My experience with the Oracle 2

Once upon a time, I was able to use nasal pillow masks and life was wonderful. Then along came a wicked mouth leak that couldn't be tamed, not even with tape. When my mouth really wanted to open, nothing could stop it. So, I switched to using full face masks, but they never fit properly and my average leak rate was always disturbingly high. I lived that way for several years, trying every solution I could think of, but to no avail. Then, two days ago, along came my brand new Oracle 2 mask. I put it on, along with a spirometer nose clip generously provided by JDS74, and had a very difficult first night.

Even with the humidifier turned up all the way, I kept waking up with a very dry mouth and throat. My cheeks puffed so much that they felt stretched out the whole next day. My AHI, which is normally between zero and one, was 5.4. I kept waking up gasping. The mask came out a few times, causing other awakenings. I didn't sleep much, but I stuck with it all night long to see if it would get any easier. In the morning, my nose was sore from the clip. I think it was irritated just enough to allow a skin infection to set in. It's been getting gradually worse since then. This isn't JDS74's fault. The clips he provided really are a lot better than the plugs that come with the Oracle. I'm just going to call it bad luck due to sensitive skin.


I welcome any suggestions for fixing my nose, as long as they don't involve plastic surgery. If it doesn't improve in a day or so, I'm going to the doctor.

As I contemplated the situation in a tired stupor yesterday, an idea emerged from my foggy brain. First, I removed the headgear and tubing from the Oracle mask. Then I cut out a small piece of a plastic bag and put it between the inner and outer flaps, making it impossible to breath through the mask. Then I found a good friend of mine, my old Swift LT. I spent last night with the Swift on my nose and the Oracle acting as a mouth plug. It was the best I've slept in years! I love the Oracle now, just not when used as directed by the manufacturer.

Not sure if this would make sense, but that almost looks like psoriasis on your nose. I have picked up psoriasis in weird spots that get irritated (pierced ears for example.) Psoriasis is an autoimmune disease that you get if you have the gene for it and some triggering event, like trauma. It's possible to have very mild psoriasis and not know it... Is it really sore or more burning/itchy? Psoriasis tends to look a lot uglier than it feels. A yeast infection will be more stinging, and it usually smells kind of funky -- which of course you would be hypersensitive to on your nose.

Good luck, and I love the idea of using the mouth mask as a gag!

Are those pustules/zits? My nares broke out horribly after two days with my brand new pillows, but after washing both the pillows and my nose religiously at bedtime for a couple days they cleared. Painful, yes, but temporary with the right care. I love my pillow now.

Sometimes there are residues from the manufacturing process left on the silicone. Never a bad idea to clean the pillows/mask BEFORE use to prevent irritation...

Mrog

So sorry that the mask didn't work for you.
I always recommend using a nasal mask if you can breathe through your nose and the Oracle if you really can't.
I like your creative solution for mouth leaks.
Sounds as if a trip to the scuba store could get a scuba mouthpiece much cheaper than an Oracle mask

My wife convinced me to go to the doctor this afternoon, so I got checked out. He thinks it's likely a staph infection, but we'll wait for a culture to know for sure. He prescribed a topical antibiotic that's supposed to work really well for staph. If it doesn't work, he'll switch it for an oral antibiotic. He said the infection was likely caused when bacteria entered skin that was made vulnerable by irritation. With the medicine, it'll likely clear up in a few days.

JDS74 wrote:Sounds as if a trip to the scuba store could get a scuba mouthpiece much cheaper than an Oracle mask

I've never tried a scuba mouthpiece. Sounds like a good idea. Since I'm stuck with the Oracle, I may as well use it for now. I'm glad I tried the Oracle. It was a good learning experience.

mrog wrote:My wife convinced me to go to the doctor this afternoon, so I got checked out. He thinks it's likely a staph infection, but we'll wait for a culture to know for sure. He prescribed a topical antibiotic that's supposed to work really well for staph. If it doesn't work, he'll switch it for an oral antibiotic. He said the infection was likely caused when bacteria entered skin that was made vulnerable by irritation. With the medicine, it'll likely clear up in a few days.

Good call. Many people are unaware they're staph carriers, and an outbreak can get out of hand in a hurry. My cousin back east is currently in convalescent care after a nasty infection on his upper thigh required extensive debridement. Best wishes for a swift recovery

If it is a staph infection, you need to dump the nose clip you used. It will be contaminated.

JDS74 wrote:If it is a staph infection, you need to dump the nose clip you used. It will be contaminated.

Or boil the hell out of it.

The tiny pustules and skin crusting are a sign of mild skin pressure necrosis. I had the same problem using the nose clips. Too much pressure over too long a period of time. It resolves without antibiotics but does take time for the skin to recover. I switched back to the nose plugs but realized that I needed to use the largest size which took a little wedging to get into my nose. They then seemed go work great and it has been smooth sailing since then with the Oracle.

There's a trick to using the Oracle. Not everyone can learn how to do it, but it's great if it works.

First, try this experiment. Get a balloon. Put it in your mouth and blow it up. Notice that no air comes out of your nose despite the fact that there's air pressure in your mouth, throat and lungs.

This is because your seal off the back of the nose with the soft palate. Try the balloon experiment again and try to feel what's happening.

Now, put on your Oracle mask and turn on the CPAP without the nose plugs. Imagine you're gently blowing into a balloon and feel your nose seal itself off at the back. Now, sort of "freeze up" and hold that configuration of your mouth and nose. Now, try to gradually relax everything while allowing your soft palate to stay closed. Gradually start inhaling through the mouth.

I find the pressure actually helps hold the palate in place, keeping the air out of my nose.

I was able to fall asleep in this position, allowing me to use the Oracle mask with no nose clips or plugs.

If you can learn to do this, it's got the advantage that there is no air pressure in your nose, which helps with some sinus or eye problems.

RicaLynn wrote:

mrog wrote:My wife convinced me to go to the doctor this afternoon, so I got checked out. He thinks it's likely a staph infection, but we'll wait for a culture to know for sure. He prescribed a topical antibiotic that's supposed to work really well for staph. If it doesn't work, he'll switch it for an oral antibiotic. He said the infection was likely caused when bacteria entered skin that was made vulnerable by irritation. With the medicine, it'll likely clear up in a few days.

Good call. Many people are unaware they're staph carriers, and an outbreak can get out of hand in a hurry. My cousin back east is currently in convalescent care after a nasty infection on his upper thigh required extensive debridement. Best wishes for a swift recovery

It sounds like my case is absolutely trivial compared to your cousin's. With the ointment, it's already starting to clear up. I'm glad I got it treated before it turned into something ugly. Best wishes to your cousin and his family! That sounds painful.

RicaLynn wrote:

JDS74 wrote:If it is a staph infection, you need to dump the nose clip you used. It will be contaminated.

Or boil the hell out of it.

Since the Swift/Oracle combo is still working well, I'll dump the clip. No reason to keep a culture on hand.

photonic wrote:The tiny pustules and skin crusting are a sign of mild skin pressure necrosis. I had the same problem using the nose clips. Too much pressure over too long a period of time. It resolves without antibiotics but does take time for the skin to recover. I switched back to the nose plugs but realized that I needed to use the largest size which took a little wedging to get into my nose. They then seemed go work great and it has been smooth sailing since then with the Oracle.

That's interesting. I'm curious to see what the lab culture shows. If nothing grows, then you're probably right. However, even if it is skin pressure necrosis, it could become infected. I'll keep using the medicine, just to be safe.

The balloon blowing trick always works for me if I feel any air going into my nose. Takes one second to do it and shut off any nasal air flow.