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Looking for some help - almost 5 years and not feeling a lot better
RE: Looking for some help - almost 5 years and not feeling a lot better
Here's a thought for going forward. If you have to change any setting worth noting its before/after timing, turn off therapy before you change the setting to show a break in therapy. Let PAP Off about a minute. Should be fairly easy to pick it out in OSCAR.
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: Looking for some help - almost 5 years and not feeling a lot better
I too would like you to try a higher PS but looking for "comfort". No hurry, this is to see if a higher PS will help you with your COPD and asthma during the night. Again targeting comfort.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
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Optimizing Therapy
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RE: Looking for some help - almost 5 years and not feeling a lot better
COPD is to be factored in with apnea or the answer cannot be accurate or complete.

This is quite possible.  Not disagreeing at all.  All I know is when I first used a nebulizer (induced asthma test at the doctor's office) it was like getting hit by the hammer of Thor.  It was fast!  

That being said, I think there's a way to go prior to pushing the COPD button.  Although I may be utterly and totally wrong in thinking this, my COPD seems to be quite controlled.  At some point, it needs to be revisited.  It's worth investigating.

I'd really would like to see if I can get closer with the knobs and whistles on my current machine.  

Although not perfect, I had a mighty fine day on Thursday.  I'd love to have more of those kinds of days.  I was more perky, more buoyant, happier, more clear than I've been in years, if not decades.  Compared to previous months, Thursday was manic in comparison.  Whether I could ever repeat that again reliably is not likely, but I'm willing to try for a while before giving up (not allowed due to Rule 22) changing course.  

I want this to work.  If the therapy is inadequate with this machine, I will pursue it further.  Not quitting.  

In the meantime, I need to clinically adjust therapy.  That's a fancy way of saying empirically finding what works for me with guidance from experienced people like you and other board members.  

If you think I'm dead wrong in my thinking, please push back.  I am ok with that.  Challenge is good, it pushes us to do things that we would ordinarily reject.  My knowledge is but a grain of sand in the ocean of truth.  With the help of AB, my knowledge will increase some - and that's very, very good.
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RE: Looking for some help - almost 5 years and not feeling a lot better
@SarcasticDave94 That's a good idea!  I will do that if/when the time comes.
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RE: Looking for some help - almost 5 years and not feeling a lot better
@bonjour
I too would like you to try a higher PS but looking for "comfort". No hurry, this is to see if a higher PS will help you with your COPD and asthma during the night. Again targeting comfort.

Being the blockhead that I am today, are you saying to go with the recommendation of Crimson Nape?  Or something subtly different?
I would up the pressure to 11 EPAP 15.6 IPAP and PS 4.6

What do you mean by targeting comfort?  Trig=High? or what were you thinking?  Being a newbie, it's hard for me to judge.  Did you mean slowly rise EPAP, then PS, or slowly increase PS then IPAP, or something else?  I am nowhere near skilled enough in the art to make this call.

Thanks for your insight.
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RE: Looking for some help - almost 5 years and not feeling a lot better
I have no issue with your plan to keep at what you're doing with this therapy. My comment about COPD is just the bug in your ear to consider, to keep it in memory that it may be a factor. Mine is pretty well controlled as well, just becomes a PAP therapy hindrance.
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: Looking for some help - almost 5 years and not feeling a lot better
@SarcasticDave94, I accept the bug.  I do need to keep my COPD in mind.  When the opportunity arrives, I will consult about this with my pulmonologist.  Due to AB, and a bit of personal research of my own, I'm a lot more knowledgeable about apnea, UARS and it's treatment than I was before.  That alone can make a discussion more productive, as it won't be all single sided.  Some give and take makes a discussion more satisfying.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Your numbers are pretty good, your highest is the CAI. I don't want to see a big swing in CAI and increasing PS could change/increase your CAI.

Because of both your COPD and Asthama, I think a trial of a higher PS could help you feel better. I equate this as comfort. The higher PS should help your breathing efficiency and as such possibly help you feel better. This is in recognition of the fact that both COPD and asthma both tend to hinder breathing. Yes I realize that both are under good control. The VAuto is not the correct machine to actually treat COPD, the ST is, with a timed backup would be that machine but you are nowhere near needing a timed backup rate.

I don't see much reason to increase pressure. Possibly in a zoomed view of the Flow Rate we might see something, but your numbers are not leaning that way. We could reduce PS to see if we can drop the CAI some but seriously you are in the area where literally how you feel should drive changes.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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RE: Looking for some help - almost 5 years and not feeling a lot better
@bonjour, I don't understand your last post.  Can you explain further?  I can't implement what I don't comprehend.  Thanks.
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RE: Looking for some help - almost 5 years and not feeling a lot better
Oh what dreadful timing!  There seems to be a big delay in my seeing the AB forum update.  @bonjour I was typing, while you were.
Thank you for your reply.
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