PB420E IFL1

snork1 · Post by **snork1** » Sat Aug 27, 2005 10:39 am

thank gawd for this forum!!!!!!!!!!!!!!!!

I finally got my PB420E machine from my local DME. It took 2 weeks and only arm twisting kept that from becoming 3 weeks, I still have to pay 10% of the $2000 they are charging the insurance company for the basic machine and humifidier, and I spent a couple of mornings on the phone trying to get hold of them, in addition to spending an hour to pick it up while they switched it from french to english and put in the WRONG SETTINGS for the prescribed pressure. I did negotiate the clinicians manual out of them, luckily.

So last night I did indeed have the runaway pressure problem, and got up , looked in the manual, changed the IFL1 setting to off, and changed to the CORRECT prescribed pressure setting, which took about 5 mintues at 3am in a groggy state, as opposed to their hour of fiddling that didn't even get it right. and the rest of the night was spent in deep sleep.

So, the one redeeming factor about going through the local DME was they were going to give me the silver lining software and cable as a bonus. (for $2000 this is a "bonus"?) Well in the 2 weeks they had they didn't get around to getting me a copy of the software and I am having some doubts that is going to happen, but at least they tossed in the cable......OOOOOPs, whats this? The machine has a RS232 jack in the back(looks like an oversize phone jack) and both ends of the cable are a standard serial connector looking thing. WRONG CABLE.

Still no sign of the Activa mask they were supposed to get a couple weeks ago. After all its such an exotic item?

Aren't we lucky to have these trained professionals to take care of us?

Quick first impression of the PB420E compared to my Remstar Auto. PB420E is an AWESOME machine. Either my remstar was indeed defective with its loud mosquito whine, which they kept telling me was "normal" or the 420E is just plain a MUCH QUIETER machine, with just a lower frequency white noise slight hum, which is much easier to sleep to. My wife agrees that its a much better sounding machine.

Whats with the complaints on the humidifier controls? They seem just fine on the back and can easily be done by feel, and how often does anyone change that setting anyway?

The air filter seemed like its weakest point and that has been improved with a small chunk of electrostatic "heater register filter".

Light for the humidifier is taken care of with a bit of aluminum foil reflecting so I can see it from above, the same as the Remstar.

I LIKE the buttons on top and they can be worked quite easily by "braille" without accidently activating the wrong one as you feel for them, which is why the Remstar NEEEDED lighted buttons.

And the 420E is TINY. Great for travel with the piggyback australian heated hose using the same power source.

I can live with the color of the control panel. There is always a Magic Marker if I NEED to change the color.

The machine just seems to be more responsive to breathing patterns than the Remstar. I like it a LOTafter one night's use.

loonlvr · Post by **loonlvr** » Sat Aug 27, 2005 3:36 pm

I too used the Remstar auto but borrowed a 420e a week ago. The cable is the right one-it is a basic phone jack and the other end is a serial cable for your computer(Plugs in back). Since the cable was to short to reach my comp, I used a long phone cable i had that had phone jacks on each end and bought a connecter from radio shack and extended it to my 420e so i don't have to move it I may be able to help you obtain the software if they don't respond.

FMichael4 · Post by **FMichael4** » Sat Aug 27, 2005 6:29 pm

that is going to happen, but at least they tossed in the cable......OOOOOPs, whats this? The machine has a RS232 jack in the back(looks like an oversize phone jack) and both ends of the cable are a standard serial connector looking thing. WRONG CABLE.

If your cable is a serial connector on BOTH ends, it does sound like the wrong one. It should have a phone connection at one end and a serial jack at the other.

I just got my PB 420 E last night!

seagull · Post by **seagull** » Sat Aug 27, 2005 7:25 pm

loonlvr, what a great idea. A really long phone cord!!! I think I'll do that.

TXKajun · Post by **TXKajun** » Sat Aug 27, 2005 9:13 pm

Congratulations, snork. I've been on the PB 420e for about 8 months now and it's a SUPER machine! Be darn sure to keep after your DME to get you the right cable and the software. It's absolutely invaluable!

Enjoy and sleep tight!

This therapy WORKS!!!!

snork1 · Post by **snork1** » Sat Aug 27, 2005 11:40 pm

TXKajun wrote: Be darn sure to keep after your DME to get you the right cable and the software. It's absolutely invaluable!

I do feel like I am running blind without the software, which I was used to using on my Remstar, especially with a new setup. I can't believe software for monitoring results by the patient is not a normal part of prescriptions. People could be figuring out what works and what doesn't so much faster!

I like that idea of the phone cord for an extension...when I finally get the RIGHT cord.

ozij · Post by **ozij** » Sun Aug 28, 2005 5:52 am

Snork,
There are 2 or three cords in this story...

1. The simple "right" cord, that has a phone jack at one end, and a serial commector at the other.
2. If you use a laptop with no serial connection: a serial to USB cable (with the relevant driver)
3. A long telephone extentsion cable, with a connector that lets you connect one telephone cable to the other - sorry I don't know the term for it, but I hope you know what I mean - you can click telephone cable jacks into each end of this little thing....

Good luck, and I hope you get the software very soon.

O.

loonlvr · Post by **loonlvr** » Sun Aug 28, 2005 6:36 am

Snork, if you get the cable but they back out of giving you the software, i'll send you a copy. Let me know.

MaskedMan · Post by **MaskedMan** » Sun Aug 28, 2005 6:49 am

Why change the IFL1 setting to off?

Guest · Post by **Guest** » Sun Aug 28, 2005 9:52 am

Because he experienced runaway pressure, snork1 changed the IFL1 setting to 'off'.

snork1 · Post by **snork1** » Sun Aug 28, 2005 9:52 am

MaskedMan wrote:Why change the IFL1 setting to off?

I would definitely like to find a better explanation of IFL1 setting than the manual's "the validation of pressure increase commands on flow limitation run".
....whatever THAT means.

But the bottom line for us users is that quite a few people, it SEEMS like MOST on this forum, find the PB420E seems to get "stuck" at high pressure if that setting is ON. A problem I had with the Remstar, but had could nothing but hit the ramp button EVERY time that happened on the Remstar.

For some reason, turning the IFL1 setting to "off/0" seems to eliminate this issue, while still giving good therapy.

I had another splendid night with my nice QUIET PB420E last night. I can't check the results, but I seem to feel darn good. I can't believe all the morons in the supply chain that made me suffer through a RemstarAuto with an obviously defective loud whine for 2 years of therapy!

loonlvr · Post by **loonlvr** » Sun Aug 28, 2005 10:01 am

Oh quit your whining(get it lol). The remstar auto maybe be louder(I have one) than the 420e(borrowing one), but just be thankful you have an Auto. Lots of ppl in here are using the "old" model straight machines with no software. Aren't we lucky I too don't really understand what that setting does, but my results sure are better with it off. Hope one of the machine heads can explain it.

ozij · Post by **ozij** » Sun Aug 28, 2005 10:04 am

IFL1 explained by -SWS

-SWS wrote:So what's the difference with the 420e design relative to UARS, then? My hunch is that the difference lies in how very aggressively the 420e will trigger on and elevate pressures when flow limitations are detected (via the IFL1 trigger). So aggressively, that more than a few 420e users have had to turn IFL1 off. There are actually two ways to turn IFL1 off: 1) within the environs of the Silver Lining 3 software, or 2) directly from the 420e's LCD control panel (by setting "FL" to 0 versus 1). There is no way to turn IFL2 off from the 420e's LCD control panel, however. In my way of thinking that probably implies that IFL1 must be turned off more often than IFL2. The 420e can be very pressure-aggressive relative to attempting to eliminate flow limitations which are believed to be associated with UARS.

Yet flow limitations can occur for an entire variety of reasons, many of which are not associated with UARS. Some UARS patients receive adequate elimination of their upper airway restrictions via air pressure, and yet others do not. When a UARS patient does happen to receive efficacious treatment from air pressure therapy, that implies the UARS patient's upper airway resistance was successfully eliminated via PAP's inflation of the elastic portions of the upper airway. Yet it is entirely possible that upper airway impedance can be high for rigid structural reasons entirely unrelated to soft tissue. In this latter UARS case, PAP inflation of the upper airway will not completely (if at all) alleviate UARS symptoms---assuming the UARS diagnosis adheres to the most common etiology attributed to UARS.

The 420E is misidentifying a flow characterisitic as a flow limitation. By turning IFL1 off, we basically tell the machine "Hey buddy, this is my normal flow, don't go about raising pressure on that".

O.

WillSucceed · Post by **WillSucceed** » Sun Aug 28, 2005 10:57 am

snork1 wrote:

But the bottom line for us users is that quite a few people, it SEEMS like MOST on this forum, find the PB420E seems to get "stuck" at high pressure if that setting is ON.

Not true! I have only heard of a few (very few) who needed to adjust this trigger. It is definetely NOT "most."

Screwing around with the defaults is not a great idea unless you really know what you are doing. Of course, herein lies the beauty of the 420E -->it can be adjusted to suit the user.

loonlvr · Post by **loonlvr** » Sun Aug 28, 2005 11:18 am

How can it not be true if it "SEEMs" to him this is the case. He did not use a definitive statement. And add me to those who shut it off and immediately got better results. Of course, it will take a week to see whether its a fluke and a 1 nite occurence. But i'm hoping.