Going rogue

[Chalkie]

I have decided to "go rogue" and experiment with pressure settings.

I am back on my old machine, the Respironics BiPAP S/T C Series, as there is a power supply failure with my new A40 that I will have to wait until next week (at least) to get fixed.

So I have experimented with going from 17-6 to 16-8 (on this machine). I discussed this a while ago on the forum and several people suggested 10cm PS was way too high and could be causing centrals, so I have cut EPAP to 16 and raised IPAP to 8 (as the hospital did on the new Philips Respironics A40, so I have only made a tiny change).

btw what would be an average kind of IPAP? I understand this machine's settings range from 4-20 cm, so 6, or even 8, seems low.

[raisedfist]

No need to worry about what an average pressure used is. The pressure someone needs is the pressure that should be used. The fact that someone else may use an IPAP of 25 doesn't matter at all for you.

A PS higher than 4-5 should basically only be used when breathing is compromised. Otherwise, you are washing out too much CO2, probably causing centrals.

You should only adjust pressures for a specific reason. Sometimes it's helpful to start over. The S/T machine doesn't auto adjust. Maybe just try something basic, such as 10 IPAP / 6 EPAP and see the results. Then ask for advice to adjust from there. In this case, undertreating and improving from there is probably better than over treating.

[Chalkie]

OK, thankyou.

Pressures are all guesswork in the absence of a titration study but I think undertreating rather than over treating at first makes sense.

[kteague]

so I have cut EPAP to 16 and raised IPAP to 8

Is that backwards? I thought the inhale is supposed to be higher than the exhale? Maybe I'm misssing something.

[chunkyfrog]

I thought that most of the folks on this forum are rogues.
[[[--I will practice civil disobedience until the "rules" are changed to something sensible.]]]
Too often those so-called rules do not exist--just liars trying to gain/keep control.

[palerider]

Maybe I'm misssing something.

Nope! you're spot on. He's also confusing other terms.

[Chalkie]

As you are obviously keen to correct me, could you please avoid language like "suckered" that you used in my last thread. That to me implies either duplicity on the intent of the doctor or gullibility on my part when in fact neither were the case.

[zonker]

As you are obviously keen to correct me, could you please avoid language like "suckered" that you used in my last thread. That to me implies either duplicity on the intent of the doctor or gullibility on my part when in fact neither were the case.

when replying to someone, could you please use the quote feature?

thank you.

[ChicagoGranny]

could you please avoid language like "suckered"

Hey, people "going rogue" should be able to handle blunt discussions. Eh?

[palerider]

As you are obviously keen to correct me, could you please avoid language like "suckered" that you used in my last thread. That to me implies either duplicity on the intent of the doctor or gullibility on my part when in fact neither were the case.

Actually, no.

You're free to not bother reading anything I say, though.

And, frankly, if you don't even care about misusing, and presumably, misunderstanding terms like 'ipap' 'epap' and 'ps', then you're going to need a lot of help with 'going rogue'.

[bombayone]

Chalkie:

Please remember that you are dealing with Americans. Blunt and awfully sure of their opinions.

[chunkyfrog]

Sometimes you have to brave the brambles to score the sweetest berries.

[zonker]

deleted

[Chalkie]

As you are obviously keen to correct me, could you please avoid language like "suckered" that you used in my last thread. That to me implies either duplicity on the intent of the doctor or gullibility on my part when in fact neither were the case.

And, frankly, if you don't even care about misusing, and presumably, misunderstanding terms like 'ipap' 'epap' and 'ps', then you're going to need a lot of help with 'going rogue'.

So I made a mistake. OH NO! Let he who is perfect cast the first stone.

Meanwhile, sorry, but I have to correct your "correction" re: PS, Pressure Support, the difference between IPAP and EPAP, e.g. pressures of 17-6 = 11cm pressure support.

Anything else "wrong"?

I know "Pale Rider" is trying to push my buttons to get a response that will lead others to join in.

I am just trying to get my therapy working. So this is not the place to take out whatever it is that is eating him. Have a bit of respect for the fact you are dealing with people who are struggling with their health and stop stressing them out with your antagonistic attitude.

You point the finger at others in your sig - I would appreciate if you ceased your harassment of me - remember the point of this forum and refrained from contributing to my future threads. The same goes for one or two others who seem to just want to score points and be disagreeable.

Thankyou.

[bombayone]

Chalkie - I wish you well with your treatment. Often this forum appears to be a play ground for the chosen few on which outsiders are occasionally helped.