Another newbie-sore nose, questions, rants

miketech · Post by **miketech** » Fri Jun 19, 2009 7:15 pm

Well, I've been on the cpap for a week now. Dr prescribed 16cm. No major apneas, just lots of hypopneas. I read your forum for a few nights before going to DME. (rant) Annoyed with the RT because I told her a few things I read here. She said "Don't read those things on the internet!" That really bugs me- it sounds like she is telling me I shouldn't try to educate myself about my problem, or learn from other people. Later she is telling me that I'm messing up the fit of my mask- but doesn't want me to touch it- like SHE is the only one who should.

Well, I am suffering from leaks from the sides, which wake me up. Seems that waking up from leaks and waking up from hypopneas makes me feel just about the same way the next day! I don't think I would be opening my mouth- but I don't really know unless I try... I am thinking about a nasal pillow mask, since some of you have said that it's more compatible to side or stomach sleepers. I do change positions quite a bit at night. But the RT says pillow masks at 16cm will make the sides of my nose bulge out. Can someone tell me if thats true?

I'm starting to get used to the pressure- I wake up in the morning thinking that the machine isn't putting out 16, so I look at the display- and it is!

But sore on my nose and the leaks are still a problem. I think I would be willing to pay for it myself, to get a mask that will solve those problems.

ww · Post by ww » Fri Jun 19, 2009 8:45 pm

miketech wrote:Well, I've been on the cpap for a week now. Dr prescribed 16cm. No major apneas, just lots of hypopneas. I read your forum for a few nights before going to DME. (rant) Annoyed with the RT because I told her a few things I read here. She said "Don't read those things on the internet!" That really bugs me- it sounds like she is telling me I shouldn't try to educate myself about my problem, or learn from other people. Later she is telling me that I'm messing up the fit of my mask- but doesn't want me to touch it- like SHE is the only one who should.

Well, I am suffering from leaks from the sides, which wake me up. Seems that waking up from leaks and waking up from hypopneas makes me feel just about the same way the next day! I don't think I would be opening my mouth- but I don't really know unless I try... I am thinking about a nasal pillow mask, since some of you have said that it's more compatible to side or stomach sleepers. I do change positions quite a bit at night. But the RT says pillow masks at 16cm will make the sides of my nose bulge out. Can someone tell me if thats true?

I'm starting to get used to the pressure- I wake up in the morning thinking that the machine isn't putting out 16, so I look at the display- and it is!

But sore on my nose and the leaks are still a problem. I think I would be willing to pay for it myself, to get a mask that will solve those problems.

Why don't you add your equipment including your mask and pressure and pressure relief (i.e. aflex) so someone can help you more.

If you have a good full face mask, spend some time making it work properly. I sleep on my side (sometimes back) without any problem and can turn over at night without causing any leaks. I started out like you are now, so work out every little problem.

miketech · Post by **miketech** » Sat Jun 20, 2009 7:27 am

I don't know what happened to my equipment listing- I did fill it out yesterday, but it didn't show up. I have filled it out again.

twasbrillig · Post by **twasbrillig** » Sat Jun 20, 2009 10:19 am

Some folks use different types of pillows to make it easier to side sleep and not cause mask leaks. There are quite a few posts here about pillows, including a photo montage of the transformation of an ordinary foam pillow into a custom CPAP pillow. There are also some solutions involving panty hose, I believe.

In regard to nasal pillows - I have only been up to 12 cm, so I can't say for sure they won't make your nostrils budge. But they (in general) are rated for higher pressures than 16, so there isn't any technical reason you can't use them.

It's hard when medical people (not sure I can call them professionals) mess with you about wanting to know and learn for yourself. You find a lot of it. Keep advocating, you are doing great.

cajun · Post by **cajun** » Sat Jun 20, 2009 10:38 am

Fellow noob here - sorry to hear about your troubles. I had a sore noise as well. I adjusted my nasal mask to take some of the pressure off my nose and slept with a small bandaid over the sore area for a few nights. That seemed to solve it, at least for now.

miketech · Post by **miketech** » Sat Jun 20, 2009 11:00 am

Thanks. I'm really annoyed with the Resp. tech. She didn't want me to touch the knob on the forehead adjustment, but I feel I had to crank it out to get the mask off the bridge of my nose. I have been fixing mechanical equipment all my life, so I am able to analyze a thing and know how it is supposed to work. I don't like the mask in the area where it touches the bridge of my nose, because I think it doesn't have adequate cushioning material there.

Of course there is a compromise between adjusting the forehead screw to get the mask off the bridge of the nose, and to have adequate edge sealing. When it is not digging into the bridge of my nose- I get leaks on my cheeks and blowing in my eyes- and I wake up many times a night hearing the leaks. After yanking the mask one way or another, I lay in bed thinking "if I just stay like this". But of course, I can't keep from moving, it's just not possible.

OK, I can admit, like everyone says- we all have different shaped faces, so a mask that is perfect for one person might not work on someone else. Maybe the bridge of my nose sticks out farther than someones elses (I'm a normal looking person- not freakish in any way) So- maybe this mask isn't the right one for me.

I'm going to try to buy something different from cpapauction.........

Here's another question I have- I don't find anything in the manual that says how the C-flex works? The RT said that the #3 setting is the easiest exhale relief. But I moved it around to 1, 2, 3, last night- and I can't even feel any differences? So is 3 really the most exhale relief?

DoriC · Post by **DoriC** » Sat Jun 20, 2009 11:22 am

Hi Mike, you're going through the hard part now but you'll find lots of help here and "this too shall pass". I don't know what type of exchange policy the DME has or what your insurance covers, but you should really try to get a data-capable machine if you can so that you can buy the software and begin to monitor your own therapy. One like I have listed in my profile or even the Pro would be OK. If you can exchange your ResMed Quattro for the ResMedUltraMirageFF, you may find it a better fit. My husband(he's Mike too), had the same problems you describe with the sore nose bridge and leaking. The UM conforms to his face much better and with a cpap bed pillow for side sleeping, he's doing much better. Keep us posted. BTW, when I told our DME I found this forum, she told me " a little knowledge is dangerous". I told her "a lot of knowledge is absolutely necessary for this therapy and my husband's health and wellbeing". She's become a little more "respectful" as time goes on and thankfully we don't have the need for her "advice" as we did in the beginning. Dori

jdm2857 · Post by **jdm2857** » Sat Jun 20, 2009 1:24 pm

I have never tried the Quattro but I have read in other posts that it should be a bit loose when the pressure is off. The seal actually inflates from the air pressure and expands to seal to your face.

miketech · Post by **miketech** » Sat Jun 20, 2009 1:24 pm

I believe my machine is a fully data capable machine? The RT told me not to try to read my data during the trial period when the insurance company needs to read the data so that they will pay for the machine. She said the reader will erase the data.

Pugsy · Post by **Pugsy** » Sat Jun 20, 2009 1:34 pm

miketech wrote:I believe my machine is a fully data capable machine? The RT told me not to try to read my data during the trial period when the insurance company needs to read the data so that they will pay for the machine. She said the reader will erase the data.

The "Plus" designation in the Respironics is very simply the basic compliance data only machine. It will give hours of use for insurance compliance verification and that is it as far as any data at all.

You will never get any other data out of it. You have been told a whopper. They want you to go past the "trial" period then there stands a good chance that you will never be able to swap it out for a real data capable machine.

If you have the "Plus" in the M Series as in your profile, nothing but compliance only data is available.
If you have the "Pro" in the M Series, you have data beyond compliance. Check the specs for each one and you will see.

rogelah · Post by **rogelah** » Sat Jun 20, 2009 1:50 pm

Mike,
I, too, had a case of ski slope nose (ski pole sides of the mask jabbing into the bridge of my nose.)

Based upon recommendations from here I did two things, 1) I got a set of Pad-A-Cheeks and 2) I got some moleskin from which I cut a form fitting piece for the bridge of my nose.

Now, I don't mind the mask. And listen to the advice about too tight, it's true.

dad1717 · Post by **dad1717** » Sat Jun 20, 2009 3:17 pm

I had the same problem with the sores but they went away after the first week. Maybe my skin had to adjust? I also think that right after waking up that the machine seems to be giving hardly any pressure, but just as you, have I have full pressure as needed (9). I think that your breathing after a long sleep is used to the pressure as opposed to when the machine starts up.

As for the masks, I have 2. ResMed Mirage Micro (nasal) and the Quattro. I get the best sleep with the Quattro but everyone is different.

One last note is that this site has been a world of information to me since I started CPAP just 2 weeks ago. It is nice to see and discuss how other folks "get along" with their situations. Best of luck to you!

Hawthorne · Post by **Hawthorne** » Sat Jun 20, 2009 3:47 pm

Your question about C-Flex- Yes, a setting of 3 gives you the most exhalation relief (or drops the pressure the most for exhaling) , 2 a little less and 1, less than that.

Sometimes a setting of 3 is too much of a difference in inhalation and exhaltion for people. If your titrated pressure, is low ( under 10), I would say that a C-Flex of 1 might be enough. It can affect how well you sleep if the change between inhalation and exhalation is too much. It could disturb your sleep. It is sometimes difficult to feel the difference, with a brief try of Flex settings. Trying a setting for a whole night gives you a better idea of what might work best for you. Some people turn it off altogether, if they don't like it.

Everyone is different of course.

Forget what you were told about the adjustment knob on the Quattro! That's ridiculous!! You have to adjust it so that it fits YOU comfortably. You wear it and you know how it feels on you. She doesn't. Adjust it to suit YOUR needs!

miketech · Post by **miketech** » Sat Jun 20, 2009 4:41 pm

Oops! So sorry, I just went and looked at the machine again, and IT IS a Remstar Pro M series! All these machine and mask names are so similar. Thanks for all your help, fellow sleepyheads....

Pugsy · Post by **Pugsy** » Sat Jun 20, 2009 7:42 pm

miketech wrote:Oops! So sorry, I just went and looked at the machine again, and IT IS a Remstar Pro M series! All these machine and mask names are so similar. Thanks for all your help, fellow sleepyheads....

RT still told you a whopper. Just looking at data won't erase compliance hours and days of use and that is all the insurance company wants. Just using the Encore Viewer software and the card reader doesn't erase the compliance data. I had my machine for a week before I got the software (3 weeks now) and my compliance hours of usage (4 weeks now) is still showing. Resetting averages might mess with therapy hours but you have to make a conscious decision and effort to reset to zero. Just looking at the averages that are offered on the LED screen doesn't erase them.

I think the RT just doesn't want you messing with the machine.

Another newbie-sore nose, questions, rants

Another newbie-sore nose, questions, rants

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Additional Comments: Also use the Mirage Micro nasal mask.