Mask fittings are a GOOD THING!

BrensTiredMom · Post by **BrensTiredMom** » Wed Jun 06, 2007 6:11 am

Forgive me for quoting Martha Stewart...LOL...

Went for my mask fitting yesterday at my local hospital/sleep lab.

First off, had no idea that this was even done if I hadn't learned about it here. I had to ASK them about it, it was never offered.

Second, had no idea that they don't just let you see/feel/try on different masks...mine actually connected each mask to a CPAP with C-flex (which I'll have) and brought it up to MY pressure. I got to lay down and try them out in my favorite sleeping positions and with the pressure on. And they got to see how the leaks were for each mask.

After going through the experience I would encourage anyone whose insurance will pay for it or who can afford it to seek a mask fitting like this out. I understand that many hospitals with sleep labs do this, although I don't know if they all do it like mine did with a machine etc. It made a HUGE difference for me.

I found out that I cannot tolerate either a nasal interface or a hybrid with nasal pillows. At 10cm pressure my ears felt like they were going to explode...and we tried 2 nasals and the Hybrid...all the same. (I have had many operations on my ears, they are very sensitive and have lots of scar tissue.) I knew I hadn't liked the nasal during my titration (I'm a mouth braether) but this confirmed it for me. What was a real surprise was the Hybrid...I thought I really, really wanted one (preferably the Liberty) but found that the nasal pillows and the 'under the chin' piece were very bothersome. So we then tried a number of full face masks. I was the most comfortable with the Quattro...and think I'm going to be very successful with it!

So if you can get a mask fitting with a machine...DO IT! It's worth it. And also, for those of you that are turned off by nasals for whatever reason...don't let people try to convince you that's the only choice!

I expect to get my machine and my Quattro today at noon...hope to start therapy tonight!!

Craig-Tx · Post by **Craig-Tx** » Wed Jun 06, 2007 7:41 am

I think that it is great that you found such good help. What was the name of the place that did the fitting, so that others who might be near your area will know of a good company. (I personally like to tell people of services I received both good and bad.)

Unfortunately a good "Mask Fitting" like you described isn't what some DME providers offer as a mask fitting. Looking back on my two mask fittings at Apria, I would have had the same results picking a mask out of a glass case.

grybeard77 · Post by **grybeard77** » Wed Jun 06, 2007 8:15 am

You might has well be blind folded and reach into a big box full of masks and be told to just try one, you'll like it...

ufo13 · Post by **ufo13** » Wed Jun 06, 2007 8:43 am

BrensTiredMom:

What were your impressions of the QUATTRO interface when you tried it at the sleep lab? Your initial opinions of the mask and your observations of it will prove more accurate IMO having had the chance to actually simulate the conditions and pressures you usually use! Thanks for the info!

All the best!

Steve,
ufo13

Goofproof · Post by **Goofproof** » Wed Jun 06, 2007 9:18 am

Lincare, uses the normal mask fittings, their employees are all diesel fitters, they hand you a opened package, take them out, and tell you diesel will fit her. Jim

BrensTiredMom · Post by **BrensTiredMom** » Wed Jun 06, 2007 11:06 am

LOL Goof!

It's so sad that this info and these services aren't readily available to everyone. Seems to me that a mask fitting like I had will mean better compliance, better therapy, less $ on masks that don't work, etc. Better for the patient and better for the insurance companies!

Anyway, the sleep lab/hospital I use is Griffin Hospital in Derby, CT. LOVE this place...can't say enough great about them. Their philosophy is totally patient-centered and it shows.

As for the Quattro v. the other masks I tried (Comfortfull I think, a weird moldable one with magnetic straps and the ResMed Ultra Mirage):

I liked how 'light' the Quattro seemed to feel...I was able to get a good seal, lay down, roll over, etc. at 10cm pressure and maintain the seal without it feeling 'tight'. The headgear seemed comfy, nothing rubbed me wrong. I like the dial that's on the forehead part...it has 24 settings to choose from v. 3 in the Ultra Mirage so you're able to get a more custom fit. I did feel an 'octopus sucking motion' that I think I've seen people talk about but it didn't bother me at all. I felt no pressure on my chin or the bridge of my nose...I did with the Comfortfull and the moldable weird one...hated those right off the bat. The only thing I wasn't crazy about is that there is a small ring of plastic inside the face part that is green and not clear. It's just a little irritating to see it when it's on your face...because it's colored your eye is drawn to it. Wasn't a deal breaker, though, I'm hoping to be soundly sleeping while wearing it! LOL

That's all I can think of. Feel free to ask any specific questions, though!

S-Dubya · Post by **S-Dubya** » Wed Jun 06, 2007 11:07 am

So glad that you found a DME that does REAL mask fittings. It makes a world of difference. I originally used Apria and they would take me back into an exam-type room, open the box, show me the mask and send me on my way. Not sure why they need a special room for that.

Due to an insurance change I switched to Praxair about 2 years ago. They are AWESOME! They have cabinets full of most every mask available and they let me try as many as I want. They ask good questions and make great suggestions. Depending on which tech I get they will occasionally bring out masks to try just for fun or because the mask is new or unique. They set the machine to my pressure and let me lay down, and really give the mask a thorough trial. Great people!

Too bad most DMEs just don't get it. Buying CPAP masks (and medical supplies in general) is not like buying auto parts.

ufo13 · Post by **ufo13** » Wed Jun 06, 2007 11:43 am

BrensTiredMom:

Thank you for all the great info on the QUATTRO! Just the kind of information I was looking for and it will be very helpful to all of us considering this mask! Please keep us posted with your thoughts on this mask as you use it, it is GREATLY APPRECIATED!

All the best,

Steve,
ufo13

BrensTiredMom · Post by **BrensTiredMom** » Wed Jun 06, 2007 1:45 pm

You're welcome Steve!

Janine · Post by **Janine** » Wed Jun 06, 2007 1:52 pm

I assumed such things like mask fitting were standard! Now I know why so many people have mask issues. The place that I went to had me try on a bunch of masks, at my pressure, lying down etc. I didn't know I was lucky!

I have used the Quattro for about a week, and really like it. My only problem is that it is wider in the lower part than the UMFF and I am a side sleeper. I am working on sleeping on my side and not dislodging the mask, and I think I am figuring it out. I slept on the recliner last night to test out a theory and my AHI was 0 and leak rate standard for the mask and after only 6 hours of sleep I feel great. It is overall quite comfortable (octopus is right, kinda funky but fine).

BrensTiredMom · Post by **BrensTiredMom** » Wed Jun 06, 2007 5:30 pm

I'm a little concerned about that too Janine as I sleep on my side...but I was so much more comfy in the Q than the UM that I decided I could work it out. Someone posted recently about having a firmer pillow on top of a softer pillow and sort of sleeping off the side of it. Glad you had such a great night!! I'm sure you'll figure a way to make that happen in your bed!

blarg · Post by **blarg** » Wed Jun 06, 2007 6:40 pm

Janine wrote:I assumed such things like mask fitting were standard! Now I know why so many people have mask issues. The place that I went to had me try on a bunch of masks, at my pressure, lying down etc. I didn't know I was lucky!

This was my mask fitting experience at my DME (from a thread a long time ago):

Blarg wrote:I just got back from my "mask refitting" appointment with the DME. Wow was that an experience.

I guess I'm just too helpful. I brought in a night's printout from Encore to show the leaks I was complaining about. The tech, who had been perfectly nice up to that point, said, "WHERE did you get THIS from?!?!?!" "Uh.....Encore....?" "You stay RIGHT HERE, I'll be back." She grabbed the smart card from my machine and left.

I had the distinct feeling of being sent to the principal's office. About 10 minutes later she comes back, "Your card still shows all this info, so HOW did you get it back on there?" "I just didn't delete it." "What do you mean?" "I mean there's a setting that says whether to delete the data or not, and I chose not to so you guys could do your thing as well."

She looked at me like I was trying to tell her that the sky was green for a few seconds and then said, "I'll be right back." She left again with my smart card.

Obviously the smart thing to do was to play dumb. Oh well. My cover's already blown.

She comes back and says, "I can't find this setting in Encore anywhere." "I'd be happy to show you." "I don't think I can do that." "No worries, I'm comfortable here." She got specifically annoyed that I didn't feel the need to correct her problem for her. "Ok, fine, follow me."

So I showed her where the .reg files are and noted that double clicking one or the other will change the setting. She said, "Oh. I'm sorry, you see, most people don't know that's there and if they have the software they're not supposed to have..... *glare*, they delete their compliance data and then we can't convince the insurance company that they're being compliant. I'm sorry if I was abrupt, let's start over." (Yeah, oops, I treated you like you're 3 and you actually know more than I do about the software. Rewind.)

So then we went back to the room we started in, and I pulled out my Activa. I noted that I was using a Large cushion at the moment and it's probably just too big. "Where did you get that mask?" "From the tech that gave me the machine." "We normally don't give that mask out from the start." "Why, it isn't your cheapest?" *glare* "And you want an Auto permanently?" "Not your cheapest machine either?" *double glare*

At this point I was really sick of answering all of her little snarky questions, so I said, "Look, if you have concerns about my therapy, talk to my doctor. I'm here to get a mask fit, so can we do that please?" "First tell me if you changed pressures on your machine." "If I didn't it wouldn't have been set at what was prescribed." "How do you mean?" "The original tech left it at CPAP 15 when the whole point of having an Auto was to titrate me since I never did a titration sleep study." "You never had a sleep study?" (insert my eye roll here) "My AHI was 37. I never had a second study to get titrated." "Oh."

I finally just said, "Ok, so what masks do you have?" She pulled out 3, which were a comfort classic, a comfort gel, and something else (standard nasal mask). I asked about nasal pillows. She said that she didn't have any in stock. Whatever, I'll survive. I was more convinced she just didn't know what nasal pillows are. So, I grabbed the comfort gel and started fitting it. It's much smaller than my activa cushion and fits better, but does need to be tighter to seal at all. She didn't have extra cushions for the Activa, so fine, I'll take the comfort gel. She let me keep my Activa and take the comfort gel, so I guess I'll just find cushions on my own.

The crazy thing is up until today I was relatively convinced that they actually wanted to help me. Now I know that I should use them for another free mask or two (if what I have doesn't work) and then ignore the fact that they exist.

Yup, you were lucky.

Janine · Post by **Janine** » Wed Jun 06, 2007 7:18 pm

Well, CRAP! The people at my place are very nice. I think the RT thinks I don't need ot know everything I do, but she is very cool about it. Which is good since i have had too many years of idiots thinking they know more about medical stuff than I do, when they don't (insulin pumper, 23 years).

I can't see how this kind of attitude is supposed to help compliance but I guess if they get paid, they don't care... Sorry about your experience, blarg! I will be in Portland next week, want me to go in and go all Canadian socialized medicine on her ass?

darthlucy · Post by **darthlucy** » Wed Jun 06, 2007 7:34 pm

Gah, how I hate arrogant healthcare providers who think that a lowly "civilian" can't possibly know the secret squirrel handshake that only their vast medical training can bestow upon them. Not OSA related, but I recently saw an orthopedic surgeon about an ongoing knee problem that one of his partners had been treating. Interrupted everything I said, disagreed with everything (even seemed to accuse me of lying when I said I had a fractured kneecap 1.5 yrs ago...."Well, I don't see any evidence of that on the x-ray!" I wanted to say, "That's because it healed a year and a half ago, idiot, and it was on the BACK of the kneecap where your blessed x-ray couldn't see it!")

jennmary · Post by **jennmary** » Wed Jun 06, 2007 10:41 pm

I am split on this one in some ways. I used to be a medical assitant (moved on to bigger things) in a drs office. It drove me insane to have people come in there completely sure they were dying from some rare, horrible disease or illness....when really it was something stupid like athelets foot (you get the point lol). People read crap on webmd and suddenly think they have graduated med school and are capable of making these outrageous diagnosis. Just try convincing one of them that what they are having is a migrain and not a brain tumor.
On the flip side I hate when a dr doesnt shut his mouth and listen to what I am trying to tell him. I have lived in this body for 26 years....I think I know when it is not functioning properly.
Like I said......I am split.

Mask fittings are a GOOD THING!

Mask fittings are a GOOD THING!

Your observations!

Thank you BrensTiredMom!

Mask	Humidifier