Another approach to Provent

[NateS]

I just don't see why inconvenience of a current methodology could possibly make anyone want to hang onto it when something more convenient comes along.

It's not the "inconvenience" - it's the emotional marriage which occurs.

If you are in the computer field, then surely you could not have missed the way users and programmers religiously clung to DOS and the command-line interface and ridiculed the entire concept of GUI as nothing but pictures and toys!

And a mouse - ha ha ha!

It may be that that is what we are doing. But we don't know whether or not that is true yet. And I am sure that the entreprenurial folks making and selling Provent aren't going to be deterred by this resistance, now are they?

Nate

[westozman]

This was on TV here in Oz last night, when you get past the short car add, it's worth a look.

http://aca.ninemsn.com.au/article/84684 ... eakthrough

[pats]

I just don't see why inconvenience of a current methodology could possibly make anyone want to hang onto it when something more convenient comes along.

It's not the "inconvenience" - it's the emotional marriage which occurs.

If you are in the computer field, then surely you could not have missed the way users and programmers religiously clung to DOS and the command-line interface and ridiculed the entire concept of GUI as nothing but pictures and toys!

And a mouse - ha ha ha!

I saw it, but I didn't understand it. Maybe I was exempt because my first programming environment was so extremely inconvenient that it was easy to leave it behind. Can you imagine typing with no backspace-delete key? You can't unpunch a hole in a card.

[NightMonkey]

I feel that many cpap users are ultra-skeptical about Provent for three reasons.

The first is the result of the aggressive and questionable advertising campaign for Provent.

The second is because of the lack of feedback in the form of flowcharts and numbers from an attached or nearby device, measuring the effectiveness of therapy for what we have been taught is a life-threatening condition if left untreated.

The third is because we worked very hard to accept and eventually welcome a very unnatural process into one-third of our lives in order hopefully to be healthier and live longer, and now some company, rightly or wrongly, is whispering or shouting in our ear that maybe all this effort and inconvenience might not have been necessary. So yes, we are skeptical to the point of disbelief and ridicule of the whole idea of Provent.

But then again I try to imagine what it must have been like when cpap came along and these doctors and companies from Australia were first trying to tell the public that our sleeping was unhealthy and dangerous, and that wearing a mask and blasting some high pressure air from a hose up our noses was going to make things a whole lot better.

I assume that people were very skeptical at that time, and no doubt engaged in a lot of ridicule of cpap therapy.

For every theory of a "cure" or therapeutic benefit that gets advanced and advocated in medicine, there must be at least ten that get cast aside and disproven. We see and read about those cases every day.

So Provent will have to prove its effectiveness against this sea of resistance and ridicule and challenges to logic, just as cpap did. We will have to wait and see what the outcome will be.

Regards, Nate

Nice post but you entirely overlooked a critical point that has nothing to do with the psyche ->

So Provent will have to prove its effectiveness against this sea of resistance and ridicule and challenges to logic

There seems to be nothing left for Provent to prove. Provent has published on its website for all to see the scientific evidence that Provent leaves most patients in a very unhealthy state of sleep apnea (at home and while traveling) ->



So where is the "challenge to logic" that you speak of? There is no need to be skeptical when scientific evidence is available. The "challenge to logic" is holding great hope for Provent while ignoring the results of the studies.

At this point I continue to maintain that everyone should have an analysis of positional affects on their condition before experimenting with Provent. Many will find that positional therapy is more effective than Provent at no additional ongoing cost and no inconvenience of trying to get little thingies glued air tight onto the nostrils.

Now Provent for emergencies such as power failure or machine failure? Certainly! I now have a prescription in hand and plan to pick up a trial pack of 20 the next time I am on the DME's side of town.

[pats]

At this point I continue to maintain that everyone should have an analysis of positional affects on their condition before experimenting with Provent. Many will find that positional therapy is more effective than Provent at no additional ongoing cost and no inconvenience of trying to get little thingies glued air tight onto the nostrils.

Personally, I prefer specific advice from a suitably qualified doctor who is fully informed about my medical history, travel plans, etc. to any general, one-size-fits-all, advice, no matter how well qualified you may be to give medical advice.

You seem to feel that changing position and using Provent are mutually exclusive strategies. My sleep doctor and I agree that, for me, position, APAP, and Provent are all useful complementary strategies. Your mileage may vary. Get advice tailored to yourself from someone who is both qualified to give the advice and informed in detail about your own medical history and situation.

For the time periods over which I plan to use Provent, and relative to the other costs of my planned vacation, the cost of Provent is far too small to care about. At $2 per night for 15 nights, Provent for the whole vacation costs about the same as one hotel restaurant dinner. Throwing in enough for home use to get and remain acclimated, maybe two dinners.

Again, this is something where decisions need to be made based on individual situations. I'd be willing to pay thousands of dollars for the convenience, not having to worry about loss or damage to a machine on which I'm depending, and not having to worry about using it 5,000 feet above its specified operational ceiling. With Provent, I'll actually take with me about twice as much as I expect to use over the vacation so that I can put some in my suitcase and some in my carry-on.

As far as getting the little thingies glued in is concerned, I've done it twice now with no difficulty at all and an airtight seal first try. I do wash the area with plain soap and water, rinse, and dry thoroughly before applying them, follow all the instructions, and use a large mirror. I don't know whether a tendency to grow hair in that area would make it harder to get a good seal. The most difficult situation I anticipate for applying them is on long overnight flights, before settling down to sleep. I don't know whether I'll do them at my seat or in the restroom. It depends on whether I can learn to apply them without looking at a mirror or using only a small one.

[-tim]

If your out in areas with very high elevations, I'm betting every cpap company's engineers would like data on that.
I would be tempted to call their 1800 numbers and ask.

[pats]

If your out in areas with very high elevations, I'm betting every cpap company's engineers would like data on that.
I would be tempted to call their 1800 numbers and ask.

The highest elevation I plan to sleep at is 12,500 ft. I don't think a single case, self selected, with no control, would be of much interest. At least, not enough to inspire them to do the research about all the means of transportation on the tour to find out if I would be able to keep my APAP with me, which would be a minimum requirement before I would consider using it for the vacation.

I've gone on previous tours with the same company and there were days when all except the bag I keep with me during the day was picked up from my hotel room and I didn't see any luggage again until I got to my room at the next hotel in the evening. We spent the day both traveling and site-seeing while our bags went straight to the hotel.

Of course, with Provent I will keep a supply in my day bag, so I would have it at night even if something went wrong with the baggage handling.

[NightMonkey]

At this point I continue to maintain that everyone should have an analysis of positional affects on their condition before experimenting with Provent. Many will find that positional therapy is more effective than Provent at no additional ongoing cost and no inconvenience of trying to get little thingies glued air tight onto the nostrils.

You seem to feel that changing position and using Provent are mutually exclusive strategies.

You will not find any such idea in my posts. The thought is your own.

My previous post says, "everyone should have an analysis of positional affects on their condition before experimenting with Provent".

It should be clear to the average reader that the statement leaves "experimenting with Provent" as a followup option once the issue of positional therapy is known. If in the first step the patient finds position has no effect on his condition then it can be ignored when he experiments with Provent.

Personally, I prefer specific advice from a suitably qualified doctor who is fully informed about my medical history, travel plans, etc. to any general, one-size-fits-all, advice, no matter how well qualified you may be to give medical advice.

Has your doctor asked you about the elevations at which you will be sleeping in the Andes? Has he warned you that high elevations can be tough on sleep apnea patients and warned you Provent has not been tested at high elevations?

Oh, wait a minute, no need to answer that question. I see he is a "suitably qualified doctor who is fully informed about (your) medical history, travel plans, etc." so I am sure he has discussed this with you.

[-tim]

If your out in areas with very high elevations, I'm betting every cpap company's engineers would like data on that.
I would be tempted to call their 1800 numbers and ask.

The highest elevation I plan to sleep at is 12,500 ft. I don't think a single case, self selected, with no control, would be of much interest. At least, not enough to inspire them to do the research about all the means of transportation on the tour to find out if I would be able to keep my APAP with me, which would be a minimum requirement before I would consider using it for the vacation.

I've sent fare more expensive equipment on trips for research data. A single case study with a well documented diary would be useful for the engineers. It doesn't hurt to ask and I bet if any one says "yes", they won't want all the equipment back. Just take lots of memory cards and send them back through the trip.

I would be taking an SpO2 meter with me. If your from sea level, this trip could be hard. If your from Denver, not so bad.

[chunkyfrog]

Hubby uses alcohol prep pads to clean off his nose before putting on his Breathe-Rite strip.
Nothing is as as effective for 'de-oiling' the nose.
As for Provent, for myself: I might be tempted to try FREE samples (for a nap), but not buying them for a trial.
Nate and Monkey: thank you--I can add no more to your intelligent comments.
High altitude; hmm--might ask doc for an emergency tank of O2--oh, wait, never mind.

[NateS]

There seems to be nothing left for Provent to prove. Provent has published on its website for all to see the scientific evidence that Provent leaves most patients in a very unhealthy state of sleep apnea (at home and while traveling) ->



So where is the "challenge to logic" that you speak of? There is no need to be skeptical when scientific evidence is available. The "challenge to logic" is holding great hope for Provent while ignoring the results of the studies.

Very good point. From an academic standpoint, it makes one wonder as to how effective the early cpap machines were compared to the machines of today.

Nate

[NightMonkey]

Very good point. From an academic standpoint, it makes one wonder as to how effective the early cpap machines were compared to the machines of today.

Nate

Here are a lot of assumptions but I would think for a typical OSA patient who had a good titration in the lab and could deal with what were probably crude masks the therapy was pretty good.

Like if you had no resources today but basic machines, set them on 10 cm and you probably could get good treatment for a significant portion of the patient population.

Speaking of gluing on Provent, I read that Dr. Sullivan glued the masks on in the first experiments. Nice! - No strap marks.

I don't want to travel back in time.

[pats]

At this point I continue to maintain that everyone should have an analysis of positional affects on their condition before experimenting with Provent. Many will find that positional therapy is more effective than Provent at no additional ongoing cost and no inconvenience of trying to get little thingies glued air tight onto the nostrils.

You seem to feel that changing position and using Provent are mutually exclusive strategies.

You will not find any such idea in my posts. The thought is your own.

I'm sorry - I misunderstood the emphasis on "before" as meaning you meant they should not be tried simultaneously, the way I'm doing it.

Has your doctor asked you about the elevations at which you will be sleeping in the Andes? Has he warned you that high elevations can be tough on sleep apnea patients and warned you Provent has not been tested at high elevations?

Oh, wait a minute, no need to answer that question. I see he is a "suitably qualified doctor who is fully informed about (your) medical history, travel plans, etc." so I am sure he has discussed this with you.

Of course "fully-informed" includes knowing the altitudes. One of the first things I did during the consultation was hand him a simplified itinerary - no fluff about the scenery - annotated day-by-day with the altitude at which I would be sleeping that night. As I expected, he read it carefully before giving me any advice. I'm sure he would have asked if I had not handed him the information.

We did not discuss general issues of altitude and sleep apnea, only my case and my vacation plans. Remember, it was a doctor-patient consultation, not a seminar on sleep apnea management. That is why I emphasize the fact that his advice is specific to my case, and anyone else considering similar travel should get their own medical advice.

As far as the general issue of the advisability of my travel is concerned, in addition to the sleep specialist I've consulted my own primary care physician and the HMO's travel advisory service. My PCP's response, when I called her attention to the sleep apnea diagnosis and reminded her of my travel plans, was "I think that you will do fine in the Andes.". The travel advisory service issued prescriptions for an antibiotic to use if needed for digestive problems, which they do for travel to any area without very good water and food safety, and a drug that helps with high altitude adjustment.

[pats]

Hubby uses alcohol prep pads to clean off his nose before putting on his Breathe-Rite strip.
Nothing is as as effective for 'de-oiling' the nose.

Maybe I should get some of those for use on aircraft. At home, I can use a facecloth and hang it up to dry after washing.

[Gerald?]

I keep hoping to check in and see some people with oximeter readings comparing nights on Provent to nights on CPAP, but no joy.

Just wondering if any of the Provent users have done this?