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RE: Introduction - Sleeprider - 01-13-2021
Knitman, my comments are not polished to political correctness, and I have no dog in the fight with regard to NHS. I'm up to my neck in frustration over our own bureaucracy, and particularly as it pertains to durable medical equipment. We have a number of members from UK and let me balance what you perceive as my criticism, with a very very positive story of the NHS. I think you will find this to be a great read with a fairy tale outcome. It happened in spite of my low expectations. http://www.apneaboard.com/forums/Thread-9-year-olds-uncontrolled-apneas-on-bipap? Hope you enjoy, and congrats on your new machine. It will actually respond preventively to your particular issues, and I think you will find it more comfortable, however I hope you will indulge us with some patience and even fallibility. I just do the best I can with the experience I have working with members here.
RE: Introduction: Peace/info - Knitman - 01-14-2021
That story is amazing. Good for you but most especially for mum and child.
I do appreciate you are very well informed about SA and it's treatment but not about the NHS and you even brought it up in this story, and with inaccurate information. The lady didn't correct you because 1. she was too polite and more concerned with her child 2. is ignorant of the facts. (Many people are. Our white population is 95%. Many will tell you it is far far less.) The correction is that we can choose where and by whom we are treated. A lot of people do not know this. It is sadly a very British trait to 'not make a fuss' and to still think of Drs and the like as well above them so they wouldn't dream of having a second opinion. My neighbour is a very good example. I diagnosed her and told her bluntly her Dr was wrong and told her why and armed her. She got the right diagnosis and treatment.
I want a second opinion re my CHF. Not because I don't have it, I do, but I fear I am not being treated properly. My cardio seems to think his job is over with me. My pain Dr who is also an anaesthesiologist Is this something you know about? I understand your father had this and I apologise in advance if this is too close to home for you.
Anyway, reading her story made me worried I have bought the wrong machine. Have I?
It is an Airsense 10 auto. Would you care to suggest settings? Is it an ASV?
I was looking back at my readings January last year and some nights I had high, very high, Hypops and no OA or CA.
I seem to get OA/CA about the same but more often CA. The CA was often remarked upon by my husband over the years.(40 of them). Last night he got up and came too close around my side so of course my CPTSD reacted and I lunged at him. However, her heard me making breathing sounds and I do not know how but I had switched off the machine between 3:13am and 4:17am. I have no recollection of doing that. Nor can I think why I would. I love my machine.
Anyway, I have the machine and will use it tonight or if I go for nap.
kindest regards
colin
RE: Introduction - Sleeprider - 01-14-2021
ASV or the CS Pacewave in Europe is a technology capable of treating mixed and central apnea. I think I described how it functions in the other thread. I have not noted central apnea as a common feature of your therapy results, however the ASV is capable of treating obstructive apnea, central apnea, hypopnea, periodic and cheyne-stokes respiration. The cautionary note is that a 2015 study determined a health risk for individuals with congestive heart failure with left ventricular ejection fraction less than 45% (SERVE-HF). A newer study (ADVENT-HF) appears to refute the SERVE study and indicates that ASV is an appropriate and safe therapy for CHF patients, and the problems with the previous study related to failure to properly titrate the machine and supervise compliance.
If you indeed have a reasonable expectation of having central or complex apnea, and take advantage of the capability of the ASV to even out respiration to maintain a steady tidal volume and minute vent on a breath to breath basis, that is something we can talk about in more depth. Read the ASV section of this document https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: Introduction - Crimson Nape - 01-14-2021
The AirSense series is Resmed's regular CPAP line. The Autoset model allows for a variable pressure range setting. The Bi-level and ASV models are in the Resmed AirCurve product line. The pricing structure for Resmed units seem to be, set a price for the base model and just double it for each model above the previous one. The last statement was said in jest, but not far from the truth.
In a previous post you mentioned coughing up blood into your mask; I was wondering if using a nasal or nasal pillow type of mask may be a better option for you. It would allow for easy access to your mouth during these events and negate having to stop and clean the mask. Any mouth breathing could be addressed with a chinstrap.
Good luck!
RE: Introduction - Knitman - 01-14-2021
(01-14-2021, 10:42 AM)Crimson Nape Wrote: The AirSense series is Resmed's regular CPAP line. The Autoset model allows for a variable pressure range setting. The Bi-level and ASV models are in the Resmed AirCurve product line. The pricing structure for Resmed units seem to be, set a price for the base model and just double it for each model above the previous one. The last statement was said in jest, but not far from the truth.
In a previous post you mentioned coughing up blood into your mask; I was wondering if using a nasal or nasal pillow type of mask may be a better option for you. It would allow for easy access to your mouth during these events and negate having to stop and clean the mask. Any mouth breathing could be addressed with a chinstrap.
Good luck!
Thank you kindly.
bleeding from my mouth is not a normal occurrence but is likely to be over the next few months as every 3 weeks I will have more extractions, 3 at a time. Done like this because of my other problems. I have also just realised as I type that Claudia is the first female dentist I have ever seen and I have issues at all in keeping my mouth open and gagging. I did not live in the UK until I was 17. Fillings were done without anaesthesia!
The last dentist I saw was a man in 1994. He slapped me. Yes I did write that. I was clearly very nervous and he hurt me and I reacted by moving and he slapped me and told me to keep still. Being the good boy I was taught to be, I did as I was told and he carried on. It was years before I realised he had abused me and I could have reported him. Not even the nurse said anything.
Back on point, use Dr Dakota's memory foam neck do dah. It is very comfortable and it keeps my gob shut. A miracle.
No more dry mouth. If I have just a nose mask, how would I breathe out? No, I'm not that stupid. Just realised; the same as I do now. I have not even heard of the AirCurve so will take a look but would I need it? Sleeprider will know the answer to that.
RE: Introduction - Sleeprider - 01-14-2021
Regarding nasal therapy, if you exhale from your mouth, it won't work for you.
In the Resmed lineup, the current CPAPs are all Resmed Airsense 10, and the models are CPAP, Elite and Autoset.
All bilevels or BiPAPs are Aircurve 10, and the models are VPAP S, Vauto, ASV, ST and ST-A. In Europe different names may be used for models, like CS, CS Auto, CS Pacewave. The Resmed Titration Protocol document I linked before provides a complete description of the intended use and function of each of those machines.
RE: Introduction - Knitman - 01-14-2021
According to what I have read an hour or so ago, ASV is not for me because of my CHF.
Am I confused about Central Apnea and Clearway Apneas being the same?
I have set up the machine. I have done a mask fit. I have to say this machine is very quiet and I thought I had not done the mask fit part right as I could hardly feel it and it said GOOD.
I am not at all sure how I should set the pressure. leave it from 4 to 20 or from 11-20 as my Dreamstation ?
I think that is about all.
Oh, thee app doesn't appear to an app but a web page either on my laptop or my phone. Also, what info will it give me? Or is letting Oscar read the card the best way to go?
kindest regards
RE: Introduction - Sleeprider - 01-14-2021
The Autoset will tell us things in your chart we couldn't see with the Dreamstation. I think for initial setup, start at 10.0 minimum, 16.0 maximum and EPR full time at 2. The app is MyAir, and will track hours usage, mask seal, events per hour, and number of sessions as Mask On/Off. It will give you a history graphically. Strictly summary information and not very useful to us on the forum. Keep using Oscar.
RE: Introduction - Knitman - 01-14-2021
Thank you, Sleeprider. Is there a reason to put the top number at 16 and n ot 20? Have gone over the 16 mark several times.
I am glad I can still use Oscar because I was thinking the info on the webpage was minimal.
The only My Air app I can see for my android phone is for the Airsense mini. The only I have found so far is opening the MyAir webpage, sign in, and my info can then be seen. It has reported that I used when I was doing the mask fit.
I will post what Oscare says tomorrow after a sleep.
kindest regards
RE: Introduction - Sleeprider - 01-14-2021
If you can handle the potential to reach 20, that's fine. I often limit top pressure for people not accustomed to it, and until I see a need for it. As I said before, the Resmed will show us some clues that we didn't have before, so it may be interesting to lift the curtain on that variable breathing, and see if there is anything to it.