Out of the Frying Pan and Into the Fire! Then, Deep Sleep.

Good story Bob. Thanks for posting it and congratulation on a therapy well done.

Thank you for posting that story in so much detail, Bob. It's the details that make it so helpful -- both for newbies in distress, and for those of us attempting to help them.
And a big thumbs up for your docotor!

O.

ozij wrote:Thank you for posting that story in so much detail, Bob. It's the details that make it so helpful -- both for newbies in distress, and for those of us attempting to help them.
And a big thumbs up for your docotor!

O.

Absolutely...ditto!!

Great job, Bob.

ozij wrote:And a big thumbs up for your docotor!

O.

Glad to see my o found another position so quickly. Obviously you practice nepotism.

Great and inspiring story, Bob. I am new to cpap and struggling every night, as I too am a mouth breather. I hope my story ends up as happily as yours, because last night I almost packed up my machine and 3 masks to go back to the DME. Even though I have never felt like I got a good night sleep, ever, I always looked forward to crawling into bed, under the covers, and relaxing after a hard day, but lately, I'm so depressed and I dread going to sleep. I'm feeling worse, it seems, on cpap and getting discouraged. Your story gives me the inspiration to keep trying, at least, for awhile. Also, your doctor seems great...mine is an idiot! I'm in the process of going to a new sleep doctor. I hope that works out. I don't know what kind of doctor you're becoming, but wouldn't it be great if you considered being a sleep doctor?

Great story Bob!!! I agree with you in that taping + the Swift fx is much more comfortable for me too than wearing a full face mask. I can sleep now sleep on my stomach..great.

By the way, I was able to get rid of the chin strap and only need the mouth tape now. No longer get those puffs of air in my cheeks trying to escape.

Thanks for sharing your whole history as you did. I am so glad that this working so well for you and that you found it before you move on to clinical rounds.And yeah, the Swift FX is a very nice mask

silver

Thanks for all of the encouraging responses. As usual, the CPAPTALK.com community is supportive and I appreciate that. Last night I was far too congested to use the nasal pillows, so I slept without APAP and woke up fatigued. I think I may have surgery to open up my nasal passages a bit, perhaps submucosal turbinate reduction. I am not sure, but after experiencing real sleep this week, I know I don't want to have to go without therapy 30% or more of the time due to congestion. It's perhaps ironic that I don't have allergies, don't have post-nasal drip, don't blow my nose a lot, etc., yet my nose is always stuffed up just enough that I have to mouth breath. Now that I have a proven method of using nasal APAP therapy, I am motivated to get my nose cleared up so I can sleep with APAP every night for the rest of my life.

plr66 wrote:However (OT), I'm having trouble reconciling your avatar to your being a medical student. Can you explain?

My avatar is a photo of fictional hero Jack Bauer wielding a firearm in the line of duty. Very bad ass. I'm having trouble understanding your comment - how being a physician entails being a pacifist, which I think is what you're getting at. I see no contradiction. Murdering another human being in defense of one's self, one's family, one's community, or one's country is morally justifiable. Protecting one's self is as basic a human right as I can come up with. Note my use of the word 'defense'; aggressive wars or, at the individual level, retaliation completely out of proportion to the instigating aggressive action are not acceptable to me.

Feel free to PM me if you want to discuss.

-Bob3000

Bob3000 wrote: My avatar is a photo of fictional hero Jack Bauer wielding a firearm in the line of duty. Very bad ass. I'm having trouble understanding your comment - how being a physician entails being a pacifist, which I think is what you're getting at. I see no contradiction. Murdering another human being in defense of one's self, one's family, one's community, or one's country is morally justifiable. Protecting one's self is as basic a human right as I can come up with. Note my use of the word 'defense'; aggressive wars or, at the individual level, retaliation completely out of proportion to the instigating aggressive action are not acceptable to me.

Feel free to PM me if you want to discuss.

-Bob3000

No need whatever for a PM discussion. The avatar just struck me as odd for a characterization of yourself as an aspiring medical doctor. Nuff said. Was not meant as an attack, but just a question for clarification.

Although I don't know all of your experience so far with cpap, I would suggest that you consider a couple of easy possible fixes for the congestion before you consider surgery. Decrease your humidity setting for a week--even take it down to passover (zero heat, but with water in the tank). Then try NeilMed Sinus Rinse spray bottle (available with saline packets at WalMart or Walgreens) every other night or so. These two things resolved my issues, and I only rarely use the NeilMed Rinse anymore. Getting the heat setting right on the HH is the key I think.

Thanks Bob for the great details of your journey. Like someone above, I ran across a couple tactics you implemented that were new to me. Could expand on the terms, "Tongue Trick" and the DIY mouth appliance you used? I'm a mouth breather that did well for 3 years with a Ruby chinstrap. May have been the change to a nasal pillow, but I went back to mouth breathing. I was wearing out the Rubys so fast that I found thicker neoprene and made my own. When that and plenty others failed I got a papcap last week. The first night my leaks rate showed the same as no chinstrap!! The next night I realized that the "valving" done by the tongue at the back of the throat could be improved by moving the strap to just in front of my adam's apple. VIOLA!! I've seen a minimal leak rate for 4-5 nights, until my pillow wrestling slides the whole cap forward and I lose tension on the chinstrap... More work to do on making it "mine".

Congratulations again on your success!! When can we expect your shingle hung out in apnea as a specialty?!?!!?

Kelvin

plr66 wrote: No need whatever for a PM discussion. The avatar just struck me as odd for a characterization of yourself as an aspiring medical doctor. Nuff said. Was not meant as an attack, but just a question for clarification.

Wonderful. I was afraid my response would get the thread off track, but you're even-keeled and I will be too.

plr66 wrote:Although I don't know all of your experience so far with cpap, I would suggest that you consider a couple of easy possible fixes for the congestion before you consider surgery. Decrease your humidity setting for a week--even take it down to passover (zero heat, but with water in the tank). Then try NeilMed Sinus Rinse spray bottle (available with saline packets at WalMart or Walgreens) every other night or so. These two things resolved my issues, and I only rarely use the NeilMed Rinse anymore. Getting the heat setting right on the HH is the key I think.

I will try lowering my heated humidifier. Right now it's at 60%, so I have a lot of room on that. I did actually try a nasal saline rinse today. Basically, when gently squirting the rinse into my left nostril, it would mostly go down my throat and only if I simultaneously expelled air our of my right nostril could I get the rinse to come out of the right nostril. After that, the rinse trickled out of my right nostril, but it certainly didn't flow. When I applied the rinse to my right nostril, it flowed out of my left nostril quite well. It's like there's a one-way valve in my right nostril today! Normally if I lay on my side, the nostril closest to the pillow gets clogged within a few minutes, and the nostril away from the pillow clears. If I flip to my other side, within a few minutes, the process repeats, so I know there is probably no structural blockage as both nostrils can clear, just rarely at the same time. I will keep working on the nasal rinse, too. Very good advice, thanks.

kwikwater wrote:Thanks Bob for the great details of your journey. Like someone above, I ran across a couple tactics you implemented that were new to me. Could expand on the terms, "Tongue Trick" and the DIY mouth appliance you used? I'm a mouth breather that did well for 3 years with a Ruby chinstrap. May have been the change to a nasal pillow, but I went back to mouth breathing. I was wearing out the Rubys so fast that I found thicker neoprene and made my own. When that and plenty others failed I got a papcap last week. The first night my leaks rate showed the same as no chinstrap!! The next night I realized that the "valving" done by the tongue at the back of the throat could be improved by moving the strap to just in front of my adam's apple. VIOLA!! I've seen a minimal leak rate for 4-5 nights, until my pillow wrestling slides the whole cap forward and I lose tension on the chinstrap... More work to do on making it "mine".

Hi Kelvin. The DIY oral applianceis described in this thread. The tongue trick is where you push your tongue toward the back of your throat and flatten out the base of the tongue. You can have your mouth open and still not get any air past your tongue in this position. Rested gal and some others worked on it for awhile. Some people's tongues adjust so that they no longer need tape or a chinstrap, other do not.

kwikwater wrote:Congratulations again on your success!! When can we expect your shingle hung out in apnea as a specialty?!?!!?
Kelvin

I have two and half years left (I am on a research year right now). I am trying to keep an open mind about the different specialties I will see during my clinical rotations, but right now I am interested in surgery. We'll see!

Bob3000 wrote:Last night I was far too congested to use the nasal pillows, so I slept without APAP and woke up fatigued. I think I may have surgery to open up my nasal passages a bit, perhaps submucosal turbinate reduction. I am not sure, but after experiencing real sleep this week, I know I don't want to have to go without therapy 30% or more of the time due to congestion. It's perhaps ironic that I don't have allergies, don't have post-nasal drip, don't blow my nose a lot, etc., yet my nose is always stuffed up just enough that I have to mouth breath. Now that I have a proven method of using nasal APAP therapy, I am motivated to get my nose cleared up so I can sleep with APAP every night for the rest of my life.

First I encourage you, with the lower pressure, to try a full face mask on those days when you are congested. I just spent the last 3 weeks with the flu and was able to continue using my cpap with my Quatro instead of using my hybrid with nasal pillows (they hurt to touch my nose). It actually makes surviving a cold or flu much much easier. The pressure and extra humidity seems to relieve some of the congestion.

Second since I have been on cpap my congestion is much less. My asthma has decreased, my allergies are less. Maybe it is because I am breathing filtered humid air for 8 hours make the difference.

However some people find the humidity more problematic so you should play with those settings.

tbas wrote:...dread going to sleep. I'm feeling worse, it seems, on cpap and getting discouraged.

Ahh, the dread going to sleep phenomena! I had it off n'on for months and I was getting good therapy at the time..don't give up! Patience and persistence!!!

Bob, it sounds like you could benefit from regular use of a Neti pot. It will give you better nasal irrigation than a spray. Have you tried one yet? If not, check out the following link:
https://www.youtube.com/watch?v=j8sDIbRAXlg
Good luck!
Papillon