Further proof Doctors not always are right

shippy · Post by **shippy** » Sun Apr 06, 2008 8:11 am

Hi folks

I have been playing with my new toy Bi-Pap over the last several weeks and changed the settings from the Docs original Bi-Level 20/16 setting to an auto setting of 17/14 and this is what i have seen.

20/16 Bi-level setting seven day's 3/13 to 3/19/08

Avg. AHI - Max Leak - 90% Leak - Avg. Leak - Lrg. Leak
7.06 - 102.14 - 52.19 - 43.63 - 0

17/13 Auto Bi-Pap setting seven day's 3/30 to 4/5/08

Avg. AHI - Max Leak - 90% Leak - Avg. Leak - Lrg. Leak
3.19 - 99.14 - 49.81 - 40.99 - 0

Quattro Full Face Mask on both weeks data

Highest one night AHI on Bi-level was 11.6
Lowest one night AHI on Bi-level was 2.3

Highest one night AHI on auto was 6.2
Lowest AHI on auto was 1.0

Very unscientific ha! ha! and if i was more computer savvy i would post the reports but sadly i'm not. Got this data off Encore Pro Analyzer nightly report. The period in between 3/19 to 3/30/08 was at straight cpap 16 and those numbers were not great either. I realize a one week comparison is not enough time to analyze but the improvement is dramatic and i sure feel better on Auto than on Bi-level, also some of the higher numbers are due to mask leakage and back sleeping i assume.

Dale

NightHawkeye · Post by **NightHawkeye** » Sun Apr 06, 2008 2:06 pm

Good work so far, Dale!

Do you plan to continue making adjustments, or are you satisfied to stay with these pressure settings for a while?

shippy · Post by **shippy** » Mon Apr 07, 2008 12:41 am

Thanks Nighthawkeye

I plan on staying at the current setting for at least two more weeks while i monitor the data and will try some more tweaking if necessary. Numbers are not real good but not that bad at the current setting. I was on straight cpap for more than a year at 16 c.m.'s and this Bi-Pap is new to me and i will take it slow for now till i figure it out.

Dale

Slinky · Post by **Slinky** » Mon Apr 07, 2008 5:20 am

I haven't met a doctor yet who could walk on water. And those I've encountered who tried always ended up slipping on the ice and falling on their face.

NightHawkeye · Post by **NightHawkeye** » Mon Apr 07, 2008 5:58 am

shippy wrote:Numbers are not real good but not that bad at the current setting.

I feel the same way about my own therapy, Dale. My AHI usually seems to bounce around between 3.0 and 5.0. I guess you could say there's room for improvement. I just haven't found the secret to perfect xPAP therapy yet.

Regards,
Bill

Slinky · Post by **Slinky** » Mon Apr 07, 2008 7:48 am

Boy, Bill!!! Yer a real wet blanket today. You didn't even bother to comment on my feeble attempt at humor. I'm gonna go sit in the corner and pout.

NightHawkeye · Post by **NightHawkeye** » Mon Apr 07, 2008 7:54 am

Slinky wrote:Boy, Bill!!! Yer a real wet blanket today. You didn't even bother to comment on my feeble attempt at humor. I'm gonna go sit in the corner and pout.

I'm sorry, Slinky. If it's any consolation, I thought about it ...

I've taken so much flak in the past about beating up medical "professionals" that I tend to let such things go by without comment, that is unless I see an opportunity to get a really worthwhile jab in.

Regards,
Bill

Slinky · Post by **Slinky** » Mon Apr 07, 2008 9:07 am

Too late. Fergeddit. You blew it.

oceanpearl · Post by **oceanpearl** » Mon Apr 07, 2008 10:02 am

Remember that the person who graduated last in his medical school clas s still called DOCTOR!

mindy · Post by **mindy** » Mon Apr 07, 2008 10:06 am

Slinky wrote: I haven't met a doctor yet who could walk on water. And those I've encountered who tried always ended up slipping on the ice and falling on their face.

On their face???? I thought a different part of the anatomy might be more appropriate

m

Slinky · Post by **Slinky** » Mon Apr 07, 2008 11:49 am

Well, what can I say? Sometimes you can't tell one end from the other. Both ends in some people are quite capable of spewing BS. Including doctors.

shippy · Post by **shippy** » Mon Apr 07, 2008 7:20 pm

I feel the same way about my own therapy, Dale. My AHI usually seems to bounce around between 3.0 and 5.0. I guess you could say there's room for improvement. I just haven't found the secret to perfect xPAP therapy yet.

Regards,
Bill

Here's my problem Bill i had a misconception about Auto machines i thought
That an Auto would find a persons sweet spot each night and AHI's would be consistently lower but such is not the case. I was on straight Cpap at 16 c.m. for over a year and my AHI's were running 1.5 to 3.5 with a long term AHI of 3.2 so if i set the auto between 20 and 10 and the machine senses an event it will run all the wey up to 20 to take care of the event and exhale pressure will follow along. My thought is i need to average some where near 16 c.m. since on straight cpap i was doing well at 16 so by setting the machine up at the current setting 17/13 it goes no higher than 17 and averages 15.5 or so on the nightly Encore report or close to that 16 i was at before. To clarify actually its the sleep lab and technician who recommends a pressure setting to the Doctor who then writes a prescription and my title of this post might be a little harsh. But i have a copy of the last sleep study i took in December last year and it shows most events cleared up at a pressure of Bi-level 20/16 that may have been the case that one night in the lab but with the use of software i could read my card and i knew my therapy was not good at 20/16 and i began to feel like i did before starting Cpap treatment.

Dale

NightHawkeye · Post by **NightHawkeye** » Mon Apr 07, 2008 7:44 pm

shippy wrote:My thought is i need to average some where near 16 c.m. since on straight cpap i was doing well at 16 so by setting the machine up at the current setting 17/13 it goes no higher than 17 and averages 15.5 or so on the nightly Encore report or close to that 16 i was at before.

I'm chuckling as I write this, Dale, because some folks here may tell you that the method you used to arrive at your pressures is all wrong. Nevertheless, I can tell you that what I found when I used BiPAP was that the IPAP pressure I needed was about the same as my CPAP pressure. The EPAP pressure that worked for me was 3 or 3.5 cm less than IPAP. It sounds like you're going to let your best results lead you to better pressure settings though, and you certainly can't go wrong with that approach.

I'll also tell you that the BiPAP-auto never worked well for me in auto mode. It invariably went to whatever maximum pressure I had set it for. Consequently, I ended up using it in straight BiPAP mode instead.

Just my experience, of course.

Regards,
Bill

shippy · Post by **shippy** » Mon Apr 07, 2008 8:27 pm

Bill

If you go back and look at my post (Shot Myself In The Foot) RG and Wulfman gave me some number settings to play with and one of the suggestions was Bi-level 17/13 I didn't print it out or write it down at the time and by mistake set the machine to auto but it seems to be working for me. I just went back and looked at those suggestions and noticed the suggestion was for Bi-level not auto. Common sense tells me if my other machine set at 16 was effective then this auto needs to average some where near 16 and that is my reasoning. If others think this is wrong then please speak up as i need all the help i can get and thats how we learn together on this forum.

Dale