3 Weeks In

Greetings!

I am about 3 wks into my treatment. I had feared receiving a low end unit from the home health therapist, but am satisfied that the doc prescribed a good one. If my profile is working right, the product info show be appearing below.

Initially, the LCD was saying 8 hours per night of operation, but today the reading is 6.4 (last 7 days). I keep waking up at a high pressure, cheeks blowing out, mask leaking in all directions. I'm trying to figure out if it's just me, the machine, the mask, or the position of the stars. In self-defense, I've tightened the straps, but now of course, I wake up with painful bone bruises. I'm working on a compromise.

The online sizing chart says I have the right size mask.

So I want to understand the machine a little better. I was told by the therapist that the doc ordered a range of 4-20, apparently the max range. 4 is way low, almost undetectable, and the machine allows me to easily move up as far as 6, which I've done. I have no way that I can see to go above 6. Card reader required?

The LCD shows a pressure of 11.5. Would that be "average" for the night? Could I be hitting well above that at peak periods?

The Flex setting is currently at 3. The therapist told me which setting is the most aggressive, but I don't remember what he said.

I see "FOSQ" settings. What's that about? They are all set at the minimum right now.

Thanks in advance!

- Jim

Hello & Welcome, JimIllinois! Glad you found this forum—SO much useful info and everyone here is so willing to help!

Cannot understand why your doc would prescribe a 4-20 range. Hoping some of our wiser old timers will chime in here on that one. I believe that FOSQ feature is for docs/DME's to program in survey questions for users to respond to.

"You are getting sleepy . . ."

Thanks for the quick Hello.

I'll explain a little more. My sleep study results showed a number of 78 per hour, with a very low blood oxygen level, but since it took me so long to get to sleep wearing the Frankenstein test probes and chest straps, there was not enough time left to set up a CPAP.

I have an appointment for an office visit (he was booked for 5 weeks in advance), where I expect to be set up for a follow-up sleep test, but in the meantime they thought it was prudent to get me started on the machine. I believe that's why he went for the A-flex auto and a very wide range.

The daytime results have been dramatic, but the high pressure steam engine wake-up call is a problem. As summer approaches, I'll be able to listen to the birds at 4:30 am, but for now it's pretty boring.

- Jim

Your doc did you right by getting you a machine NOW and even better it is an AFlex which is top-of-the-line.
Do yourself a favor and buy the software NOW. Also find a way to keep that machine.

OSA severely impacts our memories.
Listing the wrong equipment is very common. All those pictures look alike.
I always prefer the poster also enter their equipment and pressure in the post because equipment is OFTEN changed and not changed in the posters profile.

To be clear equipment includes mask and machine plus software, if used.

The machine make and model will be clearly written across the top of the machine. Pencil and paper can be helpful in getting this correct.

The mask will have a label on the back of headgear indicating make and model. Included with the mask is a brochure that will have a graph showing the leak rate at several pressures.

Always list your pressure AND leak rate with the name of your mask.

While you are at it -
make sure you are logged in - go up to top left side of page
select Control Panel
Profile tab
Edit equipment
change How would you like your equipment displayed from Image to Text
Select Submit
All those pictures look alike

Double check to be sure it matches exactly what is written across the top of your machine and you select the correct equipment and mask. The make & model of the mask are on a tag on the back of the Headgear and in the included brochures.

Indicating your pressure and leak rate is also very useful.

Welcome,
GumbyCT

JimIllinois wrote:I was told by the therapist that the doc ordered a range of 4-20, apparently the max range. 4 is way low, almost undetectable, and the machine allows me to easily move up as far as 6, which I've done. I have no way that I can see to go above 6.

Probably what you're moving up to 6 is the ramp start pressure, not the machine's minimum pressure setting. Because if you were really moving the minimum pressure in the pressure range, you could definitely move it up a whole lot more than 6...you could move the min all the way up to whatever the max is set at (20. )

Ramp start pressure is accessible to the user. You'd have to go into the therapy setup menu to actually change the pressure setting itself (the 4 - 20 range.)

PM me your email address if you'd like to have the Provider manual (clinical manual) for your machine. And let me know if the word "A-flex" is written on top of the machine or not.

my edit -- fixed the quote box to show up right.

Thanks for all of the advice. I have the Respironics M-series A-Flex machine, and I will change to text rather than pics to describe my equipment.

I am a computer geek, so I had already been looking hard at the software. Awfully expensive for software that just reads and changes parameters. On the other hand, it IS the medical industry...

Good point delivered about my ability to change ramp parameters, not the core parameters. I've found the instructions for using the LCD to change core parameters. I know I can do that now, the question is whether that's a smart thing.

I think for the low end of the band, it makes sense to move closer to my nightly average. I don't think lowering the max is necessary, or even smart. The unit works its way up from the bottom and only goes as high as it needs to go to stabilize my airway. Anyone disagree?

I don't see the leak figure on the screen, so I guess that's something to be accessed with the software.

Thanks again, everyone. This is a great resource.

- Jim

JimIllinois wrote: I think for the low end of the band, it makes sense to move closer to my nightly average. I don't think lowering the max is necessary, or even smart. The unit works its way up from the bottom and only goes as high as it needs to go to stabilize my airway. Anyone disagree?

Wellll, as a matter of fact, yes. For some people, some machines will work their way up for the wrong reasons. Those people have to limit the top. Or ever to decide keep the machines on fixed pressure. That said, I think you're right in not making any changes in the maximum pressure at this point.

Moving your minimum up is a good idea - and it may ever keep the pressure from going too high.

O.

Thank you for the insight, O.

I keep learning new things. My original complaint was waking up with a raging windstorm around my mask due to high pressure, so maybe that is an issue to watch.

-Jim

I had a follow-up with the doc yesterday.

He says he prefers to set the machine to either a narrow range or to the exact number needed per my smart card history. I like the narrow range better, since it allows the machine to adjust to small changes in my "needs."

He also offers to print out my smart card history any time they're open, for no charge. Nice.

But I'm going to go the software and card reader route and learn to analyze what the stats say.

We're scheduling another sleep study to do the mask adjustments and check whether I am getting any REM.