help me address these comments

Inflammatory remarks and snide comments really have no effect on me. If you have statements that you would like me to take seriously, please PM me with them. If however you are just playing to the crowd, grandstanding or otherwise podium slapping then please understand that I am rather unphased.

gvz wrote:I called 411 for the medical center he works at, spoke to the operator, asked specifically for sleep lab, and Calist picked up.

That's a little worrisome, since his PSG skilz suck. Hopefully he doesn't actually touch any of the complicated electrical stuff.

gvz wrote:...he is a real person...

Then why can't he understand that everyone here is a real person, too? He does not understand basic courtesy and respect. He allows his insecurities to control his behavior. He thought that by simply posting "I am a sleep tech", that that would give him instant credibility. He thinks that by having one or two special skills, and by showing up in a forum where those skills may have value, that that would give him preferred status and importance. He does not understand that respect takes months to create and a split second to lose.

"IMHO" he's going to continue his little "whistling in the graveyard" quips and believe that a 180-degree change of heart will magically occur.

It won't.

gvz wrote:Blegh.

Blegh back.

BTW, the inherent problem with your "WinO2Flow" device is you can't account for circulatory time so you're always at least 25 seconds behind in event identification and much more than that in response (change in FIO2 > pAO2 > paO2). The event has been long over by the time your therapeutic attack begins. Your device may be of value with overall baseline drops, but if you dropped 300 times a night, that's not the problem.

NM, I don't understand one word you said but I trust every word you said.! Why is that?

gvz wrote:

Well, I don't think he's getting any if he is posts like this in his spare time.

I think he is getting off on what is going on here. He loves it. He is like a teenager in a whorehouse.

Whoah. Wow. that's a pretty harsh thing to say about someone.

GVZ -- I don't know you and have no beef with you on any level, other than your support of this guy. I have a hard time understanding how you can continue to defend him after his behavior towards me regarding my use of the ventilator. He was really ugly to me about the ventilator, provided absolutely, positively inaccurate information on it, was proven wrong and refuses to admit or acknowledge it.

Or what about his "opinion" that comes out in the form of a "professional opinion" about ASV machines? There are numerous people here using them and he says what he does about them. How John managed to maintain his calm is beyond me, but not unexpected because he is a nice man and a gentleman, proven over and over again.

I'm going to phrase this as a question but don't really want or expect an answer -- how can you ignore these facts and continue to show support?

On the other hand, it's your right to do so and I will offer you respect for that right. I think you're in the minority however, as most people here see the situation for what it is.

DoriC wrote:NM, I don't understand one word you said but I trust every word you said.! Why is that?

Yep -- I agree with you completely Dori!! A lot of what Muffy/NM says goes way over my head, but I trust what he says to be accurate.

DoriC wrote:NM, I don't understand one word you said...

When a respiratory event starts, it takes at least a few seconds to use up the existing oxygen in the alveoli. Then the deoxygenated blood takes at least 25 seconds to get down to the finger where it is measured by the pulse oximeter. A 10 second respiratory event, then, has already been completed for no less than 15 seconds and oxygen level recovered. Adding oxygen to the system will probably take another minute anyway to get to the alveolar level and have therapeutic action. Cardiopulmonary disease will increase these times. Consequently, his system is totally dyssynchronous with what he's trying to fix.

BTW, we're talking about this thing he built:

viewtopic.php?f=1&t=56424&p=529056#p529056

NM, your physiologic explanation makes sense. And,in fairness, gvz said his contraption was something fun to geek out about.

But what if gvz's apparatus could take data on flow restriction from the XPAP and used that to regulate the rate of supplemental O2? IOW, the lower the airflow, the higher the O2 concentration in the mask? (I have no idea how that could be done, but it wouldn't surprise me if gvz could figure something out.)

I'm thinking about the question whether frequent desats to 90% or so may be riskier long term than has been assumed.

viewtopic/t56308/Why-Arent-Doctors-Payi ... evels.html

M.D.Hosehead wrote:But what if gvz's apparatus could take data on flow restriction from the XPAP and used that to regulate the rate of supplemental O2? IOW, the lower the airflow, the higher the O2 concentration in the mask? (I have no idea how that could be done, but it wouldn't surprise me if gvz could figure something out.)

Supplemental oxygen is not the choice for flow restriction, pressure is. The cause must be treated.

By itself, oxygen in OSA:

Does not correct the obstruction;
Can blunt arousal thresholds so the desats actually end up even worse;
Does not fix the wretching against the obstruction that creates large hemodynamic pressure swings; and
Does not fix the EDS, which is caused by the arousals necessary to open the airway.

I do not believe the time factor could be overcome. Even if you measure oximetry at the ear, circulatory time is in the neighborhood of 14 seconds, still way too late. And in practice, a low flow bleed in system is usually fine to correct persistent baseline drops.

Where is calist now? Not Muffy is just getting warmed up!! Stay tuned!

DoriC wrote:Where is calist now? Not Muffy is just getting warmed up!! Stay tuned!

Personally, I'm waiting for a serious "battle of the intellect" between the two! Any bets on who would come out on top???

Not Muffy (aka Muffy and StillAnotherGuest) are all proof that fish is great brain food.

Rested Gal
I think you are betting on a stacked deck.
Where is Snore Dog, Goofproof, and The Wolfman when you need them.


I await the time with patience!

Allen

rested gal wrote:Not Muffy (aka Muffy and StillAnotherGuest) are all proof that fish is great brain food.

I definitely have fish envy seeing that monster... I think that's about twenty times bigger than anything I ever caught.

note to self: get a bigger worm and a MUCH larger bobber

P.S. I love this rendition of a classic fishing song: https://www.youtube.com/watch?v=FYvVTqldGBE

Fish?

That's not the fish.

That's the BAIT.

Wait'll you see the fish...