CL2 just not fitting well

mtsarpilot · Post by **mtsarpilot** » Fri Aug 18, 2006 5:36 am

Got my new CL2 yesterday and was excited to try it out. I ordered the Nasal Pillow and Simple Cushion in M/L. My DME gave me a large Direct Interface to try as well.

Very quickly the excitement turned to frustration. My nares are pretty ovalized and elongated, and the bottom of my nose is quite flat in respect to my face (90 degree angle, not angled up). The Nasal Pillows would not seal no matter what I tried. They seem more rounded, and come in at an angle instead of flat under my nose. I did the fishing line trick which really helped the approach angle. Now at least they can make a seal, but I have to tighten the vertical adjustment pertty tight to get that seal.

Although frustrated, I went to sleep with the Nasal Pillows. 2 hours into the night I woke up with it outright hurting because of how tight I had to make the vertical adjustment. I had to take them off.

I switched to the Simple Cushion. To get it to seal I have to change the angular adjustment so that it pushes the cushion against my face. It can't just rest their, it has to be somehwat tight to make a seal. I slept the rest of the night with the Simple Cushion and it seemed to work OK.

I'm pretty sleepy this morning, indicating it was not the best night's sleep.

The Direct Seal is not offering much more promise than the Nasal Pillows as it does not seem to make a good seal in my ovalized nares and the same approach angle issues (have not put fishing line on it yet).

Anyone got any more suggestions? For those that the CL2 fits well, are you able to have the vertical adjustment such that the Nasal Pillows rest lightly into the nose or do you have to tighten them upwards pretty hard to make a seal?

Thanks for any advise,

Joel

oldgearhead · Post by **oldgearhead** » Fri Aug 18, 2006 5:47 am

1) Nasal Pillows - yes the fishing line will allow you to flatten the angle. However, I now use two garbage bag/bread wrapper tyes. The kind that are made out of a piece of wire covered with paper. Just fasten one on each of the corner anchors (spot where the stainless steel adjustment piece fits over the plastic stud). Then twist them together in front of the tube to adjust the desired angle.

2) Direct Seal - Use either a 'panty hose' strap, or a small chin strap to tie around your head and the front of the direct seal. This should pull the direct seal tighter against your face..

Good Luck,
OGH

lferrel · Post by **lferrel** » Fri Aug 18, 2006 5:02 pm

Hi,

The CL2 works well for me. I tend to use the direct seal almost all the time. Before I got the Direct Seal, I used the nasal pillows.

I find what works best for me is to screw out the vertical adjustment before putting the mask on. I get it situated right, turn on the BIPAP and then gently screw in the vertical adjustment to where it just barely forms the seal. To tight, and it will hurt your nares. Plus, the seal is not nearly as good as when it is barely seated.

Lowell

linda b · Post by **linda b** » Fri Aug 18, 2006 7:42 pm

I also use and very much like the CL2. I've been using the simple cushion. I just could never get used to the nasal pillows. I used the pantyhose fix for quite awhile until I made my own extra strap out of 1/2" wide elastic covered in fleece and with velcro on each end to stick onto the headgear just above the ears. Yes, you do have to have the simple cushion pretty snug against your face, but I have found that after about 10 minutes, I don't even realize it is there. The amount of air pressure you have to use may also make a difference in how 'tight' you need to have it. My advice is don't give up. It is really a very good interface.

puffing billy · Post by **puffing billy** » Sat Aug 19, 2006 12:10 am

If you still have problems try the Breeze, especially if you are a side sleeper, as the adjustments you make remain. Also the Breeze has a range of cushions that you can try.
I have a CL2 mask which have given up on.

Billy

Missy · Post by **Missy** » Sat Aug 19, 2006 5:49 am

I , also, use the CL2. I started with the pillows, but am now sold on the direct seal. The trick for me was to have the headgear comfortable, lay down, then use the adjustment to get the interface into the nostrils just until there was a seal. I sleep on my side, so I turned on my side, fine tuned the adjustment and then got up and made a mark on the plastic as to where I found it most comfortable. Also, I put a thin film of chap stick on my nostrils to help with the tenderness until I got them "toughened up". Hope this helps.