How to change Ramp time of PB 425?? and more ?'s!!

Liissa · Post by **Liissa** » Thu Mar 16, 2006 12:05 pm

Hi all,

Does anyone know how to change the ramp time on this machine. It's currently set to 20 minutes and would like to set it to 30? (Pressure is 17/8 and all the other settings were left at the default according to the patient manual).

Also just wondering--

Machine was brand new with 0 hours when we rec'd it....Checking now and I see it's shows 114 hours used and then on the next screen (the time the patient breathed), it only shows 94 hours....so what happened to the 10 missing hours. Would that be "mask" leaks??

I've been monitoring this board for the past 6-8 weeks since my husband was dx'd with severe apnea....so far he's having NO luck with his treatment. Was originally on straight CPAP at 17, but could not tolerate the high pressure, even with a 30 min. ramp time -- so--after many calls to DME (I think we have one of those "evil" DME's), he was changed to a PB 425 Bi-Level two weeks ago and continued to try - (best he can) on the Bi-Level with Mirage FF Mask. That was not working well either - (mask leaks) and waking many times in the night etc. -- called DME again and asked for help...10 days later (after cancelling one appt) he brought a a nasal pillow system (Resmed) -- but it seems that he is having leaks with this also....much louder air sounds than with the FF mask and it seems to blow cold air toward my side if my hubby is facing in that direction...is that normal?? On top of that - he's still not sleeping well and actually probably sleeping less - waking by 2:30-3 AM each morning and can't get back to sleep, so he gets up and goes downstairs until it's time for work... I'm getting worried -- he seems so exhausted -- even more so than before treatment began...yet I want so much for him to continue treatment and continue to hope that we will find the right combo of machine/masks so that he can benefit. (During the sleep study he had 186 events in 2 hours, so his apnea is pretty severe -- during the titration they needed to consistently use high pressures to control the apneas, but even at that he still experienced some centrals and some hypopneas, through there was overall suppression of events and some normalization of sleep architecture).

For the record -- We were never given any choices on masks/machines etc., we simply get what they bring...when we ask questions, the DME simply keeps saying we need to give it more time, but it's been almost two months....and there is absolutely NO improvement, like I said before -- sleeping is worse, or less because of trying to adjust to treatment! We also have NO idea of whether this is working at all---no reports, DME has never checked/downloaded any info from either machine? We don't have the software ourselves, because we do not want to buy it until we know this is the right machine, plus from what I understand the only info you can get for this machine is compliance, which really won't tell us much??

So--as you can tell I'm very concerned and frustrated......how long should it take to see ANY improvement!! I'm afraid he's simply going to give up if something good doesn't come of this soon -- and that is the last thing I want to happen!

Thanks for your suggestions and help....great website!!!! I've learned so much here!!

Liissa

oceanpearl · Post by **oceanpearl** » Thu Mar 16, 2006 12:10 pm

Sounds as if you need a new DME.
I went in to my DME for a new mask. They put me in a room with a couple of dozen different mask's and a Bipap machine. The tech told me to find and test the one that I liked, wear it for 15 minutes, move my head around and ring the bell when you find the one you want.
You need to get the doc to write the prescription for "mask of choice".

Liissa · Post by **Liissa** » Thu Mar 16, 2006 12:24 pm

Unfortunately, changing DME's isn't really an option for us....we live in a very small town in a rural area...this DME is about 45 miles away from us as it is, and it's a tiny company...only one full-time RT on staff, which is why it takes so long to get things done...we checked with the Sleep Lab, also 25+ miles away and they told us, this is the closest available to us...and that if we changed now, we'd incur all new expenses for the initial set-up, hoses, masks, humidifier etc., which would quickly wipe out our DME benefits--we have an HMO plan--so we must stay within network to have ANY benefits.

If anything we'll probably, like many here -- buy our own equipment and software and pay out-of-pocket down the road...once we are confident we have the right machine/mask and that it is actually helping! Our HMO benefits will be exhausted in a few months and that is when we'll have to make that final decision, but for now....as you can tell we are kind of stuck with who we have.

ozij · Post by **ozij** » Thu Mar 16, 2006 1:39 pm

The cold air is normal - I can feel it when air from my mask hits my arm....

An you're right about the software for the 425 - it gives breathing patterns and compliance, but nothing about apneas, hypopneas or snores.

Since you're so far from reliable professionals, you might want to consider looking for a machine on line, and buying one with software that is more informative.

I don't know enough about insurance etc. in the States, but have read enough on this forum to know that eventually, many people have found that buying on line turns out to be even cheaper.

Your husband has to be at least as comitted to his own therapy as you are - the decision to continue to look for a solution - no matter how annoying things are at the moment - is one that a CPAP user takes on his or her own, in the dark of night, when the mask is something between a bother and a torture, the noise driving you crazy, and you think sleep will never come..... you can't do it for him.

Here's one text that helped me a lot a year ago:
A beginners diary

Maybe you can get your husband to read it - and to join the forum.

I wish you both well. Good Luck!
O.

Liissa · Post by **Liissa** » Thu Mar 16, 2006 2:03 pm

ozij--

Thank you for your kind response.....We will of course, continue to research and look for the best treatment options...my husband isn't much of a computer person, but I'm always telling him about all I learned from this site -- It's been a great resource to us......we still are in the early stages here, and I understand that...I was just hoping he would have had SOME relief by now. I've seen so many folks here who have had relief and have great results, sadly for him that is not happening....but we will keep trying. It's just scary to me, because I don't see ANY improvement and he seems so tired......I don't want anything to happen to him....that's ultimately my greatest concern--his heath and well being....I want so much for him to sleep well...and for this treatment to help him....I didn't mean to imply that he will give up ...I'm just afraid that he may if there isn't some sign of improvement...right now I can tell he's feeling worse -- but he is still trying each and every night...and I encourage him daily to keep up the struggle, because I believe at some point he will get to a place where this does work for him...or at least, I hope it will.

I've learned so much about sleep apnea from this site....it's a wealth of information, much more than we've ever been given from the DME...It truly is a wonderful site, I read it everyday and it's a huge benefit to have all of you to vent to or simply ask questions. You are all very supportive, understanding and educated on the subject of Sleep Apnea...

I look forward to more suggestions and ideas!
And still looking for instructions of changing the ramp time, if anyone knows!

Thank you!