Thread on TAS board.
Well if this is the case wader, rg, and titrator might have their pick of used masks available
Aura not working for some... Uh Oh...
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wading thru the muck!
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Mikesus,
By no means do I think that this mask won't out perform all other nasal pillow interfaces on the market. The negative complaints I've read either deal with leaks associated with the pillows being to small, or the headgear shifting which seems to occur only for people with slippery heads. The pillow size is apparently being addressed with the pending release of the XL seals and the slippery head thing is going to cause problems with any headgear.
By no means do I think that this mask won't out perform all other nasal pillow interfaces on the market. The negative complaints I've read either deal with leaks associated with the pillows being to small, or the headgear shifting which seems to occur only for people with slippery heads. The pillow size is apparently being addressed with the pending release of the XL seals and the slippery head thing is going to cause problems with any headgear.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
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Ann N.
Well, actually my comments about unacceptable leakage were related to possibly the high pressure I require. My head is not particulary slippery. (My scalp is covered with hair as one might expect for a woman.) I can use either the medium size or large pillows for my Breeze with about the same good results. I tried both the medium and the large for the Aura, neither worked. My head, face and nose are all the usual issue, nothing at all out of ordinary. I think that the reason the Aura will not hold the seal for me is probably due to the 17/13 pressure I require. Even if I get a seal, it is lost whenever I start moving around. I would really like to know if other high pressure people have found the same thing.
Ann
Ann
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wading thru the muck!
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- Joined: Tue Oct 19, 2004 11:42 am
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Ann, I was going to ask you if you'd tried adding homemade straps to the sides to stabilize the nasal pillows part. As in the picture of how I added straps to my Aura:
click here for picture of exactly where I add side straps down low on the Aura
But then, I thought...you know, Ann is a smart cookie and a determined one. I'm sure she tried additional straps.
So, in true lab rat fashion (*gulp* ) I decided to go set my autopap to straight cpap at a pressure of 20....to see what it was you're experiencing with nasal pillows and a high pressure.
Whewwwwwieeee. My hat's off (and mask's off!!) to those of you who are dealing with stratospheric pressures coming in at you, even if you do get bi-level relief on exhalation.
And, sure enough - just as you said - the Aura's nasal pillows (the Large that do me so perfectly at my autopap pressure range that never hits above 13 briefly on occasions) ....at 20 were leaking every time I moved my head. No amount of adjusting the wire or the front of the headgear changed the situation...leak, leak, leak. My usual stabilizing side straps didn't prevent that at all. Would drive a person nuts.
However, if I took my fingers and pressed the least little bit to push the pillows against my nose just a bit.... the leaks stopped.
Bingo! Now if I could just find something to use as a strap to keep the nasal pillows literally squashed against the front of my nares.....what to use, what to use? I didn't want velcro because this was going to have to go against my cheeks, in essentially the same position that the Swift's straps lay.
I cut off one leg of a pair of panty hose. The "leg" is stretchy, soft, long enough...hmmm, might work. I draped the middle of the panty leg so that I had two equal lengths of panty hose leg hanging straight down between the two nasal pillows. Then I wound one of the lengths around the bottom corner of the silicone pillows holder, coming out on the outside of a nasal pillow. Same thing with the other length - winding it once around the other bottom corner. The winding looks kind of like a wide W by the time you've wound around the bottom piece of silicone enough times for the panty hose leg to pass by the base of both pillows.
I put the mask on, fired up the pressure of 20. After I got the pillows in place as best I could with my fingers, I then let go of the pillows and simply tied the dangling ends of the panty hose leg behind my neck with a bow knot for easy readjustment. Voila'. Leaks stopped instantly. And the smushed pillows still felt comfortable. No undue pressure on my nostrils. I undid the bowknot and retied it looser, still ok. I found that it could be tied fairly loose and work, probably thanks to the stretchiness of panyhose material.
But the true test: Would that jury-rigged pantyhose leg pillows strap keep the Aura's nasal pillows sealing absolutely at 20 cm H20, if I tossed, turned, moved my head up/down/all round on a pillow. Could it hold a seal comfortably, no matter what? YES!!!! The Aura was noisy as heck up at that high pressure, but the noise wasn't from leaks!
Ann, you might want to sacrifice one leg (pantyhose leg, that is!!) and give that a try. I did try using just the pantyhose leg trick and not using the side straps I usually have on my Aura. Didn't work that way. I had to use BOTH the stabilizing side straps AND the pantyhose pillows stabilizer to have it stay absolutely leakproof.
I know that seems like a lot of stuff to add to any mask, but if it works, it might make a good but presently unusable mask work for you - and work comfortably. Just occurred to me....that might be something that could make a difference to the guys who are experiencing leaks with the nasal pillows being too small too. Shove those pillows against the nares with the panty hose trick. And won't you be a pretty sight?
A note to the cautious - I figured a pressure of 20 would keep the silicone tubes of the nasal part open...that winding the panty hose leg around them wouldn't crush them...and it didn't. But what about at lower pressures? I switched my autopap back to my usual setting that starts at 8 cm. Got a magnifying mirror and examined every place that the panty hose was around. The tubes seemed to stay open just fine at 8. By then, I'd unplugged and replugged my machine in enough for one day...heheh, so I never tried it any lower but it looks like there'd be no problem with the pantyhose trick.
The additional strap I already had up higher was already comfortable since it really doesn't touch my face except at the very tailends of my eyebrows. The addition of the pantyhose leg down at the nasal pillows area itself does, of course, touch the cheeks. I just wore it for the fifteen or twenty minutes of all this pressure experimentation, so I don't know how much of a line it would leave in the morning.
It worked so well though, that I'm thinking about continuing to use the pantyhose strap from now on, just for extra leakproofness, even though I was not experiencing leaks with the Aura and my other higher added strap.
As a side note (heck, this post is already long, so what's a bunch more lines!) I did notice this when using that pressure of 20... that straight pressure was absolutely awful to try to breathe out against. After I got that part of the experiment over with the panty hose, I changed the setting to cpap with c-flex at 3, and pressure still at 20. I wanted to see if C-flex could give much/any exhalation relief for people who are at very high pressure. Unfortunately, C-Flex doesn't give much relief at all up there. Barely put a dent in it for me. Not much drop at all. Also, instead of C-Flex waiting to almost the very end of exhalation to kick pressure back in, it comes in before you're even halfway through exhaling. I understand now why people who are prescribed bi-level machines really do need them, with a bi-level's precision settings, and why C-Flex would not be a good enough option for the high pressure folks. The only exception would be if they fell into the patient population for whom an autopap/c-flex would let them spend a great deal of time down at lower pressures anyway... going up to their full titrated pressure only occasionally and briefly.
click here for picture of exactly where I add side straps down low on the Aura
But then, I thought...you know, Ann is a smart cookie and a determined one. I'm sure she tried additional straps.
So, in true lab rat fashion (*gulp* ) I decided to go set my autopap to straight cpap at a pressure of 20....to see what it was you're experiencing with nasal pillows and a high pressure.
Whewwwwwieeee. My hat's off (and mask's off!!) to those of you who are dealing with stratospheric pressures coming in at you, even if you do get bi-level relief on exhalation.
And, sure enough - just as you said - the Aura's nasal pillows (the Large that do me so perfectly at my autopap pressure range that never hits above 13 briefly on occasions) ....at 20 were leaking every time I moved my head. No amount of adjusting the wire or the front of the headgear changed the situation...leak, leak, leak. My usual stabilizing side straps didn't prevent that at all. Would drive a person nuts.
However, if I took my fingers and pressed the least little bit to push the pillows against my nose just a bit.... the leaks stopped.
Bingo! Now if I could just find something to use as a strap to keep the nasal pillows literally squashed against the front of my nares.....what to use, what to use? I didn't want velcro because this was going to have to go against my cheeks, in essentially the same position that the Swift's straps lay.
I cut off one leg of a pair of panty hose. The "leg" is stretchy, soft, long enough...hmmm, might work. I draped the middle of the panty leg so that I had two equal lengths of panty hose leg hanging straight down between the two nasal pillows. Then I wound one of the lengths around the bottom corner of the silicone pillows holder, coming out on the outside of a nasal pillow. Same thing with the other length - winding it once around the other bottom corner. The winding looks kind of like a wide W by the time you've wound around the bottom piece of silicone enough times for the panty hose leg to pass by the base of both pillows.
I put the mask on, fired up the pressure of 20. After I got the pillows in place as best I could with my fingers, I then let go of the pillows and simply tied the dangling ends of the panty hose leg behind my neck with a bow knot for easy readjustment. Voila'. Leaks stopped instantly. And the smushed pillows still felt comfortable. No undue pressure on my nostrils. I undid the bowknot and retied it looser, still ok. I found that it could be tied fairly loose and work, probably thanks to the stretchiness of panyhose material.
But the true test: Would that jury-rigged pantyhose leg pillows strap keep the Aura's nasal pillows sealing absolutely at 20 cm H20, if I tossed, turned, moved my head up/down/all round on a pillow. Could it hold a seal comfortably, no matter what? YES!!!! The Aura was noisy as heck up at that high pressure, but the noise wasn't from leaks!
Ann, you might want to sacrifice one leg (pantyhose leg, that is!!) and give that a try. I did try using just the pantyhose leg trick and not using the side straps I usually have on my Aura. Didn't work that way. I had to use BOTH the stabilizing side straps AND the pantyhose pillows stabilizer to have it stay absolutely leakproof.
I know that seems like a lot of stuff to add to any mask, but if it works, it might make a good but presently unusable mask work for you - and work comfortably. Just occurred to me....that might be something that could make a difference to the guys who are experiencing leaks with the nasal pillows being too small too. Shove those pillows against the nares with the panty hose trick. And won't you be a pretty sight?
A note to the cautious - I figured a pressure of 20 would keep the silicone tubes of the nasal part open...that winding the panty hose leg around them wouldn't crush them...and it didn't. But what about at lower pressures? I switched my autopap back to my usual setting that starts at 8 cm. Got a magnifying mirror and examined every place that the panty hose was around. The tubes seemed to stay open just fine at 8. By then, I'd unplugged and replugged my machine in enough for one day...heheh, so I never tried it any lower but it looks like there'd be no problem with the pantyhose trick.
The additional strap I already had up higher was already comfortable since it really doesn't touch my face except at the very tailends of my eyebrows. The addition of the pantyhose leg down at the nasal pillows area itself does, of course, touch the cheeks. I just wore it for the fifteen or twenty minutes of all this pressure experimentation, so I don't know how much of a line it would leave in the morning.
It worked so well though, that I'm thinking about continuing to use the pantyhose strap from now on, just for extra leakproofness, even though I was not experiencing leaks with the Aura and my other higher added strap.
As a side note (heck, this post is already long, so what's a bunch more lines!) I did notice this when using that pressure of 20... that straight pressure was absolutely awful to try to breathe out against. After I got that part of the experiment over with the panty hose, I changed the setting to cpap with c-flex at 3, and pressure still at 20. I wanted to see if C-flex could give much/any exhalation relief for people who are at very high pressure. Unfortunately, C-Flex doesn't give much relief at all up there. Barely put a dent in it for me. Not much drop at all. Also, instead of C-Flex waiting to almost the very end of exhalation to kick pressure back in, it comes in before you're even halfway through exhaling. I understand now why people who are prescribed bi-level machines really do need them, with a bi-level's precision settings, and why C-Flex would not be a good enough option for the high pressure folks. The only exception would be if they fell into the patient population for whom an autopap/c-flex would let them spend a great deal of time down at lower pressures anyway... going up to their full titrated pressure only occasionally and briefly.
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Ann N.
Thanks to all of you who made suggestions about how to handle the Aura. I appreciate your input very much.
Rested Gal-
WOW! What experimentation!!! RG, no wonder you are sooooo respected and admired on this board! Every post of yours is reasoned and logical. I thank you so much for your concern and for your exploration into the problem I was having with the Aura. Yes, indeed. It looks like the root of my problem was rooted in the high pressures I use. That information is very valuable for those of us with high pressures-- the Aura is probably not the mask of choice for us. So, that is valuable for others to know in advance of ordering the mask.
However, it also looks lke I might be able to jerryrig(sp?) a solution since I already have purchased it. But, the question remains: after I have done so, would the result be satisfactory for regular usage. I will certainly play around with it for awhile and see what I can come up with.
I currently use a Breeze which works well but, of course in true hosehead fashion, I am always interested in finding the "perfect" mask. It might be that the hard shell of the Breeze is what enables it to work well with high pressure.
BTW, I think I am in love with my BiPAP. I find it is very comfortable breathing via the BiPAP inspite of the high presssures. When I wake up I am in no hurry to discontinue it, just watch TV a little while, even before I get up. Maybe it just goes to show that one can get used to most anything (except tight straps on the interface, for me anyway).
RG, thanks again. I am indebted!!
Ann
Rested Gal-
WOW! What experimentation!!! RG, no wonder you are sooooo respected and admired on this board! Every post of yours is reasoned and logical. I thank you so much for your concern and for your exploration into the problem I was having with the Aura. Yes, indeed. It looks like the root of my problem was rooted in the high pressures I use. That information is very valuable for those of us with high pressures-- the Aura is probably not the mask of choice for us. So, that is valuable for others to know in advance of ordering the mask.
However, it also looks lke I might be able to jerryrig(sp?) a solution since I already have purchased it. But, the question remains: after I have done so, would the result be satisfactory for regular usage. I will certainly play around with it for awhile and see what I can come up with.
I currently use a Breeze which works well but, of course in true hosehead fashion, I am always interested in finding the "perfect" mask. It might be that the hard shell of the Breeze is what enables it to work well with high pressure.
BTW, I think I am in love with my BiPAP. I find it is very comfortable breathing via the BiPAP inspite of the high presssures. When I wake up I am in no hurry to discontinue it, just watch TV a little while, even before I get up. Maybe it just goes to show that one can get used to most anything (except tight straps on the interface, for me anyway).
RG, thanks again. I am indebted!!
Ann
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Mike, that's essentially down were I added the pantyhose leg...yes. I'll fire up PaintShop Pro and try to draw it in, the way I have it looping over, under, over, under...snaking along the bottom. But yes - holding each corner down there is what I did with the pantyhose leg. Worked perfectly at 20 cm H20.
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wading thru the muck!
- Posts: 2799
- Joined: Tue Oct 19, 2004 11:42 am
RG,
Glad you are onboard with solving the problems of the aura nay-sayers. I think if you can't make the aura work, you'll probably not get any nasal interface to work. I suprises me how quick some users are willing to toss it in the trash.
Glad you are onboard with solving the problems of the aura nay-sayers. I think if you can't make the aura work, you'll probably not get any nasal interface to work. I suprises me how quick some users are willing to toss it in the trash.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
-
rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Well, I fully understand the frustration of getting a new interface, especially when one's heard others raving enthusiastically about it - only to have it leak like crazy and not get the job done at all. For what masks cost, there should be extra straps included, instructions for "fixes" if the standard issue doesn't work, at least three sizes of pillows, extra velcro if straps won't reach.
We shouldn't have to jury-rig things with pantyhose legs to make 'em work. The mask DESIGNERS are being paid to do what we all end up doing on our own and sharing with other message board readers. That little rant out of the way, here's the way I make the nasal pillows seal at high pressure....my latest "retouch"...
We shouldn't have to jury-rig things with pantyhose legs to make 'em work. The mask DESIGNERS are being paid to do what we all end up doing on our own and sharing with other message board readers. That little rant out of the way, here's the way I make the nasal pillows seal at high pressure....my latest "retouch"...
OK Laura !! Here's the deal. I'm starting my own Medical Supply Company and I'm going to hire you as my Chief designer of Cpap masks. Your salary will be $150,000 per year with Insurance and paid vacation. I'll also give you a company SUV.
You must use real people in your mask testing lab...... fat people....skinny people.....big heads....little heads....bald heads....bearded faces......smooth faces........low pressure....high pressure......make sure each mask fits perfectly in each situation.......Apap......Cpap.......Bipap. The mask must be comfortable.............No tight straps......no bulky headgear........each mask should be adjustable so that the patient can switch from Nasal mask to Nasal Pillow with one simple adjustment. Each interface should come with Silicone Cushions....Gel cushions......Petite size....XS.....Med.....Med Plus.......Large......X Large and ....Super large. Also available in Shallow. Remember......All masks must be Latex free.
OK....do you want the Job ????? Sorry....Only teasing
Shuuuuuu Weeeee ...That was a useless post ! I think I'm going crazy. Think I'll go upstairs......fill my water chamber......Clean the filter......Wash my Activa Cushion......strap on the headgear......turn on my Tranquility Bipap machine and sleep....................oops...forgot to go to the restroom.
Rich
You must use real people in your mask testing lab...... fat people....skinny people.....big heads....little heads....bald heads....bearded faces......smooth faces........low pressure....high pressure......make sure each mask fits perfectly in each situation.......Apap......Cpap.......Bipap. The mask must be comfortable.............No tight straps......no bulky headgear........each mask should be adjustable so that the patient can switch from Nasal mask to Nasal Pillow with one simple adjustment. Each interface should come with Silicone Cushions....Gel cushions......Petite size....XS.....Med.....Med Plus.......Large......X Large and ....Super large. Also available in Shallow. Remember......All masks must be Latex free.
OK....do you want the Job ????? Sorry....Only teasing
Shuuuuuu Weeeee ...That was a useless post ! I think I'm going crazy. Think I'll go upstairs......fill my water chamber......Clean the filter......Wash my Activa Cushion......strap on the headgear......turn on my Tranquility Bipap machine and sleep....................oops...forgot to go to the restroom.
Rich
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee