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[Diagnosis] New diagnosis, in shock
#21
RE: New diagnosis, in shock
(02-03-2020, 12:25 PM)Dormeo Wrote: But no way Kaiser/Medicare would cover the cost of the Vauto, so I bought a lightly used machine from a trusted on-line seller.  Before I made the switch, I asked for a copy of my prescription for masks and other peripherals so I could use an online CPAP supply place.  If Kaiser ever looked at my compliance data for my original machine, they would probably want it back, but they apparently don't look after the initial compliance period.  So I'm keeping it as a back-up machine.

More information than your really need, but I hope it is of some help.

Thanks, very helpful to get a sense of how the Kaiser system works.  How long was the "initial compliance period", do you know?
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#22
RE: New diagnosis, in shock
CPAP devices are passive. they do one thing, and that is splint the airway open with very little pressure.  
There is some variation with CPAP, up to 3cmw, between inhale and exhale, for "comfort".

 How much pressure?  Let's do an experiment OK?

Get a tall glass of water and a straw.  With the straw near the bottom of the glass blow bubbles.  Assuming the glass is 8 inches full that was as much pressure as your CPAP is capable of producing, 20 cmw.

The point is this is not enough pressure to inflate a balloon.  

The machines you describe are "ventilators"  and are pre-CPAP
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#23
RE: New diagnosis, in shock
(02-03-2020, 05:01 PM)Silverwitch Wrote:
(02-03-2020, 12:25 PM)Dormeo Wrote: Thanks, very helpful to get a sense of how the Kaiser system works.  How long was the "initial compliance period", do you know

I had reviews from the technician at one week, one month, and 90 days, I believe.  Nothing after that.  I'm not sure what was driven by their protocols and what was driven by Medicare.
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#24
RE: New diagnosis, in shock
(02-03-2020, 04:43 PM)Silverwitch Wrote: Can you point me to a good explanation of how on earth one exhales against pressure in the first place?  

Another way to think of it is to picture walking outside on a windy day.  You can still inhale/exhale even in a strong wind.

Looking at at the numbers only, a typical xPAP machine can be set to a range from 4 cmH2O to 20 cmH2O. 
4 cmH20 = 0.057 PSI
20 cmH20 = 0.284 PSI
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#25
RE: New diagnosis, in shock
[attachment=19891]
Had my first appointment today following sleep test a couple of weeks ago showing severe sleep apnea.  Was given a loaner AirSense 10 autoset10 and respironics dreamer nasal mask to start using tonight, with an oximeter since my oxygen was low at times during the sleep study. I don't know the settings -- will have to fool around with the machine to find the screen showing that information. I have a return appointment in a week at which time, if this machine works out, I will be given my own AirSense autoset10. Also was given a copy of my sleep study report.  The font is pretty small but hopefully you can read it.
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#26
RE: New diagnosis, in shock
I was an insomniac who couldn't nap and never snored. 

CPAP has been such a gift for me!  It has improved my quality of life significantly, and I am no longer an insomniac.
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#27
RE: New diagnosis, in shock
(02-01-2020, 03:00 PM)harrywr2 Wrote: At least in the Greater Seattle area Kaiser is standardized on Resmed.
Interesting.  When I got mine from Kaiser Santa Clara 12 years ago they were standardized on Respironics.
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#28
RE: New diagnosis, in shock
Silverwitch,
   Welcome to the club. I was also surprised at my diagnosis. I am a 60 yo male who took a home sleep test because my partner told me that I was snoring.  I came back with an AHI around 17.  I have felt great when I use my CPAP machine.  I do want to get my AHI numbers lower (around 3 or so) but I should be more compliant with masks, etc.  As a result my bp is slightly down and is my pulse rate. I do not wake with nocturne anymore and generally feel better.
       I describe the shock as similar to first getting eyeglasses.   You might think print is getting smaller or feel a bit of strain. I used my partner s reading glasses and then got an exam and the difference in getting reading glasses  prescribed was tremendous. I did not know what I was missing.  You will likely find the same with your cpap machine.
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#29
RE: New diagnosis, in shock
As a former California Kaiser member who went to the Novato Sleep Apnea clinic because my experience wasn't so great with Apria, I found the Novato clinicians to be very helpful. You know, with Kaiser you kind of have to be a squeaky wheel to get the service you need but it's there so be persistent until you are satisfied.

This is just me, but I avoided a CPAP machine for years through my wife's complaints that I "held my breath when I slept" and at 58 I have advanced heart failure. I guess we're all preaching to the choir here, but sleep apnea is no joke. It may take some getting used to, and mask fitting is really important, but you can and will adapt and you'll never sleep without it.

Best of luck to you!
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#30
RE: New diagnosis, in shock
After a one-week trial on the Resmed AirSense10 I am happy to report that it has been very successful!  Every day I felt good, rested. Even with the novelty of the machine and mask I slept soundly through the night, awakening only once to go the the bathroom and easily falling back to sleep. I was able to tolerate being on the machine for 8 to 9 hours a night.  I was wakened occasionally when the pressure increased and/or the respironics nasal mask went askew but was able to get back to sleep. (I am getting better a adjusting the mask to prevent it from slipping.) For someone who has struggled with sleep for many years, this feeling of being rested is quite a gift. 

Today I had a visit with the Kaiser technician and was given my own ResMed AirSense10.  The tech shared with me the report on my week of sleep. My AHI was 5.7, quite an improvement over the 41 recorded during my sleep test.  My oxygen levels had been abnormal during 13% of my sleep test, but on the machine they were normal the entire time. Two numbers on my report that I didn't notice in time to ask the tech about were the Central Apnea index of 4.0 and obstructive apnea index of 1.4.  There's nothing on the report to indicate normal values for these measurements.  Does anybody know? Are the values ok?

I suppose my values could be improved (and perhaps they will improve as I get better at managing the mask and sleeping through pressure increases), but given the very positive initial response, do I really need to be concerned about making improvements? In other words, is it good enough from the perspective of protecting my health?  I hesitate to get involved in Oscar type microanalysis if I'm already close to being successfully treated. Any risks that anybody can see of my simply relying on the dumbed-down reports provided by the AirSense app? 

I want to give credit to Board participants for helping me achieve this initial positive result. Your acknowledgment of difficulties you've had and your encouragement made me feel I could manage this kind of weird and unexpected life change. In addition, Board resources enabled me to learn a lot about how to manage the equipment and deal with odd things that happen like having a bolus of air explode in your mouth while you're sleeping. That would have really freaked me out if I hadn't been warned! So thank you all.
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