD), pediatric patients
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#29
RE: GurdBonk Starting
Well, I am $2160 poorer, but hopefully if my physcian comes through I will have the new ASV by Monday.  

And I will be ALIVE and hopefully sleeping like a baby soon.

Thank you so much!
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#30
RE: GurdBonk Starting
Great! I'm very relieved to hear your needs will be met. We look forward to helping you adapt and cope with the new machine. You should be able to return the Vauto if you didn't open it up. Finally, it looks like your post count reset for today.

I notice you have a full face mask in your profile. I would bet you can breathe through your nose, and a nasal pillows mask like the Resmed Airfit P10 may be something to consider. It is very light and minimal, easy to seal, and as long as you avoid mouth leaks it is a very comfortable lightweight option that looks a bit less medicinal. Either way, at least you will be saving your health with the ASV.
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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