bjhunt01 therapy help thread

[bjhunt01]

So I am not misbehaving and keeping settings as is for a data gathering. I am proud of myself because I am miss twidly fidget!
Here is last nights. Waaaaaaa taaaaa daaaaaa!!!!

[Dog Slobber]

Very nice.

Leaks are looking great.

Hows the aerophagia?

When you're ready you want to increase pressure. Had it not been for you aerophagia and mask leaks, I'd suggest setting your minimum to 10, maximum 20 and see where the machines wants to go.

But, that could result in leaks and aerophagia discomfort.

I'm still in favour of moving your minimum to 10, your machine is shooting up to 10 anyway and that's where you're spending the night.

I'd also consider moving the Maximum up a bit and see how you make out. Say 11.

Basically move the maximum up a bit, see how you make out for a few days. If your aerophagia troubles return, stay put or knock it back. If you're concerned about how you'll do on higher pressures, make your changes in the morning and then at bedtime it won't be fresh in your mind to dwell on.

The differences between 10.2 and 11 aren't much.

[zonker]

So I am not misbehaving and keeping settings as is for a data gathering. I am proud of myself because I am miss twidly fidget!
Here is last nights. Waaaaaaa taaaaa daaaaaa!!!!

oh, well, look at you miss twidly fidget!

see what happens when you listen to suggestions?

now, how did you sleep? any aerophagia? other than that one break, were you waking up during the night?

i have many more personal and nosy questions, but that's enough for now.

[zonker]

The differences between 10.2 and 11 aren't much.

laddie, you know i love you. but you and others on this forum say that from time to time. and for some of us, that just isn't true. particularly when we are brand new. at least, i know it was for me.

it was one of my biggest stumbling blocks in the early going. i know it was down to aerophagia, but even as i was adapting, that was a pretty big jump.

not lecturing, mind you.

just sayin'!

[djams]

Re: establishment of a new minimum pressure - would that minimum be going lower or higher with normal Autoset?

It is the "For Her" mode that sets a new (higher) minimum pressure. Here's the info from the clinical guide:

AutoSet for Her mode

AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:

• Reduced rate of pressure increments designed to help prevent arousals.

• Slower pressure decays.

• Treats apneas up to 12 cm H2O and continues to respond to flow limitation and snore up to 20 cm H2O.

• Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:

If two apneas occur within a minute, the pressure reached in response to the second apnea will become the new minimum treatment pressure until the next treatment session.

So I have a question based on reading this. SInce I am an easily awakened person, and this says "......designed to prevent arousals" can you help me understand your suggestion to go to the straight AutoSet? I are cornfused!

Here's my point. At you present pressure settings (max 10.2):

Using Autoset For Her mode, your pressure jumps straight up to 10.2 and stays there all night.
Using Autoset mode, your pressure will jump straight to 10.2 and stay there all night.

In order to get the benefits of the auto adjusting algorithms, you're going to have to increase pressures - It's OK to do this slowly, and do it when you're ready. I did it slowly. Tried to make a big jump and it didn't work out. Aerophagia, just like you. Eventually got my min to 12 and my max to 20. This was back in the early FFM days.

Here is my point(finally )So, while idling and gathering data, why not also switch over to Autoset mode so we can see if there's any significant difference in your flow rate chart?

Look at your pressure chart from last night - in order to get the benefits of the gentler pressure changes offered by the "for her" mode, you first have to *have* pressure changes.

And speaking of last night's chart, super-duper job on the leaks!!! No leaks in the second half of the night makes me think that your tape did not break down. Did you do anything differently?

[bjhunt01]

Thank you all!!!

Wow! When you all finish duking it out - maybe add a Pugsy recommendation too - let me know!!!! Those are a lot of changes and not in agreement!!! Although there is general concurrence to raise both the minimum and maximum. Also not in line with make no changes and collect data a few more nights. But I shall ponder them and figure out what my instincts say as to what changes, to what degree, and when.

Let me see if I can answer all the questions:

1.Yes I had some mild aerophagia - both ends if you care and if it matters.
2.Yes I did not have any tape disconnects - I LOVE the blue tape! Also have a slightly new technique for applying it.
3.Yes I did do some things differently - merely out of exasperation: I didn't put on the winter cap that keeps the Scunci's
from slipping (so they slipped a little) and I didn't wear the neck collar. Hating that after several nights. I was kind of hoping the blue tape would do the trick and I could ditch the collar. Maybe I can.
4. Another thing I did differently was apply the ports slightly differently so that they are more parallel rather than slightly angled. Been trying to get this right all along. Had them just right last night.
5. I slept very well. Just up once to use restroom. But I didn't get enough sleep so I am tired. ONE MORE TIME, tonight I am trying to get into bed and actually asleep by 11:00 and see how that goes and if I feel less tired.
6. OH! Here's a change I made. By accident, but kept it going. I'd been taking 6 mg. of melatonin, 1 mg. clonazepam, and an antihistamine to knock me out because I can stay awake a long time. I ran out of melatonin about 4 nights ago. The first night without it seemed to go ok, surprisingly, so the next 3 nights I went without it as well. I am of the mind of the fewer drugs the better if they aren't needed.

If I forgot anything, let me know! You all are the best! Barbara

[djams]

Wow! When you all finish duking it out

I am very much in agreement with DogSlobber's suggestion, for the record.

It just depends on how bad the aerophagia is for you.

I'm believe Pugsy takes a hiatus from the forum every year at this time. The nerve of that woman. about a week she'll be back.

You're stuck with us until then

[Dog Slobber]

The differences between 10.2 and 11 aren't much.

laddie, you know i love you. but you and others on this forum say that from time to time. and for some of us, that just isn't true. particularly when we are brand new. at least, i know it was for me.

Point taken.

An extra CM of pressure for me, at my current pressure and my experience means nothing, but I can't apply that to others. Thanks for the gentle reminder.

1.Yes I had some mild aerophagia - both ends if you care and if it matters.
2.Yes I did not have any tape disconnects - I LOVE the blue tape! Also have a slightly new technique for applying it.

Hopefully, we have the leak taken care of. So know it's aerophagia and therapy.

More pressure (min and max) will likely improve your AHI and Flow Limitations. It's just a question of how much pressure and how soon.

The best way to determine that is with experimentation.

Increase Min and Max in gentle increments, wait a few days, watch your graphs and see how you feel.

[Pugsy]

I am still hanging around but not as active. Grandson is here for a visit.
I post as I have time or as needed.

The choice of regular apap mode or the for her apap mode....I doubt seriously that if the same settings are used that the pressure changes will be all that different from what we are seeing now in the for Her mode. The machine pretty much goes up to the max setting and stays there for the FLs.
Do the FLs need to be killed off with more pressure? Maybe.... but not at the expense of the aerophagia monster setting up house again.

You have a maybe evil and a for sure evil....I take the maybe evil any day of the week.

The "gentler" changes touted by the for Her mode really aren't coming much into play here right now because the machine pretty much goes up to max and stays there...it's not really changing once it does that.
Would there be more up and down with the pressure in regular apap mode......dunno. Maybe and then maybe not because of the FLs.
They are still going to be ugly in regular mode.

I still say work on one thing at a time....leaks and sleep quality because of fixing leaks from whatever the cause....takes precedence over more pressure to kill FLs IMHO. If a person isn't sleeping so good because of wake ups from leaks or mouth breathing or mask comfort....it doesn't really matter much what the pressure may or may not do in an attempt to kill of FLs that may or may not be causing a problem worse than the aerophagia monster will cause.

[zonker]

Thank you all!!!

Wow! When you all finish duking it out - maybe add a Pugsy recommendation too - let me know!!!!

now, now. please don't get us wrong. the number one thing we love to do is help newbies. the second thing we love to do is disagree among ourselves about that help!

seriously, there are a very few people on this forum that i wouldn't give the time of day to. but dogslobber and djams are never in that category. i was just trying to say that sometimes a newbie can be scared of making changes too fast. it's not a matter of right or wrong. it's just a difference of degree.

in the end, i fully expect you (or any other newbie) to try ALL the things and find out what is right for you.

i predict that, sometime in the near future, YOU are going to be one of those people here, giving out advice based on your own experience. so i guess you better get busy getting that experience, huh?

[zonker]

The differences between 10.2 and 11 aren't much.

laddie, you know i love you. but you and others on this forum say that from time to time. and for some of us, that just isn't true. particularly when we are brand new. at least, i know it was for me.

Point taken.

An extra CM of pressure for me, at my current pressure and my experience means nothing, but I can't apply that to others. Thanks for the gentle reminder.

well, now, THAT'S not right.

aren't you supposed to flame me for being such a bully?

<sigh> guess i'll have to try harder next time.

[Okie bipap]

aren't you supposed to flame me for being such a bully?

Why do you have to bully people all the time? Are you just trying to make your self feel more important? Or are you just so insecure you bully others in order to build yourself up.

Now you got chewed out for being a bully. Do you feel better now?

[bjhunt01]

Ok you gang of nutty people: You all are better than Comedy Central

First of all thank you for telling me Pugsy takes a break. I noticed her absence and was concerned and about to ask. And I'm happy to hear you Pugsy are having a visit from your Grandson. I have 2 and I think they are so much fun.

So here is what I did last night and I'm so bummed about this ugly graph, especially since I thought the one the night before was a work of art and a thing of beauty:

I raised my minimum from 6.8 to 7
I raised my maximum from 10.2 to 10.4
Stayed with For Her for now
Well taped, no cervical collar because I did so well without one the night before, put my winter cap back on to keep Scuncis in place.

I got an ugly graph. Except for the centrals at the going to sleep beginning, being awake from 2:30 to about 4 (so that's why the Centrals and other uglies) and getting up to use the restroom at 9,
all the obstructives, hypopneas, RERA's, and a central occurred between 10.32 to 10.38. A few RERA's in the beginning were at 10.4.

A little leaking. A little aerophagia.

I was hoping to feel so good by going to bed a few hours earlier than usual. Just before midnight. But then I was awake in the middle of the night for 1.5 hours.

I am incredibly tired. Have been all week, lacking my usual energy. So tired that I went back to sleep for 2 more hours without the mask after I turned the machine off at 11:19 a.m. Woke up about 1:15 p.m. I'm still really tired. My brain feels yukky. While I was asleep it seems like I was dead asleep. I don't recall wakeups. I feel like I could sleep for 2 more hours.

Go back to 10.2? Stay with new pressures and press on? Throw mask, machine at wall and sleep in an upright recliner the rest of my life?

[Dog Slobber]

Don't get discouraged by that one night, and it's not that bad.

That huge cluster between 2:30 and 3:45, it looks like you were wide awake. Again from 9:00 - 9:45, looks like you were awake again. That looks like a whole huge of SWJ

Now disregard that and look how great you did from 11:30 - 2:30 and 4:00 - 8:30. Focus on the positive, remember we are volatile meatbags at the end of a hose [ * ], and not to focus on a single night.

Your settings of 7.0 - 10.4 are not wildly different then 6.8 - 10.2, resist you urge to tinker, and watch it for a few days looking and feeling for trends.

[ * ] Attribution: palerider

[zonker]

aren't you supposed to flame me for being such a bully?

Why do you have to bully people all the time? Are you just trying to make your self feel more important? Or are you just so insecure you bully others in order to build yourself up.

Now you got chewed out for being a bully. Do you feel better now?

pardon me, i have to go start an OT thread and see how long it takes to get it shut down.