CPAPtalk.com

StillAnotherGuess wrote:Is there a description for 'daytime hypercapnea' in the literature?

Absolutely.

StillAnotherGuess wrote:if I had it, how would I know?

Arterial Blood Gas.

cowlypso wrote:

(tj1) wrote:I found out personally that the general atmosphere on that site (CPAPTALK) is basically distrust of sleep techs, sleep doctors, dme providers, and a belief that everyone should self-titrate and avoid supine sleep at all costs.

But if you want proof for yourself, all you have to do is go to that website and write: "Take this from a registered sleep tech: you should not be adjusting your CPAP machine yourself" and watch the magic happen.

I'd really love it if some sleep tech came here and posted exactly why we should not adjust our machines ourselves. Not just that we should take their word for it because they are sleep techs, but the actual reasons why.

It won't be from that one. He's a Manager whose SleepFu skilz are poor.

Now where's my long-handled wooden spoon.

deltadave wrote:

StillAnotherGuess wrote:Is there a description for 'daytime hypercapnea' in the literature?

Absolutely.

StillAnotherGuess wrote:if I had it, how would I know?

Arterial Blood Gas.

I just had my annual physical and they did a blood draw for that. I was surprised to see they did carbon dioxide. The results give a normal range of 21-32 mmole/L. My result was 26 mmole/L. How far above and below that normal range do hypo and hyper capneaic individuals range?

Mmmm, a year ago, my result was 29 mmole/L. That was taken a few days before I was referred for my first sleep study.

Mr Bill wrote:

deltadave wrote:

StillAnotherGuess wrote:Is there a description for 'daytime hypercapnea' in the literature?

Absolutely.

StillAnotherGuess wrote:if I had it, how would I know?

Arterial Blood Gas.

I just had my annual physical and they did a blood draw for that. I was surprised to see they did carbon dioxide. The results give a normal range of 21-32 mmole/L. My result was 26 mmole/L. How far above and below that normal range do hypo and hyper capneaic individuals range?

Mmmm, a year ago, my result was 29 mmole/L. That was taken a few days before I was referred for my first sleep study.

That's a serum (venous) Total CO2. We want arterial gas tension, which is 35 - 45 mmHg.

While serum CO2 might give a clue about the hypercapnia under discussion, it cannot differentiate as to whether it is of respiratory origin or metabolic in nature.

More from Zwillich et al:

http://www.temple.edu/imreports/Reading ... %20OHS.pdf

deltadave wrote:

Mr Bill wrote:

deltadave wrote:

StillAnotherGuess wrote:Is there a description for 'daytime hypercapnea' in the literature?

Absolutely.

StillAnotherGuess wrote:if I had it, how would I know?

Arterial Blood Gas.

I just had my annual physical and they did a blood draw for that. I was surprised to see they did carbon dioxide. The results give a normal range of 21-32 mmole/L. My result was 26 mmole/L. How far above and below that normal range do hypo and hyper capneaic individuals range?

Mmmm, a year ago, my result was 29 mmole/L. That was taken a few days before I was referred for my first sleep study.

That's a serum (venous) Total CO2. We want arterial gas tension, which is 35 - 45 mmHg.

While serum CO2 might give a clue about the hypercapnia under discussion, it cannot differentiate as to whether it is of respiratory origin or metabolic in nature.

That said, using an online Henderson-Hassleblad calculator and assuming that you have a normal pH (generally a safe assumption), your pCO2 values are 48 and 43 mmHg for CO2 (-HCO3) of 29 and 26, respectively.

I see, because for the purposes of this discussion we want to know what it is right after oxygenation in the lungs and not after its been increased by metabolism in tissues. That said, the idea of having an arterial catheter gives me the willies.

deltadave wrote: That said, using an online Henderson-Hassleblad calculator and assuming that you have a normal pH (generally a safe assumption), your pCO2 values are 48 and 43 mmHg for CO2 (-HCO3) of 29 and 26, respectively.

So, how sick is Mr Bill?

StillAnotherGuess wrote:

deltadave wrote: That said, using an online Henderson-Hassleblad calculator and assuming that you have a normal pH (generally a safe assumption), your pCO2 values are 48 and 43 mmHg for CO2 (-HCO3) of 29 and 26, respectively.

So, how sick is Mr Bill?

I have been considering your question very carefully, and want to be sure I have a good response before I post.

Thus far, the potential reply candidates to the question "How sick is Mr. Bill?" are:

• RUFKM? Just look at his avatar!
• Answering that question would reveal the Big Secret, and then I'd have to kill ya.
• Disclosing that information would violate the Muffin - Client Privilege, and then they'd have to kill me.
• That information could be such a surprise to Mr Bill, that it would kill him.
• This thread is moving so dreadfully slow, the boredom is killing everybody (or anybody)(if there is, in fact, anybody) following it.

Consequently, you can see how disclosing that information would be the equivalent of a visit by the ELE.

Then (all, some, none) of us will be "Born Again and Resurrected".

Sayyyyyy....

It's amazing how an answer will just magically appear when you talk things out...

deltadave wrote:Then (all, some, none) of us will be "Born Again and Resurrected".

TS, if one were to look up and see the (an) ELE bearing down on them, I don't believe they would be able to qualify to be "Born Again". If you weren't "Born Again" at that point, you couldn't pass through Fear and Regret (a fiery object the size of North Dakota heading for your head at 25,000 miles an hour would tend to do that) and fulfill the obligations of Contrition (clearly the Requirement of 1428) with any degree of sincerity (i.e., it's tough to show "sincerity" when you're screaming at the top of your lungs

"AAAAAAAAAHHHHHHHI'MGONNADIEEEEEEEEEEEEEE!!!!!!"

if you catch my drift).

Further, the OP's creation and application of this NeoBuzzPhrase would also be somewhere between inaccurate and inappropriate. At best, his slow improvement would be metaphorically classified as a "conversion".

deltadave wrote: Further, the OP's creation and application of this NeoBuzzPhrase would also be somewhere between inaccurate and inappropriate. At best, his slow improvement would be metaphorically classified as a "conversion".

'Conversion' would occur after being thrown through a windshield. so a conversion experience is relatively fast. But your valid point still remains that born again and resurrected lays somewhere between inaccurate and inappropriate.

A bit off topic, but what is the difference between setting your machines BPM from Auto to Off?

NJSleepless wrote:...what is the difference between setting your machines BPM from Auto to Off?

As previously noted, "Auto" will engage a sophisticated multi-layered algorithm focusing on:

• Respiratory rate;
• Expiratory time; or
• Respiratory cycle time

that is specifically designed to avoid overdriving the patient, encourage spontaneous breathing and promote respiratory synchrony.

"Off" turns the machine into a rock.

StillAnotherGuess wrote:

deltadave wrote: Further, the OP's creation and application of this NeoBuzzPhrase would also be somewhere between inaccurate and inappropriate. At best, his slow improvement would be metaphorically classified as a "conversion".

'Conversion' would occur after being thrown through a windshield. so a conversion experience is relatively fast.

That is not so (unless the conversion in your example is from an intact body to a jellyfish).

The religious experience in that case would need to pass from surprise, disbelief, fear (or terror - this would be a sliding scale), realization, self-pity, regret, bargaining, acceptance, enlightenment, contrition and THEN eligibility for conversion. In actuality, your guy, traveling at a speed of 117.3 feet per second (let's say he was up on I-5 doing the "speed limit" HAHAHAHAHAHA before he decided to leave his vehicle and take a look around) would be lucky to go surprise, disbelief, fear/terror, SPLAT.

Instantaneous or "enhanced" conversion (Revelatory Conversion) could only occur in a milieu of supplementary intervention of a divine nature. This is quite rare, but certainly the best example of this would be Paul on the Road to Damascus (the "Road" theme, as you know, was later employed by Crosby and Hope in "Road to Singapore", "Road to Morocco", "Road to Perdition", etc.).

deltadave wrote: Instantaneous or "enhanced" conversion (Revelatory Conversion) could only occur in a milieu of supplementary intervention of a divine nature. This is qute rare.

So, if we accept the premise that Ameriken thought he was having a religious moment with his ASV, that is functioning for him as an S/T, can we also say the Road to Enlightment may, on rare occasion, be through a windshield?

Or, this could be a reference to the second season of 'The Fringe' when she comes crashing through the windshield from inside the car after having spent some time in the adjacent dimension with Dr Bell.