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Therapy Questions, EPR, CA, Low O2
#91
RE: Therapy Questions, EPR, CA, Low O2
Your results are good, but without knowing how your oxygen levels are impacted, the key piece of information is missing. You don't have an apnea problem, but you seem to have a problem with desaturation, even without the apnea.

As far as burning your lungs, you are certainly aware that 90% of members here use higher pressures than yours, and many use pressure exceeding 20 cm. I don't think burning your lungs is much of a concern. Any RT should know the uses of pressure, and the significance of Positive End Expiratory Pressure (PEEP) on oxygenation, as well as the impacts of pressure support upon pulmonary expiration. The ones you work with continue to defy this expectation. I think you should consider buying a recording oximeter like the CMS-50F from Supplier #19. It's not the most elegant unit, but affordable, and will give you the information needed to either pressure your doctor for a better solution, or set your mind at ease that your oxygen saturation is okay.
Sleeprider
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#92
RE: Therapy Questions, EPR, CA, Low O2
(09-07-2019, 11:12 AM)Sleeprider Wrote: Your results are good, but without knowing how your oxygen levels are impacted, the key piece of information is missing. You don't have an apnea problem, but you seem to have a problem with desaturation, even without the apnea.  

As far as burning your lungs, you are certainly aware that 90% of members here use higher pressures than yours, and many use pressure exceeding 20 cm.  I don't think burning your lungs is much of a concern.  Any RT should know the uses of pressure, and the significance of Positive End Expiratory Pressure (PEEP) on oxygenation, as well as the impacts of pressure support upon pulmonary expiration.  The ones you work with continue to defy this expectation.  I think you should consider buying a recording oximeter like the CMS-50F from Supplier #19.  It's not the most elegant unit, but affordable, and will give you the information needed to either pressure your doctor for a better solution, or set your mind at ease that your oxygen saturation is okay.

Yes, I am looking at getting the CMS-50F.  Am hoping to get this oxygen issue settled soon.  I know many members have expressed how the higher pressures have helped them and I was really hopeful that higher pressure would help me, too.  Don’t know why PEEP didn’t help my desats at the 8 min/12 max/EPR 3 setting, but at least I tried it several nights.  I’ll get back with y’all once I have charts to post with O2 therapy!
"Freedom is the oxygen of the soul."
Moshe Dayan
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#93
RE: Therapy Questions, EPR, CA, Low O2
I hope your O2 therapy is supported by insurance as it seems to be splitting hairs to deny such coverage. All we can do is try to support your efforts to make that happen, and you certainly gave CPAP every opportunity to be effective, including using the best possible machine. I just feel you medical team has been unsupportive or incompetent, in getting you the help you need. I wish this problem was uncommon.
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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#94
RE: Therapy Questions, EPR, CA, Low O2
Get the CMS-50 and post those charts.
They will not be accepted by your medical team as fact because your meter is not a part of their validated equipment but it should be enough to at least get a full night study done.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#95
RE: Therapy Questions, EPR, CA, Low O2
   


Bought an Invacare O2 concentrator yesterday with only 2500 hours on it (Medicare didn't work out and I own this machine).  Here is last night's sleep chart below with 2Lpm O2.  Not sure how to read these sleep charts because I can't tell if higher or lower readings are best for the different categories.
"Freedom is the oxygen of the soul."
Moshe Dayan
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#96
RE: Therapy Questions, EPR, CA, Low O2
Your AHI is low, which is normal for you, so the low pressure of 6 with EPR 1 is working as expected. Your tidal volume, respiration rate and other statistics are unchanged as compared to before oxygen. The only way to know if your SpO2 has improved is if you monitor using an Oximeter. It's safe to say that at 2-L/min oxygen, you are receiving more O2 at the mask, which should compensate for your low respiratory volume. In time, you should "feel" the benefits of the oxygen, and that may be the most important measure.

You may want to read the Oxygen Bleed With CPAP wiki http://www.apneaboard.com/wiki/index.php..._with_CPAP
From the Wiki you can see your nasal pillows mask flows about 24 L/min at 6 cm pressure gives you a mask O2 of 27%, compared to atmospheric oxygen of 21%.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#97
RE: Therapy Questions, EPR, CA, Low O2
(09-13-2019, 11:06 AM)Sleeprider Wrote: Your AHI is low, which is normal for you, so the low pressure of 6 with EPR 1 is working as expected.  Your tidal volume, respiration rate and other statistics are unchanged as compared to before oxygen.  The only way to know if your SpO2 has improved is if you monitor using an Oximeter.  It's safe to say that at 2-L/min oxygen, you are receiving more O2 at the mask, which should compensate for your low respiratory volume.  In time, you should "feel" the benefits of the oxygen, and that may be the most important measure.

You may want to read the Oxygen Bleed With CPAP wiki http://www.apneaboard.com/wiki/index.php..._with_CPAP
From the Wiki you can see your nasal pillows mask flows about 24 L/min at 6 cm pressure gives you a mask O2 of 27%, compared to atmospheric oxygen of 21%.

Sounds interesting.  l’ll read the article tomorrow.  Since the finger oximeters can only give an O2 reading at the time it is accessed, there’s no way of knowing how low my O2 dropped during the night or for how long.  At some point, I’ll get an overnight oximetry test, so that should give more info.  I was disappointed that I didn’t see a marked difference in last night’s chart with getting 2L of O2.  Have no idea why.  Maybe tonight will be better.
"Freedom is the oxygen of the soul."
Moshe Dayan
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#98
RE: Therapy Questions, EPR, CA, Low O2
(09-13-2019, 11:40 PM)kingskid Wrote:
(09-13-2019, 11:06 AM)Sleeprider Wrote: Your AHI is low, which is normal for you, so the low pressure of 6 with EPR 1 is working as expected.  Your tidal volume, respiration rate and other statistics are unchanged as compared to before oxygen.  The only way to know if your SpO2 has improved is if you monitor using an Oximeter.  It's safe to say that at 2-L/min oxygen, you are receiving more O2 at the mask, which should compensate for your low respiratory volume.  In time, you should "feel" the benefits of the oxygen, and that may be the most important measure.

You may want to read the Oxygen Bleed With CPAP wiki http://www.apneaboard.com/wiki/index.php..._with_CPAP
From the Wiki you can see your nasal pillows mask flows about 24 L/min at 6 cm pressure gives you a mask O2 of 27%, compared to atmospheric oxygen of 21%.

Sounds interesting.  l’ll read the article tomorrow.  Since the finger oximeters can only give an O2 reading at the time it is accessed, there’s no way of knowing how low my O2 dropped during the night or for how long.  At some point, I’ll get an overnight oximetry test, so that should give more info.  I was disappointed that I didn’t see a marked difference in last night’s chart with getting 2L of O2.  Have no idea why.  Maybe tonight will be better.

For about $100 you can get a recording oximetry. Look for the CMS 50F as one of the more comfortable ones. The Data can be imported into Oscar and be plotted in the graphs with your APAP
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#99
RE: Therapy Questions, EPR, CA, Low O2
See Supplier #19 for the recording oximeter Jaswilliams mentioned. May members use a recording oximeter and can post charts that include pulse and SpO2.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


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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