Doctor visit tomorrow and I hate my SD card

[anglett]

This will be my first visit with my doc since I started my CPAP therapy and I'm trying to get a list of things to talk to him about. This will be the last time I see him since he's actually ending his practice at the end of the month so I'm going to have to find another doctor soon, but that actually leads to my biggest question. I want to get a copy of my prescription for my CPAP. Just to be straight, I just need a script for the CPAP, humidifier, and mask and then everything else like the tubing, filters, etc I don't need a script to purchase, right? Then have my doc write it good for 99 years? I want a copy just in case for some weird reason I need to purchase another machine but most importantly another mask. I may want to use another supplier besides my DME, especially since my deductible is $1500. I just want to be prepared, and I've been reading everything I can on here searching for information but I'm just not feeling any better at all and if it's any possible I'm feeling worse.

I printed out my data to take to him to look at. He's just my family doctor not the sleep doctor who subscribed my pressure, but I was hoping he could look at it to see if it was helping me or not. The RT said not to expect any changes for 1-2 months at least, but I do want to make sure I'm doing ok so far. I couldn't get my data from last night because I had trouble with the SD card. The software said that it couldn't read the card. When I put the card back in the machine after looking at the data it refused to take the card unless the data was erased. So i told it to erase it and the machine worked fine. I've never had so much trouble with an electronic device in my life.

Also, Is there a post link that explains what everything means and what is good or bad for leaks and AHI? All I know is 95th percentile is 6 and maximum is 13.2 for leaks and then AHI is .6 on average since I've started.

[Lizistired]

You can copy your patient data file and take that to your appointment.

[robysue]

I couldn't get my data from last night because I had trouble with the SD card. The software said that it couldn't read the card. When I put the card back in the machine after looking at the data it refused to take the card unless the data was erased. So i told it to erase it and the machine worked fine.

The one time I had this behavior with the S9 that I was using a year ago, it turned out the problem was my computer had a virus that was tampering with the card. You might want to run an anti-virus scan or two to see if anything turns up.

Also, Is there a post link that explains what everything means and what is good or bad for leaks and AHI? All I know is 95th percentile is 6 and maximum is 13.2 for leaks and then AHI is .6 on average since I've started.

For an explanation of AHI, AI, CAI, HI, you can see my Understanding the data in your sleep test report. The big difference between the CPAP numbers and the sleep lab numbers is that the machine only has the wave form data to work on: Anytime there's a problem in the wave form either an apnea or a hyponea or a flow limitation is going to be scored. In the lab, the apneas and hypopneas are only going to be scored IF the EEG data indicates you were actually asleep when the problem happened AND (for hypopneas) if there is either a 4% drop in O2 or (a 3% drop in O2 or an arousal) depending on what standard the lab uses. An average AHI = 0.6 is excellent---particularly if you are feeling better.

For understanding the leaks, here's a primer:

Your leak numbers are: Median: ???, 95th% 6.0 and Maximum 13.2 What do these numbers mean?[/quote]

Since you are using an S9, the numbers represent your UNINTENTIONAL leak rates.

In other words, ResMed and ResScan subtract off (an estimate for) the intentional leak rate for your mask at your pressure setting. So all the leak that is reported is UNINTENTIONAL or EXCESS leak---the kind you want to minimize.

Median: ??? (You didn't tell me what this number was.)
This means that for 50% of the time the S9 was running, your unintentional leak rate was AT or BELOW ??? L/min. It also means that your unintentional leak rate was AT or ABOVE ??? L/min for 50% was running. If these are overnight figures, that's 50% of the night with leaks AT or BELOW ??? L/min and 50% of the night AT or ABOVE ??? L/min.

95%: 6.0
This means that for 95% of the time the S9 was running, your unintentional leak rate was AT or BELOW 6.0 L/min. It also means that your unintentional leak rate was AT or ABOVE 6.0 L/min for 5% was running. If these are overnight figures, that's 95% of the night with leaks AT or BELOW 6.0 L/min and 5% of the night AT or ABOVE 6.0 L/min. And how much is 5% of the night? Well, 5% of one hour is three minutes. So you can get an idea of an upper bound on how long your worst leaks (the ones above the 95% leak figure) lasted by multiplying the usage (in hours) by three minutes/hour. For example, if your machine was running for 7.3 hours and the 95% leak figure is 6.0, that means your leak rate was AT or ABOVE 6.0 L/min for a total of (7.3 hours)*(3 minutes/hour) = 21.9 minutes

Maximum: 13.2
This means that at some point when your S9 was sampling the leak rate it detected a leak of 13.2 L/in. We know you could not have been leaking at this rate for more than 5% of the night because your 95% is much lower than 13.2. When the max leak rate is this higher than the 95% leak rate it could simply be that the S9 happened to sample the leak rate just as you were making a major adjustment to the mask and you knew the seal was broken because you'd pulled the mask away from your nose in order to reseat the mask. Or it could be that you had a 15 minute leak that was worse than the rest of the night. (Note that a max leak of 13.2 is a pretty decent max leak.) Only the leak line tells which case is more likely.


Are the leaks really a problem?

Leaks come in three basic varieties:

• Leaks that are LARGE enough and LONG enough to adversely affect your therapy. These obviously have to be dealt with. Are your leaks in this category? Well, the Resmed engineers believe the machine is capable of compensating for leaks up to 24 L/min as long as they're not too long lasting. The infamous Mr. Red Frowny Face shows up when the Resmed engineers believe your leaks are both LARGE enough and LONG enough to compromise both your therapy and the data the machine records. Mr. Red Frowny Face shows up when your 70% leak rate is AT or ABOVE 24 L/min. In other words, the Resmed engineers believe that if your leak rate is AT or ABOVE 24 L/min for 30% (or more) of the night, there's a real leak problem that the machine cannot cope with. And at that point, you really do need to do something to address the leaks. With a 95% leak rate of 6.0, your leaks do NOT fit into this category!
• Leaks that are LARGE enough and/or LONG enough to adversely affect your comfort. These are leaks that are either not large enough or not long enough to clearly adversely affect your therapy and the data. But if a leak wakes you up, it's a problem. If you wake up with dry eyes from leaks causing air to blow in your eyes, that's a problem. If you wake up with a dry mouth, that's a problem. If you can't get to sleep in the first place because every time you move in bed the mask springs another leak that makes you more alert, that's a problem. And if you can't get to sleep because the leaks simply annoy you and keep you from drifting off into slumberland, that's a problem. In other words, if the leaks are causing you discomfort, they're a problem and they need to be dealt with so that you'll be more comfortable, and hence, sleep better.
• Leaks that are NOT large enough and/or long enough to adversely affect your therapy AND do NOT cause you any discomfort. My advice on these leaks is to not lose sleep over them. No one is going to have 95% leak rates equal to 0.0 L/min night after night after night. If that 95% leak rate is below 10 or 15 and you're sleeping through the leaks and not waking up with any problems caused by the leaks, then don't get too worried about working excessively hard to eliminate the last bit of leaking.

So in conclusion, your leak data is very good!

[anglett]

Thanks robysue I really really appreciate your help AND of course your blog. I have read it all actually several times. With feeling like crap things are not making sense I guess and I'm not making sense to myself. My doc is going to refer me to a neurologist now for my headaches since my numbers look so good compared to my horrible sleep study numbers and I still feel completely craptastic. I'd probably just give up if it wasn't for this forum and all the success stories.