wife finally gave in, want update on machines

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wilsonintexas
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wife finally gave in, want update on machines

Post by wilsonintexas » Mon Oct 06, 2014 6:05 pm

Story and backgroun nd then questions last.

It has been a while saince I have been on the board. (company moved my office that had internet access, then beneign pitutary tumor, radiation tyreatment, and mineer's). So life has been busy.

A while back I noticed that my wife's breathing was spotty, put on my 02 meter and saw a lot of 02 dips. But when I could time her most of her stoppages were 5-7 seconds, below the 8 seconds needed to be counted as an event.

She aslo has MS, and very shallow breathing. After a recent operation she had a collapsed liung, and even 2 weeks later her volumn is 750 ml, but she can only inhale for less than 2 seconds. We got her an 02 machine perscribed while we waited for the tests...... based olow o2 from a DR recorder dueing the night. On 02 her spo2 was in the 90-95 range most of the time. in an hour 15 drops below 90, but none below 88.

SO finally got her into a study, AHI 7.5 (just above the limit). Of these 6 centrals, 1 mixed, 3 obstructive....... and 34 which were to short to count as an event but had 02 drops.

She aslo has MS, and very shallow breathing. After a recent operation she had a collapsed liung, and even 2 weeks later her volumn is 750 ml, but she can only inhale for less than 2 seconds.

So she is headed to a second study to tritrate her.

I started with an S9, then went to bipap, and eventually ended up on ASV.

before the study I tried here on a spare S9 set at 4 min and max. and she had trouble adjusting to the pressure during the day, watching tv. She is very worried about adjusting to the machines..... which I know takes time.

Talking to the DR and nurse, they are considering bipap to try make it easier to adjust to.

I know we want a machine that can record data.

I already have sleepy head and am comfortable with it.

I have the recording spo2 meter, and can integrate it with sleepy head.
I have my old S9, and a RESMED that I currently use.

SO the questions,

1) if we end up with sgtraight CPAP or bas there been a machine out there to replace the S9 autoset? If we are straight cpap I am tempted to request a S9, so we have a spare machine.

2) i see RESME has the airsense s10 out. How is it working out for rolks? Is there much user experience between the S9 and S10? ?

2) What is the current state of bipaps?

This forum helped me a LOT when I struggled through cpap a few years ago..... glad many of you are still here to help my wife.

I tried to search machine recommendations (which use to be a hot topic for newbies) and did not see any recent postings.

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Pugsy
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Re: wife finally gave in, want update on machines

Post by Pugsy » Mon Oct 06, 2014 6:16 pm

When she tried the S9 did you have EPR turned on?
It won't work at 4 cm because it can't go below 4 cm but maybe 6 or 7 cm with 3 EPR might be easier for her to get used to.
I know it sounds weird but that difference between inhale and exhale might actually be easier to get used to.

You might look at the new AirSense for Her Autoset...it has a special mode for women that might help. Supposed to be gentler. At least that's what I have read.

In regular BiPaps (bilevels) and not the ASV bilevels not much has changed except that the latest 60 series Respironics bilevel auto mode machines have an adjustable pressure support in auto bilevel mode.

In terms of ASV bilevels...the latest models have an adjustable minimum and maximum EPAP instead of just a minimum...both Resmed and Respironics.
Have no idea what the latest ResMed ASV line (AirCurve Adapt) might have beyond what the S9 Adapt Auto has....if anything different.

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wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Mon Oct 06, 2014 6:25 pm

Thanks for the quick reply, I tried her with EPR at all settings, but we never went above 4.

I will see if she is willing to try a with a setting of 6 or 7 and an epr set up......

Thanks for the comments.

My current RESMED ASV is 2 years old, so I will be looking into a replacement for it later this year.

wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Mon Oct 06, 2014 6:35 pm

I assume we are talking ablut the S10 airsense for her..... is that forrect?

Does it record data and can I load it into sleepy head?

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Pugsy
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Re: wife finally gave in, want update on machines

Post by Pugsy » Mon Oct 06, 2014 7:08 pm

If you never used anything more than 4 cm then EPR never had a chance to kick in and help because it can't go below 4 cm so worth maybe trying it with EPR and the pressure set so that EPR can actually work its magic.

ResMed doesn't seem to be calling them "S10" models...we know what is meant but I don't think that ResMed will be using that nomenclature.
They might abbreviate it to A10....but so far what I see has been AirSense 10 or AirCurve VPAP 10
but I know what you meant..

Yes...we are talking about the AirSense 10 AutoSet for Her model...not the regular AirSense 10 Autoset.
https://www.cpap.com/productpage/resmed ... idair.html
The AirSense 10 AutoSet for Her has 3 modes of operation
1..cpap mode
2...regular apap auto adjusting mode like the S9 AutoSet has
3...and the new special apap auto adjusting mode for women...this is the new special supposedly gentler algorithm...now I don't know if it is worth the hype but to my way of thinking...better to have it available just in case it might come in handy.
It's going to take people using this mode who used the S9 Autoset to come up with comparisons. Brand new to cpap newbies never used anything else may love it but they might also have loved the S9. They don't have anything to compare to.

The regular AirSense 10 Autoset only has modes 1 and 2 above....like the S9 AutoSet.

Yes. SleepyHead's latest version has just been updated for the AirSense machines...might still be a bit buggy but it's working. ResScan 5.1 will work with the new machines.
I don't know when Mark will get the Aircurve VPAPs working with Sleepyhead...may be a while since they aren't even out on the market yet and Mark needs the data off the SD cards to make Sleepyhead work with them.

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wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Fri Oct 10, 2014 9:00 pm

Thanks for the link and sorry about the confusion. If she is perscribed cpap (probably will) I will request this machine. So far this group has been pretty good about perscribuing the specific machine I requested when I was first going through this.

I have not gotten her to try the s9 autoset with a pressure of 7 and epr of 4....... but the study is coming up and wew will see.

Right now whe is on 02 only and her sats are ok..... she is hoping to stay on 02 only..... not sure what has to happen for that to work.

herr AHI was just above 5.0 cutoff at 7.x. but there were the 34 events just under the 8 second limit where her sats dropped. the 02 is dealing with them pretty good.


I know that I had to fail cpap, then fail bipap before I was put on an ASV. (by the say my AHI on ASV os usually 0.00 sometimes o.01 or 0.02 which is either 1 or 2 2vents...... I am really really happy with that...... My o2 is staying in the 90-95 percent range with just a few drops below that....

So what is necessary for her to be able to keep the 02, but not have cpap?

As I said earlier her o2 sata on just oxygen are 90-95 most of the night, very few drops below 90, none hit 88. Some times she moves up to the 95-100 range..... so I think that just o2 might be ok for her.......

Thoughts?

I think I have some on and off of 02 recordings if they would help.

But as I said, I am pretty sure that during the titration study she will be perscribed cpap, and I want her to have the best chance of getting use to it.

wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Mon Nov 03, 2014 2:36 pm

My wife's titration came back and they are starting here on BIPAP because of a large number of hypo events.

I was all set to request the airsense auto for her..... but now it is bipap I need to rethink.

I am looking and am am not sure if the Aircurve 10S is an auto bipap or not. I can not find a bipap for her.... I really liked the ida of the for her algorithm.

Any help would be appreciated. The DR is willing to write teh script for any machine I want.
thanks

I just re-read Pugsy's previous post and she mentioned the new PR auto bipap...... maybe that is the one.

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bwexler
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Re: wife finally gave in, want update on machines

Post by bwexler » Mon Nov 03, 2014 3:18 pm

When I called Rested they said the Air curve models would not be available until next year.

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palerider
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Re: wife finally gave in, want update on machines

Post by palerider » Mon Nov 03, 2014 3:34 pm

wilsonintexas wrote: I am looking and am am not sure if the Aircurve 10S is an auto bipap or not. I can not find a bipap for her.... I really liked the ida of the for her algorithm.
the AC10 S is a set bilevel (not bipap) machine.

the ac10 vauto is an auto titrating bi-level.

there is no new prs1 auto bipap.

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Pugsy
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Re: wife finally gave in, want update on machines

Post by Pugsy » Mon Nov 03, 2014 3:36 pm

As far as I know the only special "for Her" algorithm is in the AirSense 10 AutoSet for Her.
I don't think it is available in the bilevel devices at all.
I don't see the AirCurve machine being available anytime soon.
So your choices right now in the bilevel machines are between ResMed S9 VPAP (either the S for fixed mode or Auto for auto bilevel mode) or the Respironics PR System One 60 Series BiPap Pro (fixed) or Auto (has auto mode available) models 660/760

The PR S1 60 Series BiPap Pro model 660 has 2 modes of operation available ...cpap and fixed bilevel
The PR S1 60 Series BiPap Auto model 760 has 3 modes available...cpap, fixed bilevel and auto bilevel

The S9 VPAP S has 2 modes available...cpap and fixed bilevel...
The S9 VPAP Auto has 3 modes available...cpap, fixed bilevel and auto bilevel.

The AirCurve machines when they become available I would assume will have the same things that the VPAPs have
AirCurve 10 S...2 modes...cpap and fixed bilevel
AirCurve 10 Vauto......3 modes...cpap, fixed bilevel and auto bilevel.

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palerider
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Re: wife finally gave in, want update on machines

Post by palerider » Mon Nov 03, 2014 4:02 pm

Pugsy wrote: The AirCurve machines when they become available I would assume will have the same things that the VPAPs have
AirCurve 10 S...2 modes...cpap and fixed bilevel
AirCurve 10 Vauto......3 modes...cpap, fixed bilevel and auto bilevel.
That's what the marketing blurb says...

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wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Mon Nov 03, 2014 6:11 pm

We need to order the machine this week. ust called resmed, they do not have a release date for htenew bilevel machines

So it lookls like it will be the S9 (which will be able to share spares with my S9 ASV) or the PR.

We know from some TV Test sessions that my wife will not adjust to well to the machine, so I am willing to give common spares if the PR is "less agressive"

I think that the DR may perscribe straight bipap to start (18/8) but I am going to try and at least get an auto bilevel so we have the option when things settle down to try sommething else.

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archangle
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Re: wife finally gave in, want update on machines

Post by archangle » Mon Nov 03, 2014 9:40 pm

S9 should be fine. It's a good machine with a long track record.

A10 would probably be better, but it doesn't have the track record yet. I wouldn't worry that much about which one of these two you get.

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palerider
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Re: wife finally gave in, want update on machines

Post by palerider » Mon Nov 03, 2014 9:49 pm

archangle wrote:A10 would probably be better, but it doesn't have the track record yet
given that it doesn't even *exist* yet, that would be a true statement.

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wilsonintexas
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Re: wife finally gave in, want update on machines

Post by wilsonintexas » Mon Nov 03, 2014 10:25 pm

I am going to try for the Pr S1 760.

The deciding factor is that the S9 keeps the same pressure delta etween inhale and exhale as it increases pressure. I know that she finds it hard to breath out againsgt pressure. The PR will let each float independtly. This will probably be a little easier on her.

To be honest, we may end uo in straight bipap anyhow. A LOT of her events are only 3-6 seconds long and would not count as an event, so teh machine would not adjust for them in teh auto mode..... but at least we can try it later if she has problems with a straight bipap. The DR is perscribing 12/8, so until we can verify compliance we will probably have to start there. but in a month or so.......


So off to start dealing wiht APRIA tomorrow.... I am looking forward to it so much.

The DR has already said he would write up what we want...... I am not sure hew will know I am moving to an auto out from under him.......

Thanks for all of the support and quick replies on this.