Please bear with me, I've got serious brain fog today. I've been on CPAP since Jan. 14th...have had problems exhaling against the pressure. I'm a smoker, REALLY need to quit, I know (and if anybody has tried something to help them quit, that really works, please let me know!) Around the first of March I thought I had a sinus infection and had a bad cough though the doc did prescribe anibiotic also gave me shot of presidone (sp) and some tablets of the same and said I had to quit smoking, I had emphysema not bronchitis.
Did I quit smoking? NO. But I did quit using the CPAP and the coughing/wheezing, feeling like I was drowing went completely away. Of course all the horrible symptoms I had pre-Cpap are back in full force.
Why did I get better from stopping the CPAP? Is my pressure set too high? If someone with emphysema can't use CPAP does BIPAP work better? Auto?
Just trying to get some info and get this straight in my mind before I call the doc on Monday.
Thanks guys.
Emphysema & CPAP
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Guest
Hi Southernmaid
I'm not a doctor, and I think the you really should ask a pulmonologist (lung specialist) about this combination of emphysema and CPAP, it certainly complicates things.
I have no idea if stopping cpap helped, it might have. However, at the same time a few other things happened:
Do look for a specialist to consult about this combination of malfuctioning lungs with high pressure air blowing into them.
And did your cpap perscription take your emphysema into account? That is, do you have bi-pap or c-flex, both of which make exhaling easier? Tell your sleep doctor about the emphysema too!
Good luck, and feel well!
I'm not a doctor, and I think the you really should ask a pulmonologist (lung specialist) about this combination of emphysema and CPAP, it certainly complicates things.
I have no idea if stopping cpap helped, it might have. However, at the same time a few other things happened:
Could be the antibiotics (did you take them?) prednisone tablets (ditto) and shot helped.the doc did prescribe anibiotic also gave me shot of presidone (sp) and some tablets of the same
Do look for a specialist to consult about this combination of malfuctioning lungs with high pressure air blowing into them.
And did your cpap perscription take your emphysema into account? That is, do you have bi-pap or c-flex, both of which make exhaling easier? Tell your sleep doctor about the emphysema too!
Good luck, and feel well!
southernmaid,
The above guest had great points. Good questions and insights, far better than anything I can say here. But I do wish you well. Do you know what your prescribed pressures are? Mine are high and I was prescribed the bipap, but if you check out some of these other topics you'll see alot of people here really love the auto. I guess they're both similar, and both are supposed to be better than the straight cpap.
I agree a pulminory specialist is a great way to go. They often work with many sleep apnea patients and therefore might be more knowlegable and hopefully up on the latest technology. And often they work closely with the sleep labs. You take your chances with any doctor, so be sure to ask lots of questions. But a specialist might have more experience that's needed.
Quitting smoking is awful hard, harder than most addictions, from what I've been told. I don't smoke, but have two parents who have. They eventually kicked it, but I sure wouldn't recommend their methods. My father switched from cigarettes to pipe, then quit after getting lip cancer. My mother was always a cigerette smoker, but only quit (cold turkey and with the use of a hypnotist, of all things) after suffering a breakdown over learning her mother had Altheimerz disease.....complicated scenario. ..... But do you think there might be a way of cutting back on the number of smokes you take, at least initially? Might help some, I don't know. Hopefully someone here will have some good suggestions for you. But don't feel bad, it IS one of the toughest addictions to overcome, don't let anyone fool you into thinking otherwise. But there must be a sensible way of stopping or cutting back. Hope there is for you. Good luck and keep in touch.
Linda
The above guest had great points. Good questions and insights, far better than anything I can say here. But I do wish you well. Do you know what your prescribed pressures are? Mine are high and I was prescribed the bipap, but if you check out some of these other topics you'll see alot of people here really love the auto. I guess they're both similar, and both are supposed to be better than the straight cpap.
I agree a pulminory specialist is a great way to go. They often work with many sleep apnea patients and therefore might be more knowlegable and hopefully up on the latest technology. And often they work closely with the sleep labs. You take your chances with any doctor, so be sure to ask lots of questions. But a specialist might have more experience that's needed.
Quitting smoking is awful hard, harder than most addictions, from what I've been told. I don't smoke, but have two parents who have. They eventually kicked it, but I sure wouldn't recommend their methods. My father switched from cigarettes to pipe, then quit after getting lip cancer. My mother was always a cigerette smoker, but only quit (cold turkey and with the use of a hypnotist, of all things) after suffering a breakdown over learning her mother had Altheimerz disease.....complicated scenario. ..... But do you think there might be a way of cutting back on the number of smokes you take, at least initially? Might help some, I don't know. Hopefully someone here will have some good suggestions for you. But don't feel bad, it IS one of the toughest addictions to overcome, don't let anyone fool you into thinking otherwise. But there must be a sensible way of stopping or cutting back. Hope there is for you. Good luck and keep in touch.
Linda
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southernmaid
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I did take all the meds as directed. Last night I tried using my CPAP and woke up coughing. I think maybe this is beyond the capability of my GP to handle so I will find a pulmonary specialist. I had such great improvement after starting CPAP, I wish that was enough of an incitive to give up that nasty smoking habit. I hope I don't find that with emphysema I have to give up CPAP.
Thanks for the good wishes.
Thanks for the good wishes.
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southernmaid
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rested gal
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southernmaid, given your possible lung problems and potential for having trouble exhaling against pressure, I think you should push extra, extra hard to be give this specific machine:
Respironics Remstar Auto with C-flex and heated humidifier
I'm not a doctor, but that's what I'd absolutely insist on...no substitutions. Not just "an auto" and not just "cpap with C-Flex". And not a Bipap or bi-level machine either, because you'd still be stuck with "10" as the top pressure all the time even though the exhalation pressure could be set as low as necessary.
I'd hold out for that one machine - Respironics Remstar Auto with C-Flex and heated humidifier. I'd get the doctor to specify every word of that on the Rx, so the DME will have to give you that exact machine. Easy for me to say, heheh, since your insurance company will have the final say about what they will or won't pay for. And who knows what your doctor thinks of autopaps in general.
With that particular auto you might find that you'll be spending more time at inhalation pressures lower than 10 AND getting relief every time you breathe out. I think you need every bit of relief from pressure you can get - and that means "auto with c-flex." The one I named is the only brand of auto available right now that can give relief on every exhalation while still operating at the same time as an autopap.
Just my non-medical opinion.
Good luck!
Respironics Remstar Auto with C-flex and heated humidifier
I'm not a doctor, but that's what I'd absolutely insist on...no substitutions. Not just "an auto" and not just "cpap with C-Flex". And not a Bipap or bi-level machine either, because you'd still be stuck with "10" as the top pressure all the time even though the exhalation pressure could be set as low as necessary.
I'd hold out for that one machine - Respironics Remstar Auto with C-Flex and heated humidifier. I'd get the doctor to specify every word of that on the Rx, so the DME will have to give you that exact machine. Easy for me to say, heheh, since your insurance company will have the final say about what they will or won't pay for. And who knows what your doctor thinks of autopaps in general.
With that particular auto you might find that you'll be spending more time at inhalation pressures lower than 10 AND getting relief every time you breathe out. I think you need every bit of relief from pressure you can get - and that means "auto with c-flex." The one I named is the only brand of auto available right now that can give relief on every exhalation while still operating at the same time as an autopap.
Just my non-medical opinion.
Good luck!
Smoker
I am also a smoker. I pick up my machine tomorrow. Also, I have a touch of emphysma (or the beginnings of). The sleep study did not affect me in any way concerning coughing. I actually felt better - as if my lungs were cleaned out for the first time in years - lol. The doctor who will do my gastric bypass surgery in a couple of months required you to quite smoking for 6 weeks before he will do any surgery. I have purchased the patch and will begin very soon. The gastric bypass surgery is too important to me to continue to smoke as I am diabetic and want to get off of the insulin and other medications.
Maybe you need a real incentive to make you quite. I have no doubts at all that I will quit. Pray for me, please!!!
Good luck,
Becky
Maybe you need a real incentive to make you quite. I have no doubts at all that I will quit. Pray for me, please!!!
Good luck,
Becky
I just had my first night of sleep study. My questions is, when I have the gastric bypass surgery and lose weight, will I still have to wear this equipment? I have not received all results, but oxygen level did go down to 76. That they did not like.
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southernmaid
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Hi Becky, Good luck to you too! I had no problem whatsoever with my sleep study, I think they used an autopap! And I had several really good weeks on CPAP, it was when I had a little sinus drainage plus a wheezing cough that I realized I wasn't coughing so much during the day, only at night using the CPAP. Now that the wheezing and coughing have completed cleared up (unless I use the CPAP), I don't know for sure what is going on.
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southernmaid
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IllinoisRRT
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I would first like to back up what everyone else said about talking to your doctor first. That said, I do have patients that have both a COPD-type illness and sleep apnea. From what I remember in respiratory school, the COPD family of diseases (which includes emphysema) is obstructive. Therefore, you have trouble getting all of your air out anyway, to put it very simply. I would imagine that it would make CPAP difficult. BiPAP may be a better option for you- let us know what your doctor says!
Christine RRT
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wading thru the muck!
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Christine,
Thanks for posting your comments on this topic. In the case of people that have other respiratory problems in conjuction with OSA it becomes much more critical that they work with a qualified medical professional. Thanks for pointing that out at the beginning of your reply. For these patients, the consequences of receiving the wrong treatment can be more severe than those of us with plain vanilla OSA.
Thanks for posting your comments on this topic. In the case of people that have other respiratory problems in conjuction with OSA it becomes much more critical that they work with a qualified medical professional. Thanks for pointing that out at the beginning of your reply. For these patients, the consequences of receiving the wrong treatment can be more severe than those of us with plain vanilla OSA.
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
Positive End Expiratory Pressure
I'm not a health care expert by any stretch of the imagination. However, I have read that CPAP and BiLevel are both used to successfully treat emphysema. One Respironics BiLevel machine in particular uses a feature called "BiFlex" which some COPD type patients find useful. That BiLevel machine with BiFlex achieves an elevated pressure toward the end of exhalation. That elevated pressure toward the end of exhalation is called "Positive End Expiratory Pressure" or "PEEP".
PEEP is beneficial for some patients who cannot easily expel enough air at the end of respiration, such that their lungs can reach ambient pressure. Rather, at the end of expiration these COPD/emphysema type patients may have a residual positive respiratory pressure known as "Auto-PEEP". The problem with this residual patient respiratory pressure known as "Auto-PEEP" is that additional respiratory muscular effort must be made to initiate inhalation----not an easy task for some COPD/emphysema patients. PEEP pressures are typically set on BiFlex machines slightly lower than AutoPEEP to help these patients more easily initiate inhalation.
Aside from the Respironics BiPAP Pro series that uses BiFlex, Respironics also offers other machines that deliver "PEEP" and the end of expiration. Those machines would be the various REMstar models with C-Flex. I could have this wrong, but I am under the impression that the "PEEP" achieved via Respironics machines with C-Flex cannot be accurately set----where as the "PEEP" achieved via the Respironics BiPAP Pro series can be set with a finer degree of precision.
Again, I am not a health care expert, so everything I have said here must be read simply as the basis for further research/investigation (versus verified fact). Good luck!
PEEP is beneficial for some patients who cannot easily expel enough air at the end of respiration, such that their lungs can reach ambient pressure. Rather, at the end of expiration these COPD/emphysema type patients may have a residual positive respiratory pressure known as "Auto-PEEP". The problem with this residual patient respiratory pressure known as "Auto-PEEP" is that additional respiratory muscular effort must be made to initiate inhalation----not an easy task for some COPD/emphysema patients. PEEP pressures are typically set on BiFlex machines slightly lower than AutoPEEP to help these patients more easily initiate inhalation.
Aside from the Respironics BiPAP Pro series that uses BiFlex, Respironics also offers other machines that deliver "PEEP" and the end of expiration. Those machines would be the various REMstar models with C-Flex. I could have this wrong, but I am under the impression that the "PEEP" achieved via Respironics machines with C-Flex cannot be accurately set----where as the "PEEP" achieved via the Respironics BiPAP Pro series can be set with a finer degree of precision.
Again, I am not a health care expert, so everything I have said here must be read simply as the basis for further research/investigation (versus verified fact). Good luck!
southernmaid,
You said: (1) you have trouble exhaling against a pressure of 10 on a cpap, and (2) your oxygen level dropped to 86 % during your sleep test, and (3) you have been diagnosed with emphysema.
In my non-medical opinion, you need a pap machine with a lower exhale setting than the inhale setting - one with which you are able to exhale the carbon dioxide in your lungs.
The VERY FIRST thing I think you MUST do is get to a good, a very good, pulmonologist (lung doctor). Preferably a Board Certified Pulmonologist. Let your Pulmonologist decide what kind of pap machine you need.
The next thing you must do is get your mask fitted properly! This can be done only when you are lying down, not sitting in a chair. Our facial structure changes enough between the two positions to have a serious affect on the mask fitting. The DME provider should have an RT, not a tech, come to your home to fit your mask. With your medical situation it is far too important to not get the mask fitted properly.
Question why you need a full face mask. Question what happens to all that carbon dioxide in your lungs when - if for any reason (like a power failure, lying on the exhalation port, etc) - you become unable to exhale ALL the CO2. You may die.
I AM NOT A DOCTOR, NOR AN RT, NOR A DME. I am a layman, 70 years old, who has smoked (and still does) for 54 years.
I am try to quit, but qualified medical people have said it is far more important to FIRST get apnea under control because with apnea you are exhausted, not simply tired, and dieting and quiting smoking become MORE difficult than normal until you get some good quality rest with your apnes/hpnopnea index under 5 consistantly. It is hard enough to quit when you are under normal medical conditions, but with apnea present it becomes even more difficult.
However, your situation may be very different than mine and *your* Pulmonologist may prescribe a different order of events than mine.
Watch that carbon dioxide exhalation. Personally, with my own conditions, I would be VERY concerned if I were prescribed an AutoPap. The C-Flex reduction of pressure at exhalation is simply not enough for me to breath OUT the carbon dioxide. I would most likely die with an AutoPap
Read as much as you can as soon as you can. Take notes with you. Go to your Pulmonologist with as much knowledge as you can so that your diagnosis will be most beneficail to YOU. Your comfort and life are at stake.
I'll pray for you southern maid.
Andy
You said: (1) you have trouble exhaling against a pressure of 10 on a cpap, and (2) your oxygen level dropped to 86 % during your sleep test, and (3) you have been diagnosed with emphysema.
In my non-medical opinion, you need a pap machine with a lower exhale setting than the inhale setting - one with which you are able to exhale the carbon dioxide in your lungs.
The VERY FIRST thing I think you MUST do is get to a good, a very good, pulmonologist (lung doctor). Preferably a Board Certified Pulmonologist. Let your Pulmonologist decide what kind of pap machine you need.
The next thing you must do is get your mask fitted properly! This can be done only when you are lying down, not sitting in a chair. Our facial structure changes enough between the two positions to have a serious affect on the mask fitting. The DME provider should have an RT, not a tech, come to your home to fit your mask. With your medical situation it is far too important to not get the mask fitted properly.
Question why you need a full face mask. Question what happens to all that carbon dioxide in your lungs when - if for any reason (like a power failure, lying on the exhalation port, etc) - you become unable to exhale ALL the CO2. You may die.
I AM NOT A DOCTOR, NOR AN RT, NOR A DME. I am a layman, 70 years old, who has smoked (and still does) for 54 years.
I am try to quit, but qualified medical people have said it is far more important to FIRST get apnea under control because with apnea you are exhausted, not simply tired, and dieting and quiting smoking become MORE difficult than normal until you get some good quality rest with your apnes/hpnopnea index under 5 consistantly. It is hard enough to quit when you are under normal medical conditions, but with apnea present it becomes even more difficult.
However, your situation may be very different than mine and *your* Pulmonologist may prescribe a different order of events than mine.
Watch that carbon dioxide exhalation. Personally, with my own conditions, I would be VERY concerned if I were prescribed an AutoPap. The C-Flex reduction of pressure at exhalation is simply not enough for me to breath OUT the carbon dioxide. I would most likely die with an AutoPap
Read as much as you can as soon as you can. Take notes with you. Go to your Pulmonologist with as much knowledge as you can so that your diagnosis will be most beneficail to YOU. Your comfort and life are at stake.
I'll pray for you southern maid.
Andy
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NeurosurgeryNP
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