Therapy numbers, lack of them, weight loss, etc

Therapy numbers, lack of them, weight loss, etc - Printable Version

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RE: Therapy numbers, lack of them, weight loss, etc - retired_guy - 09-07-2014

(09-07-2014, 03:36 PM)Galactus Wrote: BTW- At the end of my 7 days this way I plan to change to BiPap using the information previously provided.

I agree with this too, although it will be hard to improve on your present experience. But I like the idea because I'm a big believer in futzing. So educated and informed futzing sounds like a plan to me. Vaughn's recommendations are great.

(09-07-2014, 05:16 PM)vsheline Wrote: Seems to be no explanation then.

Which means "the experiential event is idiopathic in nature...."

Wow, I impress even myself!

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-07-2014

(09-07-2014, 05:16 PM)vsheline Wrote: Seems to be no explanation then.

You can measure the pressure created by each machine by removing the mask from the hose and (with machine running) dipping just the end of the hose vertically into a deep bucket of water (having at least 8 inches of water depth) to find out the hose depth needed to stop the hose from blowing bubbles into the water.

If the depth at which bubbling stops is 18 cm (which is about 7"), this means the air pressure is correctly 18 cm H2O.

But at first the bubbles will be violent and splashy until the tip of the hose is deep into the pail, so put the water pail (but not the machine) in the bathtub so splashes will not get your bedroom wet.

Well this sounds like a fun science project lol. I may actually try that just to see what the deal is. And of course to have a reason to play with the cpap machine in the bathtub. I can only imagine what the wife shall say.

(09-07-2014, 05:16 PM)vsheline Wrote:
(09-07-2014, 04:43 PM)Galactus Wrote: I can't wait to get a week in so I can switch and see if this change was worth the $$$ I spent, lol. I hate to put it in terms of money but it's how I feel some days. If it works it will be well worth the investment.

You will probably find the new machine even more comfortable in AutoB mode.

Also, the cost and inconvenience of a new overnight sleep lab titration will be unnecessary (to find the pressure you need now that you have lost a lot of weight).

You may even find that BiPAP therapy is more effective for you and you have more energy during the day.

I really can't wait to see, holding my breath! Ummmm Uh Oh I mean breathing well!

(09-07-2014, 05:44 PM)retired_guy Wrote:
(09-07-2014, 03:36 PM)Galactus Wrote: BTW- At the end of my 7 days this way I plan to change to BiPap using the information previously provided.

I agree with this too, although it will be hard to improve on your present experience. But I like the idea because I'm a big believer in futzing. So educated and informed futzing sounds like a plan to me. Vaughn's recommendations are great.

Well I have to say maybe the numbers will not get much better or even any better. But you know it would be very nice to not have a pressure of 18. If I could get down a bit it might be less annoying than it is now. And that would be a bonus for sure.

(09-07-2014, 05:44 PM)retired_guy Wrote: [quote='vsheline' pid='82416' dateline='1410128214']
Seems to be no explanation then.

Which means "the experiential event is idiopathic in nature...."

Wow, I impress even myself!

Back to the idios..... again? Grin

RE: Therapy numbers, lack of them, weight loss, etc - vsheline - 09-07-2014

(09-07-2014, 06:23 PM)Galactus Wrote:
(09-07-2014, 05:16 PM)vsheline Wrote: You can measure the pressure created by each machine by removing the mask from the hose and (with machine running) dipping just the end of the hose vertically into a deep bucket of water (having at least 8 inches of water depth) to find out the hose depth needed to stop the hose from blowing bubbles into the water.

If the depth at which bubbling stops is 18 cm (which is about 7"), this means the air pressure is correctly 18 cm H2O.

But at first the bubbles will be violent and splashy until the tip of the hose is deep into the pail, so put the water pail (but not the machine) in the bathtub so splashes will not get your bedroom or machine wet.

Well this sounds like a fun science project lol. I may actually try that just to see what the deal is.

Yes, if the pressure on either machine is not correctly calibrated then you will want to have it serviced right away, while it is still under warrantee and before you need to use it again (as your regular machine or as a backup or travel machine).

ResMed warranties are 2 yrs and are valid regardless of whether the unit has been resold or not, and I would guess it would be the same for both of your PRS1 models. I suppose if you called Respironics and gave them the model (REF#) and serial number Respironics would be able to tell you when the machines were manufactured and whether both are still under warranty or not.

With my ResMed machine(s), only DME's are allowed to send in units for repair (and this is true whether or not the unit is still under warrantee). But it does not need to be the same DME who originally sold the unit. Any helpful DME would be able to call up ResMed customer service and go through a few troubleshooting steps on the phone to verify the problem and receive an RMA (Return Material Authorization) number to get the unit serviced or repaired for me. If I was going to be charged for anything (a non-warranty repair), ResMed would call me up first, to get my authorization to do the work.

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-09-2014

(09-07-2014, 05:16 PM)vsheline Wrote: Yes, if the pressure on either machine is not correctly calibrated then you will want to have it serviced right away, while it is still under warrantee and before you need to use it again (as your regular machine or as a backup or travel machine).

Good Plan I shall check on that.

I know RG will love this, "I am so looking forward to the futzing in 2 days!"

I'm curious though as to how much weight is placed on events that happen while awake, ie., just going to sleep or just waking up, are they as important as during sleep time? I've noted in the past few days that the machine is showing events which are occurring while I'm awake, like lying in bed waking up, or the same when going to sleep, and I'm just wondering if I should care about them or not?

[Image: 2s6pts5.jpg]

RE: Therapy numbers, lack of them, weight loss, etc - retired_guy - 09-09-2014

Nope, awake breathing doesn't count. Well, actually breathing while you're awake is a good thing to do. The alternative is a bit cumbersome. But as far as meaning anything in the context of "sleep" apnea, no it doesn't. Apparently the brain stuff treats breathing differently when we're awake than when we're asleep. Not that I would be opposed to your futzing with it anyway. Futzing's always a good thing to do.

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-09-2014

(09-09-2014, 10:33 AM)retired_guy Wrote: Nope, awake breathing doesn't count. Well, actually breathing while you're awake is a good thing to do. The alternative is a bit cumbersome. But as far as meaning anything in the context of "sleep" apnea, no it doesn't. Apparently the brain stuff treats breathing differently when we're awake than when we're asleep. Not that I would be opposed to your futzing with it anyway. Futzing's always a good thing to do.

Don't you worry, rest easy, we shall begin futzing away shortly, and we shall not stop futzing for at least a while. We may even be lucky enough to make something worse while futzing, as that is the ultimate goal of any true futzer!

So good to know if I am there rolling about waking up or going to sleep I shouldn't pay attention to that time, good to know, thanks!

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-11-2014

Ok so today is day 7. I have recorded the 7 days of data in order to begin futzing. And now with no further ado the FUTZING SHALL COMMENCE!

Oh and RG pay close attention to yesterday as I did not periodically breathe! I had to check I was still alive in the mirror.

Here's what the last two days look like along with the weeks average.

[Image: nvuw.jpg]

These are the available machine settings;
[Image: i2k3l3.jpg]

The suggested settings change (and they make sense to me now that I understand more) are as follows;

Min EPAP: 13 (about 5 less than now)
Max EPAP: 18 (about the same as now)
Min Pressure Support: 1
Max Pressure Support: 4
Max IPAP (or perhaps called Max Pressure): 22 (set to the sum of Max EPAP plus Max Pressure Support, unless you start to experience problems from high pressure.)
Ramp: same as now
Bi-Flex: same as C-Flex now

This part is easy;
In settings I have Min EPAP which I can find and set to 13.
Pressure Support Min and Max are there so can set those to 1 and 4.
Max IPAP I have and can set as well to 22.
Ramp I don't use so I'll leave it off.
Bi-Flex set to 3 same as CFlex.

Here are the questions though;
I don't see a Max EPAP though, so how is that set?

There are also stand alone lines for IPAP, EPAP, CPAP Pres, do I need to set anything there?

There is a Rise time setting of 0-3, do I set anything there? What is that? Is that how fast or slow it will change? I think someone mentioned that as well.

I just read the settings again now and I am confused, I thought Min and Max PS I understood to be 1 and 4. However when I read it I don't think so as it says Max PS 0.0 - min of [8 or (Max IPAP - Min EPAP)] and then Min PS shows 0.0 - (Max PS) so now I'm not sure what should be set.

Edit -- I'm reading and reading and I have come to the following; Seems to me the settings should be;

Max IPAP 20 (I am now fixed at 18 so +2 should be more than enough)
Min EPAP 13 (Seems like a good starting point)
Max PS- 7 (This is the max difference allowed between IPAP & EPAP and is 20-13=7)
Min PS- 1 (This is the min difference allowed between IPAP & EPA)
Rise Time- 1 (0 is off 1 is 200 msec, 2 is 300 msec and 3 is 400 msec, just seemed like a place to start though maybe 0 is better)
Flex- BiFlex at 3 (Same as my current CFlex setting)

That is what I think

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-11-2014

Bump for help. Anyone have an opinion on those settings?

RE: Therapy numbers, lack of them, weight loss, etc - retired_guy - 09-11-2014

I really don't Galactus. I'm not strong on the Phillips machine, but from what little I think I know I think you're fine.

You're going to have a heck of a time improving on your earlier results though. But I'm all for futzing around and see what the machine thinks it can do.

Like I say, "If it's broken, fix it. If it's not broken, break it."

RE: Therapy numbers, lack of them, weight loss, etc - Galactus - 09-11-2014

(09-11-2014, 09:09 PM)retired_guy Wrote: I really don't Galactus. I'm not strong on the Phillips machine, but from what little I think I know I think you're fine.

You're going to have a heck of a time improving on your earlier results though. But I'm all for futzing around and see what the machine thinks it can do.

Like I say, "If it's broken, fix it. If it's not broken, break it."

Hey thanks RG, what I'm concerned with is when you review my understanding of PS do I understand that correct and have those settings right in your opinion? I read it like 5x and I think that makes it correct just looking for a double check.

In all honesty I'm not trying to get better numbers so much as looking to lower the pressure if I can, as it is a bit annoying.

But hey let's break it who cares we fix it later Smile

Just tell me what you think about the PS, that was my reservation.