Anybody had problems with their CMS-60D?

[OutaSync]

Since I've been home sick this weekend, I popped on my new CMS-60D to see if there was any pattern to the times I felt really bad as opposed to just bad. The times that I had pounding head and heart and felt weak and sweaty sometimes did coincide with the low O2 readings on the report.



I saw my GP today. My pulse/ox, chest x-ray and EKG all looked "fine", but he has ordered a 24 hr pulse/ox test so I can run them both at the same time to see if mine is defective. We couldn't get the numbers to match while I was in the office.

I got my CMS-60D from SE Medical Supply, so I shouldn't have any trouble returning it if found defective.

[-SWS]

I saw my GP today. My pulse/ox, chest x-ray and EKG all looked "fine", but he has ordered a 24 hr pulse/ox test so I can run them both at the same time to see if mine is defective. We couldn't get the numbers to match while I was in the office.

Bev, averaging time can account for very quick SpO2 drops being recorded differently from one brand meter to the next. If brand A averages readings at 2 seconds while brand B averages at 4, 6, or 8 seconds, the first brand can catch and reflect those brief SpO2 drops the second brand may not reflect.

Do you per chance know the "averaging" time in seconds for all or both oximeters being compared? That just may account for the differences you saw. These two studies describe the issue in better detail:

http://www.chestjournal.org/cgi/content/full/127/1/80

http://cat.inist.fr/%3FaModele%3Daffich ... esentation

I agree that faulty equipment is another possibility.

[Snoredog]

I think you need to fix your backup mode on your machine cause it clearly ain't a workin.

[OutaSync]

SWS,

I think mine is set for 1 sec, but don't know about the Dr.'s. Apria is supposed to be setting me up with a 24 hr monitor. Frankly, I think the thing is going crazy. I just checked it and it's showing an O2 of 94 and a pulse of 226. I feel fine right now. Jim tested it on his finger several times and it gave eratic readings like 86 O2 with a pulse over 100. In the Dr's office his pulse was his normal 57.

Snoredog,

Those two were from daytime recordings.

Bev

[-SWS]

I think mine is set for 1 sec, but don't know about the Dr.'s. Apria is supposed to be setting me up with a 24 hr monitor.

I believe 1 second averaging is much more sensitive than most meters. So if yours is averaging at 1 second it will score highly transient SpO2 dips drastically different than meters averaging at 4 or especially 8 seconds. Again, the difference can be drastic.

Frankly, I think the thing is going crazy. I just checked it and it's showing an O2 of 94 and a pulse of 226. Jim tested it on his finger several times and it gave eratic readings like 86 O2 with a pulse over 100. In the Dr's office his pulse was his normal 57.

For a 1-second meter those readings just may be accurate. The pulse readings sound wacky. Were those wacky pulse readings right after putting the probe on?

Could be the meter needs time to discard the first batch of pulse-measurement artifacts before correctly calculating pulse. Could be the meter's bad, exactly as you say. Maybe other owners of Contec meters can comment on whether their meters require artifact settling time before pulse readings are accurate.

I think you need to fix your backup mode on your machine cause it clearly ain't a workin.

Those two were from daytime recordings.

Clearly?

[OutaSync]

This is from the last hour or so, while sitting at the computer



Is that possible?

[Snoredog]

I think you need to fix your backup mode on your machine cause it clearly ain't a workin.

Those two were from daytime recordings.

Clearly?

I was assuming that was from sleep monitoring. if those are daytime then what is happening at night? Dropping down to 65% ANYTIME is bad. IF that is daytime it goes back to my theory a person who breathes poorly at night also breaths poorly during the day. We see improvement some by use of the machine at night yet nothing is done about how they breathe during the day.

Does that thing have a like a 2 sec. sampling time?

I would think if she also had poor circulation in her finger it could impact the SA02 reading. Maybe Apria will loan her a good quality Nonin and finger probe. I agree a shorter sample would produce greater dips seen. I would want more of an average.

[-SWS]

Not only is it possible, Bev, but it might be accurate.

Look at those time demarcations on the X axis. Those demarcations are 5 seconds each. Now look at the pulse width of all your SpO2 drops. Those SpO2 drops are all less than 4 second widths (on edit: oops... the 13:55 to 14:08 SpO2 drop is not close to being under 4 seconds. ). If your doctor's meter was averaging at 4 seconds or 8 seconds (instead of 1 second like your meter), then we should expect drastically different numbers on your doctor's meter.

Print the two white papers I have linked above and bring those to your doctor next time you see him. He/she needs to be very aware that a meter set up for sustained SpO2 trends analyzing COPD won't reflect those highly transient SpO2 drops that any 1-second meter can catch. Again, that doesn't mean your equipment can't be faulty. So far it looks as if yours may be averaging much smaller time windows than your doctor's meter.

That's why I'd find out what your doctor's meter is averaging at and what the Apria meter is averaging at.

Snoredog, were you really referring to 2-second sampling or 2-second averaging? I think you meant 2-second averaging, since sample rates are fixed.

[Snoredog]

averaging, I could see using a shorter averaging period if you wanted to get a snap shot off current readings. the higher 4 and 8 second avg. you mention is what I've read others using.

wouldn't surprise me if she forgets to breathe during the day, a lot of people do that. People go around holding their breathe all day.

[-SWS]

The other possibility I've wondered about is the part of Bev's etiology that contributes to those CSDB traits on her BiLevel NPSG.

Researchers still don't know just what causes that---they only know PAP pressure can aggravate it. One theory floating around has to do with CSDB possibly being related to atypical transient characteristics of O2/CO2 blood gas exchange---possibly even skewing chemoreceptor sensitivity itself (my interpretation from memory, so please beware!). So Bev manifests CSDB traits on BiLevel, and she manifests incredibly quick SpO2 drops even during the day. Are those two physiologic traits possibly related?

Still, it's possible that her meter is going bad. She needs to find out if other Contec owners experience erratic pulse reading values---perhaps during an initial settling period.

[OutaSync]

Wouldn't my heart be exploding if it was beating that fast? Don't tell me I have bifarcated dysregulated breathing while awake, as well?

Snoredog, It records every second. I can zoom it up to show by second or by minute. I agree that my breathing isn't right during the day and that carries over into the night, but I can't put my finger on what is wrong.

I don't believe the Dr. will read any reports. I've been going there for 20 years and he doesn't know me from Adam. He always asks me what tests I've had done. He talks to me on his way out the door (five minutes are up). Yes, I know I need a better Dr., but aren't they all like that these days?

[-SWS]

Wouldn't my heart be exploding if it was beating that fast?

My question was whether that 200 reading was a sustained reading or just a brief reading right after putting the meter on. If it's a sustained reading than your meter or probe is clearly broke.

If it was just a brief reading, then it's probably typical artifact as your meter "settles in" to the correct readings.

So which case is it, Bev? A brief reading after putting the meter on or a sustained reading? If it turns out your 1-second meter understandably differs from your doctor's 4 or 8 second meter and your 200 pulse was a "settling" nuance of the CMS-60D:

It's conceivable that you can exchange your CMS-60D meter for an identical CMS-60D with the same design characteristics and operating nuances.

[Snoredog]

what I meant to say was her pulse was clearly not right

[-SWS]

what I meant to say was her pulse was clearly not right

Hear hear!

If it's a sustained reading than your meter or probe is clearly broke.

Perhaps one of those two little infrared windows on the finger clip needs to be wiped cleaned?

[Snoredog]

Wouldn't my heart be exploding if it was beating that fast? Don't tell me I have bifarcated dysregulated breathing while awake, as well?

Snoredog, It records every second. I can zoom it up to show by second or by minute. I agree that my breathing isn't right during the day and that carries over into the night, but I can't put my finger on what is wrong.

I don't believe the Dr. will read any reports. I've been going there for 20 years and he doesn't know me from Adam. He always asks me what tests I've had done. He talks to me on his way out the door (five minutes are up). Yes, I know I need a better Dr., but aren't they all like that these days?

I would seek out a pulmonologist, or pulmonary doctor if he is a ABSM Certified Sleep Doc too even better. You can retrain your breathing habits with bio-feedback, that is how the Resperate Blood Pressure device works, it trains you to breathe slower where it lowers blood pressure by up to 30 points. All this device does is monitor your breathing rate and provide a tone when you should breathe, 15 minutes per day I think is all that is needed and in 4-6 weeks BP is lower without medication.

Now when you go on CPAP machine for OSA it does basically the same thing, it prevents the apnea so you don't overshoot during the recovery phase and these machines seem to stabilize breathing somewhat, which is also a form of bio-feedback. Yoga breathing is another form of bio-feedback as they spend a lot of time on breathing properly.

You may have a job where you do a lot of talking, that means while you are talking you may not be breathing. My 90yr old mother does that, she talks so much her lips turn blue from not breathing, I have to tell her Mom shut up for a few minutes so you can breathe. She says oh are my lips turning blue? um yeah..