COPD, Emphysema and such with Apnea.

[annbower1125]

these are my results from 4 years ago, I will upload the new ones as soon as I get them. My asthma or my copd doesn't seem to be under control, it probably doesn't help that my pressures on my auto cpap is 4 to 20 and my regular doctor has no idea what to do, I hope he is trying to find me a doctor to help me with it, my insurance is a stickler.

[retired_guy]

Ok, focusing on your cpap a little, because we really aren't that good at focusing on our actual copd things in this forum, it may be premature to know if cpap has had an effect positive or negative on your asthma.

We need to get your cpap working right for you before anything else.

Sooooooooooooo, do you have any results from a sleep study, or readings from your machine so far?

For openers, I think a range of 4 to 20 is not a good idea. If it were me, I'd start shrinking the range from both ends. Say 6 to 18 for a few days, then 8 to 14? Something like that. But to do that you have to know what your results are on a day to day basis. So let's start by learning that.

Once your apnea is controlled properly it will be interesting to see what effect that has, if any, on your asthma exacerbations.

It will also be important to keep an eye on your humidifier. Some asthmatics will not do well with humid air. Some on the other hand do better. So that's something to think about.

[surferdude2]

The FEF 25-75% is a very important number since it is an indicator of how fast the air comes out of the smaller passages in the lungs. Since a spirometry test is heavily dependant on the correct effort of the patient, be sure to give it your best try when doing the test. Inhale until it hurts and then blow like a cannon. Even so it is accepted that an 80% rating of the expected is within normal bounds. It's an age based scale and the FEF 25-75% starts downhill fairly rapidly after about age 20 and really rapidly if you smoke.

Since you have had a previous test and have the documentation, you have a benchmark to compare with. You'll note that you are in much better shape than I am with respect to the FEF 25-75% reading. Hopefully you no longer smoke and things won't be going downhill at a very fast pace.

[retired_guy]

Hey guys, for the purpose of this puny little thread, let's try to always bring the scope back to how these things are impacted by, are made better by, or made worse by cpap therapy.

Our tendency is no doubt to discuss our mutually goofy copd things, but there's lots of forums for that. I'm really hoping we can focus on the more limited effect of apnea and copd in here.

In fact, if we don't the big guy will give us the boot!!! Or the big gal will give us the hammer.. That would be worse.

[surferdude2]

I agree, it's way too depressing to discuss COPD since in my case (emphysema) there is no cure.

Apnea on the other hand is has cures as well as effective treatments. However those little jewels aren't easily accessed by those who are also affected with some form of COPD. Therein lie the basis for this thread and as hopeless as it may be, I will be willing to discuss it until I turn blue in the face (poor choice, I know).

I will add something constructive when I think of something but it may take a while...hmm...let's see now..last night I raised my pressure to 11cm of agua and got the first whole hour without any flagged items. That may not seem like much but it's a major milestone for me. I have had to sneak up on the higher pressures since initially I couldn't stand anything over 7.6 and thought I'd suffocate and die if I tried to go as high as my Pulman suggested (that's be 10). Now that I'm over that hump things look a little brighter. It reminds me of when I got my first motorcycle and couldn't ride too fast lest the wind hitting me in the face bothered me to no end. In a couple of weeks I was hitting 90 and loving life...well up until that horse fly hit me tween the eyes. There I go getting off topic again.

OK, retirded_Man, errr...retired_guy, your turn.

[annbower1125]

congrats on the no flag hour, careful on that motorcycle. They are too dangerous in Florida

[surferdude2]

I have a question that is bothering me especially since I bought this ResMed S9 Elite used, although from a dealer who assured me it was like new. Here's my concern, when I first lie down and turn it on, it starts up right away (I don't use the ramp) and since I'm running the EPR at the highest setting (3) it starts throbbing away and I get some idea of how that pressure feels. Then somewhere around 20 ~ 30 minutes later, the pressure seems to have abated a great deal since I don't feel it nearly as much. Is that by design or do I have a defective unit? I might expect that from an auto unit but this is the straight CPAP Elite EPR and definitely not an auto.

ps. My motorcycle days were in '55 so no worries Ann.

[retired_guy]

I agree, it's way too depressing to discuss COPD since in my case (emphysema) there is no cure.

There ya go! Something positive to start us off...

Actually there isn't anything all that depressing about our emphysema any more than any other inconvenience.. Sore gizzards can be the pits! Then take Herb for instance: He's going to miss the starting lineup with the Cowboys because he's got a funky hip, and funkier knees. Peter too! So we don't have it so bad. It could be rabies or something serious.

Besides, the emphysema won't kill you. It'll be the flu you catch from some jerk that "never gets the flu shot because I got one twenty years ago and it made me sick!" that'll kill you. No big thing.

Apnea on the other hand is has cures as well as effective treatments. However those little jewels aren't easily accessed by those who are also affected with some form of COPD. Therein lie the basis for this thread and as hopeless as it may be, I will be willing to discuss it until I turn blue in the face (poor choice, I know).

Well now, you are just a little ray of sunshine, Surfie... Let's work on our attitude a little. First of all, there is nothing "hopeless" on God's green earth, and especially nothing hopeless about treatment for sleep apnea.

Currently I am average 5 or 6 events......... A week....... I have been at zero now for the last 3 days. I feel great! Yeah, I can't run with the big dogs yet, but I can cheer them on... I have fine tuned my therapy over the past few months to the point where there really isn't anything to improve. I've worked with the pressures, the epr settings, the leaks, the mask, and with my sleeping positions and diet. I've lost 10 pounds which is not nearly what I want to lose, but just that much made a decidable difference in my daytime ability to function. I take some of my prescriptions, such as Singulair as I'm supposed to. Others like Combivent I use maybe once a day instead of 4 times a day. I pay attention to what I need to do to keep feeling well.

It's all manageable, and like I said not really a big deal. Every day I see so many people with serious issues. I will not allow my piddly little "severe" emphysema to be a major problem.

But the first and most important thing I needed to do when they handed me my machine was to embrace the possibility that this would be something to make me feel and function better, and not some sort of idiot award for smoking too many years.

I will add something constructive when I think of something but it may take a while...hmm...let's see now..last night I raised my pressure to 11cm of agua and got the first whole hour without any flagged items. That may not seem like much but it's a major milestone for me.

Yes, that is positive. And yes, we do need to sneak up on our sweet spot rather than take a shotgun approach.

I have had to sneak up on the higher pressures since initially I couldn't stand anything over 7.6 and thought I'd suffocate and die if I tried to go as high as my Pulman suggested (that's be 10).

Are you running with your EPR on? If you set your pressure at 10 with your EPR at 3, then your exhale pressure would be a puny little 7 which you have indicated you can handle without feeling you're suffocating. Then you could slide it gently up from there in a few days if it seems needed to control the apneas.

And watch your sleeping position. I find it very very helpful to sleep with my head a little elevated. I am sleeping on my back and my side equally well and I love it.

Now that I'm over that hump things look a little brighter. It reminds me of when I got my first motorcycle and couldn't ride too fast lest the wind hitting me in the face bothered me to no end. In a couple of weeks I was hitting 90 and loving life...well up until that horse fly hit me tween the eyes. There I go getting off topic again.

OK, retirded_Man, errr...retired_guy, your turn.

Gee... can't think of anything to say.......
Ann? Where ya at?

[retired_guy]

I have a question that is bothering me especially since I bought this ResMed S9 Elite used, although from a dealer who assured me it was like new. Here's my concern, when I first lie down and turn it on, it starts up right away (I don't use the ramp) and since I'm running the EPR at the highest setting (3) it starts throbbing away and I get some idea of how that pressure feels. Then somewhere around 20 ~ 30 minutes later, the pressure seems to have abated a great deal since I don't feel it nearly as much. Is that by design or do I have a defective unit? I might expect that from an auto unit but this is the straight CPAP Elite EPR and definitely not an auto.

ps. My motorcycle days were in '55 so no worries Ann.

Yep, I think I know what's going on. There will be a time perhaps when you want your EPR at 3. But this is not the time. Change it to 2 and see if things don't flow a little smoother.

[PaytonA]

R_G,

How can you possibly run out of things to say. You are stretching my ability to believe in something. LOL