Continuation of leakage discussion

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mrog
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Continuation of leakage discussion

Post by mrog » Tue Jul 29, 2014 10:43 pm

This is a continuation of the discussion of my leak problem that started here. Rather than continue to hijack that thread, I'm starting one of my own.
Pugsy wrote:There's something wrong if you can even get 0 flat line leak while awake and if you can't at least get a 0 flat line leak with a mask while awake....and your only choices are leak at the top or the bottom..the mask isn't working...it's either the wrong size or simply that mask isn't suitable for your facial structure.
I agree. I'm using a large Quattro. If they made an XL size, I'd love to try it. According to the sizing template, my face is in the larger part of the large range. My facial structure also doesn't help. The mask pivots on my cheek bones and the mask's seal isn't thick enough to allow a good seal at the top and bottom.
Pugsy wrote:Have you ever used the mask fit feature with your machine? Where it blows your prescribed pressure and lets you adjust for fit and gives you a smiley face or frowny face if the fit is good?
Yes. If I hold my face in just the right position, I can get a green face. But I can't really keep it that way when I'm sleeping. My other option for getting a green face is to tighten the headgear to the point of pain. I'm not a fan of pain. I keep the headgear as tight as it can go without causing much discomfort.
Pugsy wrote:Full face masks have more surface area to deal with so simple physics is going to make sealing more difficult but people manage to get it done all the time. It's not impossible but your leak graphs scare the devil out of me and I am not a person who scares easily with a little ugliness every now and then in the leak department. I am not kidding when I say I see reports with nasal masks and people are mouth breathing all over the place and the leaks aren't as bad as what I saw on your report.
I'd love to get it fixed.
Pugsy wrote:If a new hose doesn't fix the issue (never hurts to try the obvious simple fix first) then you need to look at maybe a different mask.
Which ones have you tried? "Tons" of masks and liners (found you said that elsewhere) doesn't help me much.
Were you able to get decent leak lines when your pressure was 13 and has it only been since the increase to 17 that you have had such ugly leaks?
Have you ever tried a nasal pillow mask?
I tried a brand new hose last night. It was due for replacement, anyway. I didn't see any difference in the numbers. I'm going to remove the humidifier tonight to rule out any leakage there.

I've used a couple of different suppliers in the last few years. At both places, I tried every mask they carry. I didn't keep notes of them, but it was at least ten versions at each supplier. Out of the full face masks, the large Quattro works the best for me.

I used to use nasal pillows years ago when my pressure was a lot lower. But these days, I just can't keep my lips closed. Even with a chin strap, I have to fully seal my mouth with tape to keep it from leaking at night. I don't want to open a debate here about the safety of taping. I'm not really comfortable with it, so I don't do it anymore.
Pugsy wrote:Oh...also check the anti aspyhxia valve on your mask to make sure it isn't stuck open. Do you know how to do that?
Good idea. I checked the valve and it seems to move freely. I can't detect any air coming out of it when the CPAP is turned on and the mask is on my face.

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Pugsy
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Re: Continuation of leakage discussion

Post by Pugsy » Tue Jul 29, 2014 10:51 pm

When you were using the nasal interface mask with chin strap did the mouth opening leaks wake you up often or did you sleep right through them?

Have you tried one of the newly released FFM like the ResMed AirFit F10? Or the Quattro Air?

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Tue Jul 29, 2014 11:27 pm

Pugsy wrote:When you were using the nasal interface mask with chin strap did the mouth opening leaks wake you up often or did you sleep right through them?

Have you tried one of the newly released FFM like the ResMed AirFit F10? Or the Quattro Air?
The mouth opening leaks were bad enough to wake up both me and my wife.

I haven't tried those masks. My current health insurance doesn't have any DME coverage, so I've been buying supplies online for a while. Maybe I should call my local RT and ask if they have samples of those I can try on. If it works a lot better, I'd consider paying their inflated price. Have you heard of the new masks fitting hard-to-fit faces better than the Quattro?

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JDS74
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Re: Continuation of leakage discussion

Post by JDS74 » Wed Jul 30, 2014 4:55 am

I'm a little late to this discussion but have you thought to try the Oracle 2 mask?
I have a discussion on my experience in using this mask linked in the signature block below.
After learning how to not nose breathe at night and starting to use a soft cervical collar, my unintentional leak rate is usually zero. Here is a recent leak graph. For Respironics equipment, the leak rate shown is the total rate. For my mask, the intentional rate hovers around 37 to 42 LPM depending on pressure which for me ranges from 10 to 25 cm H2O.

Image

If you decide to try this mask, send me a PM and I can get you some nose clips that actually work as opposed to the nose plugs that come with the mask.

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Julie
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Re: Continuation of leakage discussion

Post by Julie » Wed Jul 30, 2014 5:05 am

And just in case you haven't tried any, what about liners like Pad-a-Cheek that do help with leaks for many people?

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Pugsy
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Re: Continuation of leakage discussion

Post by Pugsy » Wed Jul 30, 2014 6:58 am

mrog wrote: The mouth opening leaks were bad enough to wake up both me and my wife.
Gottcha, I was hoping that they weren't that bad.
mrog wrote:I haven't tried those masks. My current health insurance doesn't have any DME coverage, so I've been buying supplies online for a while. Maybe I should call my local RT and ask if they have samples of those I can try on. If it works a lot better, I'd consider paying their inflated price. Have you heard of the new masks fitting hard-to-fit faces better than the Quattro?
It's a crap shoot as to whether the new masks will fit you better or not.

The AirFit F10 uses the same cushion as the Quattro Air ....headgear and forehead piece being different. I don't have a F10 but I might have a Quattro Air but unfortunately I think it is in the medium size which from what you say about the Quattro...I bet is too small but let me check.

BUT the F10 comes with free return insurance from cpap.com...meaning if you hate it you can return it and get your money back an cpap.com even provides a prepaid shipping label.
https://www.cpap.com/productpage/resmed ... dgear.html

I think it is painfully obvious that your Quattro isn't even coming close to getting the job done.

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Denial Dave
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Re: Continuation of leakage discussion

Post by Denial Dave » Wed Jul 30, 2014 7:22 am

I went back and looked at the postings for leaks and they are bad almost immediately after starting the machine.

It does point to an incorrect size mask or simply just the wrong mask for you.

At the risk of repeating what may have already been suggested.

#1 I have to guess that you are setting the headgear while laying down? if not, have you tried to get the mask & headgear set while laying down?

#2 Have you tried going through these suggestions at the link below for "taming the mirage quattro?"

Following those suggestions along with the use of pad-a-cheek liners helped me solve my leak issues

http://maskarrayed.wordpress.com/taming ... e-quattro/

good luck!

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Pugsy
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Re: Continuation of leakage discussion

Post by Pugsy » Wed Jul 30, 2014 7:30 am

For those wondering just how much leak we are dealing with here see the below image. I brought it forward so you don't have to scroll through 4 pages in the other thread to find it.
He has just tried a new hose on the off chance there was a big hole in the hose. Also has checked to make sure the anti asphyxia valve is working properly and not stuck open. He has also checked the entire circuit to make sure air isn't leaking elsewhere.
So this appears to be all mask/skin leak. I think the worst I have ever seen for such a prolonged time anyway.

Image

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palerider
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Re: Continuation of leakage discussion

Post by palerider » Wed Jul 30, 2014 9:48 am

Pugsy wrote:For those wondering just how much leak we are dealing with here see the below image. ...
So this appears to be all mask/skin leak. I think the worst I have ever seen for such a prolonged time anyway.

Image
*awards the worst leak ever trophy*

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Fri Aug 01, 2014 8:30 am

JDS74 wrote:I'm a little late to this discussion but have you thought to try the Oracle 2 mask?
That's one I haven't tried. It's an interesting concept, though. I tried a couple of hybrid masks that cover the mouth and have nasal pillows. I found that they were designed for smaller mouths than mine and so they leaked. In inner seal on the Oracle 2 could, in theory, prevent that.

I'm not sure I want to deal with the nose plugs and cleaning requirements of the Oracle 2. (I used to use a Somnomed, and it didn't take long to get tired of cleaning it.) But, I'll certainly keep it on my list of options. Thanks for the tip!

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Fri Aug 01, 2014 8:47 am

Julie wrote:And just in case you haven't tried any, what about liners like Pad-a-Cheek that do help with leaks for many people?
I tried Remzzzs, Quietus, the Pad-a-Cheek liner, and many variations of homemade liners using different shapes and fabrics. My favorite is the Quietus liner with the tacking agent. There's also a version without the tacking agent, but it doesn't stay put as nicely. I've been using Quietus liners for a while and they help a lot. (You should see how bad my leak rate is without a liner!) The liner reduces the leak rate and, more importantly, makes the leaks silent. I burp enough from aerophagia. I don't need my mask to burp all the time, too!

By the way, for anyone interested in making homemade liners, I found that flannel works better than jersey knit or other thin fabrics. I created a template for a liner that works well with the Quattro medium size mask. You can get it here. That was back in the day when I was experimenting with different mask sizes. (I currently use a large, but I didn't alter the template on the computer to be large.)

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Fri Aug 01, 2014 8:50 am

Pugsy wrote:BUT the F10 comes with free return insurance from cpap.com...meaning if you hate it you can return it and get your money back an cpap.com even provides a prepaid shipping label.
https://www.cpap.com/productpage/resmed ... dgear.html
I didn't know that. Thanks! That could come in handy.
Pugsy wrote:I think it is painfully obvious that your Quattro isn't even coming close to getting the job done.
Yes, it it.

Do you happen to know of any full face masks that are larger than the Quattro large?

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Fri Aug 01, 2014 9:05 am

Denial Dave wrote:I went back and looked at the postings for leaks and they are bad almost immediately after starting the machine.

It does point to an incorrect size mask or simply just the wrong mask for you.
I believe the large Quattro I'm using is a bit too small for me. I wish they made an XL size. It would also help if the air cushion was a bit thicker so it would fit my face contours better.
Denial Dave wrote:#1 I have to guess that you are setting the headgear while laying down? if not, have you tried to get the mask & headgear set while laying down?
Yes. I learned that one early on.
Denial Dave wrote:#2 Have you tried going through these suggestions at the link below for "taming the mirage quattro?"
I've followed some very similar steps a few times before. I never could get it to seal properly. As you pointed out, it's not the right mask for me. But it is the least bad option I've found so far.
Denial Dave wrote:good luck!
Thanks!

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Pugsy
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Re: Continuation of leakage discussion

Post by Pugsy » Fri Aug 01, 2014 9:07 am

mrog wrote:Do you happen to know of any full face masks that are larger than the Quattro large?
I have zero personal experience with any full face mask except very brief trial on a couple of occasions so I don't know how the sizes might compare. So sorry. Even if I did...I would be in the smallest size category anyway.

We will have to rely on other's personal experience on FFM and sizing.

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mrog
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Re: Continuation of leakage discussion

Post by mrog » Fri Aug 01, 2014 9:08 am

Pugsy wrote:He has just tried a new hose on the off chance there was a big hole in the hose. Also has checked to make sure the anti asphyxia valve is working properly and not stuck open. He has also checked the entire circuit to make sure air isn't leaking elsewhere.
I also removed the humidifier a couple of nights ago to make sure it wasn't leaking. I don't see any difference in the leak rate from that.

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Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: I use a Swift LT and an Oracle HC452 at the same time.