Dr. Krakow, salesman extraordinaire? UPDATED

deltadave wrote:

ignorant1 wrote:

Deltadave wrote:
IMHO", after dropping MAP via bilevel to reduce aerophagia, Ig1 improved Sleep Efficiency through hygiene and CBT.

Nope. My bilevel experience was very short term and didn’t help my aerophagia problem at all.

I consider ASV a form of bilevel ventilation (those forms being spontaneous, timed, spontaneous/timed, auto and adaptive servo ventilation). I was hoping that using "bilevel" as a descriptive term would aid readers to visualize a pressure waveform that spends most of the time at a lower baseline with only brief peaks at high(er) pressure, and thus, a first-line approach to aerophagia.

So do you still think ASV is not likely to help aerophagia over and above VPAP?

A unscheduled time out in this thread is needed...

Honestly, I must know who wrote 'Euro-English, an unsolicited editorial by Rocklin'. Was it ingnorant1 or Rocklin? I found it to be comic genius! Thank you to whomever crafted it for the induced laughter! I am still wiping tears from my eyes!!

John

Now back to the very entertaining, but educational posting on Dr. Krakow, salesman extraordinaire...

SleepingUgly wrote:

deltadave wrote:

ignorant1 wrote:

Deltadave wrote:
IMHO", after dropping MAP via bilevel to reduce aerophagia, Ig1 improved Sleep Efficiency through hygiene and CBT.

Nope. My bilevel experience was very short term and didn’t help my aerophagia problem at all.

I consider ASV a form of bilevel ventilation (those forms being spontaneous, timed, spontaneous/timed, auto and adaptive servo ventilation). I was hoping that using "bilevel" as a descriptive term would aid readers to visualize a pressure waveform that spends most of the time at a lower baseline with only brief peaks at high(er) pressure, and thus, a first-line approach to aerophagia.

So do you still think ASV is not likely to help aerophagia over and above VPAP?

You were in charge of that experiment!

deltadave wrote:

SleepingUgly wrote:So do you still think ASV is not likely to help aerophagia over and above VPAP?

You were in charge of that experiment!

I'm the subject! I need an experimenter and a project manager!

deltadave wrote:gvz wrote:Unfortunately, there will be no rapture in 2012. They figured it out. Sorry Muffy.

is that 3?

jnk wrote:1001? I'm shocked!

who knows why he-she chose that id

deltadave wrote:Hey, if somebody's gonna throw one down the center of the plate, I'm more than happy to knock it out of the park.

is that 3

2 B Sleeping Soundly wrote:A unscheduled time out in this thread is needed...

Honestly, I must know who wrote 'Euro-English, an unsolicited editorial by Rocklin'. Was it ingnorant1 or Rocklin? I found it to be comic genius! Thank you to whomever crafted it for the induced laughter! I am still wiping tears from my eyes!!

John

Now back to the very entertaining, but educational posting on Dr. Krakow, salesman extraordinaire...

Mark Twain.


The real one, not the one ignorant1 diagnosed as having two personalities.
But then that Mark was actually called Samuel Clemens...

And you should read his hilarious chapter on the German language, an appendix to his "A tramp abroad".

The Awful German Language
http://www.gutenberg.org/files/5788/578 ... h.htm#p600

...I must know who wrote 'Euro-English, an unsolicited editorial by Rocklin'. Was it ingnorant1 or Rocklin?

Before Rocklin (or one of his alternate personas) tries to claim credit…
I posted the “Euro-Language” essay, but alas I cannot claim to have written it – it was shear plagiarism on my behalf. Someone sent that to me long ago. I facetiously gave credit to Rocklin simply to propagate the humor.

.

jnk wrote:On its face, yes, utterly beside the point. But if one considers docs who treat to be mostly artists and docs who research to be mostly scientists, then it is possible to read posts by the people who genuinely admire the art of K and posts by people trying to find the science of K and failing, and can sincerely agree with both of them in a wishy-washy sort of way, like me, and still maintain some semblance of self-respect. Or at least that's my goal. One day. Long-term.

Huh? Jnk, I love ya, you know that, but . . . subtitles, please.

jnk wrote:Then again, I didn't choose a humorous Nazi character as my avatar then consider bad German jokes by others to be verboten.

I don't. I just wanted to see ig twist in the wind. And boy, did he ever.


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Quick chorus:

gvz wrote:Let it shine, let it shine, let it shine.

One day at a time, one day at a time.




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Now back to ig's id: the good, the bad and the igly.


THE GOOD:

ignorant1 wrote:Agreed. And it is also entirely possible that further research will invalidate Dave's skeptical POV. Time will tell.

I don't have that luxury. I must decide. Now.

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THE BAD

ignorant1 wrote:And yes, I still highly respect and value DeltaD’s contributions here.

It’s nice having him around – he’s kind of like the living antithesis of the old bumper sticker from the 60’s that reads “question authority”

Wow.

I think you just poured a bucket full of water on the wicked witch of greenwich.

Dave, are you just going to stand there and take that abuse?

I know, I know, you usually pay $500 an hour for far more pungent abuse by Vassar Ph.d candidates writing their thesis on German Expressionism and the roiling Schadenfreude of the masses.


STOP. DAVE. PLEASE. STOP. DAVE.
(Hal, open the pod-bay doors)


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THE IGLY

ignorant1 wrote:But the real proof is in this editorial I dug up – the one that you wrote several years ago:

(proceeds to plagiarize someone else's work, and then boast about it.)

Sir:

When you find yourself in a hole . . .

Stop digging.


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UH, WELL PLAYED, SIR:

ignorant1 wrote:So now we have an expert in the field

While I respect Dave's extensive career as a sleep clinician, he presents nothing that leads me to believe that he is an expert in the field of ASV.

Dave, if you are in the literature with ASV (or with any sm issue for that matter), please let us know.

("Jeopardy" Music begins to play)

And the answer is . . .

ZZZZZZZZZZAAAAAAAAAAAAAPPPPPPPPPPPPP!

Not a single paper.

Not even a "letter to the editor" of an obscure publication.

Invisible.

But, hey, we all knew that, right?

WTF.


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Barry and I came to a verbal agreement on something that we believe is brand new.

Other parties have to agree.

Technology has to work.

Hopefully, (from my greedy POV) we can franchise it, but that's likely a stretch.

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My sweet, quarreling com padres of CPAPtalk:

Perhaps it is time for a new ASV thread, one that looks at the future.

I'll post it tomorrow.

Be there or be chi- . . .

roc

(redacted)

.

ignorant1 wrote:Sleep efficiency has improved, primarily due to 1.) alleviating arousals due to aerophagia...

At the risk of generating (more) agita in SU, I would return to the Watson template which proposes that it is the reverse that occurs.

Further, I would also submit that aerophagia decreases Sleep Efficiency through an increase in Awakenings (a critical distinction and decided difference from Arousals) and Wake.

testing

Mike6977 wrote:

jnk wrote:On its face, yes, utterly beside the point. But if one considers docs who treat to be mostly artists and docs who research to be mostly scientists, then it is possible to read posts by the people who genuinely admire the art of K and posts by people trying to find the science of K and failing, and can sincerely agree with both of them in a wishy-washy sort of way, like me, and still maintain some semblance of self-respect. Or at least that's my goal. One day. Long-term.

Huh? Jnk, I love ya, you know that, but . . . subtitles, please.

But that WAS my attempt to give subtitles to this thread.

[Cue dramatic music]

A lone, little-understood doc is seen leading people into the desert in an attempt to set them free from the tyranny of the nationwide regime of dumb bricks with too little straw. But he is hounded and pursued. What happens next? Tune in next week for the continuing saga.

[Fade. Credits. Raise house lights.]

People are being helped.

Cool.

But some of those people are people who do not have central apnea but who are being treated by a machine that was designed to treat central apnea. And oddly enough, that is what is being given credit for the help. Any sane clinician anywhere, multiple or not, would want to know why. Wouldn't he? I mean, if he cares. Because if there is something to it, everyone should be getting in on the act. And the evidence would need to be more than what can be said in a phone call, I would think.

And although I don't know that much about ddave personally, I have seen evidence he cares. Deeply, and often.

That's why any implied hints that he is only lobbing dirt clods and throwing rocks makes the hair on the back of my neck stand up.

Or maybe I just need a haircut.

jnk wrote:But some of those people are people who do not have central apnea but who are being treated by a machine that was designed to treat central apnea.

Says who?

Do you know Pete's true agenda in all this?

What's his true purpose for developing this and future lines of products?

Can you tell me why ResMed are called (by some inside the industry): "The Taliban of Sleep"?

Way, way more to this than even what most sm people know, imho.

There is ambition.

And audacity.

And then, there's ResMed.

God save us all.

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jnk wrote:Any sane clinician anywhere, multiple or not, would want to know why. Wouldn't he?

Yes, he would want Barry to go through the established channels. But the established channels often ain't ready mentally, physiologically or politically for what a pioneer has to say. I know this from real experience through my wife's (Ronnie B Harmon) work and that of her partner in crime, Richard Rosner.

http://www.jaapl.org/content/34/2/150.full

http://www.linkedin.com/profile/view?id ... S&trk=tyah

http://en.wikipedia.org/wiki/Richard_Ro ... iatrist%29

Yes, long after the dust settles, comes words like "pioneer" and "world renowned".

But first come the rejections and the naysayers.

This is true whether Barry's work stands the test of time or not.

And, if it doesn't, I give him great kudows for putting his a$$ on the line: it takes guts to get up on that live high wire.

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jnk wrote:Because if there is something to it, everyone should be getting in on the act.

If we can work out the details, everyone will.

Still a number of obstacles to overcome, I've been working on them this morning and hopefully, will meet with the principals at SDI this week. Ego is one, and the unforgiving God of Technology is another.

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jnk wrote:And the evidence would need to be more than what can be said in a phone call, I would think.

The evidence will be hard core. A quick glance at Ronnie and Richard's CVs and you know we don't operate any other way.

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jnk wrote:And although I don't know that much about ddave personally, I have seen evidence he cares. Deeply, and often.

I have seen the same evidence.

There is no question that Dave is on the side of the angels, imho.

But his POV must be put into perspective.

His word is not . . . The Word.

Nobody should have that power.

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Gotta run, pitching Columbia University on this (hoping it'll catch fire) in a few minutes,and, classically, I'm f*cking late.

God, it's been a while since I made a sale call.

Hope this suit doesn't make my a$$ look fat . . .

roc

.

Mike6977 wrote:Yes, he would want Barry to go through the established channels. But the established channels often ain't ready mentally, physiologically or politically for what a pioneer has to say. I know this from real experience through my wife's (Ronnie B Harmon) work and that of her partner in crime, Richard Rosner.

What do you mean by this? It seems that Ronnie B. Harmon (and since when does a husband use his wife's middle initial?!) and her partner in crime (ha ha), Richard Rosner, are well established and accepted in mainstream literature.

ignorant1 wrote:
Sleep efficiency has improved, primarily due to 1.) alleviating arousals due to aerophagia...

Deltadave wrote:
At the risk of generating (more) agita in SU, I would return to the Watson template which proposes that it is the reverse that occurs.

Point well taken. The sequence of events is critically important for understanding cause & effect.

Deltadave wrote:
I would also submit that aerophagia decreases Sleep Efficiency through an increase in Awakenings (a critical distinction and decided difference from Arousals) and Wake.

Again, an important distinction that merits clarification. Thank you.

Jnk wrote:
And although I don't know that much about ddave personally, I have seen evidence he cares. Deeply, and often.

That's why any implied hints that he is only lobbing dirt clods and throwing rocks makes the hair on the back of my neck stand up.

Deltadave’s contributions to this forum are absolutely invaluable to everyone here; especially so to those that are seeking to actually learn something vs. being blindly led around by a nose ring. His tolerance for the ignorant (not just me) & the obtuse, plus his desire to impart his knowledge to us plebes is appreciated & applauded!

Conversely, some people seem to take up significant amounts bandwidth for no plausible reason…

Rocklin/Mike wrote:
...the established channels often ain't ready mentally, physiologically or politically for what a pioneer has to say.

Yes, very true. Wow. Another brief moment of coherence & clarity? The adjustment to your meds is apparently working. Bravo to your wife’s boss. (Which voice in your head said that by the way?)

Rocklin/Mike wrote:
…real experience through my wife's (Ronnie B Harmon) work and that of her partner in crime, Richard Rosner.

SleepingUgly wrote:
What do you mean by this?

SU, he's leaving clues to solve the riddle. At least we now have an explanation about why he hasn’t been permanently institutionalized – his wife has “connections” to keep him out on the street. Since she & Rosner have an interest in “correctional psychiatry”, I can’t help but wonder if this is how Rocklin and his wife met? (Maybe he’s the ultimate in “pet” projects for her to study? Talk about bringing your work home with you – sheesh!)

Oh man. Reading this is exhausting. I'm the ASV user with aerophagia. I'm just sick of hoping that something works when it doesn't. I'm considering looking into surgery for my palate so I don't have to be turned into a blimp. My doc found that i had bubbles coming out the other end (sorry if I offended you). I really hadn't noticed until then because I'm kinda use to a round belly.