Love RespCare Hybrid but ASV doesn't???

palerider wrote:do you have any way to measure the size of the holes?

caliper, small tool. they should be under 2mm in diameter. (at least, on mine they are)

Each of the six ports comfortably accepts a Torx T5 tip.

Nate

CORRECTION - They also accept a Torx T6 (That one was out of order in my set) but it doesn't slip through as deeply.

I notice your IPAP range goes pretty high (23). Could higher pressure be related to the leak rate on that mask?
Is there any way to see what happens to your AA valve at higher pressures?

When I cover two of the ports and get the Green Happy Face, could Mr. Happy be simply telling me that he's adding some mysterious little leak elsewhere that I can't find to ResMed's required anti-asphyxiation number and he's cool with that?

In other words, is he saying that I'm protected with just 4 ports open because he's counting that other mysterious invisible leak into the safety calculation? And that, considering the invisible leak elsewhere, he doesn't want all 6 ports open because it prevents effective therapy, as demonstrated in my charts above?

Nate

chunkyfrog wrote:I notice your IPAP range goes pretty high (23). Could higher pressure be related to the leak rate on that mask?
Is there any way to see what happens to your AA valve at higher pressures?

I'm open to trying that, chunky.
How would I try that?
Or can that info be deduced or interpreted from my the SH charts posted above where the LLs are through the roof?

Best wishes, Nate

It probably doesn't make much difference but you do have your machine set for full face mask with that mask?

A mirror?
That's how I deduced my flapper was hung up on the flexifit 431.

squid13 wrote:It probably doesn't make much difference but you do have your machine set for full face mask with that mask?

Yes, each time I attach the Hybrid to my S9 VPAP, I set the mask setting to FFM.

Thanks,

Nate

NateS wrote:

palerider wrote:do you have any way to measure the size of the holes?

caliper, small tool. they should be under 2mm in diameter. (at least, on mine they are)

Each of the six ports comfortably accepts a Torx T5 tip.

Nate

CORRECTION - They also accept a Torx T6 (That one was out of order in my set) but it doesn't slip through as deeply.

the ones on my mask fit the end of a t6 with a tiny bit of play, but a t7 won't quite fit.

I'm tempted to say try taping off two of the holes and see what happens. (I'd do it if it were me) because there's plenty of venting happening with the other holes and whatever other leaks there are. ... I'm certainly not *advising* that you do this though. I don't want anything to happen to you!

chunkyfrog wrote:A mirror?
That's how I deduced my flapper was hung up on the flexifit 431.

I'd wondered, putting finger over the aa ports and seeing if there was any air, but, I figured he'd already done that...

chunkyfrog wrote:A mirror?
That's how I deduced my flapper was hung up on the flexifit 431.

I think I will have to ask Karen to serve as my "mirror" - need another pair of hands and/or another set of eyeballs.

Will report back.

I'm pretty sure that the Mask Fit feature runs the machine at full pressure as a leak check.

Nate

The Innomed rep should send you a new shell to eliminate the possibility that the vent ports are too large by whatever mystery.

Then if the problem still exists, I have no idea what to say. The exhaust profile (pressure/vent curve graph) of the Hybrid looks very similar to some of the ResMed FFMs. That would seem to indicate that the Hybrid would work with S9 VPAP.

I will second the idea of blocking off 2 of the vent holes, but will add that for your safety some controls will be needed. Set an alarm for 3 or 4 hours after you go to bed. This will wake you up and then you can do a quick assessment to see if you are alive or not...

An alternative suggestion would be to take a nap while under observation. If you wake up refreshed you may be getting enough fresh air to avoid re-breathing. If the air in your mask is not being cleared out with fresh air you should develop a headache and end up highly anxious. The data seems to indicate that you could block off a couple of the vents without problems but understand this has risk associated with it. It would be much better to get another mask and see if the holes are smaller.

Another thing you can consider, and this has much less risk, is to pull the cushion off, and using plastic wrap and tape, seal off the opening. Next get a kitchen trash bag and note its size (ie 30 gallon). 30 gallons is about 114 liters. You can then seal the mask inside the collapsed trash bag, turn the machine on, and time how long it takes to inflate the bag. Since only the vents are allowing air to flow because the rest of the mask is sealed up, you can come up with a rough estimate of the air flow through the vents per unit of time.

Next you need to find the specifications for the mask. If your rough measurement is similar to the specification, you will have to look elsewhere for your leak issue. On the other hand if your rough measurement is 33% higher than the specification, blocking 2 of the 6 vent holes will bring you back to the original specification and you will have discovered that the excess leak is through the vent hole size and not from the fit to your hairy face.

HoseCrusher wrote:Another thing you can consider, and this has much less risk, is to pull the cushion off, and using plastic wrap and tape, seal off the opening. Next get a kitchen trash bag and note its size (ie 30 gallon). 30 gallons is about 114 liters. You can then seal the mask inside the collapsed trash bag, turn the machine on, and time how long it takes to inflate the bag. Since only the vents are allowing air to flow because the rest of the mask is sealed up, you can come up with a rough estimate of the air flow through the vents per unit of time.

Next you need to find the specifications for the mask. If your rough measurement is similar to the specification, you will have to look elsewhere for your leak issue. On the other hand if your rough measurement is 33% higher than the specification, blocking 2 of the 6 vent holes will bring you back to the original specification and you will have discovered that the excess leak is through the vent hole size and not from the fit to your hairy face.

Okay, had a detailed conversation with the InnoMed rep today, both by phone, email and texting. Here is what he had to say after reading my email(s), studying my charts, and getting some additional commentary from me:

1) He claims/said that if the readings I am getting with the Hybrid are as shown in the chart I sent him, to-wit: Leak Rate at 95% = 144.00, there is "no way" that could be an accurate leak reading; that if I actually had a leak that powerful that the mask would either fly off my face (perhaps a bit of hyperbole) or it would produce a rush of air so great that there is no way I could miss feeling and finding it around the mask perimeters and/or nasal inputs;

2) He told me that he and their engineers report that InnoMed is getting "a slew" of complaints coming in all across their mask line from people attaching their masks to the new ResMed AirSense 10 machines, which has raised a question in their minds as to whether the new AirSense 10 machines have been programmed to work optimally only with ResMed masks;

3) He acknowledges the fact that my machine is NOT an AirSense 10 but an S9 ResMed VPAP Adapt furnished to me in December of 2011, but he calls my model the "former Cadillac of the ResMed line" and that it comprised such a tiny percentage of ResMed S9 machines attached to InnoMed masks that, carrying the above hypothesis backward, such a "mask exclusivity feature" could have been first introduced on their "top of their line" S9 ResMed VPAP Adapt without producing a user complaint to InnoMed or that such a complaint could have been misattributed to some other source at the time, since it would have been so rare.

4) He then asked me by followup SMS:

"Is there a way that you can do the mask test with another mask and then use the hybrid with out doing the test? See if the report differs. I am curious as to the algorithm in the mask test and how it is manipulating results."

It so happened that I had done something very similar last night after signing off from cpaptalk and going to bed:
I had taken out my ResMed AirFit F10 which I had tried for over a month to use, as reported in another thread, without constant intolerable leaks and, for the first time, last night, I ran it through ResMed's "Mask Fit" test and, amazingly I got a Green Happy Face and so I slept with the AirFit F10 without any large leaks all through the night! If you cut off the "hump" starting around 3:30AM (Really 4:30AM EDT) where my nose started to itch (one of the disadvantages of the F10), this is a pretty good "under the red line" leak chart for me:



Then, this morning, I hooked up my InnoMed Hybrid and ran it through the 3 minute Mask Fit on the VPAP and got a continuous Red Angy Face and could not reproduce the experience of making the Green Happy Face appear no matter how well I covered those two port holes with my finger!

Needless to say, he felt this experience added support to the tentative theory of their engineers and will be back to discussing it with them.

I don't know whether to buy this theory or not and I am surely not qualified to do so, and he promised to get back to me after conferring further with their engineers, but what I think I understood him to say is that ResMed machines do not merely tell the user when the mask fit needs to be adjusted, but that they also adjust the machine's tolerances between accepting and rejecting the fit of the mask, and that it is the latter part of the algorithm which could have left ResMed room to play with the machine's acceptance of non-ResMed masks, pointing out that ResMed sells a competing hybrid mask, which is less popular but more expensive.

(In my mind, sort of reminiscent of the recent Green Mountain - Keurig II fiasco.
http://arstechnica.com/gadgets/2014/03/ ... -lockdown/
and
http://arstechnica.com/tech-policy/2015 ... -java-drm/)

I am not in a position to judge this theory and welcome input from my colleagues here on cpaptalk as to whether this is pure malarkey or has some substance.

Regards, Nate

Nate, I don't think I buy it. The machine doesn't know what mask is on the end of the hose. It only knows that you've told it what type of mask (I.e., Full Face, nasal etc,) and is therefore expecting a certain vent rate typical for that type of ResMed mask. But, we've already established the hybrid vent rate is close to typical for a ResMed FFM. Now, it's possible there is some elaborate electronics and algorithms in place to determine the brand of mask on the end of the hose, but I really doubt it.
I contend that if you get a flow rate on the end of the hose that is close to the expected vent rate as selected by the mask setting you will get a happy face. You can test this, and I will too, by placing just your hand over the end of the hose in "mask fit" and adjusting your fingers to control the exhaust to see if you can get a Happy Face.
Off to try it!