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In anticipation of my BIPAP Re: New Thread
RE: In anticipation of my BIPAP Re: New Thread
I'm a bit confused.. how do you know you have an enlarged left atrium? Is there a cardiologist in the picture here somewhere too? Did I miss that?

Should you mention it? The sleep doctor should be covering his bases whether you mention it to him or you don't. If he writes a prescription for ASV without getting evidence that your ejection fractions are OK then I'd no longer trust that doctor. This is basic stuff for someone whose career is based on sleep and PAP machines.

EDIT: If they've diagnosed a left atrium issue then you presumably had an echo cardiogram to diagnose that. When was it done and what was the documented left ejection fraction (if any)?
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RE: In anticipation of my BIPAP Re: New Thread
Not ventricle, atrial.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096293/

I had an echocardiogram as part of some visit to the urgent care a number of months back because I thought I might be having a heart attack.  They said I wasn’t.

I have this app that has all my health stuff like test results and it says among the Results:
LEFT ATRIAL ENLARGEMENT [-0.15mV P WAVE IN V1/V2]

No previous ECG available for comparison

I was never contacted about it and when I asked my primary she wasn’t concerned about it.  Should I be concerned?

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Yes I fixed the ventricle/atrium word in my post when I spotted it :-)

Firstly Phoebe.. I am not a doctor. However I read and google from time to time.

Are you SURE you had an echo cardiogram or was it simply an ECG?? EDIT: The names sound similar but they are very different.

If you thought you were having a heart attack and they performed an echocardiogram then the full results of that might tell you your left-ventricle ejection fraction.
Maybe there's a "full" echocardiogram study and a "cheap and cheerful" version. I really don't know if there are different types or not. Getting them to send you the full results might save you some money by avoiding a subsequent echo cardiogram test. I'd want the results in my medical files anyway.

Next thing... the left atrium is connected to the left ventricle by a valve. There are several reasons why the left atrium can be enlarged. One reason can be caused by an issue with the left ventricle. Do you see where this may be leading?

If you get those echo cardiogram results and they tell you that your left ventricle ejection fraction is too low then you need to know that. If that's the case, there is no point having the ASV titration test because no one will write the prescription for an ASV. Even if they DID write the prescription it would be due to incompetence and I would not be happy knowing that you were using ASV until the latest study is published and I know exactly what it says.

There's a lot of "ifs" in all the above and I don't want to freak you out.... but you and your doctor(s) need to know the answers.

Finally, Please don't shoot the messenger but you may also want to read the "tips" section of this webpage for left atrial enlargement.
There are a few that apply to you given what you've told us.

https://www.healthline.com/health/left-a...prevention

Tips
Keep high blood pressure and high cholesterol under control.
Eat heart-healthy foods.
Avoid using alcohol and tobacco products.
Maintain an active lifestyle.
Try to lose weight if you’re overweight.
Reduce stress, as this can lead to problems with heartbeat.
Let your doctor know if you have a family history of heart or cardiovascular conditions.
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RE: In anticipation of my BIPAP Re: New Thread
Trying to end the evening on a more upbeat note..

Your past 2 nights showed considerable improvement with flow limitations.
We still have more in reserve that we can squeeze out of the VAuto if necessary.
Let's see if the next few nights confirm if we've found a repeatable improvement simply by using the VAuto
I hope we can make it three in a row tonight.
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RE: In anticipation of my BIPAP Re: New Thread
Coffee Hello everyone.

First, in response to AQ, regarding the Left ATRIAL Heart Enlargement: (I read the information you have provided, thank you).  Smile

NAME OF PROCEDURE: Office EKG with Interpretation Only on 8/1/19

COMMENTS: Sinus Rhythm, LEFT ATRIAL ENLARGEMENT [-0.15mV P WAVE IN V1/V2], Measurements: Interval Axis Rate: 84 P:58, PR: 166 QRS:17, QRSD: 81 T:19, QT: 341, QTc: 404

It always bothered me that my primary care doc. didn't appear to feel the need to investigate this any further.  I tried to sleuth out information on line, but although I found information that indicated it's a thing, I assumed that it was nothing to be concerned about because of the lack of interest by the doc.  With the ASV test coming up I think I'll call the sleep doc on Monday and ask him about this.  I have found so far that even though my primary doctor is making all my referrals, she is not sharing my medical information, so it has been up to me to remember everything and share it all myself.  This enlargement issue may well be nothing to worry about, but better safe than sorry.

In the meantime, I wonder if I should start another thread regarding this EKG finding and see if maybe any of the members who are doctors might have some insight?  Of COURSE realizing that nothing they may say would constitute medical advice.

Second, I'm gathering a bunch of chart info and preparing to try to post the views this morning, hopefully any technical problems will have cleared up.

BBS,
Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
AQ, I read your note about the past two nights showing considerable improvement in the FLOW LIMITATIONS.  So I started looking through my charts to find the OVERVIEW for the ONLY day so far where upon waking up I felt I had been reborn.

I post it here:

[attachment=19395]

(Sorry that the calendar is in this shot).


I do see some FLOW LIMIT, but I really guess I shouldn't give a s**t BECAUSE I FELT SOOOO GOOD.  And since "it isn't about the numbers, but how you feel" maybe this example is what we need to shoot for again?
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Here are the overviews for the night before last and last night:

1/23/20 THURSDAY

[attachment=19396]



1/24/20 FRIDAY

[attachment=19397]


If you would like any zooms, let me know what time period you would be interested in?

Now here's this: I have been wondering for the last couple of days if perhaps my husband's poor sleep is "infecting" me and messing up my therapy.  I have been reviewing tons of my video clips and something is quite noticeable.  In a large percentage of my clips, during periods of my moving, the moving, NOT always, but often, appears to be in reaction of my husband either getting out of bed, rolling over, making sounds, and stealing covers.

Now, obviously he was not present during my sleep studies, and those results speak for themselves, that yes I have severe OSA, but the treatment I am doing here at home may be causing my therapy to be affected in a negative way.  I was thinking of TRYING an experiment.  I will try tonight to sleep in the guest room by myself.  I know my husband will not be happy about this, but I am very curious to see what happens to my sleep quality and OSCAR data.

What do you guys think about this proposed experiment?

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
Good morning Phoebe.

EKG and ECG are the same thing... and it's not an echo-cardiogram... it's an electro-cardiogram (or electro-cardiograph depending on your preference).
One is the name of the equipment and the other is the name of the result. (compare that with telegraph and telegram).
So you won't get any ejection fraction numbers from that test.

The data from 1/12 had good flow limitations. The statistics on the left show that your results were 0.07 or better for 95% of the time
The data from 1/23 had good flow limitations. On the left we see they were 0.11 or better for 95% of the time
The data from 1/24 were not as good. The numbers were 0.32 or better for 95% of the time. However the first part of the night was better than the second half.

So once again your results are a bit of a tease.
If you scan your zooms, the first half of the night should look "decent" but the second half should look generally worse especially at 5:15, 5:42 and between 6:10 and 6:45
You may even have car-compactors at 5:15 and 5:42 (or thereabouts)

The spare room experiment sounds logical to me.
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RE: In anticipation of my BIPAP Re: New Thread
HEYYYY AQ.   Wave

I gotta run and p/u my blood pressure meds, and then off to work 11-7.  Sorry for the teases, I didn't start out on purpose with that, but now you have me enjoying the delay, lol

So when I get home tonight I will post the zoom areas you mention.

I have opportunities to read and reply from work, just not post images.  So it's a forced tease today.

The settings are different in the chart of 1/12 when I felt really good.  I believe we changed the settings to see if we could eliminate the rest of the FLOW LIMITATIONS.  Perhaps I should go back to those settings tonight and see what happens before abandoning my husband?

Have a great day!

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: In anticipation of my BIPAP Re: New Thread
I wouldn't go back to those older settings. PS was only set at 6.4 not 6.8
I think it was a better-looking night simply due to your seemingly random (but probably not random) data-tease-effect. ;-)
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