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(08-14-2019, 02:10 PM)Cruiser Wrote: I went back to the doctor this morning. They have given me another 3-4 week trial with Bipap and a fixed setting of 17/13. Apparently during my titration, this setting produced 0 AHI, while 16/12 produced a number of centrals. I asked the doc why they had breath support turned on, and her reply was 'some of the bipaps do that.' It almost sounded like she wasn't very familiar with Bipap in general.
The test unit I got was a Dreamstation, so I have no idea what it actually translates to.
Tomorrow night, I will pull up my first night in OSCAR to see what happened and post.
Right now, I am thinking I may just get 2 x Resmed's VAuto's. In Ontario, I think one would be fully covered and I would buy the. other at ~$1100.
I can almost assure you that if centrals showed up at 16/12 they will also be equally prevalent at 17/13. I would suggest your doc's expertise with titration is at least equal to her knowledge of bilevel. It would be interesting to see some results, and it sounds like you're using a ST machine.
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.
I went to the doctor on Wednesday. To be honest, I learned that she may not know that much about BiPap, and the RT at the DME may also not be that up to speed. I use the DME right now because it is free and close to the clinic, so I can kill two birds with one stone.
I tried the 17/13 fixed settings the first night, and honestly, I couldn't get used to it. The ramp was set to start at a pressure of 9 which was still pretty high. I was so fed up after trying it twice throughout the night that I went in and reconfigured it to be an AutoBipap. It was much better...
Anyways, last night I managed to get my first full night. I have to say I much prefer to Resmed systems - just the little things on the dreamstation seem to be missing - I cannot put on my mask and just start breathing, it is louder, I have to press a button to start the ramp feature, the water level isn't as easily seen.
This morning, I do have a bit of a headache. Also, I don't feel that well rested. I think some things need to be tweaked...any suggestions?
Be sure to minimize the monthly calendar or we won't see the flow limitation and other results. Looks like a good start, and the maximum pressure was 18.3/14.3 which is slightly higher than your titrated pressure. That does suggest the titration was done well, but the use of auto pressure is certainly easier from a comfort point of view. There is very little OA here, and you might tolerate a starting pressure at 15/11.
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.
Thanks Sleeprider, I will post after tonight. I will look to reduce it min to 11.
Is almost 8% PB normal? I am beginning to wonder if I just buy an ASV and be done with it. New is only $2200 on secondwind...so it would then treat the centrals I am seeing.
You have a history of central apnea, so periodic breathing may be more of a concern, but Philips machines will flag really minor respiration oscillations as PB. As long as the low point of respiration is not also flagged as hypopnea or CA, I don't think it is very significant. So much of this is better seen in a zoomed view to really judge if it is more than a fluctuation.
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.
I switched back to 17/13 last night fixed. I woke a few times with my FFM leaking and woke up tired this morning. The AHI is improved vs the Auto Mode, but I am going to try to see the difference between 17/13 and 16/12 tonight.
The PB was also better when fixed, however, I have woken up a number of times literally confused as to whether I should be taking in a breath or not.
Right now, I am so confused as to whether I should go the APAP route, VAuto, or pushing for an ASV. I know I am technically treated, but it still doesn't feel right.
Quick update - I went back to the doc yesterday. I wasn't exactly enjoying the fixed bipap pressures of 17/13. The test Dreamstation also flagged some nights with Periodic Breathing of up to 15%. I raised this with the doc and she just brushed it off, even after questioning her response. She simply looked at the AHI numbers and brushed me aside on anything unrelated. I feel like that is their definition of treated! She even said I didn't get any on the Resmed Autoset - so no issue - LOL...the Autoset doesn't flag PB. I also mentioned that as I fall asleep, I was almost waking up in a panic as my body didn't know whether to breath in or out for a few seconds. This happened probably 5 times in the week...
Anyways, the doc wrote me a prescription for an Autoset. I went to the DME to pick it up. Wow, are they ever slick in their process. I ended up with a bill of $1k (to be paid by my insurance)...and I am still trying to understand what it included over the provincially mandated price. I think for $700 I got an F20, 6 filters, an SD Card and 'support.'
Needless to say, I got home and found a used Resmed Air Curve 10 ASV for $600. It has 1826hrs, but the lady swears her mother only used it for a few days, but was left plugged in for a few months. Either way, I decided to take the plunge and it should show up shortly; especially given the price. The reason I feel the ASV may help is that I notice a lot of waxing and waning on my graphs but they are not flagged. I figure an ASV will hopefully be able to respond and help me sleep better. I plan to try it a few nights, and if it helps, then it will become my main machine.
I have already taken a number of days off, been 'compliant', and lost more in wages than an ASV and still don't feel significantly better. All my doctor seems worried about is taking away my license if I am not treated to show her good numbers. /rant
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
I'm so glad to hear you're finding your Duck doc and DME are so very supportive in your needs and concerns. Sorry I still can't get the sarcasm font to take effect.
Seriously, I do wish you success that something works better than what you've had so far.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Such a frustrating process. Patients should not know more than their doctors. Or, rephrased, doctors should be ashamed to not know more than their patients (when it's within their specialty).
Good for you for taking this into your own hands.
Although my experience pales in comparison to yours, I can relate. My sleep "doctor" didn't care that I was air-starved and experiencing rainout - that was all perfectly fine according to him, as long as my AHI was low enough for my insurance to pay him.
