Ventilator Problems -- DME Response

[Madalot]

I have been on the phone numerous times with the owner of the DME about the ventilator. He has also spoken to the RT that knows this machine inside and out.

Based on what I'm describing, the RT feels the problem is "patient/machine interface" meaning he thinks my mask is leaking. Because I am pretty intelligent and adjusting the mask would be the FIRST thing I would do (and have done) and the problem persists, the DME wants to really look at this more. Plus, I explained that I put a brand new mask on last night after finding a break in my old one. Obviously, it didn't fix the problem.

The RT suggested changing the Trigger Type from Flow Trigger to Auto-Trak. I have agreed to try this setting for tonight. If I still have the problem, I will take the machine in tomorrow morning. They will do the download and if they can't figure it out immediately from that, the DME has a second ventilator (this surprised me, but then I realized I had heard that their other vent patient went off it, so it makes sense that they have the unit) and they will swap the units out to see if the other unit does the same thing. If it does, then the problem is ME -- if it works fine, then the problem is the ventilator.

So, I'm using my machine tonight with one setting changed and see what happens.

My DME is being VERY responsive and keeping me involved in the decisions. The three of us (DME, RT and Me) are working together to find the best course towards a solution.

[WindFlyer]

Madalot- It's nice to hear that your DME is working for you. Personally I don't trust or expect very much from any DME in my area, although I did find one who were fairly responsive and willing to work with me. Problem is, like all DME's, they only carry equipment from the big three- Respironics, ResMed and maybe F&P. That's one of the biggest "tricks" I've learned since I started CPAP six years ago- you've got to shop around for a good DME.

So good luck to you. Glad it's working out for you.

[Madalot]

Madalot- It's nice to hear that your DME is working for you. Personally I don't trust or expect very much from any DME in my area, although I did find one who were fairly responsive and willing to work with me. Problem is, like all DME's, they only carry equipment from the big three- Respironics, ResMed and maybe F&P. That's one of the biggest "tricks" I've learned since I started CPAP six years ago- you've got to shop around for a good DME.

Unfortunately, the area I live in is pretty rural and the choices in DMEs are very limited. This is a smaller, "mom & pop" type company. There are at least two other DMEs that I could use that are larger and probably have more resources, but I doubt I would get the personal service that I'm getting with mine. I'm working directly with the owner of the business, which is not something the others one are likely to do.

That's not to say that I haven't had my share of issues, but communication with the owner seems to have resolved most problems -- and he has made it clear that he has my best interests in mind.

[DoriC]

Maddy, What are these settings and what's the difference between Flow Trigger and Auto Trak? I'm glad you're getting some feedback from the DME, no chance of talking to the RT directly? Thanks for the update.

[Madalot]

Maddy, What are these settings and what's the difference between Flow Trigger and Auto Trak? I'm glad you're getting some feedback from the DME, no chance of talking to the RT directly? Thanks for the update.

Hey Dori -- I pulled the information straight from the Manual:

Trigger Type:

The device can be set to trigger breaths based on automatic flow thresholds or specific flow settings. You can select either Auto-Trak or Flow Trigger as the Trigger Type. When Auto-Trak is selected, the Auto-Trak Trigger initiates based on automatic flow thresholds. When Trigger Type is set to Flow Trigger, Flow Trigger Sensitivity and Flow Cycle Sensitivity become active, and the trigger initiates based on the Flow Trigger Sensitivity Setting.

Now, if I understand this correctly, we have changed it to make the vent automatically figure out when to start the air flow for inhalation. Prior with Flow Trigger, it did so based on the sensitivity settings.

Edited to add: I'm not holding a lot of hope that this change is going to fix the problem I've had the last four nights, but I think I need to try it first before saying it won't make any difference.

[Madalot]

Surprise of all surprises --

The ventilator did NOT act up last night. Hmmm....

Trigger Type to Auto-Trak instead of Flow Trigger made a noticeable difference. Everything seemed "smoother" if that makes any sense. And I had none of those episodes that have plagued me the previous four nights.

I think I'm going to go another night and make sure things seem on a better track. If the problem occurs again tonight, I'll stick with the plan to do a download and switch the machine tomorrow. If the problem doens't occur tonight, we may have fixed this.

[DoriC]

Great news! Here's hoping things will go smoothly from now on!

[Madalot]

Thanks, Dori --

The plan right now is to use it at these settings tonight AND do an overnight pulse ox just to make sure we haven't screwed up something else. If I have another good night, we seem to have fixed the issue, which says something was up with ME and the vent was not malfunctioning. My DME is expecting a call from me tomorrow to let him know if things were good again and if so, we'll leave things as they are. If not, I'll go in tomorrow and do a download and possibly switch out the machine. I'm cautiously optimistic that this fixed the problem.

I am a little miffed at the fact that making that one change to the Trigger type made such a big difference last night. I can't help but wonder why it wasn't done sooner, considering I've commented so many times about discomfort here and there. The Auto-Trak just felt so much easier and smoother -- the transition from EPAP/IPAP wasn't as difficult for me.

I'll post again tomorrow and let you all know how it went.

[Jersey Girl]

Dear Madalot,

Your machine sounds very complicated and sensitive. That said, it sounds like you may be on the right track. Please let us know tomorrow how you slept tonight. I am hoping that you sleep peacefully and comfortably all through the night...

Warmly,

Jersey Girl

[Madalot]

Your machine sounds very complicated and sensitive. That said, it sounds like you may be on the right track. Please let us know tomorrow how you slept tonight. I am hoping that you sleep peacefully and comfortably all through the night...

Thanks, Jersey Girl. I'm getting ready to head in that direction now and am hoping for a calm night.