Newbie s9elite questions

Hi,

I have questions about my s9 Elite auto pap. I had flu and high fever when my husband picked up the machine, and as I am brand new to the therapy, I was hoping someone might be kind enough to answer what are probably easy questions for the pros on this list.

1. I have the machine set to auto 4. I have it on ramp, which I like a lot (which is good 'cause I can't quite figure out how to turn it off yet), and the humidity at a good temperature. As I underestand, the machine adjusts to the right pressure when needed, thereby providing what I need when I need it? My usual horrid waking has turned into a neutral experience and NO headache so even if the pressures aren't just right yet, it's a start.

2. I only got a user's manual and there is no mention of how to manually adjust the pressure. I will be turning in my data card in just a week to my pulminologist so I am hoping I am OK using these first ten days just to be compliant?

3. is there software for this machine that will run on a Mac or iPod?

4. Of course, I have read the manual, but it is very short and doesn't mention some things.

4. This is a duplicate question on another post, but I am now ready to start learning about the stats and numbers, which
are now rather confusing to me. Any good book recommendations would help. I read several wonderful articles in the "Learn" section today, but did not one that talked about the basic stats one needs to be aware of. I will invest in a couple of books, but don't have the funds to buy indiscriminately.

Anything else you can offer about this excellent machine would be welcome. I am not the most savvy person tech wise,
but learn fast so thanks for anything you can offer.

Namaste,
MoonBear

MoonBear, I think the Elite only runs in straight cpap, so it doesn't adjust pressure to prevent events. It DOES have exhalation relief, though. PM Uncle_Bob to get the clinician's manual. The data programs aren't specifically designed for Macs, but there are workarounds; try searching the site. Glad to hear things are going well for you with your therapy!

MoonBear wrote:Hi,

I have questions about my s9 Elite auto pap. I had flu and high fever when my husband picked up the machine, and as I am brand new to the therapy, I was hoping someone might be kind enough to answer what are probably easy questions for the pros on this list.

1. I have the machine set to auto 4. I have it on ramp, which I like a lot (which is good 'cause I can't quite figure out how to turn it off yet), and the humidity at a good temperature. As I underestand, the machine adjusts to the right pressure when needed, thereby providing what I need when I need it? My usual horrid waking has turned into a neutral experience and NO headache so even if the pressures aren't just right yet, it's a start.

The S9 Elite is a straight CPAP---once the set pressure is reached after your ramp period, the pressure is constant at the set level. For many people, this is not a problem. If you're "horrid waking" is now "a netural experience" with "NO headache" it sounds to me like the pressure is probably at a pretty good setting for you.

The ramp feature starts the S9 off at a pressure that is lower than your prescribed pressure and "ramps" it up at a fixed rate (depending on the ramp time) until the set (prescribed) pressure is reached. The longer the ramp time, the gentler the increase in pressure is. One note: The S9 won't record apneas/hypopneas during the ramp period.

Whether you can (currently) fiddle with the ramp depends on how the tech set the machine up. In the menu that comes on when you first turn the machine on, there may be three icons in a column at the left of the screen: If one of them looks like a right triangle, that's the ramp setting. That will let you control how long the ramp lasts. If you hit the double check buttons, you should get to all the settings that the tech decided to let you control. There may or may not be a setting for letting you control EPR (exhale pressure relief). Once you have the clinical manual, you'll be able to get into the clinician's mode and set EPR to Patient so that you can adjust the EPR level in the future without the need to go into the clinical menu. Minimum ramp pressure (as opposed to time the ramp runs) seems to only be accessible from the clinical menu.

2. I only got a user's manual and there is no mention of how to manually adjust the pressure. I will be turning in my data card in just a week to my pulminologist so I am hoping I am OK using these first ten days just to be compliant?

Compliant for whom? The pulminologist? Maybe. Your insurance company? Probably not. But don't worry too much about this---the S9 takes a standard (cheap) SD card AND it records the usage (compliance) and summary data for at least 30 days on board even if there's no SD card in the machine. When you put the card back into the machine, the "new" data will be copied to it. If you want all the detailed data for the period when the SD card is not in your possession, buy a 1G or 2G card and stick it in the machine. Note---you want a PLAIN SD card---not the newer HDSD cards.

3. is there software for this machine that will run on a Mac or iPod?

Unfortunately the answer is NO since the medical world seems to have chosen PCs as the standard equipment. However there are some programs that allow you to install (and run) an appropriate version of Windows or a Windows-emulator on your Mac and then you can run ResScan in that environment. The problem that I found with this approach was the need to install the Windows environment/dual boot program AND get a valid WIndows install disk AND then install ResScan. It may be less trouble in the long run to get a decent, well cared for USED PC (laptop or desktop) running Windows XP. The PC can be several years old and hence relatively cheap. As long as the XP operating system is up-to-date, ResScan should install and run pretty easily.

4. Of course, I have read the manual, but it is very short and doesn't mention some things.

4. This is a duplicate question on another post, but I am now ready to start learning about the stats and numbers, which
are now rather confusing to me. Any good book recommendations would help. I read several wonderful articles in the "Learn" section today, but did not one that talked about the basic stats one needs to be aware of. I will invest in a couple of books, but don't have the funds to buy indiscriminately.

I posted a pretty detailed explanation of the various numbers you can get off the S9's LCD and from the ResScan software on another of your threads. PM me if you can't find it. Since I've written that post several times, maybe I should try to get it submited the "Learn" section or as a stickied post.

Anything else you can offer about this excellent machine would be welcome. I am not the most savvy person tech wise,
but learn fast so thanks for anything you can offer.

As a short-term measure until you figure out what you want to do on the computer issue to get more access to the data, I'd suggest keeping a notebook by the bed and writing down the numbers every morning. That will at least let you see trends in the AHI data and the 95% leak data. Since your machine is a staight CPAP, the 95% pressure data will just be a constant---set at your pressure level.

And if you want to eventually look at the detailed data after you get the computer issue sorted out, stick the SD card in an SD card reader and download its contents into a folder on your Mac at least once a week. The S9 starts to overwrite the detailed data at the end of seven days. If you make sure to lock the card before you attach it to your Mac, the S9 will still be happy with the card when you put it back in the S9. And you don't need a special card reader to copy the data to your mac. A standard S9 card reader designed to download digital pictures from an SD card into iPhoto will work just fine. The organization I used for backing up my S9's data is this: I have a folder on the mac called something like ResMed-Data-Files. And in that folder, I create a subfolder labeled by the date of the download. And then I copy the SD card's contents to that subfolder.

robysue, you give the best explanations. Thanks for all you do for the members of this forum!

THANK YOU. What an amazing amount of information. I am grateful, and I am sorry if I am repeating questions. I don't want to waste anyone's time. Maybe my memory isn't very food? Gee, what could that be from?

I just discovered that the machine is not recording data. It said that the machine was not used for the past two nights when, in fact, it has been on all night with the mask on all night both nights.

I admire everyone's tech savvy, and hope to be able to help others in the future as I have been helped. many thanks,

MoonBear

ResMed apparently created some confusion by combining manuals for the S9 Elite (straight CPAP with EPR) and the S9 AutoSet into one manual, with some information inapplicable to the Elite. Lazy documentation.

MoonBear wrote:THANK YOU.

You are most welcome!

I just discovered that the machine is not recording data. It said that the machine was not used for the past two nights when, in fact, it has been on all night with the mask on all night both nights.

I've not had this problem occur to me. But I can think of three possible reasons why data might not be recorded on the SD card, but might still be recorded on the machine's on-board memory.

• The SD card might be locked into the Read only mode. However, if I stick a locked SD card into my S9, I get a warning message that says something along the lines of "SD card is locked. Please remove"
  
  The SD card might not have been fully inserted. The S9 will run without a data card in it. The usage data and the summary data, but not the detailed data, are recorded on board. In my experience, the S9 will then update the SD card when it is inserted in this case.
  
  The SD card might be bad. I'd expect the S9 would give a warning that the card was unreadable. But in any case the usage data and the summary data are supposed to be recorded on board.

But none of these quite match the symptoms you described. When you look at the data on the S9's LCD and switch the time frame from 1 day to 1 week or 1 month, does the S9 still keep the denominator of the fraction (the total days of data for the period) at ONE? If that denominator goes up to two or three days, then you'll know that the summary data and the usage data is indeed still in the machine's on-board memory. But if the 1 week and 1 month data looks just like the 1 day data and that denominator stays at 1, then there does indeed seem to be a problem with whether the machine is actually recording data or not. UNLESS, of course, you accidentally RESET the data while in the clinician's menu---that wipes all the data out sets everything back to 0. I found that out the hard way once when I thought I was merely reformating the SD card in the S9.

Good luck in figuring out what's going on here. Since you're not tech savy, taking the machine back into the DME for a check-up on its recording software may be in order.

Hi,

Yes, it says I have used the machine one day for 7 hours so I am suspecting it's a bad card. Popped out the card and popped it back in tonight so I'll see if there is new data tomorrow. While I investigated the settings, I did not change any as yet. I think I need to drive the hour to the DME when my flu is gone, and sit down, demand my copy of the clinician's manual, and have them go over everything step by step. I am only hoping this won't effect insurance as I know compliance nightly is required. Isn't it ironic? The one thing that I thought would be hardest was compliance, and I had no concerns about data. Still, I consider myself a very, very lucky person to be able to use the mask right out of the box for three straight nights. I feel like I won the lottery. Thanks all.

Namaste,
MoonBear

MoonBear wrote:Hi,

Yes, it says I have used the machine one day for 7 hours so I am suspecting it's a bad card. Popped out the card and popped it back in tonight so I'll see if there is new data tomorrow. While I investigated the settings, I did not change any as yet. I think I need to drive the hour to the DME when my flu is gone, and sit down, demand my copy of the clinician's manual, and have them go over everything step by step.

Good luck. But the DME may very well not give you the clinician's manual or tell you anything about the clinical menu. They may cite vague "regulations" or they may cite "liability" on their part thinking of what you (and most people on this board, including me) would regard as a stupid scenario: They give a patient the clinical menu and carefully show how to change the clinical settings. Patient then does something really super stupid with that knowledge by really messing with either their own settings or another person's settings. Something bad happens that *might* be connected with the change in settings, and the DME gets sued as a result. Highly unlikely? Yes, but that's the whole point of worrying about liability in the first place---to legally deal with the highly unlikely, but monetarily costly situations where you might be held legally at fault.

So get the pdf of the clinician's manual from Uncle_Bob or from http://s7.zetaboards.com/Apnea_Board/pa ... p-manuals/ (where you'll have to have them email it too you.).

I am only hoping this won't effect insurance as I know compliance nightly is required. Isn't it ironic?

Yes, it is ironic. I'd consider contacting the insurance company and letting them know that you are working with the DME concerning a problem with the machine's recording of the compliance data. Also specifically ask how they define "compliance". Many of them pigggy back on Medicate's definition, which I can't remember exactly, but it's something like GREATER THAN 4 hours per night for AT LEAST 20 (or 25?) days out of a 30 day period. Please somebody correct my errors in describing the Medicare definition of compliane!

The one thing that I thought would be hardest was compliance, and I had no concerns about data. Still, I consider myself a very, very lucky person to be able to use the mask right out of the box for three straight nights. I feel like I won the lottery. Thanks all.

Namaste,
MoonBear

I too was really worried about compliance and I still feel like I won the mask lottery since not only have I been able to sleep with the mask right from the start, but also have had really good, low leak rates right from the start.

Good luck