Broken PR60?

Any PR60 experts out there?

OK I don't know what else could be causing this problem other than just the machine is broken, or there is a firmware bug. Either way, I'm upset.

So my new machine was prescribed wide open, at 4/20. I had the 'opti-start' setting turned on, so eventually after many months my start pressures eventually inched up to an average of 8 or 9 or so.

Last month I mailed the chip to the DME and he re-set the chip to start at 9 and go up to 20. I turned opti-start back on, via the clinical control panel.

Well weeks of use (well past 30 hours) have gone by and the machine is still not self-adjusting the start pressure at all, or even indicating that opti-start is functioning. It just shows, every night, the start pressure = 9. Period. The icon for opti-start operating does not show up, indicating it is working. So I assume it is not doing anything.

My average pressures each night are around 11-15ish.

Any idea what's going on? Does the machine need to be totally re-set? Should I just call PR and yell at them for yet another firmware bug? Ugh.

hyperlexis wrote:Any PR60 experts out there?

OK I don't know what else could be causing this problem other than just the machine is broken, or there is a firmware bug. Either way, I'm upset.

So my new machine was prescribed wide open, at 4/20. I had the 'opti-start' setting turned on, so eventually after many months my start pressures eventually inched up to an average of 8 or 9 or so.

Last month I mailed the chip to the DME and he re-set the chip to start at 9 and go up to 20. I turned opti-start back on, via the clinical control panel.

Well weeks of use (well past 30 hours) have gone by and the machine is still not self-adjusting the start pressure at all, or even indicating that opti-start is functioning. It just shows, every night, the start pressure = 9. Period. The icon for opti-start operating does not show up, indicating it is working. So I assume it is not doing anything.

My average pressures each night are around 11-15ish.

Any idea what's going on? Does the machine need to be totally re-set? Should I just call PR and yell at them for yet another firmware bug? Ugh.

Why would you complain to Philips/Respironics about something your DME apparently did?
You say your DME set the starting pressure to 9 cm. and that's where it's starting.
Maybe Opti-start only works when the pressure range is "wide open".......?

I don't understand what you're complaining about. Everything (the settings changes) you've described sounds "logical" to me.


Den

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Wulfman... wrote:

Why would you complain to Philips/Respironics about something your DME apparently did?
You say your DME set the starting pressure to 9 cm. and that's where it's starting.
Maybe Opti-start only works when the pressure range is "wide open".......?

I don't understand what you're complaining about. Everything (the settings changes) you've described sounds "logical" to me.


Den

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It doesn't really work that way -- my DME re-set the start to 9. So now the machine is set at 9/20 instead of 4/20. The optistart feature is supposed to kick in after 30 hours of use to raise or lower the start pressure based on what the computer in the machine calculates is ideal based on AHI, etc. So if the machine thinks the ideal start pressure should be 9.5 or 10, etc., after 30+ hours of calculations, it will re-set the start pressure accordingly. If it thinks the pressure should be lower than 9, it will not go below 9, because that's the new Rx setting. But one way or the other it should state "opti-start' on the display when running, to indicate the feature is at least running and the computer is 'thinking'. That's what the machine is not now doing, even though the setting is turned on per the clinical manual display settings, and more than 30 hours have elapsed.... I'll call the DME but PR should also know about this problem.

If anyone else has faced this problem, any advice would be much appreciated! Thanks!

can you not use your ramp? you turn it on and set it in the settings. you use it by pushing the ramp button.

If you're trying to access those settings with the card in the machine, maybe that's the problem. From what I've been reading about Opti-Start, it sounds like it's a feature that can be locked out.

And, to me, it sounds like your machine is working properly.......especially if you're going to be using a DME for therapy and technical support.


Den

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As Den says, Opti-start can probably be disabled by DME when putting machine settings on sd card.

The only way around this without going back to DME to redo settings on card, IF AND ONLY IF you are capable, would be to take out the card, reformat (wipe) it on your computer using a free utility like SDFormat, and then put it back in machine. Then, go into clinician menu and put in your settings manually.

You would want to download any sleep data into Sleepyhead or Encore before doing this. It is my understanding that all compliance data on your machine would write to the card as soon as you re-insert it, but perhaps someone familiar with the 60 series machines could confirm this.

hyperlexis wrote:
It doesn't really work that way -- my DME re-set the start to 9. So now the machine is set at 9/20 instead of 4/20. The optistart feature is supposed to kick in after 30 hours of use to raise or lower the start pressure based on what the computer in the machine calculates is ideal based on AHI, etc. So if the machine thinks the ideal start pressure should be 9.5 or 10, etc., after 30+ hours of calculations, it will re-set the start pressure accordingly. If it thinks the pressure should be lower than 9, it will not go below 9, because that's the new Rx setting. But one way or the other it should state "opti-start' on the display when running, to indicate the feature is at least running and the computer is 'thinking'. That's what the machine is not now doing, even though the setting is turned on per the clinical manual display settings, and more than 30 hours have elapsed.... I'll call the DME but PR should also know about this problem.

If anyone else has faced this problem, any advice would be much appreciated! Thanks!

Did you ever get your opti-start issue figured out? I'm having the same problem.

Zomglawlz wrote:

hyperlexis wrote:
It doesn't really work that way -- my DME re-set the start to 9. So now the machine is set at 9/20 instead of 4/20. The optistart feature is supposed to kick in after 30 hours of use to raise or lower the start pressure based on what the computer in the machine calculates is ideal based on AHI, etc. So if the machine thinks the ideal start pressure should be 9.5 or 10, etc., after 30+ hours of calculations, it will re-set the start pressure accordingly. If it thinks the pressure should be lower than 9, it will not go below 9, because that's the new Rx setting. But one way or the other it should state "opti-start' on the display when running, to indicate the feature is at least running and the computer is 'thinking'. That's what the machine is not now doing, even though the setting is turned on per the clinical manual display settings, and more than 30 hours have elapsed.... I'll call the DME but PR should also know about this problem.

If anyone else has faced this problem, any advice would be much appreciated! Thanks!

Did you ever get your opti-start issue figured out? I'm having the same problem.

Haha! Yes! In a way. Thanks for reminding me.

I sent the chip back to my DME's respiratory therapist for a monthly checkup and I told him what was happening. As I expected, he didn't know exactly what had caused the bug. But he guessed it was because it was because either he didn't activate OptiStart on the chip reprogramming itself, with the new Rx he programmed in, or because the machine was determining my start number needed was actually lower than the new number he programmed.

So he re-programmed the chip and turned on OptiStart with the reprogramming. Instead of setting the start pressure at 9, he set it at 7.

After several days of use, the OptiStart feature started working again, and showed on the display. It has been going up and down since. Now it seems to have settled around 7.5 or 8ish. It depends on which masks I use, honestly. When I go for days on a Quattro FF, it usually shows a lower average pressure needed. Same with a nasal mask. When I use my V2 FFM my 90% pressure usually shows over 11-13. So the OptiStart feature starts climbing up to 8 or 8.5. Interesting how experimental this all has been.

So that may be what you need to do. Have the DME put a new Rx into the chip, with OptiStart on (or flash the chip yourself). And lower the start pressure to below what you think you need. Then let the machine start adjusting upward on its own.

This shouldn't require such wizardry, and the clinical menu should have been able to achieve this on its own, but I guess that if there is a conflict between the clinical menu settings, and the SIM chip settings, the SIM will prevail.

Another indication how far these machines have yet to go. We still seem to all be in some sort of beta test.....

What is the exact model of your machine as shown on the bottom sticker? The one place I have heard about the OptiStart feature is on the DS460 model.

hyperlexis wrote:

Zomglawlz wrote:

hyperlexis wrote:
It doesn't really work that way -- my DME re-set the start to 9. So now the machine is set at 9/20 instead of 4/20. The optistart feature is supposed to kick in after 30 hours of use to raise or lower the start pressure based on what the computer in the machine calculates is ideal based on AHI, etc. So if the machine thinks the ideal start pressure should be 9.5 or 10, etc., after 30+ hours of calculations, it will re-set the start pressure accordingly. If it thinks the pressure should be lower than 9, it will not go below 9, because that's the new Rx setting. But one way or the other it should state "opti-start' on the display when running, to indicate the feature is at least running and the computer is 'thinking'. That's what the machine is not now doing, even though the setting is turned on per the clinical manual display settings, and more than 30 hours have elapsed.... I'll call the DME but PR should also know about this problem.

If anyone else has faced this problem, any advice would be much appreciated! Thanks!

Did you ever get your opti-start issue figured out? I'm having the same problem.

Haha! Yes! In a way. Thanks for reminding me.

I sent the chip back to my DME's respiratory therapist for a monthly checkup and I told him what was happening. As I expected, he didn't know exactly what had caused the bug. But he guessed it was because it was because either he didn't activate OptiStart on the chip reprogramming itself, with the new Rx he programmed in, or because the machine was determining my start number needed was actually lower than the new number he programmed.

So he re-programmed the chip and turned on OptiStart with the reprogramming. Instead of setting the start pressure at 9, he set it at 7.

After several days of use, the OptiStart feature started working again, and showed on the display. It has been going up and down since. Now it seems to have settled around 7.5 or 8ish. It depends on which masks I use, honestly. When I go for days on a Quattro FF, it usually shows a lower average pressure needed. Same with a nasal mask. When I use my V2 FFM my 90% pressure usually shows over 11-13. So the OptiStart feature starts climbing up to 8 or 8.5. Interesting how experimental this all has been.

So that may be what you need to do. Have the DME put a new Rx into the chip, with OptiStart on (or flash the chip yourself). And lower the start pressure to below what you think you need. Then let the machine start adjusting upward on its own.

This shouldn't require such wizardry, and the clinical menu should have been able to achieve this on its own, but I guess that if there is a conflict between the clinical menu settings, and the SIM chip settings, the SIM will prevail.

Another indication how far these machines have yet to go. We still seem to all be in some sort of beta test.....

Thanks or the reply. I was guessing it might be something with my start pressure being higher then it would recommend. I've already gotten into the clanician menu and made the changes. Now I'll see how it goes.

You figured it out, but the answer is that indeed if a card has been set with a "prescription" then there's NO WAY to override then, clinician's menu or otherwise. The machine just keeps reading it from the card.

So when the DME first sent you the card back, and it was now set to start at 9, that meant the DME wrote a prescription to the card, effectively ending your ability to control such parts unless and until the prescription is REMOVED from the card, or you use a different card.

Fortunately the DME knew what caused this and fixed the feature for you ... but bear in mind that while a card with a prescription is inserted you'll simply be unable to change anything that the prescription specifies.

khauser wrote:You figured it out, but the answer is that indeed if a card has been set with a "prescription" then there's NO WAY to override then, clinician's menu or otherwise. The machine just keeps reading it from the card.

So when the DME first sent you the card back, and it was now set to start at 9, that meant the DME wrote a prescription to the card, effectively ending your ability to control such parts unless and until the prescription is REMOVED from the card, or you use a different card.

Fortunately the DME knew what caused this and fixed the feature for you ... but bear in mind that while a card with a prescription is inserted you'll simply be unable to change anything that the prescription specifies.

I also have a PR760P.

Do I understand you to say that if I only take my card in to see the doc and not the whole machine, and he subsequently decides to say change my pressures on the card that I can't change it back to where I want it in the machine itself when I get it home?

old dude wrote:Do I understand you to say that if I only take my card in to see the doc and not the whole machine, and he subsequently decides to say change my pressures on the card that I can't change it back to where I want it in the machine itself when I get it home?

The ability to write changes to the machine settings is available within the software. It can be a one time change or a locked in change. Locked in meaning it will override any manual changes you might make. All depends on how the setting change was implemented via the software.
So it is possible for a setting change to be implemented by the doctor via the SD card and the software in his office but I doubt they bother...it's extra work. More likely a DME might do it just to be a PITA using some power control thing.

Should that happen...there's an easy solution to that little annoyance though. No big deal. Just erase the SD card and it no longer will have that little software directive in it. Insert the blank SD card back into the machine and all the old data that is stored in the machine goes right back on the SD card. Nothing of critical importance is lost and the SD card no longer controls the machine.

Pugsy wrote:

old dude wrote:Do I understand you to say that if I only take my card in to see the doc and not the whole machine, and he subsequently decides to say change my pressures on the card that I can't change it back to where I want it in the machine itself when I get it home?

The ability to write changes to the machine settings is available within the software. It can be a one time change or a locked in change. Locked in meaning it will override any manual changes you might make. All depends on how the setting change was implemented via the software.
So it is possible for a setting change to be implemented by the doctor via the SD card and the software in his office but I doubt they bother...it's extra work. More likely a DME might do it just to be a PITA using some power control thing.

Should that happen...there's an easy solution to that little annoyance though. No big deal. Just erase the SD card and it no longer will have that little software directive in it. Insert the blank SD card back into the machine and all the old data that is stored in the machine goes right back on the SD card. Nothing of critical importance is lost and the SD card no longer controls the machine.

Pugsy, which software are you referencing? Something that the doc or DME has when they write to the card, not something in the machine itself? Reason for asking is that I was planning to only take in my card and not the machine itself just to prevent them from messing with my settings.

I don't know why, but logically I would have thought that the machine settings would take precedence over the card.

If I do have to erase the SD card as you mention, how much data is stored in the machine itself that will re-write to the card? By how much I'm talking about how far back in time.

Thanks.

I believed that the ResMed can only store 7 days of detailed graphs information but a year of general data.