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Lorrubdb Therapy Thread: Fine-tuning therapy with Oscar
#91
Sad 
RE: AHI CA/UA still high, EPR changes
So is anyone EVER going to reply to me!?? Starting to get a complex  Huhsign






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#92
RE: AHI CA/UA still high, EPR changes
The OSCAR data seems to be very good, so no changes if going by that.

So the oxygen sat, this is measured with a recording oximeter? Is there any other reason why it's this low? I would be checking in with the doc about that, as I'll feel sick at that low level. Below 92% can be an issue and with 6 or more minutes at 89% they'll likely prescribe supplemental oxygen.
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.
#93
RE: AHI CA/UA still high, EPR changes
Hi Dave, Sorry I meant my sats are now over 95 not 85 with the new settings. I'm an RN and know the dangers of below 90, would never let it stay there for long, would be on oxygen by now. My doc is aware that it was dipping below 90 to 89 briefly a few times but he thought my chart/numbers look great and that I should monitor for now. Don't think he knows a thing about the Oscar readings, he just focused on my AHI which was in the 2s at that time. My flow limits were very high but when I mentioned it he didn't know what I was talking about. Sad but that's how most docs are. I know you're all too familiar with clueless doctors. Thankfully with my current settings and increased min/max so far I'm getting enough air and good oxygen, sometimes 93 0r 92 very briefly but rarely. I feel so much better, can breathe while awake and have energy. My sleep apnea test showed long periods of desats down to 73. So I must've been deprived of oxygen for years and didn't know it. Probably TMI but I think the prolonged lack of oxygen caused organ damage-atrophied pancreas and heart/lung changes that I never had before. So you and the team are doing great work helping people get their settings right so they don't suffer from low oxygen which is very dangerous. I'm lucky I didn't have a heart attack which can happen. Oh I use the wellvue O2 wear ring, just stick it on my thumb and it records the whole night on my Iphone, downloads as graph in the morning with a magnifying glass that reviews your levels every minute. It's really great, I recommend it. I'm very grateful to the whole team for helping me with your expertise to get my breathing under control, I never could have done it without you all. But I think I'll stop posting now, there's a lot of other people that need your help. I just wanted some feedback on my chart, since I've been raising my min/max pressure on my own and a little insecure about it. Just wanted to make sure everything looks ok. But seems after awhile my posts are going unanswered so get the message that perhaps I don't need more help. So thanks for your concern but I'm ok. You are a very nice compassionate person and I appreciate all your help and attention.
#94
RE: AHI CA/UA still high, EPR changes
Focusing on OSCAR data, it looks like therapy is trending well. It's doing very good there.

Merry Christmas
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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#95
RE: AHI CA/UA still high, EPR changes
Ok copy on the oxygen, wasn't sure exactly and had to pass on the info.

Focusing on OSCAR data, it looks like therapy is trending well. It's doing very good there.

Merry Christmas
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.
#96
RE: AHI CA/UA still high, EPR changes
As Dave said your numbers are fine. Because of your comments, I am concerned about your O2 Sats so definitely keep a close eye on them. IF the low O2 levels persist the next step is a VAuto, a BiLevel for the increased PS (pressure support). PS is the main driver for improving sats thus keep your EPR=3. I do not believe that you would need a backup rate.
#97
RE: AHI CA/UA still high, EPR changes
Thank you. I'm very concerned about my oxygen levels too. I was doing pretty well at settings of min/max of 9.4/15.4 with some brief dips to 92 but not below 90 and generally above 95. However, last night it dropped to 80s for almost an hour! OMG. Scared me.  I panicked and turned settings up to 10/15.6 and the numbers went up and stayed good for the rest of the night. I noticed too my flow limits weren't terrible but increased somewhat as well. 

So please help me with settings. Since this is a one day time although severe drop should I go back to 9.4/15.4 which I've done pretty well at until now? Or what settings do you recommend?

 BTW, I will call and report this to my doc tomorrow. On one chart of 1.85 I was trying a monstrous new masks, Phillips something-felt like my head was in a vise and it leaked terrible. Finally took it off at 5 am and used usual F30 for a couple of hours which felt wonderful.  However, although the chart looks bad with high CAs I noted that my oxygen was ok anyway. I think the mask was the problem because the next night with the F30 got the perfect elusive 0.0 and oxygen pretty good. 

But now I'm realizing the AHI is important but its not everything and celebrating 0.0 misses the point. Have to closely watch flow limit and oxygen too as Gideon said. 

I attached a few recent charts but system wouldn't let me post o2 chart.

Thanks so much!
Lorie

[attachment=38380][attachment=38381][attachment=38385]






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#98
RE: Please see attached oximetry
I tried to attach oximetry-looks like it worked. 


Please see  "attached files" for 12/25 night desaturation below 80. Thank you.














[attachment=38386][attachment=38386]
#99
RE: AHI CA/UA still high, EPR changes
I don't know the exact percentage numbers on the chart, but I would be calling doc and making this known. No it's not as bad as if it dropped and had stayed down. Even so the spikey drops then recovery then several more spikey drops even lower isn't a good look. I'd probably ask for both a 6 minute walk SpO2 test and an official overnight oximetry.
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.
RE: AHI CA/UA still high, EPR changes
Thanks Dave. Great  interpretation and suggestions. You’re right, it doesn’t drift down, it spikes. Wonder what that means. Noticed that my HR spikes too, sometimes to120.  I’ll do that -send doc oximetry reports and ask about the tests you mentioned. Have to say I’m more than a bit worried. No wonder I feel so fatigued some days. Maybe need Oxygen w cpap.
Thanks again






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