Stomach air

Thanks for explaining that, O.! So if he writes a prescription for it eventually, then hopefully it will be for bilevel and I can get a Respironics that will work with my $395 humidifier I was forced to purchase and that will use my card reader and software. He wouldn't stick me with a particular brand, would he? It must just be his own terminology for BiPAP?

Let's hope it's the miracle for my aerophagia I've been hoping for (she says as she's still burping at 10 p.m., wondering how she's going to "mask up" while belching)!!

Peggy

P.S. And I feel stupid, but I don't understand the reference to SlinkyLand. Is that a special subdivision of hoseheading?

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, bipap, humidifier, Prescription, aerophagia

If he writes an Rx for a bi-level you can buy a Respironics Bipap auto - which I think would be perfect for you.

Slinky is our resident Resmed user and appreciator! She's great company to have.

O.

pjwalman wrote:Thanks for explaining that, O.! So if he writes a prescription for it eventually, then hopefully it will be for bilevel and I can get a Respironics that will work with my $395 humidifier I was forced to purchase and that will use my card reader and software. He wouldn't stick me with a particular brand, would he? It must just be his own terminology for BiPAP?

Whoa! Let's back up the truck just a second now. You care about your prior investment in technology continuing to be useful to you. You think your physician should care about that, too? Since, when ... Physicians never give that a thought. Your care is far more important ...

Sorry ..., I'm letting my cynicism show.

OK, time to get the physician back on board again ... Peggy, you already know how to do this. Make sure he either writes a prescription for the Respironics BiPAP-auto, or at least for a "generic" bi-level machine. That way, you will have the option to get a machine of your choosing, from the supplier of your choice. Reports here indicate that DME's have been good about providing BiPAP-auto's, even with generic prescriptions, since there's little difference in cost to them.

Regards,
Bill

pjwalman wrote:At your suggestion, Bill, I faxed the doctor with all the gories of my aerophagia, gastric insufflation, stinky/loud/percussive/eruptive talents , whatever you want to call it. I explained that I was just starting up with a new DME provider, that a machine hadn't been acquired yet for me, and would he please authorize a trial for a BiPAP Auto since I had done research that suggested that might be helpful for some with aerophagia.

Hi Peggy, I was hoping your new 420E would help. This post probably will not help you as far as a magic solution, but perhaps in understanding - that upon the grand assumption that I'm correct.

Since I'm working on my gastric insufflation (GI) thing I've learned that we who experience it have a threshold pressure upon which the LEV starts leaking. So any pressure below doesn't factor into the problem, leaving the time and pressure spent above. This sounds like "duh" but means that average pressure is not as important as thought.

My threshold is around 9. If I had BiPAP set for 5 & 10 and not considering time to get from one pressure to the other, 50% of the time is at 5 and 50% at 10. The average pressure would be 7.5, well below the threshold but I would still have GI. In fact if the levels were 8 & 10 I would have the same results as anything below threshold is the same as 0. With my APAP, I spend less than 10% of the night above threshold and that's why I have the relief I do.

If I recall correctly your pressure settings are quite high. It's possible that your settings just don't get below your magic number so you can't get any relief, but if a BiPAP can be set with the low side just low enough, you could get 50% improvement. The trick is to find the threshold and somehow get the low side below it. One study I read tested threshold for 20 people. 11 never leaked and threshold for the other 9 ranged from 8 to 35 with the mean at 16.5.

My point with this is that your threshold may actually be quite high but you just haven't gotten below it. If your BiPap doesn't help at first, see how low they can go without compromising the therapy. I would be inclined to take it as low as the machine will allow (in range) to see what it would feel like then raise it until the bad returns. Once you find threshold you can work it from there.

Even if the pressure cannot get below threshold, just maybe something will help the LEV stay closed longer. I'm kidding, but alum powder comes to mind. I looked into GERD remedies and found lots of stuff mainly directed at increasing or decreasing acid, but I don't know which camp the pepper is in. Well, maybe in the "can't hurt to try" camp.

Next it's down to tricks to live with it. I looked my wife's large exercise ball over a few times but I hurt to bad to lay on it. That might help get the second half of it out though. I know for me (not my wife) it was a big help to lay in bed and lay on one side until the big bubble exited then the other and repeat until it didn't hurt so bad. Like an air bubble in a syrup bottle, the bubble seemed to rise when I got up.

Anyway, I sincerely hope the BiPAP works for you. And if you have trouble falling asleep, you can read this post twice and off to sleep land you go!

Pleasant dreams.

Darned if you don't have me curious about the relief potential of an exercise ball now!! Next time, by golly, I'm going to try it. I am already providing so much comic relief at my house, I might as well add some circus tricks to accompany the percussion.

Old Lincoln, I appreciate your input on ranges to try with the BiPAP. Just when I'm finally figuring out the APAP range, now a new machine comes along. Always something to learn! And while I wish I could count on my doctor having all the right answers, the fact that he prescribed 6-11 for my APAP range, which guaranteed my crappy AHI numbers would continue, doesn't inspire great confidence in that hope.

I am slowly coming to the conclusion that part of the reason for my problem is that, during events, I am gulping way more air, accounting for days that are so much worse for me. So I'm thinking the trick is to get the AHI as low as possible so I'm not gulping that air. Insufflating that air?

The 420E has been very useful as far as showing me my centrals really are not the concern I had initially thought. They're not pressure related, and they, too, seem to be directly related to my events...again a good argument to work on getting those numbers down. And thanks to O. and RG, I've now learned where a more useful range is (more at 14 than the titrated 11) and how to use the data to analyze things a little better now when they turn me loose. I am sure I will have to be pestering people again for help with the BiPAP, but I've learned how to pull my data into Excel now and a little more now about how the machines work.

So I'm getting there. Yesterday I had an AHI of 1.1, and other than a few typical morning reports , I didn't have much of a problem. You are absolutely right that I have got an LES problem, as almost immediate "activity" occurs at mealtime now, a previously rare problem now becoming commonplace, apparently aggravated by the CPAP air. I will need to address that finally, I think. But getting control of the events seems to be helping unless the last couple days have just been a total fluke.

I will keep you posted, and I thank you all for your input! I never dreamed I'd be a poster child for gas , but there you have it!! LOL!

Peggy

Peggy,

It sounds as though you and I are in the same boat. I can't get into see my sleep DR. until the middle of June, so I'll be watching your posts to see how the BiPAP helps. In the meantime, I wake up doubled over in gas pain that is still dispelling when I go to bed and blow up again. I just compared bellies with my 28 year old, 6 month pregnant co-worker. She has finally passed me up.

I have an exercise ball. How does that help?

Bev

You know what, Bev? OldLincoln might be on to something. It was just a theory of his which he discarded as looking too uncomfortable -- and certainly I wouldn't want to attempt it in the middle of the night as I am not that graceful in my most alert moments -- but in the interest of experimenting, having just gotten up from a nap and packing some spare air, I just rolled around on my exercise ball a bit, and darned if it didn't loosen up a gut cramp. With just one try at it, it would be premature of me to announce it's a definite fix, of course -- could be that wind was on its way out anyway -- but it actually did feel kind of good to roll around a little, then just rest my head on my arms on the floor and let the bottom half hang off the ball. I'd say, if you already have an exercise ball at home, it's worth giving it a try.

Peggy

Old Lincoln has some good ideas. On straight CPAP I had a lot of NRs. Switched to APAP and have had a terrible problem with gas. I don't really understand how a BiPAP would help, and now I will have to pay out of pocket for it because I've had my APAP long enough for my insurance to have paid for it.

I've been taking licorice root for a couple of days,not long enough to see if it helps. I'm not sure I want to try red pepper as I've always had a bad reaction to spicy dishes.

Meanwhile I'll try rolling around on the ball. I usually roll on it backside down to stretch out my back. (Not a good idea after eating if you have a weak LES!)

I know if I keep watching this forum, somebody will come up with a non surgical solution for this problem.

Bev

Bev, I'm not sure if BiPAP *will* help. I haven't got the machine yet, so I can't share any experiences with you. I will keep you posted on my progress, though, if you would like me to.

You and I had just the opposite experience between straight CPAP and APAP. That air blasting at me steady at 11 gave me awful, awful problems. With the APAP, it's a crap shoot. Some days are awful, but others days are great. So the APAP works better for me, though there are still enough bad days for me not to be willing to quit pursuing answers.

One thing I have noticed about my *own* situation, though, is events seem to lead to problems. In others words, if I've had a lot of events in a night, I seem to have a lot of aerophagia problems that next day: My gasping or gulping for air building up the supply way past what my guts can tolerate well, in other words. Just my theory, but I think I'm on to something. The last couple nights, I seem to have found my "sweet spot" in APAP and had very few events, and I've hardly had any backfire.

Yes, thank goodness for the forum. We will keep searching for our answers and sharing our minor successes. Hang in there, Bev! At least you know you're not alone, if that helps any.

Peggy

What do you mean by events?

Can't be letting you take my name in vain, Ozij!

And on a most fitting subject! After all these years (3 1/2) guess who is having a TERRIBLE time w/aerophagia??? And I DO mean TERRIBLE. Came close to heading into ER last weekend. I blew up like a balloon. No lower exiting, explosive upper exits and barely any relief. I have Crohn's disease with a high grade partial obstruction at my old resection site. I can't afford that pressure on the obstruction and I can't handle the nausea.

After 3 1/2 years of 100% compliance I haven't dared to use my BPAP for a week. I'm sleeping w/just 2L of 02. I'm hoping to start all over at 10/5 and build up gradually this coming week. But first we need to make sure that small bowel bacterial overgrowth isn't contributing to the problem.

And, yep, I'm a long time, dedicated Resmed fan who has turned coat at least temporarily trialing a PR SystemOne BPAP Auto w/Bi-Flex. My regular PAP is the Resmed VPAP Auto.