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I have been trying to lose weight for a long time to no avail. I'm gonna see if I can get a prescription for ozempic, as I know how critical it is to lose weight.

Anything else that may be helpful to increase my ERV? Are those lung function training machines on Amazon useful for this purpose?

The problem is the abdominal contents are pushed upwards. The diaphragm, when relaxed, is forced upwards causing the reduction in FRC (really the ERV, RV stays the same. Otherwise your lung would be a liver as all the alveoli disappear). Can the diaphragm be "toned" like abs and glutes? Don't know, but I guess if that thing is cheap it can't hurt.

Besides decreasing ERV, squashing your lungs up there also makes obstructions themselves worse (I think David White studied this. Will browse later); as you guys alluded to on TOF desats are worse because of the reduction in plant gain (FRC); and again, your ERV when supine is MUCH worse than when you did the PFT (sitting or standing).

Rubicon, I'm learning a lot from your posts in this thread. Thank you! I wonder whether you can give the OP some questions to pose to the doctor when the appointment eventually comes. I know from the experiences of friends that it can be especially hard to engage fruitfully with the medical people if you're obese, or border-line as the OP is.

That is a very thoughtful and helpful question, thank you Miss Emerita.

It seems like w/ the low ERV and high BMI my situation may be qualified as "Obesity Hypoventilation Syndrome (OHS)", is that right?

According to the Resmed Sleep Lab Titration Guide, OHS is an indication for iVAPS therapy. Would that potentially be helpful in my situation? Is this something I should bring up with my pulmonologist? It also seems to indicate higher pressure support, but I had set mine to 8 and found no benefit compared to 5 and actually a minimal increase in CAs.

For weight-loss, does anyone know if a pulmonologist would be able to help prescribe Ozempic?

YouTakeMyBreathAway wrote: ↑

Sat Apr 15, 2023 4:35 pm

It seems like w/ the low ERV and high BMI my situation may be qualified as "Obesity Hypoventilation Syndrome (OHS)", is that right?

Yeah probably. From TOF you stated your HCO3- is ~30 meq, by H-H that makes your pCO2 ~50 mmHg and that gets you into the club. However, you need an ABG to get that confirmed and solidify the diagnosis.

According to the Resmed Sleep Lab Titration Guide, OHS is an indication for iVAPS therapy. Would that potentially be helpful in my situation? Is this something I should bring up with my pulmonologist? It also seems to indicate higher pressure support, but I had set mine to 8 and found no benefit compared to 5 and actually a minimal increase in CAs.

Sleeprider wrote:You're dial-winging.

I can't believe that boy is using my expressions.

For weight-loss, does anyone know if a pulmonologist would be able to help prescribe Ozempic?

A better approach is just put the MF fork down.

Just a point in the continuum, but:

Rubicon wrote: ↑

Sun Apr 16, 2023 3:42 am

Just a point in the continuum, but:

What do you mean w/ this?

Rubicon wrote: ↑

Sun Apr 16, 2023 3:32 am

A better approach is just put the MF fork down.

I used to believe that eating less was the key to losing weight, but I've come to realize that it doesn't work for everyone.

For some people, cutting back on calories can be an effective way to shed pounds. But for others, it can be really tough to stick to a low-calorie diet, and it might even backfire by slowing down their metabolism or causing binge eating.

There are many different factors that can influence weight loss, like genetics, hormones, sleep, stress, and activity level. So what works for one person may not work for another.

Rubicon wrote: ↑

Sun Apr 16, 2023 3:42 am

You're dial-winging.

Any suggestion on what my next step should be?

So it's Monthly Support Group, and the guest presenter is one of the ladies from Nutritional Support. Because managing weight is a critical component for most patients with OSA, I included this presentation on an annual basis.

Anyway, she begins her talk with a question.

"Which diets work?" she asked.

Attendees look around, not sure what to answer. After a bit, I sticks my paw up in the air, she nods at The Rubicon and I respond:

"All of them."

Weight control is a simple formula. You run a 500 calorie deficit per day and you'll lose a pound per week. That's a fact. It's like throwing a log on the fire. After a period of time it is consumed. If the engine is running it burns fuel.

Now admittedly I had a 30K metabolic cart to do RMRs, but we'll get back to that in a bit...

Oh right, the histogram. What medications were you taking at the time of the study?

I found this to be an interesting discussion of calories and weight:

https://www.health.harvard.edu/staying- ... g-calories

Miss Emerita wrote: ↑

Sun Apr 16, 2023 5:26 pm

I found this to be an interesting discussion of calories and weight:

https://www.health.harvard.edu/staying- ... g-calories

The most important word in the article:

Lifestyle.

Gonna need this too:

But I do take issue with some of Dr. Cody's stuff:

Dr. Cody's (controversial) appointment comes as the US remains one of the fattest countries in the world, according to a new report.

‘The number one cause of obesity is genetics,' Dr. Cody said.

Hah?

So when you move from one country to another, your genetics change?

Rubicon wrote: ↑

Sun Apr 16, 2023 3:39 pm

Weight control is a simple formula. You run a 500 calorie deficit per day and you'll lose a pound per week. That's a fact. It's like throwing a log on the fire. After a period of time it is consumed. If the engine is running it burns fuel.

Probably not worth discussing, but I do want to say: While it's true that creating a calorie deficit can help with weight loss, it's important to note that the body's response to calorie restriction can be complex and variable. When the body is in a calorie deficit, it may reduce its calorie requirements, making it more difficult to lose weight through calorie restriction alone. This response can differ between individuals, and some people may have a harder time losing weight than others, even if they are following a similar calorie-restricted diet.