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Seeing Doctor Tuesday
#11
I have written down a few questions to ask my doctor Tuesday ..
The foremost one will be whether he will change any of my setting ..
don't foresee him lowering any of them ..

another would be if IPAP is allowed to go higher, what is the risk to my lungs and what danger signs should I be watching for? (Thanks vsheline ) .. It felt like I had over inflated my lungs at the beginning when the pressure was set to its max .. and don't want that to happen again .. I had a collapsed lung thirty some years ago and that is always on the back of my mind !! If I were to have another one Dr would have to staple it to my chest wall which is something I want to avoid !! If at all possible !

Question about my O2 levels staying between 97% and 98% during the night going up to 99% for a few seconds .. Is this too high a level and if so what to do to alleviate it or to reduce it to a safe level if its too high ??

If doctor wants to change my machines Mode from ASV to Auto ASV what would an example be of my settings if they are 4-3-8 now in the ASV Mode?? I'm guessing he would want to increase the pressure if he did change Modes on me !

If any other questions I should ask come to mind please let me know .. I'm interested in how my doctor will respond and what he has to say about my results so far. This will be our first meeting since started therapy .. I had a CT Scan of my lungs last week as a follow up to my last visit which was also my first .

All help is greatly appreciated to all that have responded with suggestions and information . This is a whole new world for me !

Thank you to all who help all of us new users .. I really don't know what I would have done if I wouldn't have found this this forum !! THANK YOU !!
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#12
Clarification on my duragesic pain patch .. For those who have never worn one and I really hope you never need to !! There is a slight decrease in my level of medication as the old patch reaches its end life 68-72 hours and when I put a new one on and it effectively starts emitting medication through my skin of 2-4 hours .. so there is a slight reduction in medication and thus a increase sometimes of my pain level until things level off again .. I figure that is around a 3-4 hour window that can have me walking the floor to relieve my back pain some nights !!

When I say it is effective till the 68 to 72 hour mark is because body heat makes a big difference in how fast it is absorbed through my skin. Being out in the sun during the summer can reduce the number of effective hours by 1 or 2 hours .. even a very hot shower will do the same .. or the use of a heating pad .. that is because it causes increased absorption above what is normal .. A high fever results in me removing it because the increase could be life threatening if a much larger amount is exchanged over a number of hours ..
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#13
(10-26-2014, 02:00 PM)Whitewabit Wrote: If doctor wants to change my machines Mode from ASV to Auto ASV what would an example be of my settings if they are 4-3-8 now in the ASV Mode?? I'm guessing he would want to increase the pressure if he did change Modes on me !

If any other questions I should ask come to mind please let me know.

Can you get him to compare/contrast a bit between ASV and ASV Auto mode so we can understand what the different outcomes might be? Why would one move from one to the other? Does ASV Auto give us more control over pressures, especially IPAP? Why did he choose to start you out on ASV and not ASV auto?

Later on I want to 'grill' Vsheline on this topic as well, he's the real expert from what I can see. But I'd like to hear what your doctor says in the meantime.
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#14
(10-26-2014, 05:40 PM)PhyllisBalboa Wrote:
(10-26-2014, 02:00 PM)Whitewabit Wrote: If doctor wants to change my machines Mode from ASV to Auto ASV what would an example be of my settings if they are 4-3-8 now in the ASV Mode?? I'm guessing he would want to increase the pressure if he did change Modes on me !

If any other questions I should ask come to mind please let me know.

Can you get him to compare/contrast a bit between ASV and ASV Auto mode so we can understand what the different outcomes might be? Why would one move from one to the other? Does ASV Auto give us more control over pressures, especially IPAP? Why did he choose to start you out on ASV and not ASV auto?

Later on I want to 'grill' Vsheline on this topic as well, he's the real expert from what I can see. But I'd like to hear what your doctor says in the meantime.

Phyllis .. good questions !! thanks .. Agree Vsheline seems to be well versed on the ASV machines and how they work .. seems the three of us are closely suited I that we have the same machines with the same problems .. though we are new at it while he has more experience !!

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#15
A bit of a set back as my AHI last night was 7.58 and had all of the events after sleeping 2 1/2 hours .. The first 2 hours and 34 minutes was very peaceful no apnea's or hypopnea's and then after that the rest of the night was full of them !! 56 to be exact ! all in the last 5 hours of sleeping as slept 7 hours and 23 minutes . the longest I have slept in a very longtime - Months or more !!
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#16
looking again at last nights numbers and there were 5 registered before I feel asleep and 2 with 90 seconds of waking up .. still my AHI is 6.62 if I were to minus them out .. much worse then the 2.5's I have been having all the previous week !!

Somewhat disappointed in this .. and am wondering now what the doctor will say tomorrow morning when I see him .. and if he will change the settings on my machine ??

Will be interesting to see if my numbers return to what they had been or stay at this new level tonight .. I haven't used any additional medication today and did my normal 20 minute 1 mile walk .. I do this 6 days a week weather permitting then go to the mall and walk !!

My pain level rose during the night but wasn't enough to wake me and warrant me taking my break-out medication .. but seems was enough to interrupt my sleep cycle enough to cause a large increase in my hypopnea's !!
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#17
Wabbit,

I know that you know this but do not let the small, temporary reversals get you down. I am having some of the same reactions with my therapy right now and I get a little disappointed on days when my results are not as good as other days but I keep telling myself that it is still a lot better than it was before CPAP.

I have been using a medium sized Mirage Quattro and having good results except for dry mouth. The medium is a little big on my face and tends to push my mouth open which allows air through and dries my mouth.

I felt that the small might be a better option. I finally got one and it is helping the dry mouth but the AHI and the leaks have increased. Leaks are still well under the red line but with occasional excursions above it. It is good enough. My 95% leak rate is still well below the redline. It just bothers me that I can't get rid of the flyers. My AHI is much more variable than it was with the larger mask. Still stays under 5 most of the time but it used to stay under 1 all of the time.

It is just very frustrating. I know how you feel but you must stay positive. Do not look at an occasional increase as a failure but merely as another step down the road. Sleep-well

Best Regards,

PaytonA
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#18
Another bad night with AHI up to 5.6 .. but it is down from yesterdays ..

Saw my doctor this morning and he doesn't want to change anything as I have been able to use it now with the present pressure settings .. wants me to get more acclimated to it as it seems I am now doing .. Have only used it 20 days .. will see him again in a couple of months .. told me if my AHI raises to call and get an appointment sooner but at what they are now .. he wants to see if they stabilize and wants more then 20 days worth of info to judge anything .. but thought we were at a good starting point considering my pain and pain medication effects on it !!

Have been keeping a log on my pain and can see that my apnea's increase as my pain level does !! The nights when I am relatively pain free my AHI has been around 2.0 .. It may be that when my pain increases my apnea's will increase and other nights they will be much lower .. and will have to live with that ..

It will be and is better then before I was being treated .. I do believe I feel the effects of the CPAP the past few days .., and it is a better feeling .. just now to reduce it or to reach a workable level !!
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