Swift FX causing painful nostrils - any suggestions?

[Laurie1041]

I am feeling frustrated. I have tried the EasyLife nasal mask which was very comfortable but leaves a red indentation across the bridge of my nose. I tried the Mirage SoftGel mask in size small which was very comfortable but left the same sore indentation. I tried the SoftGel this week in a medium and I don't know if I am doing something wrong, but the silicone/plastic "cut" all around my nose - it was if the silicone/plastic edges were very sharp. I lasted about 3 hours and pulled the mask off and switched back to the nasal pillows.

My pillows size extra small are causing the inside of my nostrils to become very sore - to the point of waking me up.

Any suggestions or recommendations? I would greatly appreciate it. Laurie

[Janknitz]

Yes, a couple of things:

1. Loosen it up a little.
2. Use the next size up pillows and lanisoh or something like it to help the seal and reducing friction.

Nasal irritation comes from a couple of things with nasal pillows:
1. The mask is too tight.
2. The nasal pillows cause friction as they inflate and slightly deflate with EPR.
3. The nasal pillows are too small, requiring them to be tighter and enter more of the nose, causing more friction.

We had this discussion about the fact that the nasal pillows go against your nose, not in it, right?

[ozij]

In addition, take a short break from the nasal pillows, for 2-3 nights, then return to them. Your skind has to toughen.

[msradar65]

I'm newbie. Finishing my second week, I have Swift LT for her nasal pillow mask. I have been using chapstick on the edges of my nostrils and just dealing with the soreness. It sort feels like when you have a bad cold and your nose gets irritated from wiping and blowing.

I would use some sort of protect cream day and night. My RT said to do this and just deal with it until the skin toughens up.

[Mr Earwig]

I don't know if I am doing something wrong, but the silicone/plastic "cut" all around my nose - it was if the silicone/plastic edges were very sharp.

Want me to crawl in there and take a look?

[trytryagain]

I know lots of you rave about the lanisoh cream, I like it too, but prefer the Ky jelly, its doesn't have as greasy of a feel,to me. I put it around the edges and inside each nostril, then I put a bit around the pillow openings. I don't itch as much and it washes off easily. I use the sensitive kind. It was also recommended by DME. It just has a cleaner feel to me and really does the job of sealing without a lot of pressure on nose.

[robysue]

I"m going to second the suggestion to try increasing the pillow size from XS to S. If the pillows are too small, they'll have a tendency to go to far into the nostrils and rub against the inside. And making sure the straps are not too tight. And double checking the angle that you've set the pillows at. I sometimes notice that the pillow for my right nostril rubs on a spot just barely inside my nostril and if I pull the pillows slightly to reset the angle they're at, it usually fixes the problem pretty quickly.

Another thing you might try is increasing the humidity setting very slightly to see if that helps.

And in addition to Lashinoh or KY Jelly or some other cream/ointment for protecting the nostrils at night, you might also want to make frequent use of an OTC saline nasal spray that will help with the drying out of the nasal mucous membranes without triggering rebound nasal congestion.

[Laurie1041]

Yes, a couple of things:

1. Loosen it up a little.
2. Use the next size up pillows and lanisoh or something like it to help the seal and reducing friction.

Nasal irritation comes from a couple of things with nasal pillows:
1. The mask is too tight.
2. The nasal pillows cause friction as they inflate and slightly deflate with EPR.
3. The nasal pillows are too small, requiring them to be tighter and enter more of the nose, causing more friction.

We had this discussion about the fact that the nasal pillows go against your nose, not in it, right?

Thank you! J-

Yes, I distinctly remember you saying that nasal pillows go against my nose and not in it. I had tried going from xtra small to small last week with leaks galore. My technique for putting on nasal pillows has apparently improved. . .

Last night I went up to size "small" pillows and loosened up the headgear. Much better! The size small prevents the pillows from getting stuffed up my nose. I was afraid I would get an audible leak with both changes, but did not. My 95th percentile Leak for last night was 1.2 and my AHI was 2.3.

I will turn down EPR to "2" to see if this gives additional help and will try some Lanisoh ointment so I can treat the chapped areas before I get any skin breakdown. I had an additional problem last night, but I'll start a separate thread. Again, thank you! Laurie

[cobra4x4]

If you are using the ramp feature on your machine, turn it off!

- start your machine at your titrated pressure then put your mask on, lots of people make the mistake of putting the mask on then starting their machine. The pillows need to inflate before going against your nose then once your mask is in place wiggle your nose a little to get the pillows to seat properly.

and I also suggest going up one size on the pillows.

[Laurie1041]

If you are using the ramp feature on your machine, turn it off!

- start your machine at your titrated pressure then put your mask on, lots of people make the mistake of putting the mask on then starting their machine. The pillows need to inflate before going against your nose then once your mask is in place wiggle your nose a little to get the pillows to seat properly.

and I also suggest going up one size on the pillows.

Thanks cobra4x4!

I got rid of ramp a while ago and last night I remembered that my pillows need to be inflated prior to applying the pillows which definitely helped! Went up one size and that is a major improvement! L

[trike-mike]

I second these suggestions... going up a size, setting the mask much looser, and settling it with pressure all did the trick for me. Additionally, when it is looser and working better, I was able to massively reduce the bumps out of place in the night by ditching the soft cover cheek pads if you can use it that way. It seems, at least to me, that the silicon in the straps help hold the mask in place without needing a lot of tension to do so.

[trytryagain]

When you start your machine before putting on your mask does it record the blast as a leak?

[robysue]

When you start your machine before putting on your mask does it record the blast as a leak?

Possibly.

But unless it takes you 15--30 minutes to seat the pillows correctly, that "leak" won't affect the 95% leak rate or median leak rate if you have no other problems with leaks. And I think that if you're only having some minor leak problems (as indicated by a 95% leak rate of 1.2 L/min), I think it would still take 10 minutes or more of "leaks" caused by setting the pillows before it would have any chance of affecting the leak rate numbers that matter.

[cobra4x4]

If your one that is really over concerned by the leak numbers then I have another suggestion ...

Its still based on inflating the pillows before setting them against your nose.

- Put your mask on then start your machine
- Next pull the mask forward away from your nose (so that it no longer touches) then let it back down and wiggle your nose to seat the pillows.

I personally don't like this approach since it can over time stretch your headgear or require you to make headgear adjustments more often.

[FlyingB]

I had the same problem getting used to the FX. It took weeks of switching sizes and tweaking tension on straps. As soft as the silicone is, if the edge presses against the skin for hours, it feels like a blade. I now have it dialed in, and just received a new mask which took only minutes to adjust. All the above suggestions are good. Hang in there and you will make it work. The FX is the least obstructive mask I have ever tried on my face and was determined to make it work. It is now great will very little leakage.