Gross, but important!

tomjax wrote:I think it is clearly established that organisms cannot get from the tank to the lungs.
Many will ignore this and blame the HH.

I don't know where this was ever established. Please point out your sources - other than those here who haven't yet died from infected humidifiers.

ozij wrote:<snip>

Distilled water is not sterilized water.

<snip>

Sorry, Ozij, I disagree...
Distilled water is absolutely sterilized water. It is boiled to create steam which is collected in a clean container and boiling kills microbes. It can become contaminated after the container is opened, but you can take simple steps to make sure that doesn't happen....

Happy Thanksgiving to our U.S. folks!

It is often not boiled, nor is it kept in sterile containers.

tomjax wrote:MANY people will have her condition and do not use a CPAP.
It is tempting to blamae the PAP, when it is likely coincidental, not causal, but many will make the link.

I think it is clearly established that organisms cannot get from the tank to the lungs.
Many will ignore this and blame the HH.

There is no law against bing stupid or ignorant.

Happy Thanksgiving all

Fact: microrganisms are too large to come into the hose and mask carried by within the water vapor.
However, mold spores can be blown in the air, as can dust and allergens.
These things can also enter the hose and mask from the other side.
So, will we get "infected" vapor from the humidifier? No.
Can mold grow on the sides of the tank and then be blown into the hose? Why not?

O.

Okay, so I've done quite a bit of searching this morning to distill ( pun intended ) the exact meaning of distilled water....

There are different methods of distillation for different purposes (petroleum, alcohol, specific chemicals), but the one cited for producing distilled water involves boiling in each description. Perhaps the standards and methods used are different in different countries?

http://en.wikipedia.org/wiki/Distilled_water

Your right about the verbal meaning of "distilled" - and I may be wrong about what is sold in the US.

However, http://en.wikipedia.org/wiki/Distilled_water :

Deionization
Deionized water which is also known as demineralized water (DI water or de-ionized water; can also be spelled deionised water, see spelling differences) is water that has had its mineral ions removed, such as cations from sodium, calcium, iron, copper and anions such as chloride and bromide. Deionization is a physical process which uses specially-manufactured ion exchange resins which bind to and filter out the mineral salts from water. Because the majority of water impurities are dissolved salts, deionization produces a high purity water that is generally similar to distilled water, and this process is quick and without scale buildup. However, deionization does not significantly remove uncharged organic molecules, viruses or bacteria, except by incidental trapping in the resin. Specially made strong base anion resins can remove Gram-negative bacteria. Deionization can be done continuously and inexpensively using electrodeionization.

It should be noted that deionization does not remove the hydroxide or hydronium ions from water; as water self-ionizes to equilibrium, this would lead to the removal of the water itself.

ozij wrote:http://en.wikipedia.org/wiki/Distilled_water

Your right about the verbal meaning of "distilled" - and I may be wrong about what is sold in the US.

Distillation and deionization are both purification methods, but they are different. The article says "...deionization produces a high purity water that is generally similar to distilled water..."

I think what is sold in the US as distilled water has to be produced by steam distillation. I've also seen deionized water for sale, but not very often.

Very interesting discussion, Ozij. I learned something new today. Thanks.

plr66 wrote:

GumbyCT wrote:There is prob no easier way to grow bacteria than using tap water AND not cleaning.

After sudsing a hose, how do you go about rinsing it, if you do not use tap water?

I don't think that is what Gumby meant. Do you?

tomjax wrote:.......
There is no law against bing stupid or ignorant.

.........

Also, there is no law against laws being stupid or ignorant.

Some laws in Jacksonsville:

Women may be fined for falling asleep under a hair dryer, as can the salon owner.

A special law prohibits unmarried women from parachuting on Sunday or she shall risk arrest, fine, and/or jailing.

If an elephant is left tied to a parking meter, the parking fee has to be paid just as it would for a vehicle.

It is illegal to sing in a public place while attired in a swimsuit.

Having sexual relations with a porcupine is illegal.

It is illegal to skateboard without a license.

When having sex, only the missionary position is legal.

You may not fart in a public place after 6 P.

It is considered an offense to shower naked.

You are not allowed to break more than three dishes per day, or chip the edges of more than four cups and/or saucers.

You may not kiss your wife’s breasts.

http://www.dumblaws.com/laws/united-states/florida

WHEW!!!! I'm sure glad I don't live in Jacksonville.....I'd probably be in prison.
(but I didn't say for WHICH offenses)

Den

I just asked my RT about cleaning the 6 foot hose. He said don't clean it, for the reasons of possible bacterial growth. My DME sends me essentially 3 hoses every quarter, which alledgedly my insurance BC/BS covers. I'm a newbie and haven't got those EOBs yet. We'll see. But if that's the case, I don't plan to clean them, just replace them monthly. Mostly because of just eliminating on more thing to do in the CPAP process.

One thing I'm wondering though which was mentioned somewhere along this chain, is that distilled water is not sterile water, at least not once the cap is removed. So with respect to bacterial development, what's the difference if it is stored in its container with the cap on (sealed), or in the humidifier reservoir (also sealed- although perhaps actually not, since I suppose the end of the hose is attached to the mask, which is open to the air). Also, does exhalation all get exhaled out exhaust ports of the interface, or does some actually get backed up into the tube, which then would introduce possible bacterial growth route too? With my humidifier, I don't clean it daily like the book says. Usually some water remains in the morning and I add water to an appropriate level that night. On my Respironics, filled to the line at setting of 2 probably gets me thru 2 nights. On a ResMed I previously had, the reservior held lots of water and it would go several nights before I needed to add more. I then wash the reservoir once a week.

Any thoughts out there on the actual potential for bacterial growth then, if your actually using the water within a couple of days and just replenishing regularly, and/or if exhalation does introduce bacterial potential into the tube?

Joe

SleepyJoeMS wrote:I just asked my RT about cleaning the 6 foot hose. He said don't clean it, for the reasons of possible bacterial growth. My DME sends me essentially 3 hoses every quarter, which alledgedly my insurance BC/BS covers. I'm a newbie and haven't got those EOBs yet. We'll see. But if that's the case, I don't plan to clean them, just replace them monthly. Mostly because of just eliminating on more thing to do in the CPAP process.

One thing I'm wondering though which was mentioned somewhere along this chain, is that distilled water is not sterile water, at least not once the cap is removed. So with respect to bacterial development, what's the difference if it is stored in its container with the cap on (sealed), or in the humidifier reservoir (also sealed- although perhaps actually not, since I suppose the end of the hose is attached to the mask, which is open to the air). Also, does exhalation all get exhaled out exhaust ports of the interface, or does some actually get backed up into the tube, which then would introduce possible bacterial growth route too? With my humidifier, I don't clean it daily like the book says. Usually some water remains in the morning and I add water to an appropriate level that night. On my Respironics, filled to the line at setting of 2 probably gets me thru 2 nights. On a ResMed I previously had, the reservior held lots of water and it would go several nights before I needed to add more. I then wash the reservoir once a week.

Any thoughts out there on the actual potential for bacterial growth then, if your actually using the water within a couple of days and just replenishing regularly, and/or if exhalation does introduce bacterial potential into the tube?

Joe

My thoughts would be......"slim to none".
If it's YOUR breath and you can actually breathe that hard.......then the "bacteria" would be coming from YOU.
Again....."slim to none".


Den

Wulfman wrote:

SleepyJoeMS wrote:Any thoughts out there on the actual potential for bacterial growth then, if your actually using the water within a couple of days and just replenishing regularly, and/or if exhalation does introduce bacterial potential into the tube?

My thoughts would be......"slim to none".
If it's YOUR breath and you can actually breathe that hard.......then the "bacteria" would be coming from YOU.
Again....."slim to none".

I think it also heavily depends on your home environment. I'm guessing that the bacteria coming from your own mouth (via the looong tube) may not be an issue, but there are still bacteria and mold in the air which can get into the tank and grow.

For a long time I was doing the top-op method, but at some point my tank started to smell really funny so now I rinse it out and soap/vinegar it once every week or two. I'm guessing it was just picking up stuff in the air, since I use only distilled water in the tank.

I just found some crazy mold growth around the windows in the bathroom today... I don't keep anything CPAP related in the bathroom, but still, that was like a wake up call!

echo wrote:

Wulfman wrote:

SleepyJoeMS wrote:Any thoughts out there on the actual potential for bacterial growth then, if your actually using the water within a couple of days and just replenishing regularly, and/or if exhalation does introduce bacterial potential into the tube?

My thoughts would be......"slim to none".
If it's YOUR breath and you can actually breathe that hard.......then the "bacteria" would be coming from YOU.
Again....."slim to none".

I think it also heavily depends on your home environment. I'm guessing that the bacteria coming from your own mouth (via the looong tube) may not be an issue, but there are still bacteria and mold in the air which can get into the tank and grow.

For a long time I was doing the top-op method, but at some point my tank started to smell really funny so now I rinse it out and soap/vinegar it once every week or two. I'm guessing it was just picking up stuff in the air, since I use only distilled water in the tank.

I just found some crazy mold growth around the windows in the bathroom today... I don't keep anything CPAP related in the bathroom, but still, that was like a wake up call!

echo,

That was the "qualifier" to me......"a couple of days".

Edit: If a person has that much "growth" in their house, it's more than probable that they're breathing it in at other times than when they're "on the hose".

Den

I don't understand why people believe that bottled distilled water is sterile, because it may or it may not be. Unless it says it is sterile on the label then the safe bet is that it isn't. Yes the water may be bacteria free as it condenses in the distiller but unless everything the water touches after that point is sterile the water won't be.

Also while not sterile tap water contains stuff (chloromine) to stop bacterial and fungal growth. By law our tap water is safe to drink or use for a humidifier. It does have minerals in it which will harm a humidifier or coffee pot. (scale - deposits) Which is what the vinegar is for.

I always use RO water in my HH and even it will grow stuff if I don't clean it weekly.

At work we use ultra pure sterile water in the anthrax detectors, (it is very expensive,) and if I leave a partial bag around it does grow stuff very fast. Seems like there is nothing in sterile water to stop or slow the growth. It is a very good grow medium.

I think that the best defense is a good electrostatic air filter on your AC unit to keep the air in the house as clean as possible. Because the air is full of spores, viruses and bacteria.
Cami