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Positive Suggestions Please
#1
Idea 
Positive Suggestions Please
New to this site, not new to C.P.A.P. treatment.

My condition is changing, Heart Failure is increasing, I am very near to having COPD.  Resistive to using inhalers.  Since 199? I have repeatedly tried full face masks, they hurt my face and feel as if they cause my teeth to shift, my whole jaw aches.  Nasal cushions were sort of okay, I just alternated the size of the nasal cushions.

Due to assorted issues I did not use a breathing device for about 10 years.  Assorted Doctors did not believe I needed a Sleep Apnea device.  Yes, I was officially diagnosed through at least three Sleep Lab Studies, along with hospital admissions statements 

Currently after two COVID attacks and my lungs completely filling with fluid, I now have a BiPap. ResMed, AirCurve10 VAUTO.  

I strongly tend to mouth breathing, stuff on my face gets ripped off during the night, I suspect exhaling is difficult, although the BiPap should have solved the issue as it did while I was hospitalized.

The issue I want to discuss is how I might manage to continue using my new N30i nasal pillows.

My throat keeps clogging with phlegm, unable to breathe until phlegm is cleared.  My stats show I am mouth breathing (reading clearing airway so the BiPap is able to pump the air to and from my lungs.

The inhaler I have causes an allergic reaction in my mouth.  Pulmonologist told me to use it anyway... I have a documented history of Anaphalic Shock in the past.  I am not using anything that causes allergy reactions.

Currently I am considering giving up the BiPap, the mouth breathing has several factors, heart stops several times a night, (Defibrillator is dead), Congestive Heart Failure since COVID X2 has become worse, I am retaining fluid.  Phlegm completely blocks my throat from time to time during the night, removing the mask to clear throat is required.  From time to time over the past year, intubating has been insisted upon while in ER.  I refuse. 

I am wondering if perhaps there is some sort of trigger to the thick phlegm build up, during the night.  Maybe certain foods?  My doctors are not giving me dialog, just demands. Using drugs with my allergy history is very concerning, due to past experiences.  Naturopathic Medicine I do not trust to keep me alive. I tetter on the line between Western Medicine and Eastern Medicine.  Twenty one years now, age and COVID have disturbed the balance I had.  I am Not COPD just a wisker away, according to the Pulmonologist.  Definitely Congestive Heart Failure since 2003 (Sudden Cardiac Arrest, multiple systems failure).

If someone has a positive suggestion on how I might manage the issue with mouth breathing due to my throat issues, please respond.

Thank you for reading through my post.

  Ironfish.
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#2
RE: Positive Suggestions Please
Without some CPAP or bilevel data, such as the free OSCAR program, it's going to be difficult to address your bilevel settings. However, here's a few items from your information.

One, a full face mask that hurts translates into a mask that leaks and has straps that are way too tight. At least this is an indicator of tight straps to address leaking. If this is accurate, do not tighten them this much. If leaks cannot be addressed with the mask without restoring to over tight straps, you must change mask models.

Second, with your congestive heart failure, a standard bilevel may not be your best bet. I cannot be certain, but I would steer you towards a machine with backup breath rate by ResMed, such as the ST-A. Not the ST, and maybe not ASV. I could be wrong, but I'm thinking you need a more capable machine with timing.
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