Keep the beast CLEAN!

[torontoCPAPguy]

When it comes to cleaning breathing equipment my personal habit is and will continue to be:

1. Soak the mask bits and pieces excepting the cloth headgear in warm soapy water; the purpose for which is simply to free up and get rid of the 'crud' that has accumulated and dried. I generally soak my mask bits in warm, soapy water for anywhere from 15 minutes to 8 hours. It is my opinion that getting rid of this 'crud' is essential to long term health. I use a very soft bristled paintbrush to dislodge any remaining 'crud' that may have accumulated in the wee cracks and crevices. I want it gone.

2. Any gentle soap is going to do the job. The purpose of the soap is simply to get rid of the 'crud' - IMHO nothing more and nothing less. Here is a blurb from "ABOUT.COM" that says it all eloquently:

Detergents and soaps are used for cleaning because pure water can't remove oily, organic soiling. Soap cleans by acting as an emulsifier. Basically, soap allows oil and water to mix so that oily grime can be removed during rinsing. Detergents were developed in response to the shortage of the animal and vegetable fats used to make soap during World War I and World War II. Detergents are primarily surfactants, which could be produced easily from petrochemicals. Surfactants lower the surface tension of water, essentially making it 'wetter' so that it is less likely to stick to itself and more likely to interact with oil and grease.
Modern detergents contain more than surfactants. Cleaning products may also contain enzymes to degrade protein-based stains, bleaches to de-color stains and add power to cleaning agents, and blue dyes to counter yellowing. Like soaps, detergents have hydrophobic or water-hating molecular chains and hydrophilic or water-loving components. The hydrophobic hydrocarbons are repelled by water, but are attracted to oil and grease. The hydrophilic end of the same molecule means that one end of the molecule will be attracted to water, while the other side is binding to oil. Neither detergents nor soap accomplish anything except binding to the soil until some mechanical energy or agitation is added into the equation. Swishing the soapy water around allows the soap or detergent to pull the grime away from clothes or dishes and into the larger pool of rinse water. Rinsing washes the detergent and soil away. Warm or hot water melts fats and oils so that it is easier for the soap or detergent to dissolve the soil and pull it away into the rinse water. Detergents are similar to soap, but they are less likely to form films (soap scum) and are not as affected by the presence of minerals in water (hard water).

Modern detergents may be made from petrochemicals or from oleochemicals derived from plants and animals. Alkalis and oxidizing agents are also chemicals found in detergents. Here's a look at the functions these molecules serve:
•Petrochemicals/Oleochemicals
These fats and oils are hydrocarbon chains which are attracted to the oily and greasy grime.


•Oxidizers
Sulfur trioxide, ethylene oxide, and sulfuric acid are among the molecules used to produce the hydrophilic component of surfactants. Oxidizers provide an energy source for chemical reactions. These highly reactive compounds also act as bleaches.


•Alkalis
Sodium and potassium hydroxide are used in detergents even as they are used in soapmaking. They provide positively charged ions to promote chemical reactions.

I personally opt for a gentle, 'pure' and odor-free soap to accomplish this task.

3. The second task that I am absolutely anal about is getting rid of the bacteria that has been growing. While I do believe that simply washing in gentle soap is likely sufficient..... one has to wonder why Control III is such a popular germicide. I will either dump an ounce of Control III into the warm soapy water and ensure it reaches all the nooks and crannies as I wash; or I will actually rinse the masks, refill the basin with a gallon of warm water and dump the germicide into that... I generally opt for the former for the sake of speed and convenience and the belief that it will get the job done either way.

Here is a list of excellent and vouched for soaps that are odor free and do the job, by the way:

Method Go Naked Dish Soap - TARGET
Seventh Generation Free & Clear Dish Soap - TARGET
Purex
Ivory unscented
Dr. Bronners (health food store) totally unscented
Ivory Classic Pure liquid Soap - no scent
7th Generation unscented (for handwashing dishes)
Dove Baby Unscented Shampoo - LOBLAWS
Ivory Liquid Hand Soap.
I have a pump by my sink, and a small squeeze 300ml bottle for my travel cleaning always packed

Of these 'recommended' soaps, I use the first two and when I found them I bought a case of the stuff. No more searching the isles from store to store. Ditto the Control III. Find it and get a case of it. $118 worth will last me for about 4 years at the rate I use it.

Cleanliness is next to godliness. I can only attest by saying that spending almost a month on total life support and the enduring damage and issues that one need endure to remain alive and kicking makes me a strong believer.

I have FIVE Quattro full face masks now and rotate through them over the course of the month. I have replaced the cushions once in two years (recently). I do my mask change weekly to a fresh one (kept in a ziplock baggie which has a couple of holes punched for air circulation but to keep the dust and crap out) and I wipe down the mask in use every morning with an odorless wipe of some sort, a Control III wipe if I can find them. Cheap enough. Essentially just to get the surface 'crud' off and degrease the mask.

The hoses are washed the exact same way but not quite as often. The humidifier tank is always filled only with distilled pharmaceutical grade water readily available at any pharmacy for cheap and it is tossed in with the hoses or masks to be cleaned and disinfected about once a month because it is quick and easy to do. I DO NOT disassemble the tank nor do I put it in the dishwasher. Both are absolutely unnecessary.

All of this may sound complex but rest assured it is not. The whole process takes me about a half hour once a month. And it provides me with cheap enough peace of mind.

After you have had bacteria of unknown origin blown into your lungs and wound up on life support where your lungs were being suctioned mechanically during each day (NO. YOU CAN'T IMAGINE WHAT IT IS LIKE.) and where three years (last week) down the road you are still paying the price...... rest assured, my friends, I am being more than gentle with my words here and choosing them very carefully.

I sat having dinner with my family at 7 p.m. one night. The next morning at 8:00 am I was in an ambulance en route to the trauma centre and being worked on as I was no longer breathing, nor could they inflate my lungs, which at this point were filled to the brim with gunk. I am fortunate. The ambulance was sitting at the end of the street waiting for a call; the hospital is two blocks away; the trauma unit was empty; they had ONE single ventilator available and the specialists that I needed to save my life were not on call but were actually THERE when I arrived. Everything fell into place and I am here to tell you the tale. And you can take it from me.... if there were ANYTHING more that I could do in order to make the use of airway equipment safer, you may rest assured I would be doing it. Practically speaking I believe that what I have posted is more than ample caution.

One last piece, in parting. On my follow up with a respirologist as we were looking to determine my lung capacity post-trauma and see if it could be worked on..... the respirologist, a professor at one of the local medical schools in respirology, put up my x-ray (or CT scan?) on the screen and turned to me. And turned back to the picture and then back to me. His words? "I cannot believe that these are your pictures..... we usually only see pictures like this from cadavers".

Friends, take the high road.

Oh, one last thing. For those of you that are non-compliant. Not cleaning. Not brushing your teeth before bed. Not aggresively using that XPAP gear. Etc. Please post your address so we know where to send flowers while you are suffering from all of the ailments that sleep apnea brings on. And perhaps the address of your spouse or parents so that we know where to send flowers when we no longer see you on the board. Apnea is not a joke my friends. It will kill you dead if you don't chase it down.

[Elle]

I'm sorry this happened to you. However, what happened is not that common.

I would die much sooner obsessing about cleanliness than going along with a rational regimen to keep things fairly clean. I know a couple of people who have done nothing with their machines for several years and they are doing fine. I use a baby wipe on my mask cushion daily and wash the other 'stuff' on occasion.

In general what you describe is the exception rather than the rule but again sorry for your experiences.

[locust78]

Toronto, I fully agree with your assessment of the need to thoroughly clean CPAP equipment. Aside from cuts, wounds, and surgical sites, there aren't many other pathways on our bodies that are so open as are our sinuses and lungs. I typically use the detergent and water method, but came to see in a study by Harvard Medical School and Brigham and Women's Hospital which showed that over time CPAP surfaces can break down on a microscopic level and become disinfection resistant. That concept didn't sit well with me, which is why I took it a step further and also use a device called SoClean. I use it to completely sanitize my mask, hose, and reservoir. I'm much more comfortable with my CPAP knowing that any pathogens I might have missed with hand-cleaning are being eliminated daily. I know that some might consider such an approach overkill, but for those with underlying health issues, or compromised immune systems, there can be no short cuts.

[flatag]

I know a couple of people who have done nothing with their machines for several years and they are doing fine.

And my mother never treated her OSA and she lived to 85. There are exceptions to every rule.

[torontoCPAPguy]

The "norm" is obviously... use a dirty mask and you can get away with it. For most folks.
Same with cigarette smoking. The "norm" is you can get away with it. Or so it appears. I have known many that have smoked into their nineties.
At the same time, I have spent time in hospital with folks on the waiting list for lung transplants and those that were simply being treated until they could be moved into "storage" or passed away from their lung cancer. And I'm sure all of us know someone who has passed away from lung cancer or complications if we think hard enough (the brain tends to block unpleasant thoughts and memories).
The "norm" is that you are likely to get away with using a dirty mask... although you will probably not be getting away with it but just avoiding traumatic results.

For my part, as I said, my cleaning process is so quick and easy that I would rather not take the chance.... perhaps I am being anal about cleanliness, but then again, I have experienced the traumatic result of what bacteria sitting deep in a lung can do and how fast it happens. You don't even have a chance to say goodbye... at least I didn't. I didn't have the air to say it anyway.

So, each to their own, to be sure. I just wanted to show the flip side and that what our parents told us as youngsters "cleanliness is next to godliness" is true. Sorta. It should actually be, IMHO, UNcleanliness will get you close to God more quickly.

For the effort it takes, I don't want to take the chance. Just sayin'

[DreamStalker]

...

After you have had bacteria of unknown origin blown into your lungs and wound up on life support where your lungs were being suctioned mechanically during each day (NO. YOU CAN'T IMAGINE WHAT IT IS LIKE.) and where three years (last week) down the road you are still paying the price...... rest assured, my friends, I am being more than gentle with my words here and choosing them very carefully.

I sat having dinner with my family at 7 p.m. one night. The next morning at 8:00 am I was in an ambulance en route to the trauma centre and being worked on as I was no longer breathing, nor could they inflate my lungs, which at this point were filled to the brim with gunk. I am fortunate. The ambulance was sitting at the end of the street waiting for a call; the hospital is two blocks away; the trauma unit was empty; they had ONE single ventilator available and the specialists that I needed to save my life were not on call but were actually THERE when I arrived. Everything fell into place and I am here to tell you the tale. And you can take it from me.... if there were ANYTHING more that I could do in order to make the use of airway equipment safer, you may rest assured I would be doing it. Practically speaking I believe that what I have posted is more than ample caution.

One last piece, in parting. On my follow up with a respirologist as we were looking to determine my lung capacity post-trauma and see if it could be worked on..... the respirologist, a professor at one of the local medical schools in respirology, put up my x-ray (or CT scan?) on the screen and turned to me. And turned back to the picture and then back to me. His words? "I cannot believe that these are your pictures..... we usually only see pictures like this from cadavers".

Friends, take the high road.

Oh, one last thing. For those of you that are non-compliant. Not cleaning. Not brushing your teeth before bed. Not aggresively using that XPAP gear. Etc. Please post your address so we know where to send flowers while you are suffering from all of the ailments that sleep apnea brings on. And perhaps the address of your spouse or parents so that we know where to send flowers when we no longer see you on the board. Apnea is not a joke my friends. It will kill you dead if you don't chase it down.

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

I ask because I have not had a respiratory infection since I started using CPAP 6 years ago (prior to that about 4 or 5 times per year). Does not mean that CPAP equipment is immune to bacterial contamination or makes the user immune but there are far more dangers of contracting airborne disease from your non-CPAP environment than from your CPAP equipment IMO.

[BlackSpinner]

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

[Maxie]

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

Thanks for the explanation. I was getting nervous because I thought he got the bacterial infection from using CPAP. I do agree that cleanliness is very important.

[DreamStalker]

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

Oh ok, gottch'a.

So he caught the swine flu from the non-CPAP environment ...

... or, did he used to let other people (or swine) with respiratory diseases use his CPAP equipment without properly cleaning afterwards?

Yes, I agree that people with a compromised immune system should use extra precautions.

[chunkyfrog]

Many of us could probably do a little more cleaning; but may likely wait until it reaches out and grabs us.

[torontoCPAPguy]

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

True and untrue; a mixed up story at best as we have learned over these past three years. Yes I did have H1N1... so did my entire family and the entire family that we sat with at an RCAC banquet in 2009. I am the only one that wound up in hospital with acute bacterial pneumonia. The reason? As it turns out, the reason was very likely UNTREATED sleep apnea, compounded by UNTREATED Atrial Fibrillation (likely linked to the apnea) and 'mild' Type II Diabetes being treated by a small dose of Metformin daily (likely linked to the apnea, believe it or not). This is what we have learned after three years of making the rounds of doctors, specialists, professors of medicine, reading many research and white papers, etc. The H1N1 was a mild cold-like flu and 99% of those that contracted it had it go away in a week or so. Many never even knew they had it and were carriers. It was the very young, the elderly, AND THOSE WITH COMPROMISED IMMUNE SYSTEMS or those that were simply 'run down' that had a chance of the bacterial gift left behind blossoming. I was one of those. 99% never had it go any further than a week of cold like symptoms.

During the investigations into my lung capacity after my life support stint and into my shortness of breath, we came upon sleep apnea. At almost the same time we came upon Atrial Fibrillation but did not recognize it as such and it was a fluke ECG at my family physician's office to 'test out' his new ECG machine at the suggestion of my wife that aFib was suspected and then confirmed after MANY rounds of tests. The diabetes 'came and went' like the wind. I had, at once, a family physician, an endocronologist, a respirologist, a cardiologist/electrophysiologist, a pulmonologist and more. As well as a host of technicians and clinicians. All running around in circles. They were sure I had allergies causing the shortness of breath at night, etc. I didn't believe a word of it after a while and began researching myself and putting my medical tests and records together to reach the point that I am at right now.

I thank you for your kind words and 2.5 years ago my immune system was indeed fragile; CT scans showed 'inflammation' everywhere. Pleural effusion (water on the lungs), cardiopulmonary effusion (water on the heart), liver and kidneys working at a fraction of their potential, bacterial intrusion into my stomache, etc. Oh, add a gastroenterologist to that list of doctors.

With the start of XPAP therapy and the 'perfection' of same, which we all strive for, things began to improve rapidly. With the diagnosis and proof of Atrial Fibrillation I began to supplement my diet and changed my diet to exclude almost all processed foods... I went on a "paleo-like" diet. No flower. No sugar. Etc. I stopped taking all statin drugs, unbeknownst to my family doctor, who commented on my cholestorol being 'in line' a year after I had flushed all my statin drugs down the toilet. He kept prescribing and I kept flushing and getting healthier. I have been on TIKOSYN for the aFib since December and have a follow up in August with one of the top cardiologist/electrophysiologists. We are hoping that my heart will be in shape after seven months of Normal Sinus Rhythm for me to have an ablation procedure to resolve THAT issue.

Funny thing is that much of what I am hearing, reading, discussing, focuses on the link between apnea and many, many other afflictions - and perhaps I am living proof (if not, check out aFibbers forum for more proof). Sleep apnea is not only a danger and deadly on its own.... it begets many other issues and if not addressed it WILL run you down and open you up for infection, afflictions and general "inflammation" as they call it on the aFib boards. My lungs are at 65% capacity today. Not much I can do about that. But my "inflammation" appears to be gone. No more stomache or intestinal issues. Kidneys and liver and major organs working quite well. No more pleural effusion nor cardiac effusion. Diabetes pretty much under full control with minor meds. And my last hill to conquer is that aFib.

Bacteria in the lungs is of itself a menace; but more so, detracts from the immune system's ability to fight other infections that are attempting to make headway in your body. What my CBC was two or three years ago is a far cry from what it is today. These are all common blood serum tests that everyone should be having at least annually at their physical. Know what your body is doing, where it is going and where you stand.

And for goodness sake, why would anyone introduce bacteria into the deepest and most vulnerable recesses of their body when it takes so little effort to avoid it? I am living proof of what that bacteria can and will do if your system is run down (i.e. by apnea) and how long and uphill the struggle back to good health can be. With the exception of having my tonsils removed when I was 4, I had not spent more than an hour in a hospital my entire life until that little bit of residual bacteria took hold and put me on life support. Regretably, that was MY fault. I knew I snored copiously and loudly. I knew that there were night sweats and sudden awakenings gasping for some air. I knew that I had not dreamt in 40 years (sign of no REM sleep) and that I was often tired on awakening, etc. And I ignored it.

I ignore nothing any longer. EVERYTHING is a big deal to me now. I intend to live to 120 years of age come hell or high water. A spot on my skin where there was no spot yesterday will take me to the family doctor to have it looked at. Ditto my wife and she has caught a couple of carcinomas that way in the past few years. (Did you know that they don't have to cut the carcinoma out these days? They have an injection and a cream that will kill the cancerous cells!)

So, again, thanks for remembering me and for the kind words. BUT, I am getting healthier by the day despite my brush with the grim reaper. And postulating over the past three years (three years and two weeks) there are a number of finite conclusions that I have come up with regarding apnea and my other afflictions, past and present. One of those is "cleanliness is indeed next to godliness" or.... put another way.... "let the shmutz and crap accumulate without cleaning it and you will find yourself next to God if you have lived a clean life".

[user from Singapore]

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

As someone working (not closely) in this field I have to tell you that flu is caused by viruses, not bacteria.

Also the whole "swine flu" story has been overdone by both journalists trying to sell their paper and labs trying to sell their medicine. Please do a bit of research.

It's amazing how many people think they know about this subject.

[archangle]

As someone working (not closely) in this field I have to tell you that flu is caused by viruses, not bacteria.

Also the whole "swine flu" story has been overdone by both journalists trying to sell their paper and labs trying to sell their medicine. Please do a bit of research.

It's amazing how many people think they know about this subject.

Yes, it IS amazing how many people think they know about this subject.

The 1918 swine flu killed something like 3-7% of the population of the entire world. We don't have significantly better flu treatment now than we did then, other than vaccines, and vaccines may not be available for a new strain. People travel a lot more these days, so the disease could spread faster.

3% of the US population would be 9 million people. 200 million worldwide.

The 2009 pandemic did not infect a large percent of the population, but there was a shortage of the special ventilators and ICU space that were the only thing that kept many of the severe cases alive. If a slightly larger percentage of people had gotten infected, there would have been quite a few people dying because treatment wasn't available.

Flu may not be caused by bacteria, but pneumonia and several other major respiratory diseases can be.

By the way, go get a pneumonia vaccine. It's easy, and you DON'T want pneumonia.

[torontoCPAPguy]

Sorry to hear about your bacterial experience. But how do you know the bacterial source was from your CPAP equipment? Did you actually have your equipment tested for being the source?

If you read his older posts you would know he had the infamous swine flu which ended up with him on cpap. His immune system is now very fragile and he is very right to be so concerned with the cleanliness of his equipment.

As someone working (not closely) in this field I have to tell you that flu is caused by viruses, not bacteria.

Also the whole "swine flu" story has been overdone by both journalists trying to sell their paper and labs trying to sell their medicine. Please do a bit of research.

It's amazing how many people think they know about this subject.

I need to use a larger type font obviously.
Yes, influenza of all types is caused by viral agents and not bacteria. Absolutely.
In most folks, influenza passes with symptoms like a mild cold, at least H1N1 did and yes, journalists were trying to sell papers.
In a few folks, H1N1 left behind a wee present in their lungs in the form of bacteria. From whence it came I know not and really don't care. I happen to be one of those people that were left the present. It may have been there all along from simply inhaling bacteria in my day to day activities.
The issue appears to have arisen in that I was already run down and this was further compounded by the bout with H1N1. My immune system was deficient and unable to deal with the bacteria in my lungs (from wherever it may have come from - source unknown let us assume).
The end results? Said bacteria turned into acute ACUTE bacterial pneumonia and filled my lungs with gunk in a very short time making it impossible for them to oxygenate my body. As the respirologist said once I was out of hospital and a survivor.... "We usually only see pictures like these taken from cadavers". I am the only patient to have survived H1N1 induced or related pneumonia during my stay in hospital. The others all left feet first. Not because of H1N1 directly but because of the pneuonia. My body was simply unable to fight it.

And I suppose you are right... there are many who believe they know all about a topic. I prefer to speak my piece and suggest that the reader does their own research on the topic.

[torontoCPAPguy]

Archangle:
I have it on very good authority that we came very close to 'critical mass' during the H1N1 holiday in 2009. Critical Mass? That's where there is insufficient quantity of the super antibiotics to treat the bacterial pneumonias left behind due to weakened immune systems. That's where we have too few nitrile gloves, high efficiency masks and face gear and acute care facilities. I was fortunate to be in a community where, in preparation for the H1N1 arrival, the local hospital built on about 30 extra CRITICAL CARE beds in negative air pressure isolation rooms and equipped them with the latest gear including respirators and ventilators. Let me tell you how close I was to Lord knows what.... I got the last isolation room and respirator (that's the one with the tube down the windpipe).

I cannot even begin to imagine where we would have been (the community as a whole) had the breakout been even a smidgen worse. We will get hit again before too long, of that I am sure. I just pray that we are prepared.

3 - 5% of the population would be an acceptable loss to the politicians at present versus the money needed to protect us in the future. I fear, truly, that we may look at a 20% loss or infection rate during an upcoming bout. And that, asides from being an unacceptable number, presents a domino effect in and of itself. No longer are there sufficient health care workers nor supplies. The physical plant of the city begins to break down for lack of trained staffers. Etc.

Take a look at National Geographic channel where they have been running a series on 'doomsdayers' in recent weeks. Now think in terms of reality rather than entertainment. Makes the hair on the back of my neck stand on end.