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Post-radiation changes... help requested - Printable Version

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Post-radiation changes... help requested - REMember - 04-10-2022

The muscles in my throat and the base of my tongue have atrophied significantly following radiation treatments. That changes everything. Giving the S9 VPAP Auto its head, obstructive events are nearly eliminated at much lower pressures. Central events have taken their place, and I can't find any settings that reduce them. My S9 has outlived its motor life, and I no longer trust it. I need a new machine. Recommendations? When is an ASV a good fit?


RE: Post-radiation changes... help requested - Gideon - 04-10-2022

Your OSCAR charts will help us understand what is going on, please post them.


RE: Post-radiation changes... help requested - REMember - 04-10-2022

Will do. I'll start by downloading and getting familiar with OSCAR...


RE: Post-radiation changes... help requested - REMember - 04-10-2022

My S9 requires me to delete the detailed data from the card each time the card is inserted. As a result, I have no data to show you. Only summaries. I'll have to go back to using the S9 to get the data you requested. Why isn't OSCAR showing the centrals?


RE: Post-radiation changes... help requested - Gideon - 04-10-2022

either you disabled them or they never existed in this profile,

and I never heard of an s9 requiring you to delete data to insert it.


RE: Post-radiation changes... help requested - Crimson Nape - 04-10-2022

REMember - The S9 does NOT like the System Volume information file that Windows writes to any removable device.   You will either need to write-protect your SD card before inserting it into your PC, or disable this function.  Here are some files that will allow you to turn it off or back on this option.

Download Link to: System Volume Disable/Enable Zip File

Note: Depending on your version of Windows, this file may not work.  If it still writes this file to your card, let me know.  I will proceed with Plan-B.
One more thing; Some newer USB-SD card readers, to reduce their cost, are not installing the write-protect micro-switch sensor.  Even if you set the write-protect switch on the SD card, your computer may still write this file.

Update: I found the other file and have included it here. You will need to run this file as Administrator in a Windows PowerShell window.

Windows System Mod Utility Download


RE: Post-radiation changes... help requested - Sleeprider - 04-10-2022

If your image with very limited information is accurate, your current pressure is EPAP min 13.6, maximum pressure 16.8, and you are not using pressure support. You indicate most events are central. I hope the next chart is more informative and includes the daily details. I have some thoughts that we need to reduce your pressure, add back some pressure support and make your therapy a lot more comfortable. If you are willing to let me take a "blind-stab" at helping, then my suggestion is as follows:
Mode: VPAP auto
EPAP min: 7.0
Maximum pressure 14.0
PS 3.0

This setting gives you the advantages of bilevel pressure at much lower starting pressures and allows pressure to be raised in response to any obstruction. If central apnea increase, we can cut back on PS or use a high trigger sensitivity, which can really help with low-level CA events. If your airway has atrophied, then obstruction is much less likely, and these lower pressure should provide adequate stent. I wish we had better information to work with, but if you want to give this a try, it can't do much harm. Is there a reason you have not updated your machine? Insurance issues?


RE: Post-radiation changes... help requested - REMember - 04-10-2022

Many thanks, Crimson Nape. I'll give it a try.

I just downloaded OSCAR, and that's the data as displayed. ResScan breaks down the data for that unusual night as an AHI of 1.5 with a central component of 1.5

Many thanks for your help, Sleeprider! I'll set it up that way tonight and get some data. I have no insurance other than SS, and money's tight. I also thought I was sitting on two bricks for backup until I tried to fire them up.

The attachments show some data from ResScan for that same night. Sorry about the poor quality photos.

My history, in a nutshell. I was diagnosed in '96 with an AHI of 107. The next 3 studies all showed AHIs near 120. A post-radiation study showed an AHI of 31. My pressure has been as high as 19.5 in the past, and central events just started showing up in the last few months. I'll be back with some data.


RE: Post-radiation changes... help requested - Sleeprider - 04-10-2022

No revisions in my suggested pressure. You don't have obstructive events, and we need to look at a lower range to increase comfort and the pressure support will help with the flow limits I'm seeing. Good luck!


RE: Post-radiation changes... help requested - REMember - 04-11-2022

Good morning, all.

Here is last night's data. After 26 years at higher pressure settings, a low setting of 7 last night felt very strange indeed.

And locking the SD card worked. Many thanks, Crimson Nape.