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UARS
RE: UARS
Tarah, I helped early on when you joined Apena Board. I'm pleased to see you have found significant relief with your surgery and continued use of the Aircurve 10 Vauto. I do recall reaching a point where I didn't feel additional setting adjustments on the bilevel would be productive. I usually resist surgical interventions, but I think in your case, it looked like a viable solution. Your determination to make things work, and your doctor's skill have apparently given you back the quality of life you were looking for. This story won't be lost on the many people that read this forum. Thanks for sticking with it and continuing your story.
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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RE: UARS
Ongoing saga.  I saw my ENT today because I am still having nasal congestion in my right nostril immediately upon laying down.  The nights I use Afrin on the right side are pretty good, the nights that I don't, not so good.  She numbed everything and sprayed a bunch of Afrin up the right side and said that the middle turbinate on the right side is quite large.  She doesn't usually shrink that portion during a turbinoplasty because it doesn't usually cause problems.  But that if I'm congested the moment I lay down, then it's causing a problem.  I do trust her judgement, and she is conservative in her approach.


I will go in on Tuesday for an office-based turbinate reduction on the right side.  She explained it, it sounds kind of gross, but anaesthesia for me is way worse.  She said it's well tolerated in the office.  I will just close my eyes and try to go to a happy place, breathe deeply, and get it done with.  I feel like I am SO close to addressing all the issues that have prevented me from sleeping well for the past 6 years.  Wish me luck!
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RE: UARS
I'm sure you know this but nasal decongestants are only supposed to be used occasionally and sparingly otherwise they cause rebound rhinitis (also called medicamentosa rhinitis).

Dymista helps me and can be used long term. I start getting congested every night before I even lay down, it helps just enough to keep the airways open. Not sure if you have tried it but might be worth asking about if you haven't.

My understanding is that oral decongestants are preferred over nasal sprays for chronic use but I believe they can have more side effects.
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RE: UARS
Thanks for the guidance!  I don't use Afrin much, but the nights that I do, breathing and sleeping are much better. Which is why it is time to address more of the turbinate swelling. I cannot tolerate nasal steroids, I've tried so many times and they give me really bad insomnia. I have also tried oral antihistamines and they also had intolerable side effects.  Currently I use a nasal antihistamine, azelastine, and will continue that indefinitely.  If there is something to try regarding nasal swelling, believe me, I have tried it. Surgical intervention is what has helped.
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RE: UARS
RF turbinate reduction of the middle turbinate yesterday in-office.  It was pretty gross and was uncomfortable/painful at times.  But about a million times better than general anesthesia.  I'm stuffy today, which is to be expected.  
I wanted to post a couple of images for those who don't want to read through my whole story.  The first in May 2019, when I was waking constantly, feeling half dead.  Although the flow limitations look to be in an acceptable range, ,my ENT said it was nearly total nasal obstruction on both sides.  The second image is from last night, so should continue to improve.  Have had septoplasty, cartlidge graft for nasal wall collapse, RF turbinate reduction.


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RE: UARS
The differences are subtle, and unimportant to a sleep specialist, but the difference in flow limit, tidal volume, minute vent and comfort are things medical professionals need to start considering. You have been on quite a long and difficult journey, but it seems to be paying off. Thanks for continuing this thread Tarah.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
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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RE: UARS
Hello all.

I have been working to find the correct settings, given that I can breathe through my nose.  I have been seeing this type of pattern for a while now.  What do you make of it?  It happens during very specific parts of my sleep cycle.  Additionally, it has been feeling more difficult to exhale against the pressure lately.

Thanks for you help, it is much appreciated.


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RE: UARS
Hi, tarah,

my impression and knowing something on your case; Let us try:........ I would increase 0.2 bit by 0.2 bit PS, and observe. It looks to me a ratty/flow limited expiration, basically. It may works!


good luck



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RE: UARS
Hi,
Thanks for your reply.  My min EPAP has been 6.4, PS 4.2.  I turned it down last night because it was just SO HARD to breathe against the expiratory pressure.  Maybe I need to put my ramp back on so I can get to sleep with it.  I'm also going to switch to the Bleep mask tonight because I'm sick of the deep lines on my face from the full face mask.  Do people usually use the same settings when switching to a nasal mask.
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