YouTakeMyBreathAway's Therapy Thread

[YouTakeMyBreathAway]

Oh right, the histogram. What medications were you taking at the time of the study?

I was only taking Flonase at that time.

[YouTakeMyBreathAway]

Gonna need this too:

What do you mean you are going to need this?

[Rubicon]

Weight control is a simple formula. You run a 500 calorie deficit per day and you'll lose a pound per week. That's a fact. It's like throwing a log on the fire. After a period of time it is consumed. If the engine is running it burns fuel.

Probably not worth discussing, but I do want to say: While it's true that creating a calorie deficit can help with weight loss, it's important to note that the body's response to calorie restriction can be complex and variable. When the body is in a calorie deficit, it may reduce its calorie requirements, making it more difficult to lose weight through calorie restriction alone. This response can differ between individuals, and some people may have a harder time losing weight than others, even if they are following a similar calorie-restricted diet.

It is absolutely worth discussing. You have an opportunity for significant improvement if you improve your ERV, and the only way you're going to do that is lose weight.

There is nothing "complex" about this. Calorie requirement is simply

TEE = RMR + TEF + TEPA.

It is a law. Specifically Law of Thermodynamics.

Now if you want to offer that there is stuff that is "variable", then of course there is. As you lose weight RMR could decrease. Depending on what you shovel in can change TEF. Exercise varies day-to-day. Consequently one has to adjust caloric intake to account for these variables.

As well as other factors such as "This sleeve of chocolate chip cookies won't hurt!" and "This entire package of bacon is only about 250 calories!"

[YouTakeMyBreathAway]

I tried ASV "for fun" tonight. I started at

EPAP: 4.0
Min PS: 3.0
Max PS: 15.0

and then changed it at 04:14 to:

EPAP 8.0
Min PS: 3.0
Max PS: 15.0

Not a terrible night, but interestingly this gave me the highest flow limitations I have ever had by quite some margin. And even more interestingly they seem to have happened while my pressure was at levels that I didn't have flow limitations at before, e.g. 8 EPAP, 12 IPAP.



ASV (Tonight):


BiPAP w/o ASV (Yesterday):


It doesn't seem like it was able to actually stabilize my pretty highly fluctuating minute ventilation significantly:

Top: ASV, Bottom: BiPAP

[YouTakeMyBreathAway]

Longer-term comparison of 7 days BiPAP vs most recent night on ASV. ASV clearly stabilizes my Minute Ventilation significantly:

[YouTakeMyBreathAway]

Here's another comparison of MV on ASV (blue - top) vs VAuto (red - bottom).

This shows pretty nicely that the ASV resolves most of the really bad MV drops but still has some remaining that go down to the high 3.0s:



Any thoughts on how I can increase my MV just a little more?

[YouTakeMyBreathAway]

Trying to dial in my ASV to the right EPAP and Min PS. Switched to AutoASV w/ Min EPAP 4.0 and Min PS 3.0, Max PS 15.0 to see what the machine thinks.

I had a stuffy nose from allergies, so I sprayed some Afrin before bed. The long awake time in the middle is due to the Afrin making my nose over-sensitive, causing me to sneeze repeatedly, so I took a break from sleeping for a bit.

What should I do next based on this data?

[YouTakeMyBreathAway]

For anyone who has nose-tickle issues, I can absolutely recommend doing nasal waxing. I trimmed my nasal hair before, which didn't help much, but waxing is awesome!

So now I have fewer mask off events, but I'm still tired. Can anyone spot anything in my charts that looks suspicious?

[Callen]

Weight control is a simple formula. You run a 500 calorie deficit per day and you'll lose a pound per week. That's a fact. It's like throwing a log on the fire. After a period of time it is consumed. If the engine is running it burns fuel.

Probably not worth discussing, but I do want to say: While it's true that creating a calorie deficit can help with weight loss, it's important to note that the body's response to calorie restriction can be complex and variable. When the body is in a calorie deficit, it may reduce its calorie requirements, making it more difficult to lose weight through calorie restriction alone. This response can differ between individuals, and some people may have a harder time losing weight than others, even if they are following a similar calorie-restricted diet.

It is absolutely worth discussing. You have an opportunity for significant improvement if you improve your ERV, and the only way you're going to do that is lose weight.

There is nothing "complex" about this. Calorie requirement is simply

TEE = RMR + TEF + TEPA.

It is a law. Specifically Law of Thermodynamics.

Now if you want to offer that there is stuff that is "variable", then of course there is. As you lose weight RMR could decrease. Depending on what you shovel in can change TEF. Exercise varies day-to-day. Consequently one has to adjust caloric intake to account for these variables.

As well as other factors such as "This sleeve of chocolate chip cookies won't hurt!" and "This entire package of bacon is only about 250 calories!"

As much as it pains me to agree with Rubicon, he's right.

Whether you're eating healthy food or ice cream and cookies. If you're in a calorie deficit - you will lose weight.

If you're interested in learning more about this topic from high-quality sources - I suggest you go on YouTube and watch videos by Derek (More Plates More Dates) and Gregg Doucette. They're both a goldmine of knowledge on how to optimize for a healthy lifestyle.

[YouTakeMyBreathAway]

Thank you for your input on the topic of weight control. While it's understandable that you support the notion of a simple formula for weight loss based solely on calorie deficit, it's important to consider that the human body's response to calorie restriction can be more complex than a straightforward equation.

While it is true that creating a calorie deficit can contribute to weight loss, the body's adaptive mechanisms can make it more challenging to lose weight through calorie restriction alone. When the body is in a sustained calorie deficit, it may lower its metabolic rate and adjust its energy requirements, making it harder to continue losing weight at the same rate as initially observed. Additionally, individual differences play a significant role, as some people may experience greater difficulties in losing weight, even if they are following similar calorie-restricted diets.

I spoke to my pulmonologist who mentioned the low ERV value is not a concern when taken in context of the other lung function measurements and that my lung function is normal.

[Rubicon]

While it is true that creating a calorie deficit can contribute to weight loss...

That is incorrect. A calorie deficit will result in a weight loss. A pound of fat is 3500 calories. If you run a calorie deficit of 500 calories per day, you will lose a pound a week.

TEE = RMR + TEF + TEPA.

If your body needs 100 marshmallows per day just to live, and you need 10 marshmallows to digest marshmallows, and you need 50 marshmallows cause you run a 5K every day, then if you eat 160 marshmallows a day you will maintain weight. If you eat more you will gain weight as it is stored as fat. If you eat less the body will lose weight as fat is burned to meet energy needs. That's not an opinion, that's a Law. If someone is using calorie deficit and failing to lose weight, they are making an error in the the estimation of one or more of those formula components.

I spoke to my pulmonologist who mentioned the low ERV value is not a concern when taken in context of the other lung function measurements...

I'd like to hear why that is.

BTW Is your pulmonary guy your sleep guy?

that my lung function is normal.

It isn't. And again, the PFT was done while sitting (could have been standing, but most like likely sitting). The data that you're presenting here is done while you're lying down and creates different parameters. If your ERV is bad while sitting you can be assured it's worse while lying down.

[Rubicon]

it may lower its metabolic rate and adjust its energy requirements, making it harder to continue losing weight at the same rate as initially observed.

Completely agree and I said that. But if your calorie requirement drops to 120 marshmallows per day and you're still shoving in 140 marshmallows per day, then no, the "diet will not work".

Ooops! See my first post on that.

[YouTakeMyBreathAway]

Thank you for your response and clarification. It seems that we have been expressing similar viewpoints from the beginning, and I appreciate your further explanation. When I mentioned that weight loss is not as simple as a straightforward equation, it is because the factors of the equation you mentioned (TEE = RMR + TEF + TEPA) are co-dependent and not simply additive or subtractive components. The body's energy expenditure and metabolic responses are influenced by various factors, such as genetics, hormones, and overall health. The body may adjust its energy requirements and metabolic rate in response to a sustained calorie deficit, making it more challenging to continue losing weight at the same rate. Additionally, other factors like nutrient composition and individual differences can affect weight loss outcomes.

Thank you for sharing your viewpoint, and I encourage continued exploration and discussion on this important subject.

That being said, I do want to get back to the main topic of my fatigue and sleep-disordered breathing.

I'm curious about your qualifications to disagree with the opinion of a pulmonologist. While open discussions and seeking different perspectives are valuable, it's important to recognize the expertise and specialized knowledge that medical professionals bring to the table. Have you received any specific training or possess qualifications in the field of pulmonology that allow you to challenge the opinion of a pulmonologist?

I had a discussion with my pulmonologist (who is not my sleep doctor), and they provided valuable insights regarding my lung function. They mentioned that my lung's diffusion is very good, and the FRC/FRV ratio is above 70%, indicating that my lung function appears to be normal. They also took a brief look at my latest OSCAR chart and expressed their belief that sleep apnea is not the cause of my fatigue. They explained that while my Tidal Volume is slightly lower than predicted for my height, it is still within normal limits. Additionally, they noted that none of the SpO2 dips in the chart fall below 88%, which reassured them that they are not a cause for concern.

[Rubicon]

...the factors of the equation you mentioned (TEE = RMR + TEF + TEPA) are co-dependent and not simply additive or subtractive components.

But they are simply additive components.

Seems to me the issue is less of my ability to explain it; rather, it's your willingness to accept it.

But hey, no worries. In my experience, that's very common, if not actually the rule.

[YouTakeMyBreathAway]

Thank you for your response. I apologize if my previous explanations did not meet your expectations. I assure you that I have been genuinely trying to engage in a meaningful discussion and understand different perspectives.

However, I must emphasize the importance of maintaining a respectful and constructive tone in our conversation. It appears that we have diverged into a debate centered around semantics, where the focus has shifted from the core message being conveyed. Engaging in such debates can hinder progress and derail the discussion from its intended purpose.

Misunderstandings and misinterpretations can happen, and it is more productive to address them through open dialogue rather than getting caught up in semantic nuances. Let us refocus the conversation on the main topic, encouraging a substantive exchange of ideas that promotes mutual understanding.

If there are specific points or concepts that you would like further clarification on, I am more than happy to provide additional information or engage in further discussion. Let's keep the conversation focused on the subject matter and strive for a respectful exchange of ideas.

Thank you for your understanding.