Full Face Woes

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
funky-rat
Posts: 35
Joined: Tue Dec 16, 2014 1:07 pm

Full Face Woes

Post by funky-rat » Tue Dec 16, 2014 1:48 pm

Longtime lurker, first time poster.

Was diagnosed with mild apnea as a child, many years ago. I was given this hard rubber thing to clip to my jammies, and told not to sleep on my back. Machines were reserved for those with very bad problems, and were nothing like they are today. My husband was diagnosed with severe apnea in 2007 and put on therapy. In February of this year, I complained about exhaustion, falling asleep during the day, horrible morning headaches, and wild blood sugar spikes to my doctor. We'd always blamed insomnia, but I was sent for a sleep study, and ended up doing it at home, due to said insomnia and not being able to sleep. The results came back as "mild" - my worst night was 11 events - but my oxygen saturation was very very low. Scary low. They said that I probably never drop to restorative sleep because I'm fighting to stay alive. I was fitted for a CPAP a week later. You'd think it would be over there.

I immediately had to change masks. I was given a Wisp, but I perpetually woke up with my mouth open (I'm a notorious mouth breather). They gave me a chin strap but I would rip it off in the middle of the night. They instead gave me a Quattro Air (size Small). I hated it, but I sucked it up. Lots of leaking - especially around the eyes. It also pinched my nose across the bridge, like someone was holding my nose shut. At a 2 month follow-up, I complained I just wasn't feeling rested. I'd stopped falling asleep after supper and during the day, but still wasn't feeling fantastic. They encouraged me to stick with it, and I did. In the interim, I one day noticed that I was mouth breathing a lot, and very "stuffy". Sudafed and other decongestants weren't helping. I went to see an ENT. You don't want to see a doctor look in your nose, shake their head, look again, say "It can't be", look again, and then say "I can't help you. You need to see a specialist ENT" (yes, they exist). Turns out my nose was packed with scar tissue. We still have no clue where it came from. It came on so gradually that I didn't notice. People had been saying to me "Are you OK? You seem winded." and similar things. Turns out it was because I was mouth breathing and I didn't notice. We scheduled surgery.

At my 4 month follow-up, I got a different mask. I told them I couldn't take the Quattro anymore. I was given a Fisher & Paykel Forma (small), and I loved it. It held my mouth shut, but allowed it to open slightly if need be. I had my surgery 2 weeks later, and I had splints in my nose. Due to the severity of the scarring (one nostril 95% blocked, the other 75%), I had to keep the splints in for an agonizing 8 weeks. The Forma bothered me something fierce. I couldn't even consider doing the Quattro. My husband was using the Wisp, but I knew I couldn't use that either. I ended up using the Fit Life Total Face mask (referred to in my house as the Gas Mask). I didn't like it, but it worked as well as any would - my nose was so sensitive to the touch that even sunglasses hurt. I returned to the Forma as soon as the splints came out, and all was good until a month-ish ago.

I began to be jolted awake in the night with what I can only call the "face farts". Lots of leaking around the bottom. Occasional leaking around the top. No matter what I do, I can't stop it. I wipe the mask down nightly. If I pull the bottom tighter, I wake up with a headache. I've been getting pimple like bumps on occasion, right where the mask goes. I don't know if it's starting to break down, or what. I tried the Wisp again since I don't need to mouth breathe due to my nose, but my mouth still pops open at times, and I found the nose piece uncomfortable (I wear a petite in that model). I tried it with and without the humidifier, but nothing changed. Sometimes the cushion pops out of place, and I wake up with the mask roaring, and I have to pop it back in.

I'm due for a new mask in January. I've already scheduled my time. I talked to my DME person - who is great - and she wants me to try on the Fisher & Paykel Simplus. I was looking at the Full Life and ones similar that have no post or forehead piece - that really appeals to me - but I sometimes side sleep (being on my back now after years of not being on my back is hard) and sometimes toss and turn, so I'm not sure that it would stay put. I may dig out the Fit Life tonight because I'm just sick of the face farts and other issues. My nightly usage went from 6-7 hours/night to 4-5 hours/night, and I can feel it.

Anyone have any helpful hints or masks I should look at? I have a round face and a small nose. I have no neck, so some headgear just isn't comfortable. I haven't had luck with the nose-only masks, and I am forbidden from using nasal pillows by my ENT, due to the scarring (especially since we don't know what caused it). He's all about the CPAP but doesn't want me using those. Thoughts welcome. Thanks!

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Sclark08
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Re: Full Face Woes

Post by Sclark08 » Tue Dec 16, 2014 1:58 pm

My structure is similar to your and after about 1000 trys the Resmed Ultra Mirage has been the best mask I have used. I especially like the adjustment for the nose with 4 different settings depending on your facial srtucture.

Guest1

Re: Full Face Woes

Post by Guest1 » Tue Dec 16, 2014 2:31 pm

I use 2 masks consistently. They are Resmed Quattro Air and Resmed Airfit F10. Both use the same cushion so it helps. I can get a consistent seal with both. The alternate between the two so that the pressure points on the face are different on different nights.

I use a mask liner with both of them. I am an active side sleeper. I probably sleep on my back less than 20% of the times (sleepyhead tells me when I am on the back since the pressure climbs up a lot).

With the F10, I can wear it very very loose and still have minimal leaks. It took me a while to figure out the settings on this mask to the point that I can wear it loose. It took a bunch of nights and iterations to get to this point. The only thin is

With the Quattro Air, I wear it a bit tight. But I have no red marks in the morning anywhere. Looks like the anchor on the top does its job well to move pressure points off the nose area and only the forehead. I would suggest you see the fitting video for this mask on youtube. That will be a good start to make sure you don't have leaks.

Of all the FFMs I have tried and seen, these 2 are made with the latest materials and are the lightest with lowest no. of parts. So hang in there and make the quattro air work for you.

Janknitz
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Re: Full Face Woes

Post by Janknitz » Tue Dec 16, 2014 7:27 pm

Have you replaced the cushion in your Forma? Could it be worn out?
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

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Wulfman...
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Re: Full Face Woes

Post by Wulfman... » Tue Dec 16, 2014 9:24 pm

funky-rat wrote:Longtime lurker, first time poster.

Was diagnosed with mild apnea as a child, many years ago. I was given this hard rubber thing to clip to my jammies, and told not to sleep on my back. Machines were reserved for those with very bad problems, and were nothing like they are today. My husband was diagnosed with severe apnea in 2007 and put on therapy. In February of this year, I complained about exhaustion, falling asleep during the day, horrible morning headaches, and wild blood sugar spikes to my doctor. We'd always blamed insomnia, but I was sent for a sleep study, and ended up doing it at home, due to said insomnia and not being able to sleep. The results came back as "mild" - my worst night was 11 events - but my oxygen saturation was very very low. Scary low. They said that I probably never drop to restorative sleep because I'm fighting to stay alive. I was fitted for a CPAP a week later. You'd think it would be over there.

I immediately had to change masks. I was given a Wisp, but I perpetually woke up with my mouth open (I'm a notorious mouth breather). They gave me a chin strap but I would rip it off in the middle of the night. They instead gave me a Quattro Air (size Small). I hated it, but I sucked it up. Lots of leaking - especially around the eyes. It also pinched my nose across the bridge, like someone was holding my nose shut. At a 2 month follow-up, I complained I just wasn't feeling rested. I'd stopped falling asleep after supper and during the day, but still wasn't feeling fantastic. They encouraged me to stick with it, and I did. In the interim, I one day noticed that I was mouth breathing a lot, and very "stuffy". Sudafed and other decongestants weren't helping. I went to see an ENT. You don't want to see a doctor look in your nose, shake their head, look again, say "It can't be", look again, and then say "I can't help you. You need to see a specialist ENT" (yes, they exist). Turns out my nose was packed with scar tissue. We still have no clue where it came from. It came on so gradually that I didn't notice. People had been saying to me "Are you OK? You seem winded." and similar things. Turns out it was because I was mouth breathing and I didn't notice. We scheduled surgery.

At my 4 month follow-up, I got a different mask. I told them I couldn't take the Quattro anymore. I was given a Fisher & Paykel Forma (small), and I loved it. It held my mouth shut, but allowed it to open slightly if need be. I had my surgery 2 weeks later, and I had splints in my nose. Due to the severity of the scarring (one nostril 95% blocked, the other 75%), I had to keep the splints in for an agonizing 8 weeks. The Forma bothered me something fierce. I couldn't even consider doing the Quattro. My husband was using the Wisp, but I knew I couldn't use that either. I ended up using the Fit Life Total Face mask (referred to in my house as the Gas Mask). I didn't like it, but it worked as well as any would - my nose was so sensitive to the touch that even sunglasses hurt. I returned to the Forma as soon as the splints came out, and all was good until a month-ish ago.

I began to be jolted awake in the night with what I can only call the "face farts". Lots of leaking around the bottom. Occasional leaking around the top. No matter what I do, I can't stop it. I wipe the mask down nightly. If I pull the bottom tighter, I wake up with a headache. I've been getting pimple like bumps on occasion, right where the mask goes. I don't know if it's starting to break down, or what. I tried the Wisp again since I don't need to mouth breathe due to my nose, but my mouth still pops open at times, and I found the nose piece uncomfortable (I wear a petite in that model). I tried it with and without the humidifier, but nothing changed. Sometimes the cushion pops out of place, and I wake up with the mask roaring, and I have to pop it back in.

I'm due for a new mask in January. I've already scheduled my time. I talked to my DME person - who is great - and she wants me to try on the Fisher & Paykel Simplus. I was looking at the Full Life and ones similar that have no post or forehead piece - that really appeals to me - but I sometimes side sleep (being on my back now after years of not being on my back is hard) and sometimes toss and turn, so I'm not sure that it would stay put. I may dig out the Fit Life tonight because I'm just sick of the face farts and other issues. My nightly usage went from 6-7 hours/night to 4-5 hours/night, and I can feel it.

Anyone have any helpful hints or masks I should look at? I have a round face and a small nose. I have no neck, so some headgear just isn't comfortable. I haven't had luck with the nose-only masks, and I am forbidden from using nasal pillows by my ENT, due to the scarring (especially since we don't know what caused it). He's all about the CPAP but doesn't want me using those. Thoughts welcome. Thanks!
It would REALLY help if you would add the specific machine and pressure settings to your profile.
Some of the things I'm suspecting are that your machine is an APAP in a range of pressures and the mask is not adjusted for the higher pressures and when it reaches the higher pressures, that's causing the "mask farts".
The other thing is the bed pillow you're using.......may not be right for this therapy.
You didn't say WHY you're sleeping on your back when you're not used to it. If you've been a side-sleeper before, then to me that reaffirms the bed pillow issue. With the proper pillow, you should be able to sleep in whatever position you're used to. With many standard fiberfill pillows, the head sinks too far into it and that pushes the mask out of alignment.....and causes leakage.
Anyway, those are my suspicions. If you would care to fill in the blanks, that would help immensely.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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funky-rat
Posts: 35
Joined: Tue Dec 16, 2014 1:07 pm

Re: Full Face Woes

Post by funky-rat » Wed Dec 17, 2014 1:57 pm

I chose a machine when setting this up. It's chosen in my profile - not sure why it doesn't show up on the bottom. I use the RemStar Auto Flex. I have no set pressure (my husband does, but I don't, due to the fact that my apnea events per night were actually considered "mild", but my Oxygen Saturation was very low). I try to sleep on my back despite being "trained" not to when I was young, but it's hard sometimes. Truth be told - and I don't often mention this because people take it the wrong way - I often end up sleeping in the living room as my husband has more than just apnea as a sleep issue. He's an "active" sleeper - he rolls, and kicks, and moves his arms, and talks in his sleep. Yes, I drag the machine out with me and end up sleeping in my recliner 3/4 of the time so that I can actually get some sleep. It's not his fault, and attempts to medicate it brought about bad results. My doctor and CPAP supplier both are well aware of this.

I had fairly good luck with the Forma last night until about 4:30. I woke up and it was wet under the mask (not sure why - rainout is never a problem) and it wouldn't seal, so I ended up taking it off.

I asked my supplier if the Forma might be breaking down, and she said she didn't think so (I got it in July - I can only get new masks every so often per my insurance - I'm not due again until January). She thought that perhaps my prior issues with my mouth hanging open all night so I could breathe may have been "anchoring" it to my face better and that now with my mouth shut, it's leaking.

I've tried the Quattro Air so many times and it just pinches my nose - like someone is holding my nose shut. I tried my dad's - his is a medium - and it's too large. He complains it pinches his nose too, so perhaps it's just the way our noses are - we have the same nose.

I've written down the other suggestions, and I'm going to be doing some trying on next month, but am always happy for tips.

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Sir NoddinOff
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Re: Full Face Woes

Post by Sir NoddinOff » Wed Dec 17, 2014 2:12 pm

Guest1 wrote:I use 2 masks consistently. They are Resmed Quattro Air and Resmed Airfit F10. Both use the same cushion so it helps. I can get a consistent seal with both.
I cast my vote with the reply above. Please note that I've tried LOTS of FFMs over the last year and a half. IMO, the new ResMed FFMs are head and shoulders above the rest... that being said, everybody's face is different, therefore I respect any diverging opinions. Kinda like shoes, if you think about it. EDIT: These new FFMs by ResMed are way too damned expensive tho.

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I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

Guest1

Re: Full Face Woes

Post by Guest1 » Wed Dec 17, 2014 2:48 pm

I got my F10 first by paying full price ($149). I got my Quattro Air off eBay as parts. Total Cost $48. But the parts were not sealed. They look brand new. Who knows, maybe they are "reprocessed" mask parts but they are holding up well. You could get a sealed cushion and sealed headgear and open frame for $65 - $80 on eBay. YMMV.

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Sir NoddinOff
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Re: Full Face Woes

Post by Sir NoddinOff » Wed Dec 17, 2014 8:36 pm

Guest1 wrote:I got my F10 first by paying full price ($149). I got my Quattro Air off eBay as parts. Total Cost $48. But the parts were not sealed. They look brand new. Who knows, maybe they are "reprocessed" mask parts but they are holding up well. You could get a sealed cushion and sealed headgear and open frame for $65 - $80 on eBay. YMMV.
From my experience, various workers at sleep clinics will sometimes grab the once used masks from the overnight studies and offer them on eBay or Craigslist. Some manage to get their hands on a bag sealer, not hard to do, and make the bags look official... others just stick them in a zip-lock bag and call it good. Some other folks are just rip-off artists and will sell you their old masks/junk as new or almost so. It's a crap shoot at best. If buying from those sources, I'd certainly super clean anything I bought like that very carefully... I use Contol III antibacterial solution available from our hosts, CPAP.com.

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Mask: AirFit™ F10 Full Face Mask with Headgear
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I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

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Pugsy
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Re: Full Face Woes

Post by Pugsy » Thu Dec 18, 2014 9:10 am

funky-rat wrote:I chose a machine when setting this up. It's chosen in my profile - not sure why it doesn't show up on the bottom. I use the RemStar Auto Flex
Nothing is showing up because you likely have chosen something that is incorrect and discontinued. Links to discontinued machines are broken and nothing will show up when links are broken.
There's like 5 different Remstar Auto Flex machines (or maybe more) but only one has an active link

Look on the bottom of the blower unit for a 3 digit number with either DS, REF or P in front or behind it.
I suspect that you have the model 560 if you are seeing Auto on the top of the machine...disregard the term Remstar as that name has been given as part of model name for over 15 years.

If it is a 560 machine then this is what you need to choose in the equipment menu.

for machine...PR System One 60 Series Auto CPAP
for humidifier...PR System One 60 Series heated tube humidifier with heated tube (even if you don't have the optional heated hose at this time)

If you have a different model number than 560 then tell us what it is and we will tell you what choices to make.

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Janknitz
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Re: Full Face Woes

Post by Janknitz » Thu Dec 18, 2014 4:49 pm

1. I still don't get WHY you are trying to sleep on your back? It's the worst position apnea-wise.

2. I think this is at least part of the problem:
I asked my supplier if the Forma might be breaking down, and she said she didn't think so (I got it in July - I can only get new masks every so often per my insurance - I'm not due again until January). She thought that perhaps my prior issues with my mouth hanging open all night so I could breathe may have been "anchoring" it to my face better and that now with my mouth shut, it's leaking.
Medicare and most insurers will replace the mask cushion EVERY MONTH. The mask cushions don't last long. The head gear stretches out, too, but usually those can only be replaced every 6 months. Under Medicare Guidelines, you can get a new mask (without headgear--which is STUPID, but those are the rules) every 3 months. So I'm guessing your "supplier" doesn't want to supply you with a new cushion, because it's a lot of paperwork for little, if any, profit. But that's where you need to start--a new cushion.

3. I agree with what others have said that you need to fit the mask at full pressure if your APAP is set wide open. That means you have to set it at the highest pressure, then fit your mask. Then restore the settings to the way they are now, unless you or your doctor want to try dialing in those settings better to get better quality sleep.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

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Wulfman...
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Re: Full Face Woes

Post by Wulfman... » Fri Dec 19, 2014 6:05 pm

funky-rat wrote:I chose a machine when setting this up. It's chosen in my profile - not sure why it doesn't show up on the bottom. I use the RemStar Auto Flex. I have no set pressure (my husband does, but I don't, due to the fact that my apnea events per night were actually considered "mild", but my Oxygen Saturation was very low). I try to sleep on my back despite being "trained" not to when I was young, but it's hard sometimes. Truth be told - and I don't often mention this because people take it the wrong way - I often end up sleeping in the living room as my husband has more than just apnea as a sleep issue. He's an "active" sleeper - he rolls, and kicks, and moves his arms, and talks in his sleep. Yes, I drag the machine out with me and end up sleeping in my recliner 3/4 of the time so that I can actually get some sleep. It's not his fault, and attempts to medicate it brought about bad results. My doctor and CPAP supplier both are well aware of this.

I had fairly good luck with the Forma last night until about 4:30. I woke up and it was wet under the mask (not sure why - rainout is never a problem) and it wouldn't seal, so I ended up taking it off.

I asked my supplier if the Forma might be breaking down, and she said she didn't think so (I got it in July - I can only get new masks every so often per my insurance - I'm not due again until January). She thought that perhaps my prior issues with my mouth hanging open all night so I could breathe may have been "anchoring" it to my face better and that now with my mouth shut, it's leaking.

I've tried the Quattro Air so many times and it just pinches my nose - like someone is holding my nose shut. I tried my dad's - his is a medium - and it's too large. He complains it pinches his nose too, so perhaps it's just the way our noses are - we have the same nose.

I've written down the other suggestions, and I'm going to be doing some trying on next month, but am always happy for tips.
That makes absolutely NO sense whatsoever. The severity of apnea has no correlation to the amount of pressure it can take to keep the airway open. Some folks with Mild or Moderate categories may need higher pressures, while those with a Severe diagnosis may need only lower pressures.

Again......what are your pressure settings and why are you trying to sleep on your back if you haven't before you started therapy?


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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cathyf
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Re: Full Face Woes

Post by cathyf » Fri Dec 19, 2014 6:30 pm

I have an Airfit F10 FFM, and I started out with the size small. After about a month I realized that it was simply too big -- if I close my mouth, then there is one particular spot where it won't leak, but if I move at all and it shifts the tiniest amount then it either leaks out the top or the bottom. With mouth open there is slightly more play, but as time went on -- and the cushion aged -- I was getting more and more leaks. I got my dme to special order an x-sml cushion -- on the F10 there are only 2 frames -- one fits both x-sml and sml, and the other one fits med and lrge. I popped the old cushion off and put the x-sml on and it made a HUGE difference.

There seems to be a pretty common cluster of symptoms for a group of us with apnea. We have small mouths and small faces, and so we just have a generally shorter trip between flow limitation and full-fledged apnea. I had 4 permanent teeth pulled and then wore braces for 7 years to get my teeth to fit in my mouth. And when it was time for the wisdom teeth to come in those had to be pulled, too.

I can tell that the next battle is going to be getting the headgear to last another 3-1/2 months. The one I have is stretching, and I am running out of velcro -- I am pulling it past anywhere to latch on to. I'm hoping that I can nurse this along until I am due for a new headgear, and then I can order the ForHer. Or maybe I can put a towel on my head or something to make it thicker...

Anyway, you are describing a lot of what I was experiencing, and in my case it turned out to be right-mask-wrong-size.

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Bill44133
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Re: Full Face Woes

Post by Bill44133 » Fri Dec 19, 2014 6:52 pm

Sorry to read about your issues. I use the Zzz-Mask Full Face CPAP Mask by Probasics. I like that it does not have the forehead support, and more then anything else I like the price. Compared the price to Resmed masks this mask is half price, and the replacement cushions are about half also. The mask works well for me, but every one is different. I have high pressure settings of 23/19, and so far served me well.

I wish you well...

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cathyf
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Re: Full Face Woes

Post by cathyf » Fri Dec 19, 2014 7:02 pm

Bill, I looked at that mask -- it looks very much like the F10 for half the price! Do you have any feel for whether it runs bigger or smaller than the F10? Because the only way that the small is going to fit is if it runs smaller....