MyEncore Data Points Problem

NightHawkeye · Post by **NightHawkeye** » Tue Mar 21, 2006 8:49 am

Easy enough to test out the theory. I've never deleted any patient interactions from Encore Pro.

Let us know if that fixes it.

Regards,
Bill

roztom · Post by **roztom** » Tue Mar 21, 2006 8:55 am

Well: That seems to be the only variable - other than the tooth fairy.

SO I won't delete ANY data from Pro and I'll see if I start getting more than 6 days in MY Encore.

I'll report back.

Thanks everyone,

Tom

Wulfman · Post by **Wulfman** » Tue Mar 21, 2006 9:26 am

Tom,

I believe that would be your problem. MyEncore uses that database.....and if it ain't there......it can't use it.

Best wishes,

Den

Linda3032 · Post by **Linda3032** » Tue Mar 21, 2006 11:38 am

Yep that's it. You can't delete the data in Pro - only on your SmartCard.

Moogy · Post by **Moogy** » Tue Mar 21, 2006 12:04 pm

Yes, that has got to be it, Tom. I never delete the old patient downloads in Encore. I THINK it creates the database, then MyEncore reads it.

Moogy

roztom · Post by **roztom** » Tue Mar 21, 2006 12:11 pm

If I delete data on my smart card will it still show me the range of data already in PRo?

SO does that mean I delete the smart card everyday and I won't lose the history?

tnx,

tom

Linda3032 · Post by **Linda3032** » Tue Mar 21, 2006 12:18 pm

Tom, I don't download every day, but

I wouldn't delete the data on the card - just let it overwrite the oldest data when it gets full - in about 6 months.

At the end of say 5 days when you download you will have all 5 days worth of data on the card.

Then, and only then, you can delete the individual daily downloads from Pro - if you are so inclined.

IMO, by downloading every day, you are obsessing with your numbers (unless there is very specific info you must have).

But that's just my opinion. On the other hand, your interest will help keep you compliant, which is the ultimate goal.

Wulfman · Post by **Wulfman** » Tue Mar 21, 2006 12:36 pm

Tom and Linda,

My advice is don't delete the download records from Pro and don't erase your card unless it's absolutely necessary.
Let me throw in a thought or two from my own personal experience this last week or so.
About a week and a half ago, I was getting a message (from Pro) after downloading my card that said something about text not matching something or other (I saved a screen print of it but don't have it HERE). I'd been using my card since 05/14/05 and I figured it might have reached the point where it wouldn't store any more of the non-detailed statistics. I'd been contemplating bumping up my pressure for awhile, so last Friday night I upped it to 12 and put a NEW card in the machine......OOPS! It recorded the nightly statistics on my new card and downloaded just fine into the Pro database......BUT......it lost the continuity from last May and was like I was starting over on 03/17/06. FORTUNATELY, MyEncore didn't care and has kept the continuity intact. After getting frustrated, I just erased both cards and "started over" with my recording on the cards. Encore Pro seems to be a little funny that way.....seems to lose the continuity when you change cards. Oh well......live and learn.

Best wishes,

Den

NightHawkeye · Post by **NightHawkeye** » Tue Mar 21, 2006 12:38 pm

Linda3032 wrote:IMO, by downloading every day, you are obsessing with your numbers (unless there is very specific info you must have).

But that's just my opinion. On the other hand, your interest will help keep you compliant, which is the ultimate goal.

True, but you've been compliant for several years, Linda. You're past the obsession stage. It's still new to some of us.

But, as you pointed out, obsession has its benefits, particularly to someone attempting to get their treatment optimized. Seems healthy to me.

Just my $0.02.

Regards,
Bill (reaching the end of his own obsession)

roztom · Post by **roztom** » Tue Mar 21, 2006 1:00 pm

Let me see if I got this right.

Don't delete any of the patient interactions in Pro and don't delete the card until it gets full.

I haven't deleted the card but after every download I was deleting the previous patient daily interaction.

SO I assume when you open Pro, your patient interaction log is full of downloads that have accumulated and since the card only holds data for 6 days that minimum you download at least every 6 days.

Am I getting close?

As far as obsessing? GUILTY as Charged

I've been switching masks, using a chin strap - even a sleep-mask

I've been watching my numbers and trying to see what if any variables I can detect from night to night. Much of it seems random as far as AHI, etc but leaks are more under my control.

IT has also been interesting and somewhat perplexing to watch the APAP respond or not respond to events.

When I look at my AHI/Pressure graph I am lowest at 6 - 7 cm and then my AHI goes up as the pressure goes up. I am going to lower my bottom number to 5 cm and see what happens at that pressure.

I was titrated at 9 cm but so far my APAP shows that as too high based on limited data. SO I am looking to see how the numbers interact with the pressure.

Much of it does seem random from night to night but I do expect a trend to emerge.

BEst,

Tom

Brent Hutto · Post by **Brent Hutto** » Tue Mar 21, 2006 1:10 pm

Linda3032 wrote:IMO, by downloading every day, you are obsessing with your numbers (unless there is very specific info you must have).

But that's just my opinion. On the other hand, your interest will help keep you compliant, which is the ultimate goal.

I agree with Linda completely. There's no harm in peeking every day if you feel inclined to do so but don't let the numbers become an end to themselves.

All the numbers you can download from the finest APAP with the best software are still only indirectly associated with reality. Reality is how you feel and how well you are able to live your life and that's much more complicated than any APAP machine can measure. Over time, numbers can provide a history that correlates with the history of your wellbeing. But it isn't something that matches up on a day-to-day basis.

It's entirely possible to download a nightly AHI of 20 one morning and feel great for the rest of the day, likewise it's possible to download a nightly AHI of 1.5 another morning and feel crappy. However, if your true AHI is 20 every day for a month you're probably not going to have a lot of great-feeling days.

The only way in which daily monitoring can be harmful is if you end up chasing the numbers by trying to make frequent changes in your therapy. But of course we all have way too much self-control to do that, right?

Brent Hutto · Post by **Brent Hutto** » Tue Mar 21, 2006 1:21 pm

roztom wrote:I've been watching my numbers and trying to see what if any variables I can detect from night to night. Much of it seems random as far as AHI, etc but leaks are more under my control.

Bingo. If you spent the night leaking air you need to figure out what to do differently the next night. The therapy isn't working if the pressure all blows away before it can splint your airway.

Your actual AHI is going to have a substantial "random" component if by "random" we mean caused by unstable, uncontrollable factors that we can't measure and account for. Equally importantly, the differences between your actual AHI and the "AHI" number reported by the machine have a random component as well (not to mention all sort of non-random systematic biases). That's why you can't tighten up the control loop and ride the APAP controls to keep each night's real or measured AHI to some theoretical minimum.

People frequently draw an analogy between an diabetic monitoring his or her blood sugar and a OSA sufferer monitoring his or her therapy. That is a useful conceptual analogy but in the details the analogy breaks down. A finger-prick blood sugar test is far more valid and reliable than the numbers we can download from our APAP machines. If this afternoon's finger prick shows higher blood sugar than this morning's it is almost certainly true that the person's blood sugar level has increased over that interval, not much random measurement error there. Furthermore, the diabetic has specific behavioral (and in some cases medical) remedies available that act in very short order and can be followed up with an additional blood sugar test. None of that applies to APAP. So the proper analogy for APAP monitoring is something more like checking in with a physical therapist twice a week to make sure your rehab from orthopedic surgery is progressing, not the immediate blood chemistry monitoring of a diabetic.

[Sermon Over]

Moogy · Post by **Moogy** » Tue Mar 21, 2006 1:27 pm

roztom wrote:Let me see if I got this right.

Don't delete any of the patient interactions in Pro and don't delete the card until it gets full.

I haven't deleted the card but after every download I was deleting the previous patient daily interaction.

SO I assume when you open Pro, your patient interaction log is full of downloads that have accumulated and since the card only holds data for 6 days that minimum you download at least every 6 days.

Am I getting close?

Yes, Tom, you will have a list of all your downloads on Pro, and you can go back and look at the past ones.

For myself, I never delete from Pro, but I delete my card data about every two or three days. That practice has not created any problem for me. The reason I delete is to speed up my downloads. It seems to be a little bit faster if there is less data on the card. I know the data is safe and sound on my computer, and I don't have to show the card to a DME for insurance purposes...

Yes, I download my data daily. If you look at the recent poll that was taken, there are a LOT of us who download daily. As long as you are doing well (and you seem to be!) why not watch and tweak as much as you want to, as long as it seems entertaining instead of stressful! I am sure that once the "new" wears off, I won't feel the need to do this daily. But as long as you and I are not STRESSING over it, why not?

I love data....I love playing with my computer....I am easily entertained...I have an empty nest and I have to do SOMETHING for entertainment!

Moogy

roztom · Post by **roztom** » Tue Mar 21, 2006 1:46 pm

ENtertainment: LOL. We all must have too much time. I was just thinking about downloading every few days but I do get a kick out of looking at the numbers and trying to see a correlation.

Yesterday my variable breathing was the lowest ever. for me at 10% and I felt like crap all day - never did recover. Usually I'm 25 - 30% Var breathing so that got my attention. My AHI was only .4 but I felt like crap.

Last night my AHI was 4.4 the worst ever and Var Breathing 25% - I fell BETTER today. LOL

SO to say the least, I am curious about those numbers. Plus I finally made it thru the night on the Swift !! Swift 5 Tom 3. MAybe that's why I feel weird - who knows.

Tom

Linda3032 · Post by **Linda3032** » Tue Mar 21, 2006 6:52 pm

I smile at all you "obsessors", and hope you know I never meant that in a bad way.

Nobody is as obsessed as NightHawk - God love him. .... But Tom is turning into a NightHawk 2. Lord help us all.

Jokingly, Linda

MyEncore Data Points Problem

Eureka!