Hueffenhardt Introduction (New User)

Welcome to the forum, Hueffenhardt!

Your story is a positive one and your research is well-conducted.
It is wonderful to see people taking interest and taking action in their well-being; you are doing yourself nothing but favors.

Wishing you the best today at your appointment!

Hueffenhardt

Never seen a better name for a CPAPer!

That is your real name? Maybe I am naive?

NightMonkey wrote:

Hueffenhardt

Never seen a better name for a CPAPer!

That is your real name? Maybe I am naive?

It's not my real name. It's the name of the village in Germany my surname ancestors immigrated from in 1738. The "u" would actually have an umlaut, but it is customary to replace the umlaut with an "e" after the vowel when using the English alphabet. It is pronounced something like "Hoof-fin-heart". But, I am a good sport and think the "Huffing-hard" pronunciation is pretty funny.

Well, my doctor's appointment was rather uneventful. It seems that the sleep study technicians did something funky with the way they presented the results. Some numbers did not add up like they were supposed to, and it seemed that they used two different programs (an older one and a newer one) to report the results. I could tell my doctor was a little annoyed with it, as he is the head of the whole facility including the sleep lab and has been doing this for a while. But, there was enough there to draw some conclusions. I don't remember all my numbers. I asked for a copy of the results, but he wanted to clean up the data a little before he gave it to me as he did not want to give me misleading numbers.

It was a split study. During the first part, I had no apneas, but a large number of hypopneas and arousals due to breathing difficulty. I had enough hypopneas by themselves to raise my AHI high enough to qualify for the OSA diagnosis. The doctor pointed out that my AHI underestimated the extent of my sleep problems since it does not take into account my numerous arousals. My blood oxygen levels were around 90% during my hypopneas.

During the titration study, they kept my pressure at 5cmH20 the whole time, as that was sufficient to drop my AHI below 5 per hour (either 3.7 or 2.7, I can't remember). My doctor gave me a prescription for CPAP at a pressure of 7cmH20, though because I still had a number of sleep disturbances towards the end of the night that he would like to lower.

When I came back out to the receptionist, she had my prescription in hand. Remember my sleep center is also a DME provider. She said that as a state employee with BCBS, the insurance company requires that they get approval first (which I knew from talking with BCBS). The receptionist said that it usually took about two days. I asked if it was approval for a certain machine or not. She said that it wasn't for a specific machine, and added that they had never been denied before. So, she was going to call me when she heard back from BCBS. The bad thing is their office is open only from 8 - 5, which is when I work. I don't want to take anymore time off. But, they are open during my lunch break, so that is when I'll go in. My office is close to theirs.

After studying my options for machines for quite a while, even looking at the true CPAP's since my pressure needs were so low, I am really leaning toward the ICON Auto, even though I don't have a clear prospect for getting the software right now. Thankfully, I can still get access to what I most want. I know how to access the DME set up menu to change pressure settings, and the lcd screen will give me the AHI for last 30, 7, and last night; Leak for last 30, 7, and last night; 90th percentile pressure for last 30, 7, and last night; and SensAwake™ for last 30, 7, and last night.

I'll still miss the graphs for now, but I bet the software will become widely available before too long. But, even if not, I will be happy with my decision.

By Friday, Jan. 28th, I decided to go with the ResMed S9 AutoSet with H5i heated humidifier and climateline hose. On Friday, January 28th, I finally got word that my insurance (BlueCrossBlueShield) approved a cpap machine and heated humidifier. I am working with the DME that is part of the sleep center and sleep doctor's office. For some reason, my insurance company kept asking for more and more info from my DME/Sleep Center. They had questions about the sleep study's protocol. The DME was saying that were not sure why they were causing such a fuss as they have had many interactions with that insurance company over the years with other patients and had never had a problem. The DME/Sleep Center lady wondered if it might be due to the new year as they had one other patient besides me that was going through the same thing with BCBS. It certainly wasn't my AHI, because my untreated AHI was 22 (all hypopneas).

Anyway, it took two weeks, but I'm approved. So I went into the office on the morning of Friday, Jan. 28th, to get my equipment. When the employee took me back she was saying that it would take a few minutes to program my machine. I told her that I wanted the ResMed S9 AutoSet with H5i humidifier and climateline hose and asked if they had it in stock. She said no, but they could order it for me. She went to check on it and then came back to ask me why I thought I needed an auto. I told her that my hypopneas were very dependent on my sleeping position, and I wanted the flexibility when I needed a little more such as when I have a cold or drink a little alcohol. She nodded her head in agreement and left to discuss it with someone. She was gone quite a while. When she came back she said that they got the prescription changed from the 7cmH2O to the min and max pressure APAP and that they would order the machine today. They will call me when they get the S9 AutoSet in. I asked that since I was there could I try on some masks. I said, "I know that I used the Zest and I liked that and it worked for me, but I'd also like to try the Swift FX. She offered that when I got the machine I could take home the Swift FX and try it at home for two or three days so that I could get a better idea of whether it would work for me. So, I agreed to wait until the machine comes in.

I tried on the Swift FX during my sleep study (Jan. 3rd) and it was my second choice next to the Zest at the time to try in the titration part of the study. But, I was scared that it would make my nares sore and irritated, and when I put it on again after taking it off for a moment, it felt like I couldn't get enough air through it (it may have been that the way it was positioned the second time kind of squeezed the pillow opening narrowing it. If I can make the Swift FX work, it would be my preference since it is so light and minimal.

Update: Yesterday I returned to my DME to finally get my machine and mask. My equipment has been added to my profile and can be seen below. I am very pleased with it. Last night I made my own hose management system very similar to the cozy hoze boss (http://www.pur-sleep.com/content/?id=45), except I spent two dollars at Walmart on the ID Card Reels instead of $20 plus shipping. I adjusted my settings on the S9 AutoSet in both the patient and clinician menus. I put ResScan 3.13 on my computer and set up my patient file.

I put lanolin around and in my nares before going to bed. Last night was my first night on xPAP (besides my titration study). I slept 6 hours using the machine the entire time. Most of the night was leak free, and the few times I had leaks, they were minor. Here are my numbers from last night:

Therapy Mode: AutoSet
Min Pressure: 5 cmH2O
Max Pressure: 10 cmH2O
EPR : Full Time
EPR Level : 2 cmH2O
Apnea Index: 0.9 (all Centrals)
Hypopnea Index: 1.2
AHI: 3.1
Leak: Median: 0 95th Percentile: 0 Max: 21.6
Pressure: Median: 6.4 95th Percentile: 8.3 Max: 9.9

I woke up a little before 5:00 AM and could not go back to sleep. This is not that odd because I often wake up like that. My nose is not sore at all. And my throat and mouth stayed moist and not sore all night long. I use no device to keep my mouth shut; I usually just keep it shut while I sleep unless I am stuffed up. I use the medium size pillows on my Swift FX (I have slotted/oval nares). My eyes were a little dry which I remedied with eye drops. My head gear stayed put all night (I do not think I'll need to put Velcro on the back strap). For the most part, the machine and mask were relatively quiet. We also sleep with a regular humidifier in the room which is much louder than my machine and mask. When I was first going to sleep, I could feel the the part of my nose between my nares rapidly twitched by the pillows on either side adjusting to changes in pressure. It was not bothersome just a weird sensation. Halfway through the night I awoke to hear something like distant wind chimes. My wife heard it too and thought it was the machine. It was quiet and did not really disturb us, but was unexpected.

Overall, I am pleased with my first night of treatment. I don't feel bad, but I don't feel great either (I wasn't really expecting how I feel to change much during the first night though).

Well done neighbor.

I firmly believe that a well educated patient has a much better chance at mastering the hurdles and you have done that in flying colors.

In time you will notice some difference, may not be huge at one time. The only difference I saw at first was a reduction in the nighttime trips to zero. You are young, if nothing else you are likely warding off some very nasty stuff that comes around at my age.

Brenda

Thanks, Pugsy!

Hueffenhardt wrote:Halfway through the night I awoke to hear something like distant wind chimes. My wife heard it too and thought it was the machine. It was quiet and did not really disturb us, but was unexpected.

Maybe, when a person starts on CPAP successfully, a sleep apnea fairy gets its wings!


Good start there!

snnnark wrote:
Maybe, when a person starts on CPAP successfully, a sleep apnea fairy gets its wings!


Good start there!

LOL. Thanks for the laugh.