Finally got switched to auto - new data

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palerider
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Re: Finally got switched to auto - new data

Post by palerider » Fri Aug 22, 2014 2:28 pm

FreeIndeed wrote:I have not tried a whole mask liner though.
I didn't think it could make that much difference. If it really can I can certainly try it. Do you know a particular thread that talks about making them?
here's a start viewtopic.php?f=1&t=99574&st=0&sk=t&sd= ... mask+liner

normal mask liners won't *stop* leanks, but they'll muffle them a lot, and can turn huge farty noisy ones into gentle shusssing' ones.

nothing else is working, so why not try it?

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Wulfman...

Re: Finally got switched to auto - new data

Post by Wulfman... » Fri Aug 22, 2014 2:38 pm

FreeIndeed wrote:
Wulfman... wrote:
In view of palerider's post, have you tried a ResMed Ultra Mirage Full Face?

What size do you use? (or maybe more appropriately......what is the "appropriate" size for you?)

There's a mask sizing section on CPAP-dot-COM's website. If you haven't, you might want to check that out.


Den

.
Den, I tried the Mirage QUattro full face and even with the nose screw tightened down all the way I still couldn't get it to seal. I use a medium, but was on the edge of small (according to the chart), so I have both a medium and a small Airfit F10 right now. I've tried them both alone and with the resmed's gel face seal thingy.
In comparing the Quattro (I have one) to the UMFF (the one I started with in 2005), I'll choose the UMFF every night.
In my opinion, the Quattro has a flimsier seal/cushion than the one on the UMFF.

I don't know if this has been asked or discussed, but do you have facial hair? I've never seen a leak line like yours before.


Den

.

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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Fri Aug 22, 2014 3:05 pm

Yes, I do: goatee and soul patch (flavor saver, whatever you call it ). The funny thing though is that I can always get it to seal well where it crosses my soul patch- the huge leaks are at the bridge of my nose down to about mid-cheek. THat's where I just can;t get it to seal. I've tried having the straps loose so that the mask inflates and balloons up a little and I get nose leaks. I've also tried cranking the straps down as tight as possible and that seems to give me less leaks - though still very bad. I have big cheeks and a small nose bridge - I think that might be the big rub.
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archangle
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Re: Finally got switched to auto - new data

Post by archangle » Fri Aug 22, 2014 3:28 pm

Don't obsess over hitting 20. Try to make it work before deciding you need bilevel. You may need bilevel and higher pressure, but that's far from certain from the limited data you have so far.

You're not hitting 20 too often. Even if the machine wants to go over 20, you might find out that it gives you enough relief at 20. If you decide you aren't getting enough pressure at 20, experiment with turning EPR off. For some people, EPR reduces the effective pressure in terms of the therapy.

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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Fri Aug 22, 2014 3:57 pm

archangle wrote:Don't obsess over hitting 20. Try to make it work before deciding you need bilevel. You may need bilevel and higher pressure, but that's far from certain from the limited data you have so far.

You're not hitting 20 too often. Even if the machine wants to go over 20, you might find out that it gives you enough relief at 20. If you decide you aren't getting enough pressure at 20, experiment with turning EPR off. For some people, EPR reduces the effective pressure in terms of the therapy.
Thanks for the info. I might try EPR off this weekend. Also, I love your signature line. Both of them.
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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Mon Aug 25, 2014 2:18 pm

Well, I did try the mask liner last night, but forgot about turning the EPR off. Here's the chart for last night. I couldn't get the mask to seal very well and that's clearly evident. This evening I go back in tot the DME and I'm going to tell her that I;'m not leaving until we have plans for a new mask ASAP. I'll bet 10$ though that she looks at the AHI and says "at least the autoset is working - see it's better!" Then I'll ask, "Geee, with the leakage so high how are you sure that the machine can report accurate AHI?" Fun times...

Pugsy, I did read a lot of that other thread and I'm willing to try a nasal mask with chinstrap or the bite guard method. Well see how it goes tonight. I know my DME doesn't have any hybrid masks in stock, but she does have the P10 nasal mask. That might be the next step. Any other advice for my visit tonight?

Image
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Wulfman...

Re: Finally got switched to auto - new data

Post by Wulfman... » Mon Aug 25, 2014 2:23 pm

Maybe you should switch to a fixed pressure, too.


Den

.

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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Mon Aug 25, 2014 2:27 pm

Wulfman... wrote:Maybe you should switch to a fixed pressure, too.


Den

.
I was at a fixed 13cm, and I did have a better seal on the mask (still not great) but it was obviously too low a setting. Pugsy and others suggested I switch to autoset just to see what the machine would say I needed and then my DME went along with it, so I juts switched last week. But I found that my persistent mask leaks became huge persistent mask leaks with the extra pressure. I'm hoping that if I can get a mask that actually seals I can see what the machine really thinks I need.
Matt
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Wulfman...

Re: Finally got switched to auto - new data

Post by Wulfman... » Mon Aug 25, 2014 2:36 pm

FreeIndeed wrote:
Wulfman... wrote:Maybe you should switch to a fixed pressure, too.


Den

.
I was at a fixed 13cm, and I did have a better seal on the mask (still not great) but it was obviously too low a setting. Pugsy and others suggested I switch to autoset just to see what the machine would say I needed and then my DME went along with it, so I juts switched last week. But I found that my persistent mask leaks became huge persistent mask leaks with the extra pressure. I'm hoping that if I can get a mask that actually seals I can see what the machine really thinks I need.
Matt
You could still do it with fixed pressure. Just keep (gradually) incrementing your pressure up and see if there's a higher pressure that works.


Den

.

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Pugsy
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Re: Finally got switched to auto - new data

Post by Pugsy » Mon Aug 25, 2014 3:23 pm

Heck...get the P10 and let's see how it works. If you can breathe through your nose and keep your mouth shut for half the night it will be better than what is going on all night right now. Try it without a chin strap and let's see just how bad your maybe mouth breathing is before we worry about trying to fix it.

Also how about trying minimum of 15 and max of 17 and see what happens. Leave EPR at 3. Keep a tight range and maybe lessen the impact that increasing pressure does to the leak control situation.

There's something wrong with the current mask for it to leak that much...there's more than just increasing pressure making things worse.

You aren't fitting the mask at ramp pressure are you?

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palerider
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Re: Finally got switched to auto - new data

Post by palerider » Mon Aug 25, 2014 4:13 pm

Pugsy wrote: There's something wrong with the current mask for it to leak that much...there's more than just increasing pressure making things worse.

You aren't fitting the mask at ramp pressure are you?
freeindeed has said that he's having problems finding one to fit his face... 'rocking' on the cheekbones, I believe he said at one point. leaks at the nose, or the chin... I'm hoping the p10 works

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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Mon Aug 25, 2014 7:00 pm

Yeah it hits my cheeks and leaks crazy at the bridge of my nose. I've been lying down first, then going with the pad (if I use one) then the mask. I then turn the machine on to0 "mask fit" which pumps it up to full pressure so I can "leak test" it. Then I screw around with it for maybe 10 minutes trying to loosen or tighten straps, push on the silicone seal or pull on the mask liner.

Tonight's visit was pretty bad. I get the uneasy feeling that even though I've been seeing this lady every week now she doesn't remember anything from one visit to the next. It's not comforting. TOnight she admitted that she just isn;t sure what to do and tomorrow she wants to meet with their other "specialist" because she has more experience with problems. She looked at my stats and as I expected - even though my 95% leak is 100+, she said my AHI was looking great. I said I'm, not sure it's accurate with that bad a leak rate. I sure don't feel any different with the CPAP versus without. SO, I'll check back tomorrow and see what the they come up with. I'll try either a hybrid or the nasal pillow at this point. We gotta make a move though becasue doing the same thing and expecting different results is looney toons
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Re: Finally got switched to auto - new data

Post by Pugsy » Mon Aug 25, 2014 7:19 pm

FreeIndeed wrote:We gotta make a move though becasue doing the same thing and expecting different results is looney toons
I agree.
That mask is not working and you have tried everything to make it work and it's time to move on.
And move on to a different tech too...she's scary ignorant.

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FreeIndeed
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Re: Finally got switched to auto - new data

Post by FreeIndeed » Tue Aug 26, 2014 2:44 pm

Last night I tried the ol' Mirage Quattro again. And again I just couldn't get it to seal off at the bridge. Although it looks like maybe I did get it sealed ok at 315 AM or so? Here's the chart:

Image

PS- I did set the machine at 15 min / 18 max.
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palerider
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Re: Finally got switched to auto - new data

Post by palerider » Tue Aug 26, 2014 3:26 pm

FreeIndeed wrote:Last night I tried the ol' Mirage Quattro again. And again I just couldn't get it to seal off at the bridge. Although it looks like maybe I did get it sealed ok at 315 AM or so? Here's the chart:

PS- I did set the machine at 15 min / 18 max.
after looking at that, all I can say is... we gotta get you in a nasal mask/pillows... that mirage isn't working at all

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