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Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 5:56 pm
by dsm
CROWPAT wrote:I was able to get copies of almost everything from 2002 to present. Also talked with sleep doctor who said to go ahead with my experiments.
2007 sleep study showed average O2 of 96.2 for the night. 90 was the lowest level recorded and highs at various pressures were generally in the 98-100% range. The 90 number I gave earlier was from memory and not correct per the actual data. I hope that this information quells concerns about oxygen saturation levels.
I was pretty sure you had previously highlighted normal SpO2 (mine is regularly around 95-96% vs wife who is regularly around 97-98% ) so was wondering why the 90% figure suddenly became a high point of focus.
DSM
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 6:05 pm
by -SWS
dsm wrote:so was wondering why the 90% figure suddenly became a high point of focus.
Then you must have missed CROWPAT's statement that was repeatedly highlighted that O saturation remained 90%
throughout the night.
CROWPAT wrote:No PLM in either study and O saturation remained about 90% throughout the night.
So were you
really wondering why there was plenty of legitimate room for concern?
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 6:11 pm
by dsm
Hey Steve,
I had to reset my hearing aids after that
DSM
#2 Now I know how Dr Barry Krakow felt when RG & SWS put the blowtorch on him re his comments on
'big gap' ipap/epap & dealing with UARS. It was really something to see a renowned Dr who runs a sleep clinic
dissed to the extent he was over his comments. Maybe he will come back one day.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 6:13 pm
by CROWPAT
The oxygen number was all my fault. I should not have relied on memory, and made a mistake by saying it was about 90 when I meant to say above 90%.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 7:09 pm
by dsm
CROWPAT wrote:The oxygen number was all my fault. I should not have relied on memory, and made a mistake by saying it was about 90 when I meant to say above 90%.
CROWPAT,
Your 'muddle' on the point is totally understandable.
Cheers
DSM
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 9:11 pm
by -SWS
Some fine blowtorch dissing for the discriminating connoisseurs among us:
search.php?keywords=krakow&terms=all&au ... mit=Search
______________________________________________________________________________________________________________________________________
CROWPAT,
Permissive flow limitation experiments @ 3 days each:
11/11/11 @ your next opportunity
10/10/10 (pending 11/11/11 evaluation)
9/9/9 (pending 10/10/10 evaluation)
8/8/8 (pending 9/9/9 evaluation)
7/7/7 (pending 8/8/8 evaluation)
-----------------------------------------
If excessive PB shows up for any of the above, then you will have to spend just as many nights at your
former best ASV settings as it takes you to resume that same subjective baseline you were hoping to improve
We probably won't even manage to make it to the bottom of that list based on excessive obstruction. Regardless, your job is to
subjectively assess each pressure, and tell us which fixed pressure you think you prefer----based on following-day assessment of symptoms.
So please focus
primarily on following-day
subjective assessment. We can all keep a watchful eye on machine-scored PB and all other BiPAP autoSV data-set measurements toward group discussion/evaluation.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Mon Dec 07, 2009 9:14 pm
by CROWPAT
Mission accepted. Will start with 11/11/11 tonight. Last night is at the top of the link page at
http://www.afsashoot.com/PAT1.html.
Will have results posted at the link by 1000EST tomorrow.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 4:10 am
by NotMuffy
CROWPAT wrote:Muffy's highjack of this thread was sadly successful as far as I am concerned.
That Muffy is the worst threadjacker of all time!
dsm wrote:#2 Now I know how Dr Barry Krakow felt when RG & SWS put the blowtorch on him re his comments on
'big gap' ipap/epap & dealing with UARS. It was really something to see a renowned Dr who runs a sleep clinic
dissed to the extent he was over his comments.
Well, I'm glad you cleared that up, SFB. For a minute there, I thought it was that other ill-mannered poster SAG who was responsible for that
viewtopic.php?f=1&t=26896&st=0&sk=t&sd= ... y&start=75
as he argued that the concept of "expiratory intolerance" and it's treatment made no sense, and indeed, was a misinterpretation of waveform features (it was simply a reflection of cardiac oscillations).
Right after that, BK stopped posting, removed those waveforms from his website:
http://sleepdynamictherapy.com/2008/01/ ... low-curve/
and that's pretty much the last we've heard of "expiratory intolerance".
I wonder if the anticipation of that very event was why the poster SAG saved and kept reposting that graph.
NM
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 4:35 am
by dsm
NM
So that tough old soul SAG proved that poor old (young) Barry Krakow was 'muddled' about something
How awful
& that one highly complex bit of muddle was enough to damn him to hell
DSM
(please take this as good humour )
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 7:19 am
by CROWPAT
SWS, Trial day 1 at CPAP 11/11/11 is now posted at
http://www.afsashoot.com/PAT1.html. Just got out of bed so the fog has not had time to settle in. 11 pressure felt quite odd since I am used to higher pressure and the bipap feeling of pressure changes.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 9:02 am
by Guest
NotMuffy wrote:
I wonder if the anticipation of that very event was why the poster SAG saved and kept reposting that graph.
So, if CROWPAT is prone to flutter, would Dr. Krakow suggest a VPAP Adapt SV to more aggressively normalize the inspiratory and expiratory flow?
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 10:51 am
by -SWS
CROWPAT wrote:SWS, Trial day 1 at CPAP 11/11/11 is now posted at
http://www.afsashoot.com/PAT1.html. Just got out of bed so the fog has not had time to settle in. 11 pressure felt quite odd since I am used to higher pressure and the bipap feeling of pressure changes.
CROWPAT, unfortunately, at this early trending point you do
not seem to present a pattern that will likely fit the following
"permissive flow limitation" benefit:
a middle-ground pressure... in which the convergent severity of both CSDB/CompSAS components are tolerable
Tonight it's back to your previously best-determined settings of 12/14-22/auto.
Some of my own comments toward follow-up strategy and group discussion regarding
hypoxia and
hypocapnia sometimes jointly contributing to
periodic breathing in my next post...
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 12:02 pm
by CROWPAT
I will revert tonight.
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 2:28 pm
by dsm
CROWPAT wrote:I will revert tonight.
CROWPAT,
I believe this has been a good exercise for you as I am in no doubt you will absorb the effects & intents of it as you have time to digest it.
You are lucky to have SWS willing to support you as he has whilst other distractions have taken place. (life in a goldfish bowl). Keep asking the questions.
DSM
Re: BIPAP AUTO-SV SETTINGS HELP
Posted: Tue Dec 08, 2009 2:56 pm
by JohnBFisher
dsm wrote:... You are lucky to have SWS willing to support you as he has whilst other distractions have taken place. (life in a goldfish bowl). Keep asking the questions. ...
dsn, I reached a point where I realize I don't know what I don't know! The more I see about the complexity that some of us face, the more convinced I am it is important to engage my healthcare team as I try any experiments. And I would not lightly suggest others do so without the involvement of their healthcare team. Though this has been perhaps frustrating for CROWPAT, we've all learned by watching the process. So, thank you folks for the thoughtful responses.