Help....I have sreaming ear ache

Severeena · Post by **Severeena** » Fri Jul 01, 2005 8:10 pm

I use herbal ear drops and cotton in my ears at night and no earaches.

Fifi · Post by **Fifi** » Fri Jul 01, 2005 8:37 pm

ozij this is my second sleep doc and this one is much better than my first. But this one does not 'hear me' and is often too busy, with a load of other people often in the room: students observing, people coming in for notes or bits of equipment and endless constant interruptions.

My 5 mins with the doc is often too short and doc ofter appears to have other more important things on their mind. I often feel I need to apologize for taking up their time!

I do not want to look for a third sleep doc as I am afraid of then getting the reputation of being a pain in the but. I need to try and sort this out on my own, if i can.

However I do not think I have enough information to just buy a machine outright. Getting the prescription will not be a problem, but since I have to pay for it if i buy the wrong one, I will be an expensive mistake to make.

I need more info on bipaps, I think. Not sure if C-flex will be enough.

rested gal · Post by **rested gal** » Fri Jul 01, 2005 9:12 pm

Fifi, thanks to friends who let me borrow them, I've been able to try two bi-level machines now!

Respironics BiPAP Pro -- if you get that brand, get the BiPAP Pro 2 ...it's the one that gives data. The Pro (without a "2" in its name) gives only compliance info (number of hours you used the machine...useless info.)

and

ResMed VPAP III -- that's the one that takes a good bit of tweaking of various settings to get it in sync with a person's breathing. It took me about a half hour of trying out lots of changes to get it going right for me.

I'd recommend the Respironics BiPAP Pro 2 as the bi-level machine to get, simply because it is so easy to set up. Just set the two pressures you want...one for inhaling and a lower one for exhaling. There is another setting on it called "biFlex" which can be set from 1 - 3. That's it. Easy as pie.

Don't get me wrong...the VPAP III is an excellent bi-level machine too, but gosh...it has sooo many things that have to be adjusted right or it will fight your breathing pattern. If a person is willing to take the time to test/adjust, test/adjust, test/adjust, you can get it going just as nicely as the Respironics BiPAP Pro 2. Both are smooth as silk treatment...wonderful relief on exhaling.

My point is that one of them (Respironics BiPAP Pro 2) seems to work perfectly in sync right out of the box, whereas the other one (ResMed's VPAP III) takes a good bit of tinkering. I honestly doubt that most DME employees would even be aware that there are things other than just IPAP/EPAP to set up on the VPAP III. Even if they were vaguely aware of "other settings", I doubt they'd spend the time working with a person to get it perfectly in sync. It would pretty much be up to you to adjust the several other settings yourself.

The settings on either machine can be done right on the machines themselves..the buttons on top will get you into the clinical menu where you can access all the settings.

An advantage to the VPAP III is that you can also access quite a bit of data in the panel on top of the machine. You wouldn't need software to see a lot of overnight data with the ResMed machine. You would need software to see the extensive overnight info from the Respironics machine. Of course, if you wanted to see charts and graphs, you'd need the software for the VPAP III.

All in all, I think more people would "get along better" with the much easier setup of the Respironics BiPAP Pro 2.

momexp5 · Post by **momexp5** » Fri Jul 01, 2005 9:32 pm

ozij wrote:the Respironics Cflex series -that give relief on exhale

Really??? No offense, oz, but could someone confirm this or link to some company literature or something? That's what Cflex is? I thought it was just the ramp function thingie.

momexp5 · Post by **momexp5** » Fri Jul 01, 2005 9:35 pm

rested gal wrote: I second ozij's suggestion that you talk to your doctor about prescribing either a machine with C-flex (to drop the pressure somewhat each time you exhale) or a bi-level machine (to drop the pressure to an exact cm H2O each time you exhale.)

Oopsie!! Of course, I didn't read down far enough in the thread. Thanks again RG.

Fifi · Post by **Fifi** » Sun Jul 03, 2005 4:56 am

Thank you rested gal for your detailed explanation. Exactly what I was looking for.

I was also wondering from your experience, having used both bi and auto machines, how did the bipap pro 2 compare with Remstar auto with c-flex with regard to comfort/ease of exhalation and was the downloading of the data same as with the Remstar auto with c-flex?

rested gal · Post by **rested gal** » Sun Jul 03, 2005 10:53 am

Fifi, the machine I was able to borrow was just a BiPAP Pro, not a BiPAP Pro 2. So, there was no juicy data for me to look at with my Encore Pro software.

As for comparison of the exhale comfort between the BiPAP Pro (same machine as a "2" but without data) and an Auto with C-flex, that would depend a lot on what pressure a person had to use most of the time. I experimentally have run my autopap as a straight cpap with c-flex, at various straight pressures (with C-Flex turned on "3".) I found that c-flex didn't give me much relief on exhaling at straight pressures of 15 and above. (Yeah, I pushed it on up to 20...for about 5 minutes! )

The higher the pressure, the less effect C-flex had, since the amount of drop it gives (or perhaps the length of time it stays dropped if a person's exhalation force begins to dwindle against pressure) seems to depend on a person's ability to exhale...the amount of force of a person's own natural exhalation. My ability to exhale against 15, 16 and on up was not very strong, thus the C-flex didn't feel like much of a drop at all. There was still too much coming in for C-Flex to give me real comfort exhaling. That could be very different, depending on the individual. Others might find C-Flex made a noticeable, comfortable difference even at high pressures. Didn't for me, though.

That, incidentally is where a bi-level machine really shines...when a person's exhalation power is weak, due to underlying pulmonary problems, for example; or due to simply an incoming high pressure that is hard for even an otherwise healthy person to breathe out against.

On my Auto with C-flex, I have the pressure range set for 8 - 15, and C-flex set at "3" to give the most drop when exhaling. Consistently I see this on my overnight data - over half the night is spent at the pressure of 8. The highest it has to go is usually 11, sometimes 12, and those are only for a few minutes during the night.

Since I never get above 12 on my autopap, the C-Flex gives me every bit as much relief on exhalation as what I got from the BiPAP Pro.

I had the BiPAP Pro set for IPAP (inhale pressure) 12, and EPAP (exhale pressure) 8. I set the "biFlex" at 3. I didn't try it up at higher inhale pressures.

Again - and this applies just to my experiments - the auto with C-Flex suits me better. I like being able to spend the majority of my night down at 8 and 9 with C-Flex doing its comfort thing when I exhale. And that's where autopaps shine, imho... not using higher pressures unless needed. If a person can be well treated with less pressures most of the time, a lot of problems (mask leaks, aerophagia-bloating, etc. ) can be avoided. Add C-flex to it... we can have our cake and eat it too.

The BiPAP Pro was comfortable, but I was having to spend 100% of my night at an inhalation pressure of 12. (11 might have been sufficient, but I wanted to be sure. )

If I had been using a BiPAP Pro 2, to get to see data, I might have been able to tweak it down some on the Inhale, but I believe I'd have had to keep the Exhale set on 8, no matter what. My throat closes off completely at anything below 8, if I deliberately let it totally relax while experimenting with straight pressures while awake.

If a person truly needs high pressure most of the night, a bi-level is the way to go.

But, an autopap with C-Flex is a very good way to find out if a person really does need a high pressure most of the night.

I'll put it this way:
If I were being issued a bi-level BECAUSE of difficulty breathing out against whatever single pressure a sleep study found that I "needed", I'd always want at least a one week trial on an auto with C-Flex before going the bi-level route. I'd want to see how much time I really needed to spend up at that one single pressure under normal sleeping conditions at home. Just my non-medical opinion.

Fifi · Post by **Fifi** » Tue Jul 05, 2005 7:48 am

Dear Rested Gal thank you for a most informative response.

I have now decided that I am going to buy the Remstar auto with c-flex.

I am however having Massive problems communicating with CPAP.COM.

The phone number that i have is +1 281 831 4019 is permanently on answerphone and my calls are not being returned.

I am also trying to communicate via email however the person who is responding to my emails must be just out of high school or something as in my email I ask about filters and the response I get is about mask fitting!!!!!!!!!!!!!!!!!!

I have a lot of dust and pollen allergies I used a special surgical filter with my fixed pressure cpap. Do you have any info for people with dust allergies Rested Gal?

ozij · Post by **ozij** » Tue Jul 05, 2005 11:55 am

The following filters come with the Remstar (copied from the manual)

Filter Cap & Filters ............ The pollen filter screens out normal household dust and pollens. The optional, ultra-fine filter is also included for more complete filtration of very fine particles. The filter cap is designed to reduce the noise from
the REMstar Auto.

There are instructions about cleaning and changing the filters - be sure to read them.

If you do a search for HEPA with mikesus as the author you'll find a number of informative threads as well.

Good luck!
O.

P.S. cpap.com has a toll free number: 1- 800-356-2221 (I got it form their site)

Fifi · Post by **Fifi** » Tue Jul 05, 2005 12:52 pm

Thanks ozij you gave me an idea. I thought that from abroad I could not dial a US free phone number, so I dialled it to see what would happen and I have learned something new today, all thanks to you!! It works!

I am glad to say it becomes a call that you have to pay for, which is okey but at least I was able to finally able to get through and speak to someone.

I wish they made it clear on their site that the freephone number can also be used from abroad!

I will look up the mikesus threads.

Guest · Post by **Guest** » Wed Jan 11, 2006 8:22 pm

ozij wrote:The following filters come with the Remstar (copied from the manual)
Filter Cap & Filters ............ The pollen filter screens out normal household dust and pollens. The optional, ultra-fine filter is also included for more complete filtration of very fine particles. The filter cap is designed to reduce the noise from
the REMstar Auto.
There are instructions about cleaning and changing the filters - be sure to read them.

If you do a search for HEPA with mikesus as the author you'll find a number of informative threads as well.

Good luck!
O.

P.S. cpap.com has a toll free number: 1- 800-356-2221 (I got it form their site)

Fifi · Post by **Fifi** » Thu Jan 12, 2006 2:07 am

Thank you guest,
I do clean out the filters wash the gray filter every 2-3 days on a regular basis. Since I first started this thread I have now splashed out my own money and invested in a remstar auto with cflex, from cpap.com hoping it would sort out a multitude of problems including my earache.

The c-flex function really does not help me at all, in fact I cannot get used to it. I was really hoping the pressure drop on the exhale (c-flax)would have helped my earache. Just my bad luck Looking at the various threads I must be the only person it doesn't work with!

The problem I have with the c-flex is, maybe it is a mind thing, but I start to think about my breathing,which I bet sounds weird,but it is almost as if my breathing goes out of sync and everytime the pressure drops with the cflex (difficult to describe,) drops I find it difficult for some reason, to inhale again. Almost as if I am trying to preempt when I next need to inhale,the inhale does not seem to come naturally any more with the c-flex turned on! If this makes sense. It actually makes me feel nauseous. Does any body else find that?Or may be it is just me!

I keep the remstar on pressure 7min 13 top. If I turn the 13 down to 12 I wake up gasping with my heart pounding like mad.

In hindsight i bought the wrong machine, expensive mistake, maybe I should have bought a bipap. But I can't help wondering if I would have the same problems with the bipap as I am having with the c-flex when it comes to breathing in after the pressure drops on the exhale?

I still have the darned ear ache. Just going to the doctor today again. I cannot stay without the machine. My 90% pressure is 12. I now have a problem. Earache will not go and I cannot be WITHOUT cpap.

Maybe I am just beginning to fall apart at the seams and should consider going to the vet and have myself put down!

Goofproof · Post by **Goofproof** » Thu Jan 12, 2006 12:29 pm

ozij wrote:Hi FIfi,
I find exhaling often very hard work and somewhat exhausting but I put it out of my mind so I do not think about it.
If this is what you feel after 7-8 years on CPAP, you might want to consider changing your machine.

There are newer machines nowadays - the Respironics Cflex series -that give relief on exhale - you might want to consider them. Some people find them wonderful (I haven't exprienced CFLEX presonally). Another kind of new machine is the self adjusting kind. You will also find many threads in this forum discussing the pros and cons of self adjusting (auto) machines. One major advantage of these is that they raise pressure to a maximum only when that is necessary, but otherwise maintain a lower pressure.

Could you be attempting to exhale against a nasal obstruction, and not only your usual pressure? (Did an NET check you nose recently?)

The pain of earaches is excrutciating - both outer ear - and middle ear. (The doctors call middle ear infections "otitis media").
I know, because I've experienced them both. Middle ear infections can be the result of bad irrigation/stuffiness in your nasal cavities, and the attempt to exhale against that obstruction.

While I understand how much you want to use you cpap, I would be very wary of using xPAP with an active ear infection, especially if you have trouble exhaling. This isn't only a question of how much pain you can stand, but what real harm this might cause your ear, eardrum, and in the long run, you hearing.

Outer ear infection don't start with nasal cavities irrigation problems, but I believe thay can result in fluid accumulating in your middle ear - and that too would be a reason to stay off the pap machine.

In the short run, can you considering sleeping (or at least resting) in a recliner for a night or two, till your ear infection is better controlled?

mefifi · Post by **mefifi** » Thu Jan 12, 2006 1:08 pm

Hi goofproof

Yes I do have a new machine Remstar auto with c-flex. The problems i DESCRIBE ABOVE ARE WITH MY NEW MACHINE! oops capitals.

fifi

Goofproof · Post by **Goofproof** » Thu Jan 12, 2006 3:37 pm

[quote="mefifi"]Hi goofproof

Yes I do have a new machine Remstar auto with c-flex. The problems i DESCRIBE ABOVE ARE WITH MY NEW MACHINE! oops capitals.

fifi

Mask