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Slinky wrote:. . . there was NO MENTION of ANY SETTINGS except IPAP and EPAP on my bi-level script. I wonder if my sleep doc would even have a clue if I asked about them and adjusting them? . . . .

I think it would be rare that a sleep doc would know anything much about machine settings. Such doctors exist, I'm sure, but I would think them to be the exception to the rule.

A sleep doc mostly just looks (well, hopefully, he actually looks ) at the sleep-study data a PSG tech has collected and then the doc writes a scrip based on the recommendation from the tech as to treatment pressures, and maybe a ramp setting. I think the rest of the settings are often left up to treatment techs.

The medical industry isn't ready to deal with OSA patients that make their own adjustments, but there is no provision for the docs and techs to have the time to fiddle with the adjustments for us either. Add CPOD to the mix, and a relatively new technology, like the VPAP Auto, and it gets complicated very quickly as to figuring out how best someone can be helped.

A hospital RT who was willing to read the VPAP Auto clinician's manual and then to pass on some general guidelines/principles "off the record" might be the best an OSA patient with mild CPOD who is making her own adjustments could hope for.

Ahhh, jnk! My thoughts for quite some time now!!! IF ONLY the freaking medical profession would loosen up and give xPAP patients access to the good RPSGTs and knowledgeable RTs (never thought of a hospital RT!!! duh! - and to think I gave up volunteering at our local hosptial due to gas prices .... DUMB!)

By the way, at Pressure Support of 4 the ResScan graphs showed an upper limit of 11 cms pressure being reached and restricted from going any higher (despite the 13 cms IPAP setting).

IPAP 13, EPAP 7 and Pressure Support of 3 has allowed more flexibility and a restricted upper limit of 11.40 cms of pressure. Unfortunately, its been difficult to ascertain its effect on the AHI 'cause that change was made whilst recouperating from a COPD exacerbation and possibly too soon after finishing the Levaquin. And it was before adding the ResLink and oximeter.

Now, adding the 2L of 02 after all this while and going to straight bi-level, its going to be like starting all over again experimenting w/the results. *sigh* One slow week at a time. *sigh* Have I ever mentioned I'm not the most patient patient?? Ah well, c'est le vie.

It just ticks me off!!! We've got all this data available and NO ONE w/enough sense and knowledge to really make use of it!!! (Well, no one in the medical profession we have access to). And then "they" wonder why I get so exaspirated w/the medical profession and have so little respect for many in the medical profession!!!!

If the d*mn sleep doctors would loosen up and consult w/the RPSGT or RT who acutally KNOW the capabilities and options of the various xPAPs BEFORE scripting xPAP therapy or making changes to xPAP therapy or better yet, stay the h*ll in the background and let the patient consult w/those RPSGTs and/or RTs ......

Okay. Rant over and done with - for now.

Slinky wrote:
It just ticks me off!!! We've got all this data available and NO ONE w/enough sense and knowledge to really make use of it!!! (Well, no one in the medical profession we have access to). And then "they" wonder why I get so exaspirated w/the medical profession and have so little respect for many in the medical profession!!!!

If the d*mn sleep doctors would loosen up and consult w/the RPSGT or RT who acutally KNOW the capabilities and options of the various xPAPs BEFORE scripting xPAP therapy or making changes to xPAP therapy or better yet, stay the h*ll in the background and let the patient consult w/those RPSGTs and/or RTs ......

Okay. Rant over and done with - for now.

.....YUP,kinda like the old adage---->Treated Like a Mushroom"keep us in the dark & feed us crap".....that just makes the medical folks that DO work with us, share info & include us in our quest for the same goal (preventive medicine)are that much more special ....the same reason, that we who ARE concerned with our therapy, keep coming back here day after day to learn what we can to help improve it * tim

You are likely in a spontaneous mode. Only "timed" and "spontaneous timed" modes use inspiratory times (TI). Keep seeing physicians until your night breathing issues are addressed. Not being able to breathe while lying down often indicates cardiac troubles but having nighttime breathing issues can indicate pulmonary trouble. Obviously there may be a combination of the two. If your doctor is not going to address the issue see someone else and bring all of your information (PFT results too!) and get another opinion. I'm assuming you've seen a pulmonologist.

I hope you feel better soon!

Thanks, RTeacher. I was doing just fine in Auto mode. But my local sleep doc decided a month at Auto was enough and switched me to Spontaneous mode. And, yup, it is in Spontaneous mode that I've run into the problems w/the "puff" between inhalation and exhalation. I was somewhat reluctant to play around w/settings I don't quite understand - yet - despite having the Clinician's Manual and the software.

I've just said to h*ll w/them all, put her back in Auto mode and I'm doing well. Whether I could be doing better or not I don't know.