RT bringing my first machine to my home tonight

[ellen1159]

Well, this is it. The respiratory therapist is bringing the Respironics bilevel machine she selected for me to my home tonight. Any last minute advice? I've been counting the days until I could get my machine and it's finally here, and I'm a nervous wreck that I'll panic and not be able to use it

[RandyJ]

Just make sure that on the top of the machine near the display you see "BiPap Pro" or "Bipap Auto."

You can have the RT go into the Clinician Menu and demonstrate to you that "Run Hours" = 0.0

Good luck!

[Slinky]

I haven't been following the forum lately so pardon me if I've missed whether you had an in-lab titration study w/a bi-level?

If so, how did you do sleeping during that in-lab bi-level titration study? Did you use the same mask at the study that you will be using tonight?

Unless you are really over-anxious, moreso than when facing your in-lab bi-level study, you will most likely sleep better than you did during the titration study as you will not be experiencing as many pressure changes as you did whilst the tech was titrating you trying to find THE best pressure setting for you.

[ellen1159]

I had what they called a "split-study" where I spent the first couple of hours attempting to sleep while electroded up, then around 1 a.m. I was given a bilevel machine and a Quattro full face mask (they let me take it home with me), and I slept a few more hours with the machine while the tech did the pressure changes. I haven't seen my report so I'm not sure exactly how long or how deeply I slept with the machine, but I did get a few hours in, accordign to the tech.

[ellen1159]

Well, the tech just left and I don't know whether to laugh or cry. The pressure setting the doctor programmed for me goes up to 25/15 after 45 minutes (starts at 4). I tried it while she was here and I just don't see how I'm going to be able tosleep with this thing on. The mask is a Resmed Quattro full face size medium but it feels so small, I feel like I'm struggling to exhale when the pressure is high. I practiced without the humidifier and my nasal passages are all swollen shut. I don't remember it being this bad at the sleepstudy, even though it was the same mask and supposedly same pressure setting. I was so hopign that I could go to sleep with the mask on tonight but I don't know. The therapist was sympathetic and said to call the doctor in the morning and tell them the presssure setting is too high and they could adjust it, but its just more delays. I'm just so freaking exhausted.

[RandyJ]

Don't despair. Since you have a full face mask, it won't matter if your nostrils are blocked. They may unblock after you start therapy tonight. You may have some leaks at 25cm, but one thing at a time...

During your study if you were sleeping you were probably unaware of the pressure. If you fall asleep tonight before it gets up to 25 you may not notice, unless leaks wake you up and you need to adjust your mask.

Did you get a Bipap Pro? 650 or 660 model? Are you all set with distilled water for your humdifier etc.?

[Pugsy]

Take a deep breath...

Respironics machine??? If so turn it over and tell me the 3 digit model number you see.

Yes, those pressures are high but lets see exactly what machine you have so we can see if there is further exhale relief available and if worse comes to worse...start out lower and work your way up to the pressure you need.
Some pressure is better than no pressure.

Once I know the model number I know which provider manual to send you and what options are available.

Hook up the humidifier...you are going to want to use it.

Take a deep breath...we are here to help you.

[Todzo]

Well, this is it. The respiratory therapist is bringing the Respironics bilevel machine she selected for me to my home tonight. Any last minute advice? I've been counting the days until I could get my machine and it's finally here, and I'm a nervous wreck that I'll panic and not be able to use it

Spend some quality time with the machine during the day - for the next month or two.

Spend some time laying on your bed - learning to breath quietly.

On your bed move to all of the anticipated positions. Note how the hose moves and think about how that may go (some need hose management systems - me I am fine with good initial routing).

Time to see if the mask stays on under pressure and with you moving to all of those positions. Move your chin in and out up and down. Head from side to side. Note what develops a leak and think about how you can change the fit to compensate.

Spend time watching light TV or reading a book or listening to music. You need how to learn to breath with this machine. The time in bed learning to breath quietly is a good start the time with a distraction but awake should solidify the new reflexes.

Plan on an hour or two the first few days, and hour a day for the first two weeks, and a half hour a day after that. Check mask fit every day – straps lengthen – mask parts move a bit.

Look up the “double dog dare” thread and contribute if you feel so inclined. A laugh is good now and then.

Have a great week!

Todzo

[Stormynights]

Now girlfriend, you can do this. Women are tough. You will get all kinds of support here. Dr. Pugsy is the best. Just relax and remember who you are. It is just air up your nose. You will do fine.

[Janknitz]

Hopefully the mask is still set where they put it during your split study, but if you need to adjust it . . .

Read my "Taming the Mirage Quattro" in my signature below. Pugsy will know how you can do some sort of mask fit on that machine--what I'm talking about is adjusting the straps at your highest pressure, not your lowest. If the pressure is set to ramp starting at 4 and you adjust your mask to that pressure NO WAY it will hold against 25 cm H2O. There is a way to set your pressure up to 25 just to do the fitting--I think the newer Respironics machines have a way to do this easily.

[RandyJ]

The 60 series PR System One machines have a Mask Fit feature like the S9s.

[ellen1159]

Thanks so much for your support. I still feel like crying but I feel less panicked. I think my expectations were completely off base, that I would have the same experience my ex husband had 15 years ago when he came home with his machine (went through the whole night wihtout a hiccup).

The bottom of the machine says BiPap Auto DUM and there's a number: 760P. The respiratory therapist gave me a manual for the machine but I noticed she was hesitant about telling me the numerical settings, which she programed in based on my sleep study report, although she acknowledged that I had a right to know my data. I'm going to ask for a copy of the sleep study report and my office Rx. She seems like a decent person, a bit overworked.

I feel a lot better after reading your responses. I think the exhaustion from the apnea and work has just made me feel particularly vulnerable.

[Pugsy]

The 760 is this machine
PR System One 60 Series BiPap Auto....very, very good machine with lots of options to make things easier for you.

Does the hose have a black end on it where it connects to the humidifier? If so you have the heated hose. If not you have a regular hose. We can talk about it later as needed.

I have never been able to find the provider manual for the 760 but I can get you the 750 model (that's what I have) and the main difference is the 60 series heated hose option and the 760 let's you do a minimum PS and maximum PS (in Auto mode) where I only have a single PS numerical setting available.

PS Pressure Support...it's the difference between Inhale (IPAP) and Exhale (EPAP)

With EPAP 15 and IPAP 25 your pressure support is 10 and that's going to be a bit of a chore to get used to. I tried 6 PS once and it was uncomfortable...like way too much of a rush of air.

Anyway...we can get things sorted out.

Check out my signature line for my little collection of hints that I have started. Software is explained. SleepyHead sometimes doesn't play nice with the 760 machine so I am going to send you information on EncoreBasic which does work well. If you want to try SleepyHead you will need the Patch file. If doing the Patch file (explained in the software thread) is too scarey right now...set it aside. Basic is an easier install.

So I will send you a private message with some links for what you need.

There is a mask fit feature on your machine.
I am going to send you a 750 manual for the BiPap stuff along with a 560 manual for the mask fit stuff and heated hose stuff. I haven't been able to get my hands on a 760 manual.

The mask...I can't help you with because I have never used it. Can you normally breathe through your nose just fine during the day? If so you may be able to use a nasal mask..even nasal pillow. Don't let those high pressures scare you off...there's no reason you can't use nasal pillow mask with your pressures. Others do it all the time.
But read this as it may help with the Quattro fitting for now.
http://maskarrayed.wordpress.com/taming ... e-quattro/

If you absolutely find that 15/25 is just too much...change the 25 to 20 for right now...I think it may be more manageable for you. If still too much..we can go with 14/19...keep the PS at 4 or 5 for comfort right now.
We can then watch the reports and see just what needs to be done and maybe work out a plan where you can work up to the prescribed pressure if you need it.

[49er]

If you absolutely find that 15/25 is just too much...change the 25 to 20 for right now...I think it may be more manageable for you. If still too much..we can go with 14/19...keep the PS at 4 or 5 for comfort right now.
We can then watch the reports and see just what needs to be done and maybe work out a plan where you can work up to the prescribed pressure if you need it.

As an FYI Ellen, there have been people on this board who found in carefully monitoring their data that they were over titrated at the lab and realized that a lower pressure worked very well. Obviously, I can't claim that is going to happen in your situation but you never know. But if you still need to work up to 15/25, the above advise is excellent to follow.

Hang in there.

49er

[sawinglogz]

The 60 series PR System One machines have a Mask Fit feature like the S9s.

Really? I didn't see that in the user manual (at least for the ASV). Is that in a separate manual?