hwnboy therapy thread

[hwnboy]

I stayed with the EPR 1 plan. I'm glad I did, as I feel much better today. Days 1 and 3 were good; it was just Day 2 that had me ready to throw in the towel. From my short time in therapy over the last five months, I should know that you will have your occasional off days. We will see what Day 4 holds tomorrow.

I look forward to the EPR 2 phase, crossing my fingers that it brings my flow limitations down closer to 0.05

Day 3 of 7 with EPR 1
   

[hwnboy]

Day 4 of 7 with EPR 1 - not a fan of EPR 1 so far - 
   

[hwnboy]

After five nights with EPR set to 1 and a few rough sessions, I decided to switch to EPR 2. While last night was fragmented, it felt like a step forward in terms of comfort. I was also glad to see a slight improvement in my flow limitations.  At this point, it seems likely that I’ll end up sticking with EPR 3, even if it means accepting the central apneas that come along with it. I’ve attached my last two Oscar charts: one from my final night on EPR 1 and the other from last night at EPR 2. Thanks so much for any feedback!

coutherino: I’ve read all your posts and learned a lot from them. Here’s hoping you’ll stumble across my therapy thread someday!  


Friday 10/25/24 - EPR 1
   

Saturday 10/25/24 - EPR 2
   

https://sleephq.com/public/70ef4896-8a60...29b8fc3a3b

https://sleephq.com/public/4cdb1b56-35da...886b513a33

[hwnboy]

So far so good with EPR 2, last night flow limits were higher, not sure if it could have been because of a new mask. I tried the Solo w/pillow cushion, after bathroom break breathing felt a little restricted. Would that affect FL's? Overall, I am feeling better with EPR 2 over 1 and OFF. Sleeping longer, feeling more rested in the morning. After a few more days I will return to EPR 3 and compare.

coutherino: I know you like the Sleep HQ links, and I will continue to provide those as well.

October 27th - Sunday
   

https://sleephq.com/public/4f1f08e1-b14e...c8efd12a20


October 28th - Monday
   

https://sleephq.com/public/b77f3423-fbfa...0eab0dc73e

Thank you very much for any and all help you can provide!

[Jay51]

Thank you for those OSCAR charts.  It seems like your decision tree is basically down to one major decision.  Are you satisfied with your current machine and therapy with your very best optimization strategy?  Sleeprider posted above that the VAuto would be the best machine for you if not.  I remember that you posted that you are collecting information just in case you decide to make a push for the VAuto.  I hope you get this figured out and make the correct decision here.

[hwnboy]

Hi Jay51,

Thanks for your feedback and advice as always! I hope I have gathered enough evidence that will prove to the sleep doctor that I need to try another machine. I got my current Resmed Airsense 10 just 6 months ago in May of 2024. Since I have Medicare, Once I am approved for a Vauto, do I just hand in this machine and start up another 13-month period for the Vauto? I'm not sure if you know the ins and outs of Medicare.

If you and Sleeprider agree the Vauto is the way to go, I with no hesitation am ready to switch. I'm thinking I should end this experiment phase I've been into, get back on EPR 3, lower my flow limitations and just deal with the Centrals until I can get the new machine.

Thanks for your guidance, sometimes I need to be hit over the head to see the light. I appreciate you and Sleeprider so much.

[Jay51]

Getting a script for the VAuto is usually all it takes (with insurance, medicare, etc.).  Dr.'s (almost all specialties) can write one.  Tangible evidence (OSCAR, etc.) can be presented to Dr. to help persuade.  

Also:  

• Medical Doctor
  
• Doctor of Osteopathy
  
• Psychiatrist
  
• Physicians Assistant
  
• Nurse Practitioners
  
• Dentist
  
• Naturopathic Physician
                                                                                                                                                                                         If you like your current DME, it might be best to stick with them.  You can choose another one if you want to as well.  

[hwnboy]

Awesome! Thanks Jay51

[hwnboy]

Yesterday I moved up my Sleep Doctor appointment to November 22. I will continue to document my therapy here at 8.0 cmH2O EPR 3 until then as I get ready to make my case for the Vauto. Last night was my first night back at EPR 3 in 17 days. Although I did have a few events (those last 2 central were SWJ) it was the first night in quite a while that I didn't get up to use the bathroom during the night. I slept close to 7 hours straight, which never happens. I hope that becomes a new trend. Another interesting thing was there were no events at all between 10:20 pm and 2:20 am, and I was asleep during that time. Here is the Oscar chart.

I tried the Brevida mask for the first time. For the first five minutes, I realized the small cushion was too small, so I switched to the larger one.

October 29th - EPR 3
   

https://sleephq.com/public/e2feb625-9b8a...c1046db818

[Jay51]

Your personal trend seems to be:  increasing EPR seems to get better results.  And the VAuto can increase pressure support even higher than 3.0       Still .07 flow limitations (95th percentile) on last night's chart.