Help with therapy on Dreamstation BiLevel S/T

[Pugsy]

It looks like the sleep tech went nuts for some reason...you weren't having problems with centrals until they decided to jack up the PS. And then they had to add a backup rate near the end because they washed so much CO2 out of you...treatment emergent centrals from the increased PS

Did you do a CPAP titration before? Wondering why they went to bi-level...I would have kept you at PS 4 and raised both IPAP and EPAP together until hypopneas and obstructive apneas were gone. Maybe I am missing the history...

Yeah....essentially zero centrals with PS of 4 until they decided to do 24/14 so PS of 10 and then all hell broke loose.
So what do they do then....26/16 instead of backing up PS. I am sitting here scratching my head wondering where that tech's head was.
My first thought was "up his butt".
Second thought which was even scarier is "why didn't the doc catch it"....where was his head?

[raisedfist]

It looks like the sleep tech went nuts for some reason...you weren't having problems with centrals until they decided to jack up the PS. And then they had to add a backup rate near the end because they washed so much CO2 out of you...treatment emergent centrals from the increased PS

Did you do a CPAP titration before? Wondering why they went to bi-level...I would have kept you at PS 4 and raised both IPAP and EPAP together until hypopneas and obstructive apneas were gone. Maybe I am missing the history...

Yeah....essentially zero centrals with PS of 4 until they decided to do 24/14 so PS of 10 and then all hell broke loose.
So what do they do then....26/16 instead of backing up PS. I am sitting here scratching my head wondering where that tech's head was.
My first thought was "up his butt".
Second thought which was even scarier is "why didn't the doc catch it"....where was his head?

I think because the total sleep time was like 2 hours at those presssures/settings, and the AHI was under 5, so they said "ah ha you are treated" and called it a night.

[palerider]

Oscar does not work well with the DreamStation...it's showing EPAP to be higher than IPAP. Take a photograph of your machine settings and upload it please. Your machine may work with Encore Pro - you can get that for free on Apnea Board.

HAH! I didn't even notice that little detail on my phone screen.

[palerider]

It looks like the sleep tech went nuts for some reason...you weren't having problems with centrals until they decided to jack up the PS. And then they had to add a backup rate near the end because they washed so much CO2 out of you...treatment emergent centrals from the increased PS

Did you do a CPAP titration before? Wondering why they went to bi-level...I would have kept you at PS 4 and raised both IPAP and EPAP together until hypopneas and obstructive apneas were gone. Maybe I am missing the history...

Yeah....essentially zero centrals with PS of 4 until they decided to do 24/14 so PS of 10 and then all hell broke loose.
So what do they do then....26/16 instead of backing up PS. I am sitting here scratching my head wondering where that tech's head was.
My first thought was "up his butt".
Second thought which was even scarier is "why didn't the doc catch it"....where was his head?

The questions is... is this gross incompetence, or are they trying to assure OP fails ST and thus justifies an ASV???

[ajack]

Well the lab knew what they were doing. The doctor knew what he was doing. I understand it's a shock to the system, and as I've said, ASV is going to use similar pressure too. If you have an issue go back and talk with the doctor. You can see the nonsense you are being told here.

[Pugsy]

You can see the nonsense you are being told here.

Finally something I can agree with. Just not like it was meant I am sure.

Anyone thinking that just because someone is a "pro" in the medical field that mistakes never get made.....pretty damn naive.
Unfortunately the "pros" don't walk on water and they make mistakes every day. Some big and some small but no one is ever perfect.

I think we all can see who is spouting the most nonsense here.
Take it with a grain of salt and move on.

This thread is NOT going to get derailed with shit slinging. Fair warning folks. Don't even start.
Stay on topic please....don't like the message....that's fine just remember to attack (discuss) the message. Leave personal attacks in your mind if you find them forming.

[ajack]

If all the abuse that is slung, you are going to pull me up on my comment about the lab and dr being right. It is there in the titration. And the misinformation he is being told here ?
It was even going to be dangerous for him. Your moderation is unique.

[Pugsy]

ajack says:::Your moderation is unique.

Well....it is what it is....get over it or move on.
Cold hard fact of life is I am a moderator here and there is a reason I am a moderator.
If you don't like it....tough shit as they say.

What I said was true...pros make mistakes every day. They don't walk on water and they aren't fool proof.
Also it is true that you don't know nearly as much as you think you do about this stuff.

So a direct warning to you....get back on topic and stop the personal shit or your posts will get moved to the trash can thread.
Your choice.
Go ahead and say whatever you want to say that is on topic...you have that right...we have the same rights to say what we want to say and if that means disagreeing with you...that's what will happen. You can pretty much count on it..
It's the how that people disagree sometimes or try to be the forum feelings censors that is pissing me off and derailing threads.

To everyone.....further OT comments will end up in the trash can thread.
Ajack is going to say stuff you don't agree with...hell, I don't agree with 99% of what he says..but what he says is fair game to attack. Be careful with how you say something in voicing your differing opinions.
There are ways of disagreeing with what someone says that doesn't involve slinging a fistful of shit at the same time. You all are all smart enough to realize and implement that way of disagreeing.

If you feel that what someone says is dangerous...say that is how you feel but do it without personal attacks and name calling.
I know it is on the tips of your fingertips to type...but don't do it...please.
State why you feel so and so is dangerous and move on. No need to keep beating a dead horse to death.

[raisedfist]

Back to the OP - have you ever used a CPAP by chance? I wonder how you'd do with an APAP. Or even the VAuto with moderate PS of say 2-4 for comfort reasons.

[Pugsy]

Back to the OP - have you ever used a CPAP by chance? I wonder how you'd do with an APAP. Or even the VAuto with moderate PS of say 2-4 for comfort reasons.

She's got some old posts from a DreamStation APAP posted if you dig back in her old posts.
I don't have the time right now to go find them. If you search some of her old posts some report images are available. Not sure if all APAP or cpap mode. Also unsure of how much exhale (Flex) relief was ever done but remember the most anyone can get with Respironics is a 2 cm drop even if the setting is 3.

Short on time at the moment....building a deck.

[halokittie]

Back to the OP - have you ever used a CPAP by chance? I wonder how you'd do with an APAP. Or even the VAuto with moderate PS of say 2-4 for comfort reasons.

Hi,
Yes - on a Dreamstation Auto CPAP for the last 18 months and a F&P brick for 5 years before that. Never got quality sleep although I took to CPAP quite well. Always tired in the morning after a full 9 hours of sleep, needing a nap, hard to focus. AHI always 7+. I sleep on my back due to bad shoulders but use a cervical collar, so my obstructions are low. Mostly true centrals. IIRC, pressures were 12/18.

[halokittie]

What settings did you use last night and the night before?
Get them off the machine...not OSCAR.

Is it a St, or an avaps like Oscar says? (Ie, Oscar bugs on machine type?)

The varying ipap doesn't look st like.

It's supposed to be ST. I'll get images from the machine itself. Thanks

[halokittie]

OSCAR may not play nice with this model either...which is why I wanted all settings as shown from the machine setup menu.
Statistics look weird and nothing near what reported settings were.

Sigh.... I have a monumental headache right now...what with all the smoke coming out of my ears and now this.
I think I will go pour myself a shot of some high dollar brandy that someone in Australia sent me.

I'll get shots from the machine today, thanks

[raisedfist]

Back to the OP - have you ever used a CPAP by chance? I wonder how you'd do with an APAP. Or even the VAuto with moderate PS of say 2-4 for comfort reasons.

Hi,
Yes - on a Dreamstation Auto CPAP for the last 18 months and a F&P brick for 5 years before that. Never got quality sleep although I took to CPAP quite well. Always tired in the morning after a full 9 hours of sleep, needing a nap, hard to focus. AHI always 7+. I sleep on my back due to bad shoulders but use a cervical collar, so my obstructions are low. Mostly true centrals. IIRC, pressures were 12/18.

Thanks for some reason your old posts I can't see the uploaded images anymore.

Would be nice to see them.

[Pugsy]

Thanks for some reason your old posts I can't see the uploaded images anymore.

Ooops....they were there last night but looks like she moved them or removed links or something.
I saw them last yesterday.