AirCurve 10 ST-A

[Matt00926]

You have central apnea and no coexisting respiratory or diaphragmatic illness? Your doctor/insurance is doing you a great disservice. It should be a crime to prescribe an advanced machine like the 10 ST-A to someone who doesn't benefit from it. Especially if your Dr. doesn't even understand it.

I would just look on the forums for a used ASV machine from a reputable seller and call it a day. Vast majority of these docs/companies just want your money.

It was explained earlier in the thread why he did not get an ASV (heart disease with reduced EF) and did get an AVAPS capable device (he needed a BPAP-ST capable device and doc thought he had comorbid COPD).


OP:

Correct Shin, Pulmonologist ruled out COPD since getting ST-A.  (iVAPS was a miserable failure)  The VAUTO I was prescribed prior was, in fact, the better unit for me so far.  ASV is a moot point!

So you did a pulmonary function test and your doc ruled out any restrictive or obstructive defects? That's good news!

[Shin Ryoku]

Shin, I like your new picture.

Shin, I like your new picture.

Proud PAPA?

Thanks . It's an older picture - she's 4 now, but she still sticks right by me .

[zzzZorro]

Still alive here  

Went to the Doc on Tuesday.  He agreed the ST/A was an abysmal failure with the AHI 40-50s it was ringing up and was admittedly surprised the CPAP-mode had gone down into the 4s.  He was very apologetic and said in all his years he has only had a couple cases where he had to move backward on machines.  Theory of breath support was well worth a try but was of zero use to me.  So, I'm back on the ResMed 10 VAUTO I had prior to the 'BRUTE' (ST/A).  It is pathetic the path the 'Gummit sends those of us upon who are denied the correct equipment- but that's beating a dead horse.

It will be good to get the ability to differentiate between C/A-O/A instead of just registering U/A (unknown) and to get the algorithms back the BRUTE lacked.  Last two nights was on the ST/A in CPAP mode with no EPR (fixed 14.0 and 13.8 cm respectively) with AHI-6.79 and AHI-4.35.  Tonight he wants me to try the VAUTO in 'S' mode IPAP-14 EPAP-14.

I have about decided that NO EPR is beneficial to keeping the apneas down but am currently trying to resolve , just why?

When the Doc first walked into the room, he said, "Congratulations, you are the first of my patients to set the language to French"  

He has given me specific permission to change the settings as I see fit only adding that he would like me to try any setting for at least four days unless it is not comfortable.

When I picked up the new VAUTO the DME commented, "The Doctor must really like you if he ordered you a replacement for the ST/A"...

Cheers

[SarcasticDave94]

Awesome. Congrats and nice to hear your doc is behaving.

[Gideon]

Awesome. Congrats and nice to hear your doc is behaving.  

ALL of your ducks behaved Dave.

The key is his Doc is WELL behaved!!!

[Sleeprider]

The road is long with many a winding turn. You know what to expect from the CPAP and it will certainly help more than the BRUTE.

[Shin Ryoku]

When the Doc first walked into the room, he said, "Congratulations, you are the first of my patients to set the language to French"  

Glad you are moving in the right direction and the doc is working with you.

He has given me specific permission to change the settings as I see fit only adding that he would like me to try any setting for at least four days unless it is not comfortable.

With diabetes treatment, this kind of informed patient self-management in appropriate situations is widely accepted as the standard of care. I tried asking in a Facebook support group for sleep apnea patients how many people had a sleep doc who encouraged them to make appropriate changes to their own settings. No one said yes, and I basically got run out of town for even asking the question.

Still, I wonder what percentage of sleep docs are like yours in this respect? From what I've been able to gather, it seems that most are not.

[ajack]

Well you have been for a nice tour of the PAP machine available on the market. I was going to give you this link, I came across. I don't know how valid the opinion is based on. You may be better on 14/14 fixed pressure cpap/bpap. The advantage of the vauto is that even with 14/14, you have breath shaping with Ti and such, if you need it.
https://aasm.org/resources/practiceparam...rating.pdf
"2. Patients with the following conditions are not currently
candidates for APAP titration or treatment. (Standard) [5.5,
5.8, Table 1]:
· congestive heart failure
· lung disease such as chronic obstructive pulmonary disease
· patients expected to have nocturnal arterial oxyhemoglobin
desaturation due to conditions other than OSA
(e.g., obesity hypoventilation syndrome)

@shin T1 patients are motivated to take control, a few bad hypos or DKA convince themselves of this. Sleep apnea is a silent killer, except for the snoring
Without a forum most would mess up their settings on a machine. It was only out of sheer luck that my first machine had an auto titration mode setting and full instructions on how to self titrate. https://goo.gl/7y4hh3

The forum with sleepyhead finished my apprenticeship. To the point where I'm reasonably confident that I know about 5% of what a lab tech knows. The more I read the more I realise how little I know. So next week I might be down to 3%

[zzzZorro]

'Recon it is appropriate to give credit where credit is due.  When I stumbled in here my knowledge on apnea was zilch.  With the condition/s I had it was pretty obvious that it was something that had to be dealt with and understood.  BY ME.  ..Time to stop taking everything I'm told by the Doctors as gospel- Time to look at what may have got me to this point in the first place!

The disorganization in this medical arena is unbelievable and the lack of education passed to the patients by the 'specialists' is unbelievable.  I specifically refer to Heart, Rheumatoid Arthritis, etc..  These specialists have asked, "do you have sleep apnea?" Most of us will answer NO- with a vision of 'what a screwy question'.  What specialists should be saying is; "If you are not sure we have to get your butt in for testing as apnea may be what kills you.."  Along with having a better understanding of sleep apnea themselves.

With lurking and participation here I am by no means knowledgeable of interpretation and treatment adjustments, but I can at least let a sleep specialist know that I am not another knot on the log because I have the ability now to talk on a level that lets them know that I know.

Unfortunately, in my case, I did not have faith in the sleep Doctor because of the shoddy way the office was run and by nurses who were apparently dancing to their own tunes.  What I learned was the Doctor was an employee of the organization that also employed the assistants and office help.  My ‘read’ was that he basically was saddled by what he was given by a pay grade that limited the quality, along with the fact that Doctors specializing in sleep studies were spread waay too thin.  To his credit the two times I actually met with him he was pleasant, understanding and spent over 30 minutes with me. The reason why was clear to me.  My study and the mentoring of several of you here allowed me to converse with him in a manner that probably less than a single digit percentage of the people he sees could do.

I presented here for help with conditions that were well above the normal challenge seen here.  Help and suggestions were made that allowed me to move forward and learn as best we could around the ASV (brick wall).  There is a sense of direction now that possibly will help me get the best I can from the VAUTO -until the wall comes tumbling down.

VERY SPECIAL THANKS to those who have spent their time and assisted!
Z