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Replaced my ASV, not happy, need help
RE: Replaced my ASV, not happy, need help
I'm interested in what the pulmonologist says.
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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RE: Replaced my ASV, not happy, need help
She responded to my email right away, we're talking Monday afternoon.
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RE: Replaced my ASV, not happy, need help
I probably read more into your post than I should. It's good you have a positive relationship with your doctor. To me, those results clearly pointed to a need for improved oxygen saturation. While I'm not a medical professional, I was under the impression you had already been told it was not important, and my intention was to facilitate a rebuttal and show the criteria Medicare uses, which is pretty conservative.
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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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RE: Replaced my ASV, not happy, need help
And I appreciate the info, which I will discuss when I talk with her. Meanwhile I looked back at my earlier sleep studies for comparison. The report for first PSG in 2013 says my average Sp02 was 95%, though a detail page for 6 minutes or so around midnight shows nothing above 94% and looks like an average closer to 90 or 91. The report for the second PSG in 2017 doesn't give details, just says the minimum was 89% and zero at 88% or less. A watchpat study late 2018 again had very little detail, just that there were 117 events with 4-9% desat, and a handful of desats under 90%. Apparently the powers that be don't consider anything equal to or above 90% to be a problem.
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RE: Replaced my ASV, not happy, need help
Talked to my dr last night. I'm on the border for supplemental oxygen but do qualify, and she thinks it's worth a try. I'm currently in North Carolina and going home tomorrow; the oxygen concentrator will be delivered on Friday. I have noticed here in NC that the air feels better and it's easier to breathe being at sea level instead of 5400 feet. Also the minute ventilation on my Oscar reports is averaging above 5 instead of the low 4s. It's too short a stay to see if I feel any better -- also been very active visiting etc so am tired anyway.

I looked at the wiki article on concentrators and the calibration info seems way too technical for my brain. Presumably the DME will calibrate it for me? I also seemed to pick up that XPAP machines somehow decrease the amount of available oxygen beyond what room air is, did I get that right? I'll be very interested to see if the extra oxygen makes a difference (and hoping it does).
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RE: Replaced my ASV, not happy, need help
(12-10-2019, 07:10 PM)bemused Wrote: I looked at the wiki article on concentrators and the calibration info seems way too technical for my brain. Presumably the DME will calibrate it for me? I also seemed to pick up that XPAP machines somehow decrease the amount of available oxygen beyond what room air is, did I get that right? I'll be very interested to see if the extra oxygen makes a difference (and hoping it does).
I believe you misinterpreted it.  It is physically impossible to get O2 lower than room air.
Because of the airflow of the xPAP and the intentional 'leak' of the mask, for a given flow of supplemental oxygen, the amount of O2 delivered with an xPAP will be lower than that delivered without xPAP.  This 'loss' will vary depending on the intentional leak from the mask, and thus mask 'type', and the therapeutic pressure being delivered by the xPAP.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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RE: Replaced my ASV, not happy, need help
Hope the oxygen supplement helps. They should have some tech set-up the oxy device, mainly 2 aspects as I recall, pulse or continuous and how many Liters per minute it delivers. Note these can connect to your xPAP machine via a hose with oxy bleed if wanted/ needed.

I'm above medical necessity for oxy supplement for now at occasional 92%. If I hover there for long, I am having a bad day. I was recently told that going forward from now, if I ever test an 88% oxygen on the SP02, I'm getting oxy.

Best to your success

lots-o-coffee
Dave

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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: Replaced my ASV, not happy, need help
I wrote a wiki article on oxygen bleed for CPAP. I get into some details that might be nod-worthy, but it may help you to know how it works and how it is calculated. http://www.apneaboard.com/wiki/index.php..._with_CPAP

Your higher altitude makes a considerable difference. I am certain you will find supplemental oxygen therapy makes a big difference, and I predict your doctor will prescribe 2-L/min. So you can read the wiki and understand just what that means for the oxygen concentration you will be breathing.
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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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RE: Replaced my ASV, not happy, need help
The oxygen concentrator was delivered Friday night. We set it up in the closet so as to keep noise down. That night I went all the way through without waking for more than a few minutes -- and no trips to the bathroom, which is practically unheard of. I was somewhat taken back (and dismayed) to see that I gained something like 5 pounds overnight -- no clue what that was about. But Saturday I went all day without a nap and only some mild sleepiness around midday. Went for dinner with friends and actually managed to stay awake.  So far so good except for the weight part.

Night two was a different story. I woke about 3:00 with my nose running like crazy -- went through about 20 tissues in short order, and was close to wheezing -- actually was scared enough to consider going to ER for a few minutes. It took two benadryl and about an hour for my breathing and heart to settle down. I've been miserable with allergies before but never scared -- this was the worst attack I have ever had. Ironically I just started allergy shots this week -- I am basically allergic to anything that grows. My hypothesis is that the machine pulled in pollen from shoes and clothes and the carpet in the closet and pushed a massive high pressure dose up my nose. My husband has what I think is a screwball theory that the oxygen somehow aggravated an attack that was already happening which makes no sense to me. I haven't had a nighttime attack in ages and it just seems too coincidental to have one now.

So. I moved the machine out of the closet and called the DME to get replacement tubing as I don't think there's any way to purge the one I have. I also cleaned the mask, tubing and filter -- let them soak for close to an hour with Dawn and warm water. It being Sunday the tubing won't come till tomorrow, so will forego oxygen tonight but try it tomorrow and see what happens. The good news is I was sleeping great up until the attack, and the chart looks so pretty:
   
Oh, and that five pounds went away, too.

Have you ever experienced or heard of anything similar? Does my hypothesis ring true? I am wondering if I should post a separate thread?
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RE: Replaced my ASV, not happy, need help
Looks really good, and it's a relief to know you're getting better sleep and assured oxygenation. Hard to actually connect the dots on the congestion and allergy attack, but that will hopefully settle down.
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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