New Here - Strange Behaviour

[QT2U]

Hello all. I'm new to the apnea board, but so glad to have found such a great site for information and support.

I'm hoping I can get some help figuring out what is going on with my setup. First, let me say that I'm an old fart so excuse the typos, grammar and overall messy posts. I hope I can make sense.

I have a ResMed VPAP S with H5i humidifier that I've been using for several years. I am 8 ltrs oxygen 24/7 and bipap dependent, which means (for those who don't know) that the bipap is being used as life-support.

A little background. I was never formally given a sleep test of any kind. I came home from the hospital with a script for a bipap. Things were great to begin with as I only needed it at night, and I slept fairly well. Then doc said to use it during the day, as needed, if it helped me breathe better. Well, of course it did. Why struggle if I didn't need to.

I soon found myself unable to breathe without the bipap machine. My lungs became weaker and weaker and now I'm depended on the machine to push the oxygen, so I can breathe.

Breathing still doesn't come easy. I hold the mask to my face, day and night, and take it away from my face to talk, eat and drink. I do not use the headgear as it interferes with the Chiari at the base of my neck and I end up with excruciating headaches. Life is tough, and I'm not sleeping but a couple hours a night, but I enjoy being alive. If my sleep was better, my days could be optimal.

My issue is that my machine is about to die. (Seems like it's been throwing error messages since I first received it. Humidifier, leaks etc.) The current error says that the motor has exceeded it's lifetime, and to call tech. So I did. A rep came out with two identical machines, programmed with the same settings as mine. BUT.. neither one blew air hard enough so that I could breathe.

Each time I put the mask to my face, with the new machines and tried to inhale, the air went 'flat'..almost like the machines were operating in reverse. Going flat when they were suppose to be blowing.

We tried everything, from checking the ramp to other obvious issues, and both machines continued to go 'flat'. Pressures were set the same on all machines. Mine would blow hard enough to puff out my cheeks, but the other machines air pressure seemed to 'die' when I put the mask on my face.

I am desperate. If my machine goes down, at any time, I will (die) not be able to breathe at all.

I need to know how to make the machines blow hard (17/10) when I put the mask on my face and inhale, instead of discontinuing to blow (go flat) when I try to take a breath. The machine shows the bar moving up to the 17 but there is little if any air coming out of the mask.. hardly any pressure.

At the very least I need help on how to fix whatever is messing up before my machine completely dies on me and I end up intubated in ICU. I'm terrified.

Any suggestions, Ideas, or help would be deeply appreciated. Thank you!

QT

[FrankNichols]

It sounds like you need to talk to your doctor about being on a ventilator and not a BiPAP machine.

[PaytonA]

Is the auto off and on engaged. If so the machine may decide by the time that you get the mask up to your face that there is no breathing going on so it needs to turn off. Just a thought.

Best Regards,

PaytonA

[PoolQ]

Okay, this may not be "fast", but people should be able to get you where you need to be before bed time, hopefully sooner.
I assume that you have an Aircurve 10 S, this should be on the front of your machine in the lower right? Are we talking about the same machine?

Do you have the clinicians manual, if not you can request it by email from this site-get it if you don't have it (see links at the top of the page)

There are many more settings than just the pressure settings.

What at this point it sounds like is that you need to adjust the cycle and trigger sensitivities. this is how the machine detects that you have started to inhale (trigger) and exhale (cycle) and the default may not be sensitive enough for you. The manual will show you how to set these.

you can also set the rise time:
"Rise Time sets the time taken for the device to reach IPAP. The greater the rise time value, the longer it takes for pressure to increase from EPAP to IPAP. Patients with a high ventilatory demand may prefer a shorter rise time, while patients who are slow
breathers may prefer a longer rise time"

You can also set the Ti times, min and max.

I would guess that you would not want the ramp feature enabled

Make sure the "smartStart" is enabled, sounds like you are using this

Get the manual and read up on these topics

If you still have the old machine, get into the clinicians menus and check all the settings, not just those two pressue settings. The tech "should" have done this, but don't count on it

[justMongo]

I have a ResMed VPAP S with H5i humidifier that I've been using for several years. I am 8 ltrs oxygen 24/7 and bipap dependent, which means (for those who don't know) that the bipap is being used as life-support.

Since the humidifier is an H5i, then the machine (perhaps the old one) is an S9 VPAP S.

Now the difficulty I see in the setup is: These bilevels are only spec'ed to be run with up to 5 LPM of O₂. Running at 8 LPM may throw off the bilevel switching.

I advise specialized help from competent professionals. Since this is a life support function, this is beyond the scope of this forum.

[PoolQ]

Good catch Mongo! How the CPAP responds to the increased O2 may have changed between machines.

[QT2U]

It sounds like you need to talk to your doctor about being on a ventilator and not a BiPAP machine.

Each individual is unique and not every physician uses the same method of treatment. My physician has prescribed what he believes is the best for me, but thank you for your opinion.

---

Is the auto off and on engaged. If so the machine may decide by the time that you get the mask up to your face that there is no breathing going on so it needs to turn off. Just a thought.

Best Regards,

PaytonA

Thank you PaytonA. No the auto off and on are not engaged to my knowledge. I have to physically turn the machine on and off. Thank you for your reply.

[QT2U]

Okay, this may not be "fast", but people should be able to get you where you need to be before bed time, hopefully sooner.
I assume that you have an Aircurve 10 S, this should be on the front of your machine in the lower right? Are we talking about the same machine?

My machine is ResMed VPAP S (9) Easy-Breathe. The 'new' machine is an Auto instead of an Easy-Breathe. The Easy-Breathe is my everyday machine and is throwing errors but otherwise works ok for for now. I need to get the new machine (that the tech left me) working before the Easy-Breathe quits.

Do you have the clinicians manual, if not you can request it by email from this site-get it if you don't have it (see links at the top of the page)

Yes I have a manual.

There are many more settings than just the pressure settings.

What at this point it sounds like is that you need to adjust the cycle and trigger sensitivities. this is how the machine detects that you have started to inhale (trigger) and exhale (cycle) and the default may not be sensitive enough for you. The manual will show you how to set these.

you can also set the rise time:
"Rise Time sets the time taken for the device to reach IPAP. The greater the rise time value, the longer it takes for pressure to increase from EPAP to IPAP. Patients with a high ventilatory demand may prefer a shorter rise time, while patients who are slow
breathers may prefer a longer rise time"

You can also set the Ti times, min and max.

I would guess that you would not want the ramp feature enabled
There is no ramp on my machines.

Make sure the "smartStart" is enabled, sounds like you are using this

Get the manual and read up on these topics

If you still have the old machine, get into the clinicians menus and check all the settings, not just those two pressue settings. The tech "should" have done this, but don't count on it

The tech compared settings with machines side-by-side.

[QT2U]

Good catch Mongo! How the CPAP responds to the increased O2 may have changed between machines.

Actually my BiPap Easy-Breathe machine has been working fine for years with the 8 liters inline, with the exception of the error, "motor life exceeded please contact provider", and the typical "leak" warnings. The O2 has had no effect what-so-ever on the bi-level switching. My machine functions fine as far as giving me the proper pressure. It's the NEW machine that is not working correctly. Thus I cannot let the tech take my machine until he can find me a working replacement.

[srlevine1]

One, I will say a prayer for you. Two, because this may become a life-threatening issue, you need your doctor to do more than write an Rx to the DME's respiratory tech. There should be detailed settings derived in a sleep lab and conveyed to the RT. Three, you may need to take backup procedures for power-out conditions and possible machine failure. Four, is your oxygen delivery continuous or pulsed? -- because pulsed delivery can confuse the settings. Best of luck.