New to this- Husband vpap III 5 days but not taking breaths

HelpMeBreath · Post by **HelpMeBreath** » Wed Feb 27, 2008 2:21 pm

Thats so great. Once again, to those of you who take an active interest in helping us, you're doing a really good thing.

Casiesea · Post by **Casiesea** » Wed Feb 27, 2008 6:53 pm

Ok...we have it! I figured constant harassment would be the best course of action and I was right!

We also have the Quatro FF - thanks banned!

Pressure min 4 max 14 and he says some other number is 5.

dsm · Post by **dsm** » Wed Feb 27, 2008 8:46 pm

Casiesea,

You sound very very pleased (as you should be).

Re the numbers, it is a bit tricky trying to work out what they set the machine to.

It looks like

EEP=5

PSmin=4 (ipap=9 which is EEP+PSmin)
PSmax=14 (max ipap = ipap + 5 = 14)

I think I have it

DSM

Banned · Post by **Banned** » Wed Feb 27, 2008 10:54 pm

Good job Casiesea,

Now is when we slip into the back-room and open a bottle of cheap wine.

To get to the Setup Menu you will hold down the red key and black (up/down) arrow key, concurrently, for three seconds (when hubby is not on the mask). Press 'Enter' and bypass 'Mode ASV'. At 'EEP' you will see an adjustable whole number between 4 and 10 (10 being the lightest pressure to exhale against). Press 'Exit' a couple of times to get back to the top of the Setup menu. Now use the black down arrow key and bypass 'Alarms', 'Results', and 'Options'. At 'Advanced' you will press 'Enter' to get to MIN PS. MIN PS will be an adjustable number between 3 and 6 in .2 increments (Remember, EEP plus MIN PS gives you the starting inspiration pressure). Next you will see MAX PS. Do not touch MAX PS because MIN PS will always set MAX PS automatically, generally 5+cmH2O above MIN PS. Press 'Exit' several times and 'Are You Sure', yes, to leave the Setup Menu. When you get a chance, in the next couple of days, tell us what the numbers are for EEP and MIN PS.

Cheers,

dsm · Post by **dsm** » Thu Feb 28, 2008 1:39 am

Banned wrote:Good job Casiesea,

Now is when we slip into the back-room and open a bottle of cheap wine.

To get to the Setup Menu you will hold down the red key and black (up/down) arrow key, concurrently, for three seconds (when hubby is not on the mask). Press 'Enter' and bypass 'Mode ASV'. At 'EEP' you will see a whole number between 4 and 10 (10 being the lightest pressure to exhale against). Press 'Exit' a couple of times to get back to the top of the Setup menu. Now use the black down arrow key and bypass 'Alarms', 'Results', and 'Options'. At 'Advanced' you will press 'Enter' to get to MIN PS. MIN PS will be an adjustable number between 3 and 6 in .2 increments (Remember, EEP plus MIN PS gives you the starting inspiration pressure). Next you will see MAX PS. Do not touch MAX PS because MIN PS will always set MAX PS automatically, generally 5+cmH2O above MIN PS. Press 'Exit' several times and 'Are You Sure', yes, to leave the Setup Menu. When you get a chance, in the next couple of days, tell us what the numbers are for EEP and MIN PS.

Cheers,

If the #s I posted are correct, they see surprisingly low allowing for the results we were seeing at the start & on the Vpap III.

What do you think ?

Cheers

DSM

Banned · Post by **Banned** » Thu Feb 28, 2008 8:56 am

[/quote]

If the #s I posted are correct, they see surprisingly low allowing for the results we were seeing at the start & on the Vpap III.

What do you think ?

Cheers

DSM[/quote]

I'm a little confused by the numbers Casiesea was told. It's probably unlikely his EEP was set at 5cm. That would be a hard number to exhale against in the Adapt SV (at least for me). Default EEP is 10cm. I'm using 9cm. My guess would be they set his EEP at 10cm and MIN PS at 4cm for a staring inspiration pressure of 14cm. I'm hoping we will know the set EEP and MIN PS when Casiesea has time to take a look.

Banned

Casiesea · Post by **Casiesea** » Thu Feb 28, 2008 9:05 am

EEP 6.0
Min ps 4.0
Max 14.0

Leak 23L/m
Average pressure 8.2
VT 300-695
resp 13-18
mv 4-10

He says he really doesn't feel any different this morning. Still very tired. I watched him until about 2am. He seemed very restless, but he was breathing. It did alarm once or twice.

Casiesea · Post by **Casiesea** » Thu Feb 28, 2008 9:07 am

btw what is up with the cricket in that machine?

Banned · Post by **Banned** » Thu Feb 28, 2008 9:35 am

With an EEP of 6 and a MIN PS of 4.0 his starting inspiration pressure is 10cmH2O. Question, What was the IPAP pressure you were using when your husband was using the VPAP III? That EEP of 6 sounds uncomfortable (at least for me). I suggest we try lightening up on the EEP, but before doing anything we need to know his nominal inspiration pressure from the VPAP III experience, or even the CPAP experience. At minimum, for tonight I would change his EEP to 7 and change his MIN PS to 3.0.

The chirping sound is interesting (sounds like it could be annoying if too loud). My machine sometimes makes a barely audible high pithed chirp (which I can generally ignore). I think it would be the fan, especially if you put your ear by the fan intake in the back of the machine. The question would be how loud is it?

The alarms would generally be the mask seal. They should get better as he gets more comfortable with the Quattro.

Banned

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Casiesea · Post by **Casiesea** » Thu Feb 28, 2008 9:57 am

U mean what was prescribed or what we moved it to? I believe we had moved it to 13.4 /10.4 before it broke. I think the prescription was for 12/8.

R u in Australia too? When do you sleep?

The noise is a bit annoying. We have a white noise machine (from his snoring days) and it helped tremendously! I have been trained to sleep through a lot, but chirping I can't handle!

Casiesea · Post by **Casiesea** » Thu Feb 28, 2008 10:02 am

Should I buy him one of those sleep apnea pillows? Do they help?

Also, I have been investigating Central Sleep Apnea a little. What is the deal with it? Everything I have read so far seems really vague.

Banned · Post by **Banned** » Thu Feb 28, 2008 10:20 am

It's just as i figured gyrl. For tonight I would like you to adjust his EEP to 9. You will also need to adjust his MIN PS to 3. That will bring his starting inspiration pressure (IPAP) back up to 12cmH2O and give him the exhale relief that he needs. Ensure his mask setting is Full Face and run Learn Circuit. I'm sure he will have a much better night. I've never tried the Sleep Apnea pillows as I generally sleep at the edge of the pillow. But, he may like an Apnea pillow, can't hurt. I live in northern California
dsm lives in Australia.

Banned

dsm · Post by **dsm** » Thu Feb 28, 2008 3:49 pm

Casiesea,

I am with banned on this - I agree that EEP of 9 makes more sense based on what you are telling us & what we learned from before.

I also go with PS=3 (it could go to 3.4 or 3.6 in a later trial).

It helps enormously to have someone (banned) who actually uses one of these & can confidently steer us through the set up.

DSM

Casiesea · Post by **Casiesea** » Thu Feb 28, 2008 10:14 pm

Will do.

Have I told you guys how great you are recently?

So the resp therapist from the equipment place called today. She discovered the problem with the VPAP III, seems someone in this household placed 4 pom poms into the humidifier tube. I am assuming that was my 2 yr old...LOL! Little booger must have done it when my husband hooked it up to the computer! I bet they are freaking out about this Adapt we are "borrowing". My husband told me he thought they were going to make him sign for it in blood! They kept reminding him how expensive it was.

Banned · Post by **Banned** » Thu Feb 28, 2008 10:51 pm

That story about the Little booger is funny as hell! dsm would be correct that you would increase hubby's MIN PS to perhaps 3.4 in the next trial, 3.6 in the next, and so on, if needed. My personal feeling is the MIN PS of 3.0 may be a little light, but the Adapt SV should step up and give him whatever pressure he needs, even at that setting. At the original EEP of 6 and MIN PS of 4.0 your husband would have felt like he was back on his old CPAP machine with no C-Flex, A-Flex, or EPR relief. The new setting will give him more normal breathes and should correct his apneas and non-breathing issues even at 12cmH20. I would not recommend ever going below an EEP of 9cmH2O. I'm concerned that your husband makes his peace with the Quattro FF. No mask is perfect, but it is the best one available for this machine. If the machine you are using currently is a loaner, check it for pom poms from previous users. Maybe that is the cricket sound you are hearing. Give us a shout in the am.

Goodnight,

Humidifier