Doctor visit Thrusday

I will be seeing my Doc on Thursday. It will be the second followup visit since I started CPAP. I seen him 30 days in and now this will be the 90 day visit. I've adjusted well. The first month was hard as all get out. And the second month I got my Swift LT and adjusted to it well. Since then I cant complain about my therapy. And I would miss it if I did not have it at night. One thing that also helped on my second month was I swapped out my straight CPAP machine for an Auto. That made breathing a lot easier also. I would recommend an auto for anyone having problems breathing out against the pressure of a straight cpap machine. It was like night and day for me.

My apneas still vary up and down and I'm not sure what is an acceptable number. So I dont know what to expect when I see the doctor. If he will say: "Your doing great Dennis, just keep doing what your doing now." or "We still need to make some improvements so lets up your pressure."

Here's my summary charts. if anyone has any ideas on what I may expect.
My website has more details if you need it.

looks good, I wouldn't change anything.

They sure improved the reporting software or is that your own charts?

Snoredog wrote:looks good, I wouldn't change anything.

They sure improved the reporting software or is that your own charts?

Thanks! This is direct from the 3.5 ResScan software. It is pretty huh.
Only thing is it don't export data like the earlier versions did.

-Dennis

If it is any consolation, Dennis, ResScan 3.4 can't export either. I haven't used 3.3 much 'cause I no sooner got 3.3 when I was changed to the VPAP Auto and 3.3 won't recognize the S8 IIs or the VPAP Auto.

So you like those bar graphs better than the "squiggly" graphs, huh, SnoreDog?? Guess what? 3.4 and 3.5 does the "squiggly" graphs TOO, AND they can be "stretched out" from 10 second intervals, thru minutes, and hours, AND condensed to 24 hours.

Ooops, sorry, Dennis. "They" prefer to see the AHI under 5.0, AIs preferably lower than the HIs. An AHI under 5.0 is consider "normal".

The Resmeds deduct the allowed vent rate for the selected mask when reporting the Leak rate unlike the Respironics where you have to do the math yourself. On the other hand, if you are using a non-Resmed mask it is more of a hassle to do the math. But you've got a Resmed mask so no hassle as long as it is set to the correct Mask Selection.

Just got back from my Doctor visit. I brought my own Reports and graphs with me to the visit.
My DME had not sent me a data card to download and get reports to my Doc on time for him to have their reports.
So he only had mine to work with. He was quite impressed. He said He had not seen these type charts before.
I explained that the software was the latest version. He was only used to seeing older version reports from the DME.
He also told me that in all the years he has been a sleep Doc he has never had anyone come in with their own reports.


We went over my summary chart, and 10 detail charts as well as my statistical data.
He determined that I should increase my pressure. Now here is is the kicker. He asked me if I knew how to make the changes myself.
I said, yes I do. So he suggested that since I understood my therapy in such detail that I should slowly increase my pressure
(on my own) over the next few weeks in an attempt to lower my AHI below 5.0. He suggested I do not exceed 10 H2o at this time though.
Then when I determine what pressure works he will write a script to process it formally through my DME to make them happy.

I learned everything I needed right here on cpaptalk.com
If I could not locate the answer by searching, I asked the question and someone had the answer.
I want to thank all of you for your help!

-Dennis

And I like your doctor too! You've got a goodie and a keeper.

Congratulations on your results so far! I think it's way cool of your doctor to allow you to take such an active role in your therapy. As one should.

You should have heard the reaction when I asked to change to the new titrated pressure myself without having to bring the machine in.

I'm still waiting on the call back regarding the doctors approval to do so.

Once I get detailed copies of my two studies and my prescription, I'm going to wish these folks success with their business and pay out of pocket for a data capable machine.

you might try the pressure increase to experiment if you feel better, but your AHI is not all that bad to begin with.

Increased pressure comes greater discomfort, more noise, more difficult to control leaks, so higher pressure is not always a cake walk.

again, when you get your AHI near normal base therapy on how you feel and not the AHI numbers.

Wow , very supportive Doc.

When I went in to see my Doc for the initial 30 day follow-up recently, my doc wasn't "horrified" that I had brought in reports & knew how to change the pressure, but she wasn't very supportive either... tended to view any info available on the internet, as being a black art...

I knew that my biggest issue was trying to reduce leaks, before really focusing on what was happening to my AHI value - she suggested that I see their PA asap to look at adjusting my nasal mask - however, looks like the first available timeslot is first week of October...

Luckily with forum support, I have already started making some leak reduction progress on my own.

Mike

Snoredog wrote:you might try the pressure increase to experiment if you feel better, but your AHI is not all that bad to begin with.

Increased pressure comes greater discomfort, more noise, more difficult to control leaks, so higher pressure is not always a cake walk.

again, when you get your AHI near normal base therapy on how you feel and not the AHI numbers.

Hi Snoredog,
Yes, I believe it may have been you who originally told me this. I do understand the risks now and that was part of our discussion.
Some mornings I wake feeling really good, others not quite so good. At this point the not so good out weight the really good.
It's a trial and error but at least he has given me the go ahead to work with it. I'll not make any large increases.
I'll be increasing the max pressure by small decimal increments and leaving the low pressure at 7.
And each time I make a change I will give it a several days chance to work. I have no rush.
-Dennis

Dennisla wrote: I'll be increasing the max pressure by small decimal increments and leaving the low pressure at 7.
And each time I make a change I will give it a several days chance to work. I have no rush.
-Dennis

It is the low number that you need to increase slowly.

hobbs wrote:

Dennisla wrote: I'll be increasing the max pressure by small decimal increments and leaving the low pressure at 7.
And each time I make a change I will give it a several days chance to work. I have no rush.
-Dennis

It is the low number that you need to increase slowly.

Exactly. The minimum (low) pressure is the important one. That's the one that needs to be raised to keep the throat open better.

I'm not a doctor, but I don't think you need to go so slowly about it either. I'd raise the minimum pressure by one full cm at a time (starting at 8 cm for the minimum) and give that a week.

Yep ... I would set min at 8 or 9 and max at 12.

Ok Ok ..

I'll try upping the lower side too.

But slowly.
-Dennis