Newbie?

[Dormeo]

Black Sheep, thanks for using the oximeter and posting the charts. I think we will want Bonjour to take a look at them, along with the zoomed in views in the earlier post.

[Gideon]

19 June Med SpO2 = 84
18 June Med SpO2 = 86

IMHO this is too low.  (I guess you were right.)  This is low enough for supplemental oxygen.  

Since increased PS increases efficiency, and should improve SpO2 levels, could you do a night with the Oximeter at PS = 9
I want to see if we undid something that was working.

The zoomed view tells me something is not right.  Part of that is a Med breathing rate of 28. The balance is ok between inspiration and expiration and has been that way.  I get the impression of panting.

[SarcasticDave94]

Correct on those numbers qualifying for supplemental oxygen.

[Dormeo]

Dave and Fred, Black Sheep's doctor discontinued supplemental oxygen, for reasons unknown.

Black Sheep, it'll be interesting to see what the O2 does when you revert to PS of 9.

[Gideon]

I assumed he didn't need it. Thus the check at PS =9

[SarcasticDave94]

Copy, Dormeo. I guess I don't know the whole story, and I don't need to either, but it would seem with these numbers for oxygen %, supplemental oxygen still seems a need. Then again I'm not the doc. Hope the PS edit bonjour suggests will help out. This isn't indicating I don't think it will, just hoping something helps out here.

[Sleeprider]

PS will keep CO2 at better levels, but this tidal volume is really poor, although the respiration rate is high and keeps the minute vent within reason. SpO2 is completely unacceptable, and the doctor needs to reconsider the decision to withdraw it. This oxygen saturation ranks among some of the worst I've seen. I think we need to get back to PS 9.0 as prescribed, and you should request your doctor to look at oximeter results that clearly show a need for an oxygen bleed to raise FiO2. You have lost 60 mL of tidal volume and 0.75 L/min of minute vent with lower pressure support. We went the wrong direction and need to get you back, then take another look at oximetry.

I think you know that without significant weight loss your 42 BMI and these complications point to a pretty bad situation. You may not even qualify for bariatric surgery at your current weight, but you should be looking at it and trying to get to an acceptable risk to qualify for it.

[SarcasticDave94]

FWIW here in the US, I had the Bariatric Sleeve surgery in 2016. Medicaid Insurance UnitedHealthcare approved it due to the BMI of 41 and comorbidity of COPD, sleep apnea, and the obesity.

[Gideon]

And what are your results?

[SarcasticDave94]

If you meant me and the bariatric surgery, I'm now at 227 pounds, a loss of 73 pounds. I was as low as 189 February last year during an illness. The AHI went from untreated 75 or so to 37 or so due to weight loss, with an at the time of the ASV sleep study of 100 lb loss as I weighed 200 during that PSG. So a 100 lb loss had meant halving the AHI for me.

FWIW my bariatric sleeve is a laproscopic style surgery, meaning several small incisions on the abdomen to insert a camera and the cutting and sewing tools along with removal of 3/4 of the stomach that was cut off. I had 6 incisions on the abdomen which took about a month to heal fully. Mine were glued shut with some sort of medical rubberized glue. For the first 6 months, I could only eat 1000 calories a day. Meals were only equal to 1 hard boiled eggs worth of food. I'm allowing myself a bit too many calories or I'd drop to 200 rather easily, which actually needs done. I can do so by cutting out most snacks and keeping to about 1500 calories daily.

Bottom line is for me 100 lb loss of weight halved the untreated AHI, likely due to less weight being carried on the neck. Dress shirt size was at 19 and was going up signified by increasing tightness while at 300 lb. Neck size 18 shirt is loose now, so I'm likely 17 1/2 even now at 227.