New Member, Former DME/Respiratory Tech
Hello to all. First of all, I am so glad that there is a forum for us to visit, discuss, compare notes, and obtain advice.
When I first got out of the Air Force, I had no idea what I would do. My wife and I were married just ten days before I left for basic training. My experience was in electronics and basically HVAC and Civil Engineering. After a couple of jobs that paid the bills, but didn't work out, I was able to secure a position as a Biomedical Technician for a dialysis center. I did this for about 2 years and another 6 months after moving to Austin, TX from Northeast Texas. By that time, we had a 6 month old son and the cost of living was incredible. My wife and I were working 12 hour days and we really did not know the person that was watching our young son. We decided to try to return back to Northeast Texas. I lucked out and was hired as an equipment technician for a Home Medical Company based out of Little Rock. It was a regional DME that was really like a large family. I had no idea what a CPAP machine was. I underwent training at one of our larger stores in Tyler, TX. I learned how to set patients up on home oxygen therapy (oxygen concentrators, liquid O2 systems, etc, setup hospital beds, CPAP, etc). I was the only technician as we were a smaller store. At the time, we did not even have an RT at our location. I had NO idea that I would one day need to use a CPAP. Eventually, after 6 years, I was hired by the largest hospital system in East Texas to manage their HME program. After about 3 years, they decided to stop this program along with home infusion. I finally was hired in Tyler by a new DME national company that had just purchased a Mom and Pop DME. Within the following year, I would gain two more stores. So I had been exposed to all of the new technology for CPAP and BiPAP.
Fast forward to 2011. I had injured my knee just before Desert Storm and was taken off the team that was being inserted for air support, forward air base. When I was discharged, I received a service connected disability due to my injury. For 17 years, I had no problem, however, my knee went totally out in November 2010. Feb 2011, I was about to have surgery and began feeling totally exhausted. My PCP did a work up and found that I had almost NO testosterone in my body. They repeated the test and again it was the same. After my knee surgery, I began taking injections. Fast forward to a year later. My wife and began to notice that my snoring, which I had always snored, had gotten a lot worse, now I would stop breathing for a long time, until she would bump me. I felt totally exhausted so I thought that the Testosterone was no longer working. Originally, I felt like a new person, or rather a teenager again. The results came back and my levels were normal (low normal), however, now my Vitamin D was extremely low. So another prescription. A month of so later, I was not feeling much better so I asked for a sleep study.
I was not sure how I would do in a strange bed, without my wife, with all of the wires and such hooked up to me. I was in bed by 9 p.m. (I usually stay awake until midnight) so I watched TV. Finally around 12:30 or 1:00 a.m. I guess I went to sleep. I woke around 4:30 or maybe 5:00 a.m. I didn't think they got enough data. My appointment with my Pulmonary doc was about two weeks later. He stated I had moderate to severe, however, I know that they did not get as much data as they could have if I truly slept 6 or more hours. Anyway, he ordered a second study and wanted me placed on CPAP and the technician would titrate for the level. I went into the study a little apprehensive. (When I was 5, I had been through a lot. I had severe strep throat from the time I was 18 months old, and they finally decided to take my tonsils out. Back then, they did not explain things to children. I remember then taking me to the OR and transfering me to the table. The next thing I knew, all of these people in masks came at me with this huge, black, rubber mask that had something coming out of it that burned my throat. I kicked and fought, and it took several nurses and doctors to hold me down to knock me out. Even during initial training in the military, when I had to wear full chemical weapons gear-gas mask, etc, I had a slight issue, so I knew trying to sleep with a mask on might be a problem). They ended up going with nasal pillows which I tolerated okay. The problem was, I laid there for 5 hours without going to sleep. My mind just kept racing. They did not get any data. Meanwhile, I continued to feel worse and worse every morning when I woke up. Finally, I reached the Pulmonary docs nurse and asked her if there was not something they could try in my home. They finally ordered an auto CPAP.
I have been setup for two weeks today. The first night, I was using the Resmed Swift LT nasal pillow system. This worked okay for about two nights, then the third night, I was stopped up and could not breath without opening my mouth. Also, I would wear this for about 3-4 hours and then wake up feeling like I could not breath. I decided that I had better try a full face mask. I went in and got fitted. I tried getting used to it during the evening before sleep and would wear it watching TV. I finally was able to deal with the mask and went to sleep. Again, 3-4 hours later, I would wake up and the machine would be blowing extremely hard. It was not a leak. I realized I could see what was happening with my machine.
Here is what, after two weeks the averages are:
Pressure average= 18.0 (max was 19.5) My range set is 5-20
I truly believe that when I approach REM sleep is when I stop breathing. Then my pressure adjusts up and I have a hard time trying to exhale against it and I wake up feeling like I cannot breath or catch my breath. Apparently, my pressure is too high for the nasal pillows because I will eventually open my mouth during the night to try and exhale. I am supposed to take my card in today for the RT to download and read. I am wondering if I might need a BiPap that might help more with what is happening. Any thoughts? (I am sorry for such a long post, but wanted to let you know my history. One more thing, I have NEVER had ANY respiratory issues until about 12 years ago. I suddenly developed walking pneumonia. Since then, I have had it almost every spring. In the military, I worked around a lot of asbestos, and as a biomed tech, I worked with formaldehyde that we used to sterilize the dialyzers (kidneys that each patient used up to 25 times).
I appreciate any suggestions or help!