Weight Loss Questions

[joeyv20]

It has been a very long time since I have participated here at all. It's been busy in my world and for the most part, outside of a few annoyances that were easily solved by a new mask etc. All has been well with my cpap therapy. Until now and there seems to be a convergence of just too many things at once for me to easily sort this one out. I'm hopeful that folks will be kind and help me noodle this out.
During a period of several very stressful years (caring 24/7 for a very elderly relative) I ballooned up in weight, when the stress (which was unavoidable-sounds lame but 'tis true) was relieved I was able to focus on myself and get it together. Over the past year (since her death at age 97) I got stronger, healthier and I have dropped over 60#'s. As I dropped the weight, I changed to a nasal pillow mask, I am a 50 something woman and between the changes from age in tone of my face and the weight loss, it was just a hassle trying to make a standard nasal mask (that worked for me for years) fit. I tried several masks before settling on a "Bella" (nasal pillow with ear loop thingies). It worked well for quite some time once I outfitted the ear loops with fabric covers. Then, I began to have issues with opening my mouth during sleep. I decided I should consider a chin strap but I hesitated because of a significant history of TMJ. Now, I have moved into a new chapter of life, this chapter is going to be hard fought and the initial day of battle is already scheduled, it's just 12 days away. We are fighting cancer here at our house. My husband has throat cancer, and will be receiving chemo and radiation therapy at the same time over the next couple of months. I have lost more weight in the past couple of weeks (still wanting to be healthy, I was threatening type 2 diabetes, thankfully no more!). In addition to having leaks - because of my mouth dropping open, and possible fit issues in the middle of the night- I am now blowing up like a Balloon in the Macy's Christmas parade overnight. This balloon effect happened to me when I first began therapy with a standard cpap machine, I was switched to a bi-pap and the problem was resolved. I have been using an APAP machine the past few years and it has worked great, until now.
I had figured on scheduling a sleep study when I finally reached my "ideal" weight (pretty much figure that is when the scale stabilizes) to titrate (not sure at all that is the correct term here) the proper pressure for my machine and with a hopeful heart, thinking it was possible that a machine might no longer be necessary. Now, with the coming battle there is no time to schedule an overnight study. Perhaps once we are on the other side of this battle I will be able to schedule a study but, that is months away.
I am attempting to understand the obvious factors at play here and any possible way I might address this on my own without a sleep a study. Perhaps I can tweak things and keep myself comfortable and well until I have the luxury of time. Most of my focus of research time and reading time are directed at learning all that I can about cancer, trying to attain a Phd in cancer in about a months time! While running from one dr to another as we prepare often one dr a day 5 days a week,Whew!
So, that's my story, please know, I am not looking for sympathy just some good concrete ideas I shared my story to try and provide insight into my circumstances thinking it might help you understand not just the mechanics of my machine but why my time is limited and how I got into this situation. I hope you folks will not feel as though I am asking too much, that I am taking advantage of your knowledge base unfairly (as I have not really participated and helped out here). I learned so much when I first arrived here. You were a warm and welcoming community with a tremendous amount of accumulated knowledge. I know that you are not doctors or licensed therapists, but I also know you have a tremendous amount of insight as you not only live with apnea, you have really made it your business to understand so much about apnea and the machines that make it possible for us (folks with apnea) to live a better life.
I will be grateful for any knowledge you may have to share with me. I may not respond right away, it may be difficult to find time to respond at great length, but I will read as time allows and hope you will know how grateful I am. I hope I have included enough information to at least provide a starting point for generous folks that might be willing to help me trouble shoot for the interim.
Gratefully,
Joey
Bella (nasal cushion)
REMstar BIPAP
Model: BIPAP Auto
Model: # 700M

[Julie]

Hi, so sorry about your husband - lots of good luck wishes here. Congrats on your weight loss!

I really think you should try a FF mask now - a well fitted and sized (lying down) one, because that's what I think you've been skating around, but as you found, chin straps are limited, but you do seem to have a problem that needs addressing. Are you not tracking progress with software to compare notes either daily, weekly or otherwise?

[JDS74]

With concerns about TMJ, you might look at the alternative of a soft cervical collar. It does address jaw drop and may help relieve any mouth breathing by keeping your mouth more or less closed at night.
Chin straps do have a tendency in some folks of moving the jaw back just a little and thereby contributing to obstructive apneas. This is usually not a problem but is a serious problem with oral masks.

[Todzo]

http://www.amazon.com/gp/product/1937856240

But add just a bit of high quality non CAFO non growth hormone range fed meat.

[Pugsy]

Do you have the smart card reader and software for your M series BiPap?
With the software reports we can see if pressures have room for downward adjustment and just how bad the leaks are.

When you talking about ballooning..I assume you mean air in the belly...aerophagia and a downward adjustment of pressures would maybe help in that area.

If you don't have the software I can help you out there.
The card readers are still available for purchase.

[70sSanO]

Sorry to hear of your ongoing trials will be praying for your husband's health.

For me weight loss and CPAP has (is) a crazy ride. I am approaching a weight loss of 60 lbs and have seen my numbers go off the charts. I went from a sub 5 AHI double a digit AHI. I had been running along at 12.6cm. As Pugsy said you need to start to look at the data from your machine.

Like you I wanted to get down in weight before doing a sleep study. At 50lbs I took the study and found that my pressure needed to be cut in half. Unfortunately that didn't help and I still had horrible numbers, both centrals and obstructives.

Then after stumbling across a few posts on cpaptalk about using a cervical collar, I went out and picked up a cheap one. It was night and day. I still have central apneas, (something your data will show), but They are running around 2. Even though I use a FFM I can see how the collar would help to keep the mouth closed. My pressure is now at 6.6cm.

I don't want to sound like a broken record but it has been the best $16 I have spent.

John

[Janknitz]

So sorry about your husband's diagnosis. Stay strong for him by taking care of yourself. It's like kids on an airplane--Put YOUR mask on first so you can help him.

I've lost 70 + lbs and mask fitting, leaks are a problem. I have this C-shaped neck pillow filled with buckwheat hulls, I've made it very soft. I find that if I wrap that around the front of my neck and rest the full face mask on it, it helps prevent leaks, especially because I sometimes lie on my back.

Try to get in the habit of sleeping with your tongue on the roof of your mouth (practice ALL day), as that will reduce the air swallowing and mouth leaking.