Interpreting My Report--Snoredog or Slinky--or anyone else..

Nunna my bidness, but I gotta ask:

My question is, wouldn't it be good for Slinky's doc and RT to look closely at the manual for the machine she is using, in case one or both have suggestions on how she might be benefitted by that machine beyond the treatment of OSA, even if the COPD isn't that advanced? Or is that too far outside the medical boxes to even contemplate?

If a COPD patient with OSA is already sleeping next to what is basically a ventilator every night (a bilevel with timed max and min and the ability to have a set constant gap between ipap and epap), isn't it a shame it isn't being used overnight as one, regardless of the severity of the COPD and whether that is standard practice or not? I wonder if the pulmonologist has even thought about the fact that the machine is sitting there capable of doing what it can do? True, it might not really "treat" anything at this point, but couldn't it still increase quality of life by increasing daytime energy levels, in that it would ensure the lungs get well-filled at night without a lot of extra work being done by the diaphragm?

I'm not offended if the answer is "no, that's silly." I KNOW I don't know what I'm talking about. But I'll hijack any thread going if I think it could possibly help Slinky.

jnk

StillAnotherGuest wrote: Assessment of pCO2 in COPD is done only via arterial blood gas, and ABG is indicated only in the presence of moderate to severe disease vs "routine". The first indication of CO2 retention often occurs when the patient comes into the ED acutely decompensated.

Thanks, SAG. IMO it helps immensely to hear anecdotal bits-and-pieces and facts from the clinical side of the big picture.

SAG wrote:PSG is not indicated for the diagnosis and/or management of CO2 retention, but if there is concurrent SDB with COPD ("Overlap Syndrome") then PSG becomes appropriate. The routine use of NIPPV in chronic respiratory failure is not generally indicated.

My initial thoughts and comments had to do with "Overlap Syndrome" since Slinky has concurrent SDB with COPD (yet apparently no CO2 issues). But that admittedly got me to wondering about non-overlap cases of COPD.

I think you gave us a great answer pertaining to the "usual" clinical sequence. But now I'm fishing for your personal thoughts or opinions, if you don't mind. Intuitively I would think that COPD quite often progresses to the point of creating pathologically unique SDB problems. I also realize that COPD is a blanket term covering a variety of specific pulmonary conditions. Do you think non-overlap COPD patients, as a group or population, could benefit from PSG assessment? If so what severity level or other COPD entrance criteria might be employed toward a PSG? How might COPD-related PSG assessment procedures differ from other PSG assessment procedures? I'm also wondering how COPD treatment options and outcomes might be enhanced or altered if the PSG were routinely employed. Your partially-considered thoughts and speculation are most welcomed, SAG. Anyone's for that matter! Especially Slinky's!

SAG wrote:You can search for 3-letter words by adding a "search character" (like * or +) that will allow you to look for important terms like REM, RDI and a couple others which escape me right now...

Anyway, shouldn't we really be talking about RBIs instead of RDIs? And ERA instead OSA?

LOL! I was happy as a lark when the commissioner finally ruled that it should be "Runs BATTED In" instead of "Runs DRIVEN In". But when he ruled that pitchers should be assessed by "Earned Run Average" instead of "Oblong Sliders Acknowledged" I was beside myself with what can only be described as baseball rage. Everyone knows that a good pitcher will throw countless oblong sliders that very few can acknowledge.

SAG wrote:This guy sure looks like an OSA candidate, don't he?

Yeah, that concave shadow almost looks like a beard. But it's really an obstruction.

And I still absolutely love Echo's hilarious question:

echo wrote: LOL. When was the last time they won a world series?

LOL! ...To hear a rhetorical challenge like that from any Cubs fan! But we have a good excuse... It's that gosh DARN GOAT CURSE!!!

-SWS wrote:And I still absolutely love Echo's hilarious question:

echo wrote: LOL. When was the last time they won a world series?

LOL! ...To hear a rhetorical challenge like that from any Cubs fan! But we have a good excuse... It's that gosh DARN GOAT CURSE!!!

Just to straighten everyone out, I'm not a Cubs fan, just a Blues Brothers fan. In fact, I don't even like baseball. Now BASKETBALL, that's another story I AM a Bulls fan Hey what can I say, I'm from the cornfields of Indiana - ya know, Basketball country? GO PURDUE.

Sorry I am not able to contribute the technical side of the discussion with CO2 and RBIs and RDIs

echo wrote: Just to straighten everyone out, I'm not a Cubs fan, just a Blues Brothers fan.

LOL! Okay... So I had to Google to figure out why a Blues Brothers fan would list Wrigley Field as their location or address. Here's what I came across:

Elwood's fake address at Wrigley Field (1060 West Addison) is used on the receipt they get for paying the $5000.

http://www.imdb.com/title/tt0080455/trivia
Of course!! The obvious reason for listing 1060 West Addison as one's own location or address!!!



But that is an obstructive dent in that guy's chin... right????

-SWS wrote:http://www.imdb.com/title/tt0080455/trivia
Of course!! The obvious reason for listing 1060 West Addison as one's own location or address!!!

And here I was thinking you already knew that but you wre just egging me on... doh!


The goatee guy.. yeah what kind I say. It looks very obstructive to me... obstructive to dates maybe!! *NOT* my type ... Don't care if he makes millions playing baseball!

I never knew about the billy goat curse, though, but that's really funny