Pressure sore question

I'm investing in the pads and such, but I wanted to ask a basic question on dealing with pressure sores on the bridge of my nose. While I first started wearing Hi-Tec boots (it's kind of tactical boot) I had horrific blisters, and kept loosening the fit. Eventually, as the stupid things were nearly falling off, a buddy informed me that you're supposed to TIGHTEN the fit in order to avoid blisters.

So, before I go fiddling with the mask fit, is it tighter or looser when you have pressure sores?

TalonNYC wrote:I'm investing in the pads and such, but I wanted to ask a basic question on dealing with pressure sores on the bridge of my nose. While I first started wearing Hi-Tec boots (it's kind of tactical boot) I had horrific blisters, and kept loosening the fit. Eventually, as the stupid things were nearly falling off, a buddy informed me that you're supposed to TIGHTEN the fit in order to avoid blisters.

So, before I go fiddling with the mask fit, is it tighter or looser when you have pressure sores?

If you wear your top straps VERY loose and have the upper part of your mask positioned properly, you won't get sores or blisters in the first place. It's wearing the mask too tight that causes them.
I've never worn my mask tight enough to cause me any kind of pain......and I've used both the UMFF and the Quattro.
It's supposed to "float" on your face.


Den

so just enough tightness to keep it from leaking?

TalonNYC wrote:so just enough tightness to keep it from leaking?

Yep. It can be a fine balance to find the "just right" spot, but when you do, try not to make adjustments after that. A good bed pillow can make a huge difference, too. "Standard" pillows can push the mask out of alignment and make the leak situation worse.
My logic and experience is that with the top straps loose (and whatever needed tension to keep the mask on with the bottom straps) that the upper part of the mask seal on the nose bridge gets a better seal. Anytime you crank the mask strap tension down, it can actually make the leaks worse......plus, it's pretty painful. The pressurized air inside the mask has to inflate the outside seal to keep it to the surface of the skin. The end result should make it feel like you're not wearing anything at all.


Den

Just tried it. The upper straps loose and the lower straps tight enough to hold it in place. ResMed S9 gave me Mr. Smiley.

Thanks for the info!

Also, I've use a buckwheat pillow forever, and it seems from other posts that this is a preferred pillow.

No problem. Hang in there and good luck.
Sometimes some of these things (suggestions) can seem counter-intuitive, but there are no hard and fast rules for everything. It's a matter of just TRYING different things till you come up with what works for you.


Den

Well, like I said with the boots, it was the exact opposite of the "intuitive" thing that fixed the problem, so I'm all for taking the advice of those who've been through it before =)

I agree with the technique of looser top straps and tighter lower straps to get a good fit....that has worked for me....BUT I also think the gel nose pad that you can purchase is very helpful if you are getting a sore nose bridge...and once I got my padacheek liner I never had nose bridge problems again

Well, the gel pad is already en-route, so looks like I'll be doing both.

Wulfman, I'll have to keep your suggestion in mind too. Never quite thought of doing the tightening like that: Loose on top and tight on bottom. Always learning a new trick

Starlette

Starlette wrote:Wulfman, I'll have to keep your suggestion in mind too. Never quite thought of doing the tightening like that: Loose on top and tight on bottom. Always learning a new trick

Starlette

I'd use the word "snug".
One other thing or two.......I have always positioned the forehead support in the position where it's as far away from the forehead as possible. That way, the seal can move further backwards to help seal against the upper part of the nose bridge. If you position the forehead support with an angle to it, the support will potentially reach the forehead before the seal fits well to the upper part of the nose. If you're prone to snuggling your head into your pillow (like I am), you can use the pillow to help the mask keep a seal and it's very comfortable. By the way, I'm a side-sleeper.


Den

I fall asleep on my back, but I end up sleeping on my side. What can I say, I'm weird.

I use the PAPcap as the headgear and chin-strap together with most of my masks. The PAPcap reduces mask torque and keeps my teeth precisely open enough to keep my lips closed without keeping my teeth clenched. It seems to be ideally suited to keep the nose bridge from getting too tightly cinched. I also use padacheek's antileak strap. It's like a third hand that keeps the mask even more snug all night without being too tight against the bridge of the nose. They're both great products made by forum members.

Antileak Strap
PAPcap

The Quattro has a penchant for causing nose-bridge pressure sores. I cut one of those circular cotton pads in half and rest it on the bridge of my nose before putting on the mask. There are no leaks. In a few days, the sore is reduced and I stop using the circular disks. (They're circular disks for removing makeup, I think -- you can buy them in Walmart.)

Wulfman and I are soulmates. See my "Taming the Mirage Quattro" in my signature.

Pressure sores are a result of ... pressure.
Blisters (on your feet...) are a result of rubbing -- not the same thing at all. If your boots fit, and you keep them from rubbing the same place again and again, you've solved the problem. It's a problem that starts on the surface of your skin.

Pressure sores are damage caused to your skin by pressure limiting the blood flow to it. They need time to heal, and putting more pressure on the same spot will cause more harm.