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Lubman wrote:a bit of help with CO2 dead space. Adding a hose and using a mask with a different venting design, isn't a complex change.

Hi Lubman

Adding O2 isn't complex. Making a rebreather out of an Adapt SV by plugging the vent and adding a hose sounds pretty pimped-out. Maybe, that's what our guy needs? PM me if you would like a pdf. of the provider's manual.

Banned

Banned wrote:

Lubman wrote:a bit of help with CO2 dead space. Adding a hose and using a mask with a different venting design, isn't a complex change.

Hi Lubman

Adding O2 isn't complex. Making a rebreather out of an Adapt SV by plugging the vent and adding a hose sounds pretty pimped-out. Maybe, that's what our guy needs? PM me if you would like a pdf. of the provider's manual.

Banned

We were told the following;

1. He has the most complex - complex sleep apnea they have seen.
2. 4/09/08 titration was CPAP only. Titrated pressure of 8 to 13
3. Many specialists have examined results of Feb Adapt titration against April CPAP titration - the opinions are split down the middle. 1/2 say go with CPAP, 1/2 say stay with Adapt. The results are too close to call.
4. His centrals occur after arousals. They are unusual because his brain is getting the signal to breathe but it isn't sending the signal to his diaphram.
5. No prozac, no paxil, and no zyrtec. 2 provigil per day but they won't work if he doesn't take them.
6. Reslink and Rescan order will be sent to DME

They brought in the best minds in the area on this titration. He seems to have them stumped. For now, we have decided to stay with Adapt for 3 more months since he seems to be resting more soundly and his activity level is slowly increasing. We will send her the downloads as soon as we get the software.

I am diligently working on scanning the results, however I am having issues with the scanner. If I don't get it fixed soon, I promise I will go use the neighbors.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, CPAP, DME

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, CPAP, DME

Casiesea, earlier in this thread you mentioned your husband inhaled toxic chemicals while serving in Iraq.

In your above post you mentioned that his central apneas are occurring after awakening. So I have to ask: is there a chance that post traumatic stress may be factoring in his complex SDB pathology and thus unusual presentation?

http://en.wikipedia.org/wiki/Post-traum ... s_disorder
also:
http://www.ncbi.nlm.nih.gov/pubmed/12524572
(note: Dr. Krakow has posted here and continues to research anxiety in relation to SDB)

Sorry, I meant arousals not awakenings. I will change it.

I guess the answer to the PSTD is I don't know. While he was in desert storm, he doesn't really talk about it much. I know two friends in his unit were killed in a helicopter crash.

I have always wondered about gulf war syndrome. He does have some strange symptoms.

Those articles are interesting. I do think he has significant anxiety right now, but its sort of a chicken/egg scenario. It seems a bit better since he stopped taking prozac.

He saw a new GP (lets say GP#2) on Mon. He actually has a heart murmur. New doc has ordered an event monitor and a stress test. GP#2 is a no b.s. kind of doctor. He point blank told hubby to drop 25 lbs, at least 5 by his return visit (1month). LOL. Someone needed to say it (I have but he doesn't hear me).

Casiesea wrote:Sorry, I meant arousals not awakenings. I will change it.

No problema, Casiesea! Those two terms are very easy to transpose.

You're talking to the mister of occidental transportation. Ooops... Meant to say master of accidental transposition. See what I mean? Besides, I'll give a ride to anyone who's nice. As long as they don't mind lost and lost of conversational transpositions.

Casiesea wrote:I do think he has significant anxiety right now, but its sort of a chicken/egg scenario.

I absolutely agree with that. And very many posters on the apnea message boards have first-hand experience with heightened anxiety because of sleep deprivation.


Tell hubby to hang in there!! We're definitely pulling for him and his fiercely devoted RN wife! He's very lucky to have you batting for him.

LOL.

His RN wife is about to permanently plant his grumpy butt in Doc #1's waiting room. Let her ride out the next 3 months with him. JK.

BTW, if his grumpy butt doesn't get home soon he is going to be purchasing a new family printer/scanner. This one is about to fly out the window.

Casiesea wrote: 3. Many specialists have examined results of Feb Adapt titration against April CPAP titration - the opinions are split down the middle. 1/2 say go with CPAP, 1/2 say stay with Adapt. The results are too close to call.

6. Reslink and Rescan order will be sent to DME

For now, we have decided to stay with Adapt for 3 more months since he seems to be resting more soundly and his activity level is slowly increasing. We will send her the downloads as soon as we get the software.

I am diligently working on scanning the results,

Hi Casiesea,

3. Did Doc #1 give you the consensus pressure from the CPAP group? Did she give you the consensus pressures from the ASV group?

6. I'm assuming you are using the standard (Un-Enhanced) version of the Adapt SV at home (since I do not believe the 'Enhanced' version was released at the time he first took took his machine home, and you have not stated you are using the new 'Enhanced' Adapt SV). It's great you are ordering ResLink and Rescan. My only concern is AHI and other good data maybe unavailable in the standard Adapt SV. I maybe wrong, but you may need to ask for the 'Enhanced' Adapt SV for meaningful Rescan data.

Banned

dsm wrote:We had another good and knowledgeable poster here before who needed deadspace (IIRC) and also went on to an Adapt SV (& loved it). That was ChristineQuilts - she sure is missed as she had so many insights to the more complex nature of SV & masks & venting & deadspace needs.

DSM

You're right about christinequilts being a good, knowledgable poster here. She reported the ASV treated her extremely well. Much more effectively than the Synchrony bilevel S/T machine she had been using for several years.

Christine's primary sleep breathing disorder was Central Sleep Apnea. Some obstructives, but predominately CSA.

I don't think Christine was ever prescribed "deadspace" nor was it added to her setup. As far as I know, her AdaptSV was set up in the usual way. Not with any added "deadspace" like Lubman's arrangement.

Even though Christine did not have deadspace in her setup, she was very knowledgable about what deadspace would be used for. Extremely intelligent lady who knows a lot about many of the machines.

So
CPAP mode 13cmH2O?
or
ASV mode EEP 10cmH2O + MIN PS 3 = IPAP 13cmH2O?

Banned

[quote="Banned"]So
CPAP mode 13cmH2O?
or
ASV mode EEP 10cmH2O + MIN PS 3 = IPAP 13cmH2O?

Banned

rested gal wrote:

dsm wrote:We had another good and knowledgeable poster here before who needed deadspace (IIRC) and also went on to an Adapt SV (& loved it). That was ChristineQuilts - she sure is missed as she had so many insights to the more complex nature of SV & masks & venting & deadspace needs.

DSM

You're right about christinequilts being a good, knowledgable poster here. She reported the ASV treated her extremely well. Much more effectively than the Synchrony bilevel S/T machine she had been using for several years.

Christine's primary sleep breathing disorder was Central Sleep Apnea. Some obstructives, but predominately CSA.

I don't think Christine was ever prescribed "deadspace" nor was it added to her setup. As far as I know, her AdaptSV was set up in the usual way. Not with any added "deadspace" like Lubman's arrangement.

Even though Christine did not have deadspace in her setup, she was very knowledgable about what deadspace would be used for. Extremely intelligent lady who knows a lot about many of the machines.

Aha, RG it must have been FrequentSeeker who was up to her eyeballs in deadspace - I think I blended FS's deadspace activity with CQ's knowledge of the Adapt SV (IIRC FS also got fitted up with an AdaptSV).

DSM

FS it was indeed....
O.