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Help for father
#21
RE: Help for father
Yesterday afternoon my father and I met with his doctor.  I am starting to think he is a very good doctor.  He was happy to see the OSCAR stuff I had emailed him.  He likes data.  He liked to see the SpO2 in particular.  

He asked us to bring the physical machine and he made changes to it in the office (usually the DME does it through the modem).  He started with what I had good luck on - 13/8 and Trigger = high, Cycle = low.  He put the machine on VAuto mode.  (I don't know if that is useful in this case but it is worth finding out.)

He knew about SleepyHead to some extent, which I guess is the old name for OSCAR?

He asked me to collect more data and come back in 2 weeks.  He likes the details from OSCAR much more than what he gets through the DME - he showed me the plots from the DME.  I am to bring my father to the appointment if he is not feeling well, but otherwise just come alone with data.

He said not to make changes more frequently than every 2nd or 3rd day, but if I see obstructive apneas to increase the EPAP by 2, and if I see hypopneas but no obstructives to increase pressure support by 1.

He also said if we want to try ASV he can order an ASV sleep study to see if it works.  I did not discuss iVAPS because I simply forgot.  I am upset with myself about that.  I shall discuss that next time.  I suppose the approach might be ASV titration first, iVAPS if that is unsuccessful, but I am just guessing.

There is a continued unsteadiness in my father's breathing.  I liken it to someone periodically revving a car that is idling.  This is explained by SleepRider in his 08-18 comment starting with the words "The zoomed images above ..."

The doc said it can take up to a couple weeks for people to acclimate to higher pressures and for centrals to drop.  He also said for complex cases like my father he is generally OK with AHI up to 10 if the oxygen looks good.  My father had AHI = 1.2 last night on the new settings.  

I will probably post more plots in 5 or 6 days and ask for opinions, but I want to let things settle for a bit at the new settings.  

We are not there yet but this doctor is willing to work with us and, between that and this community, I am feeling optimistic that we can (eventually) arrive at a good treatment for my father.  Thank you all!
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#22
RE: Help for father
A doctor that listens and takes an interest in improving therapy is solid gold. Sounds like a very productive visit. ASV and iVAPS are two different flavors of adaptive pressure support, with iVAPS offering much greater control, allowing the tidal volume and respiration rate to be set, while ASV uses a moving average of the patient's respiration rate and volume to set the backup automatically. This can result in inadequate treatment for individuals with COPD and other pulmonary disorders.
Sleeprider
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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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#23
RE: Help for father
The ResMed Air11 came today. Rest of family assumed it would come from Dr. or DME and they would set up machine for my father. CPAP person from pulmonologist's office is not available until Monday.

If I call the RT from the DME, she will likely tell me not to do anything until she can come out (which would mean using the damaging Philips' machine another nite. Would rather do this myself.)

Can I do this myself without putting my father at risk?

Can someone tell me comparable settings on the Air11
to what he was using on the System One?

I figured out how to put the humidity at the lowest level.


Thas has a computer screen and options:

In menu: My Options, there are:

Ramp time: Choices are Auto, and 5 to 45 by increments of 5. WHAT DO I WANT TO DO HERE?

Pressure Relief: Choices seem to be ON or OFF.

Humidity Level (I put this at one, which is what his previous machines have been set at.

Thankfully, his mask and tube and oxygen adapter, and the inline bacterial filter all fit.
====
Am caring for nonagenarian parents:  one uses a ResMed Airsense 11, and the other a ResMed Astral 150, full face masks, oxygen, humidifiers, modems.

Anyone else caring for very elderly loved ones?
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#24
RE: Help for father
What model of Resmed Air 11 was delivered?
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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#25
RE: Help for father
I think only AutoSet machines are being delivered right now. And Only in the US Sad
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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