[split] Therapy Questions

[nativedancer]

thanks sgearhart, i had wondered about the time element myself, and i will certainly give it a try.

[nativedancer]

well, the shave didn't help. terrible leaks. i called dme this morning and tried to order a new mask. dme says medicare won't cover until july. they are sending a new cushion and advise it should be changed monthly. first time i've heard that; could have saved a lot of concern, maybe, if i had known earlier. but the new cushion won't arrive for a few days, so i'm stuck in park until then. meanwhile, i'll just tighten the straps and say an extra prayer or two. i did install sleepyhead, but can hardly bear to look at last night's results. more as things develop ...

[nativedancer]

hi, retired guy. i didn't mean to ignore your reply, simply overlooked it. The numbers under cpap were very good, the best i had experienced: very first night AI .3, AHI 3.6, LEAK 15. And things continued that way for the entire week, until dme sent me back to the initial pressures. Not having any software at the time, and mostly ignorant of my s9 itself, I was unaware of any further numbers.

I am grateful for your response, and I hope I can squeeze out a few more good readings before my cushion gives out completely.

[Sleepster]

The person at the DME is misinformed. That 90 days is for routine replacement. A new user is entitled to try different masks. Call them back and explain that if they don't cooperate you'll take your business to another DME and you'll report them to your doctor's office.

As far as the nasal pillows only lasting one month, well, they last much much longer than that. For some reason Medicare has that as their standard replacement schedule and all other DME's in the US follow it. Other countries have replacement schedules similar to ours for hoses, masks, filters, and water tanks. But not for nasal pillows because they really do not need to be replaced anywhere near that often.

Yours are leaking because they don't fit you right or your straps need adjusting. Call your DME and arrange to go in for a mask fitting. Bring your mask and your machine with you. When they can't get your to fit, they'll exchange it for something that fits your better.

This is a very common problem and it's expected that it will occur.

[nativedancer]

Hi sleepster. last night, against my normal practice, i made the straps much tighter to see if it would help. lo and behold, the leak was essentially zero. i checked with sleepy and there were a few insignificant, momentary leaks, which confirmed that the thing was working, and all the numbers came down a good bit, AI 13.6, MV 6.6, AHI 15.6. These are nowhere near where I want them to be, and i am grateful for your advice re a new mask. i'll certainly look into it.

[DeepBreathing]

Hi Nativedancer. The received wisdom is that the straps should not be too tight and the mask will "float" above your skin like a hovercraft. In my experience that's rubbish. It is only by tightening the headgear substantially that I could get my Quattro Air to stop leaking. I now have strap marks on my face each morning but they're hard to see among all the wrinkles and I have much less problem with leakage.

[PaytonA]

Amen DB and again AMEN.

The tension needed on the straps is dependent on the pressure and the surface area of the mask. Then there are other things that require additional tension due to the topography and fleshiness of one's face. Prominent cheekbones can make it very difficult for a full face mask or a nasal mask to seal all the way around. Deeply recessed nasal bridge can cause the same or additional problem.

A mask that does not have a rigid frame on which the seals (cushions) fit would be helpful for some folks cheekbone and/or nasal bridge problem mentioned above. I think F&P tried to approximate that with the Simplus Mask. At least those are my thoughts.

Best Regards,

PaytonA

[me50]

your cushions will get some wear on them and not work very well. change them regularly. ffm can have a new cushion monthly. nasal mask and pillows get 2 per month. as others have said, wash your face before masking up, especially if you have oily skin. You can also try a chin strap. I had trouble with ffm from the beginning and was never told about other mask types and chin straps. I finally found someone that cared and I got a wisp and chin strap. I still use the wisp but no longer need the chin strap. Something for you to consider. YMMV

[nativedancer]

Hi Nativedancer. The received wisdom is that the straps should not be too tight and the mask will "float" above your skin like a hovercraft. In my experience that's rubbish. It is only by tightening the headgear substantially that I could get my Quattro Air to stop leaking. I now have strap marks on my face each morning but they're hard to see among all the wrinkles and I have much less problem with leakage.

thanks, deep breathing. it's heartening to read a realistic view of leaks. my experience is similar to yours. one interesting development over the past couple of nights: i changed cushions, moving to one that i hoped had fewer miles on it. sure enough, the change helped, and the leaks went to zero. i was so shocked at first that i thought the s9 had lost its mind, but no, sleepy confirmed the reading. also, AHI fell to 11.3, which allows me a '''''breath of relief," but i won't be really content until i can get under 5.

[nativedancer]

your cushions will get some wear on them and not work very well. change them regularly. ffm can have a new cushion monthly. nasal mask and pillows get 2 per month. as others have said, wash your face before masking up, especially if you have oily skin. You can also try a chin strap. I had trouble with ffm from the beginning and was never told about other mask types and chin straps. I finally found someone that cared and I got a wisp and chin strap. I still use the wisp but no longer need the chin strap. Something for you to consider. YMMV

I appreciate your input, Me50. i tried the chin strap some months back, hoping to alleviate the mouth breathing. i didn't mind the strap, but it didn't do anything for me, so i set it aside. good idea about washing before masking; i'll try to remember.