[split] Mal777 Lumis 150 ST-A iVAPS Therapy

[SarcasticDave94]

Hi Mal,

I'd like to suggest after another 1 or 2 day's use (you can always post at any time as well), give us some feedback on how you feel and include an OSCAR chart. This helps us track for trends, which I believe can be helpful info. Be as detailed as possible on comments. Best wishes for success.

[Sleeprider]

Mal777, I didn't intend to disrupt anything. We are currently using default settings in your therapy and observing your response. I don't want to jump into adjustments of settings I don't fully understand, and don't want anyone else to do so either. At some point, I hope we can the understand the periods of moderate tachypnea, but to my untrained eye, it looks far better than the chaotic rate and flow we saw previously. Just as important, I don't have a technical source that suggests an appropriate response with iVAPS settings to intervene with the respiration rate. So I guess that was what I was asking for. With all respect to Geer1's suggestions, I don't think he has specific knowledge of the conditions he is concerned with or the use of advanced PAP to mitigate it, and it throwing ideas against the wall to see what sticks.

I don't like to see you caught in the middle of a discussion that sounds unnecessarily alarming, when none of us fully understand what is going on or if we should try to manage it with setting changes. So this is my rationale to observe and understand more, before jumping into changes. One of the things I am doing is going back to threads like this one where I dealt with tachypnea before. I think the graphs in this thread, post #6 will look familiar to you http://www.apneaboard.com/forums/Thread-...-the-night

[SarcasticDave94]

Just something to consider folks, the Apnea Board is a forum for Apnea patients to help one another. For us to continue learning, let's keep the discussion and observations in the public area. Giving advice within a PM restricts learning about problems and resolutions the OP is dealing with. Discussing via PM is not a requirement.

[SuperSleeper]

Just something to consider folks, the Apnea Board is a forum for Apnea patients to help one another. For us to continue learning, let's keep the discussion and observations in the public area. Giving advice within a PM restricts learning about problems and resolutions the OP is dealing with. Discussing via PM is not a requirement.

Absolutely.  PLEASE READ THE ABOVE.  I would go even further than what Dave did... Advice or "private consulting" should not be done via private messages (PMs).  That's why we have a PUBLIC forum here.  Posting information, suggestions and advice publicly provides for "checks and balances" with many eyes on the situation.

When someone tells you they'd like to give you private advice, out of the eyes of the public forum, that would be a key red flag to me to avoid advice given in such a manner.

If the advice can stand up to public scrutiny via logical reasoning with supporting evidence, then there's absolutely no reason as to why it should have to be taken off the forums and into PMs.

Please DO NOT give personal therapeutic advice to Apnea Board members via PMs... The public forums are the place for that.  Public discussion provides safety for all involved.

[trish6hundred]

There is room for 2 very strong opinions here on this forum, that's how we learn, so that we may help others along the way. Pleas gear1, stay in the thread.

[sheepless]

I'm with Trish. going slow with caution & poking around with some trial & error are both legitimate methods & in fact aren't necessarily mutually exclusive. we should encourage ideas, problem solving, even thinking beyond conventional wisdom (actually, I think we mostly do). I've seen Supersleeper & Sleeprider (among others) identify similar sentiments as vital to the success of the forum. the key is that each of us is responsible to decide what applies to our unique circumstances & whether to apply it. we should also feel free to state, for example, thanks but for now I'm going to follow this guidance or that advisor. best after hearing various options or points of view. just like the rest of life.

sorry for the tangent Mal.

[Mal777]

I agree Trish and Sheepless


My opinion in 74 years of life, is that it is always better for second, or third opinions, particularly when someone’s health is the issue. Of course this can be fraught with problems on an open forum, where different people with strong opinions can argue the point with each other. The solution of course is a respectful discussion, all with the aim of helping the person who has the medical problem (me  haha)....as well as countless others in similas situations.  I have greatly valued the help Sleeprider has given me and have the utmost respect for all his advice and hopefully he will continue to do so to solve my dilemma. Having said that, Geer1 has also been of much help in looking at things from a different angle, so I do hope he stays in the public debate in this. The issue of course is for the discussion to be done in a respectlful and friendly way, with opinions not be taken personally. And of course in the public area, not pm’s.
My main concern at this stage of my life is to start by sleeping and breathing well,  and then try to solve my other mounting health issues, so hopefully the great advice from everyone  will continue.
As I have mentioned before my Pulmonologist, Cardiologist, ENT , GP and others have no knowledge of IVAPS, so it is you guys alone guiding me in this very complex issue.
I am very appreciative and thankful to you all and for your time and this wonderful forum

Mal

[SarcasticDave94]

Kudos, Mal, and keep at the therapy, with a sincere best wishes for success. Update us as you can. If nothing else, just check in from time to time. I want to be sure you didn't fall over due to being upside down in Oz.

[Mal777]

Seeing I have had so much trouble adapting to the ST-A IVAPS, and I had already purchased the Vauto a couple of weeks ago, and it has been sitting here in its box,(with only a few days left of 30 day trial period), I impulsively decided to try it last night, even though now I will only get 70% rather than the full 100% refund (Supplier 33) if I return it. As I said it has to be returned within 5 days if I dont want it, so I needed to make decision now. 
I realise the Vauto has no backup rate but I am still not convinced I have hypoventilation, as my latest sleep study only gives one small mention of it, when my O2 dropped in the first 2 hours of study. My oxygen levels at home, even with Airsence have been quite good... Anyway, right or wrong it is now out of box for trial next few days
I was surprised to see my Oscar results this morning.   
Unfortunately I only managed to record about 2 hours, but it gives a guide to how the Vauto will handle my situation . (See attached screenshot)
As far as settings go I used exactly the same timing controls as I was using on the ST-A Ivaps, however I had trouble setting Ipap Epap and PS .  I was trying to get max ipap to 18 and min Epap to 10  with ps 4. The machine would not go above 10-14 with ps at 4, and hence pressure was maxing out at 14 most of the night. 
 How can I rectify this? It was the best RR I have had in past 6 months on any machine, and AHI's excellent (but I did use ramp which may have diesguisd early positional events)



My full setings were

Max IPAP   18
Min EPAP  10
PS 4
TiMax 2.0
Ti Min 1.0
Trigger   high
Cycle Low
Ramp on (20 minutes)
Ramp start epap 5.0

I found the machine far more comfortable to tolerate than ST-A, had excellent RR and AHI's, Plus it is $4000 cheaper, so I'd love to succeed with it

My only issue is it makes a "whining" noise when on. Could this be a faulty machine?

Any suggestions regarding settings please, and particularly how I can get max ipap to 18 and min Epap to 10  with ps 4. I found the only way I could increase Ipap above 14 was to increase EPAP min or PS 

thanks once again 
Mal

[Gideon]

Are you trying to run yhe VAuto in a sudo fixed pressure mode with IPAP at 18 and PS = 4, then min EPAP = max IPAP - PS = 81 - 4 = 14.