Hi and Help!

[waiting2exhale]

Hi, I'm Wendy and this is my cpap story and questions. I know with all the data here these questions have probably already been asked and answered but I'm easily overwhelmed by too much "stuff'" and so will ask my own and hope for some advice.
I chose my alias waiting2exhale because that's what I feel like I'm trying without success to do.
My boyfriend and I share the same doctor. Unbeknownst to me he told the doc that Stopped breathing several times a night while I was sleeping so on my next visit to his office he suggested a sleep study. Of course I told him it was a waste of time....
I went to the sleep lab got wired up and got in the bed. The tech told me that if he thought I needed it he'd come in and put a mask on me and when that didn't happen I thought I was OK. They called me a few days later and told me I quit breathing at all about 8 times an hour and that on "average" my O2 sat was 80 during the study.
To make all of this worse, I'm a registered nurse so I flip out when they tell me this. I go back to the sleep lab they put a mask on me and I did well there. Slept without trouble, didn't take the mask off at all.
The doc has some kick back with a local cpap provider so I go there and they outfit me with what I assume is the same thing they put on me in the lab. The respiratory therapist at the store used to work in the hospital I work in and I guess she thinks I oughta know all about these things and I don't. She tells me I must have awful apnea cause the pressure they want me to use is 11. She shows me how to put water in the thing and that was about it. I usually catch on fast but I just don't know what to do. She told me she'd call me and see how it was going. Have I even heard from her at all? No. I CAN'T exhale!!! So I end up pulling the mask off after about 15 minutes. I know... call her back, take the thing down there again. I think it would be a wasted trip. Can someone here tell me what to do, other than the obvious? PLEASE!

[elena88]

Hi and Help!
by waiting2exhale on Mon Aug 16, 2010 10:10 pm

Hi, I'm Wendy and this is my cpap story and questions. I know with all the data here these questions have probably already been asked and answered but I'm easily overwhelmed by too much "stuff'" and so will ask my own and hope for some advice.
I chose my alias waiting2exhale because that's what I feel like I'm trying without success to do.
My boyfriend and I share the same doctor. Unbeknownst to me he told the doc that Stopped breathing several times a night while I was sleeping so on my next visit to his office he suggested a sleep study. Of course I told him it was a waste of time....
I went to the sleep lab got wired up and got in the bed. The tech told me that if he thought I needed it he'd come in and put a mask on me and when that didn't happen I thought I was OK. They called me a few days later and told me I quit breathing at all about 8 times an hour and that on "average" my O2 sat was 80 during the study.
To make all of this worse, I'm a registered nurse so I flip out when they tell me this. I go back to the sleep lab they put a mask on me and I did well there. Slept without trouble, didn't take the mask off at all.
The doc has some kick back with a local cpap provider so I go there and they outfit me with what I assume is the same thing they put on me in the lab. The respiratory therapist at the store used to work in the hospital I work in and I guess she thinks I oughta know all about these things and I don't. She tells me I must have awful apnea cause the pressure they want me to use is 11. She shows me how to put water in the thing and that was about it. I usually catch on fast but I just don't know what to do. She told me she'd call me and see how it was going. Have I even heard from her at all? No. I CAN'T exhale!!! So I end up pulling the mask off after about 15 minutes. I know... call her back, take the thing down there again. I think it would be a wasted trip. Can someone here tell me what to do, other than the obvious? PLEASE!

Okay, take a deep breath, pretend you are ONE Of your patients... and you are going to calmly walk them thru what is going to happen next..
First of all, nobody will be able to help you without background info (just like taking a health history) so go to the user control panel and enter
your type of machine, etc.. there is a drop down box, just pick yours.
YOU also need a copy of your sleep study, the eight page report with summary and graphs. It sounds as if you were sent home with a cpap on
a pressure of 11. The pressure really doesnt show how bad your apnea is, you can have a some very severe apnea with a low pressure, and vice versa..
The pressure number is what your machine will go up to clear an obstruction.. Right now, we dont know what you AHI is, and that is not sushi..
You are going to have to go up and read the new users info, and the cpap definitions, aslo the cpap wiki before you will have a clue as to what
people are going to tell you.. I know its overwhelming, and you just want to know how to exhale.. it aint that easy.. but there are solutions..
Normally, on most machines, there is a exhale relief feature, we call it "training wheels" whoever set you up on the machine should have
showed you how to use that.. There is also a ramp feature, which allows you to set it for five to forty five minutes at a low pressure, lets say
four or five, until it gets up to eleven. Did they show you that?
What the heck kind of machine do you have? If we know, we can teach you how to work it.. however, being a nurse, youre going to want all the
information you can get so you can take charge of your therapy. It sounds like you went thru this diagnosis, sleep study, and titration and set up
in a whirl wind.. Most of us have to wait a few weeks for all this to happen, so in the mean time we are searching for information.. because
its kinds of weird and strange to learn you have OSA..
You are likely struggling to exhale because your body has not adjusted to breathing against that pressure yet.. Mine is about the same pressure,
and I ripped the thing off in about thirty seconds and said.. screw it, Id rather die! I got back on the horse though, after tumbling off a few more
times, and its been over five months.. so if I can do it, and all these other folks can do, you can too.. In a few weeks you will be so used to
the pressure, it will feel like you are exhaling with no problem at all.. its a very strange thing, but it happens.
So you are on straight pressure of eleven, on a cpap. I dont have a cpap. I have an autopap. That is a self adjusting machine..
it only gives me a higher pressure when I need it. A cpap will give you
contant pressure at one number the entire time youre sleeping. Its also very important to have a machine with FULL data.. data you can easily
download onto your computer.. if you were set up with a crummy machine, youll want to switch it before its too late. YOu might have a nice one
and just not know it.. IN the mean time, you can practice breathing against the machine during the day, when YOU know you dont have to sleep
with the darn thing.. Start with trying to watch tv, wear it for an hour if you can, the next day two hours.. Its usually best to start this project
on a weekend.. but do what you can for now.. and dont forget to tell us what mask you have as well..
See you tomorrow!
elena

[Bearcat42]

Elena88 explained it pretty well. Getting started with Cpap is a daunting undertaking to some because there is a learning curve to overcome but you are at the right place to get the information you need to be successful. It does take some time to figure out what is going on with this new development in your life and it will seem foreign at first bit as you learn more about sleep apnea and Cpap the more confidence you will gain and the easier your therapy will be.
There is some trial and error involved as you get started so hang in there and keep asking questions. Don't be afraid to try different things that may help you adjust more easily or if you find something is not working for you. If you feel that your doctor or DME isn't communicating well with you concerning your equipment or therapy then explain to them your feelings and hopefully they will take more time to be more thorough. Don't give up and please ask if you have any questions, and thank your boyfriend. Good luck!

[Hospiceangel]

Hi,
Both elena and bearcat know what they are talking about.
I am an RN and I had a similar experience with DME.
You have to do what we know how to do as nurses. If you want to teach your patient you have to brush up on the "New" technology. That's what this forum is for. Thank goodness it's here. These members know way more than we do about OSA and CPAP.

Take a deep breath, look under the lightbulb at the top and study girl, like you did when you were in school. It will come, you have to be patient. I'm a newbie too, I've only used CPAP for 6 weeks and I have learned so much. Yes, my brain is coming back. Kick off your shoes, grab a paper and a pen, a glass of water and stay a while. Don't be afraid to ask questions. PM anybody but ask questions and know that we are all here for you.
Keep posting,
Shar:)
You can do this!

[brazospearl]

Welcome to the forum, waiting2exhale! We'd love to give you specific information to help, but we need to know your equipment. It sounds as though you need an exhale relief feature, and if we knew which machine you're using we could give you the secret handshake for that. Like the other posters have said, tell us more and we'll help all we can.

[nosenabook]

You poor thing! Don't panic.

I guess she thinks I oughta know all about these things and I don't.

But you will.

She tells me I must have awful apnea cause the pressure they want me to use is 11.

Not at all. I have really mild apnea and my pressure is 14; my husband's is moderate and his pressure is 8. It just depends.
But now you know that your DME is not an expert or she wouldn't have said that. It was neither helpful nor true.

I usually catch on fast but I just don't know what to do.

Start with your information here on the forum. Sign in and click the tab near the top left of your screen that says User Control Panel. Then click the Profile tab, and Edit equipment. You'll need the name of your machine and your mask, and possibly your humidifier, if it's separate. For the line, How would you like your equipment displayed? choose 'text,' if it's not set that way already.
Then you start reading the wiki, at the sign of the light bulb at the top of the page. Check back in an hour or a day and see what answers might have arrived.

So I end up pulling the mask off after about 15 minutes.

Completely normal.

I know... call her back, take the thing down there again. I think it would be a wasted trip.

...but you thought the sleep clinic would also be a wasted trip. However, you might be right on this one. Lots of DMEs don't know very much about the equipment or the condition; that's why it's best if you learn all about it yourself.

Can someone here tell me what to do, other than the obvious? PLEASE!

The short answer is YES! Here there are many smart and helpful people, all ready and willing to tell you all sorts of interesting things. All you need is time, and some vocabulary. Check out the CPAP definitions on the Wiki home page.

[echo]

Hi Wendy,

Many of us also started out on cpap in the dark, but we all get there. There is lots of new info to soak up but it will get easier with time. Read as much as you can, as already suggested.

A pressure of 11 is not so bad, even though it may seem like it now. The best thing to do is wear it during the day when watching tv or reading, so that you get used to breathing out against the pressure while you're awake, rather than in bed dead tired. It took me a couple of weeks to get totally comfortable at my pressure of 10.5 cm, but already after a couple of days of practice it was much easier.

As Elena suggested, there is also the EPR/flex option, depending on your machine. This can make it easier to breath out , as it lowers the exhale pressure.

Another possibility is to use to the Ramp function, which starts you out at a lower pressure and slowly increases until it gets to your pressure, for example over a period of 30 min. People usually use this feature to help them fall asleep asleep easier. Once the pressure is reached, it stays there. Many of us don't use the ramp function anymore but many still do.

practice, practice, practice, and it will get easier!

And welcome to the forum!

[waiting2exhale]

OK my machine is a REMstarPlus M series. It's set to gradually increase the pressure for the 1st 30 minutes. Starts at 4, if I am remembering right. On the book that came with it it says C-Flex the difference is real. Mask and head gear are also Remstar. I hope this helps you guys to help me.

[Janknitz]

C-Flex is exhalation pressure relief. You can set it to your comfort from 0 (no pressure relief) to 3 (maximum pressure relief--about 3 cm decrease in pressure). Since you are having trouble, set it at 3. If you can't change the setting, the provider may have locked you out of the setting, but ask here and we can walk you through how to change that.

That should help your exhalation problem.

Meanwhile, welcome to CPAP U! Study up by clicking on the Wiki light bulb above. And ask questions--we can help.

[jweeks]

She tells me I must have awful apnea cause the pressure they want me to use is 11.

Hi,

Welcome to the forum. There are a few other nurses here that do CPAP, so hopefully you will get a chance to meet all of them eventually.

There is zero correlation between severity of OSA and your treatment pressure. It is possible to have really bad OSA and need a low pressure, and it is possible to have very mild OSA and need a really high pressure. What is important is that every case of OSA has a magic trigger level where the airway is help open, and the person can breathe. The key to success is having that sleep study where this pressure is determined, and then getting a machine that is set up correctly. The comment that the CPAP technician made was needlessly alarming. I suspect that she was trying to make small talk, and it came out wrong. In any event, it appears that at a pressure of 11, your case is very treatable, and 11 is typically something that many people can pretty easily get used to (no matter how strange it might feel right now).

-john-

[waiting2exhale]

Thanks to all of you who have responded, I really appreciate it. Tomorrow I'm picking up my sleep study report then I will know more about what my sleep is like. I upped the flexi thing to 3 last night and could breath better and fell asleep with cpap on. However about an hour later I woke up feeling like I couldn't breathe. I think the force of the air is making my sinuses swell? I have some flonase somewhere, I'll try that tonight. Anyone have similar experience and if so what did you do? I really appreciate everyone for being so helpful.

[echo]

Too much or too little humidification can irritate your sinuses. You could try turning the humidifier heat setting higher or lower, depending on what it's set to now. good to hear the flex is helping you breathe easier