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!#$%* my conviction!
Mad at myself. I went to the respiratory therapist to get my new machine today. My Sleep Doctor said I could request what machine I wanted so I requested a Resmed S8 AutoSet II w/EPR. I sent a message to both the therapist and the doctor about this. The doctor approved the request, the therapist never replied. When I got there today the therapist laughed when I told him the doctor said I could have this machine and said "Well, we'll have to teach her". What??? Who's in charge anyway? The therapist, doctor, insurance? I of course had suspected this was going to happen so I was full of conviction that I would not accept another machine and that I would ask to speak to the doctor.
Did I...NO! I balked in the face of authority! I'm the proud new owner of a Resmed Auto Vpap 25 set at a Ipap of 25 and Epap of 15. My therapist, who thinks he is smarter than the doctor, does not know how to set this new 25 so the "rest" period is 8, like I requested, instead of the preset 4. I hope I don't feel like I'm suffocating while I'm trying to go to sleep tonight! He also could not figure out how to set the advanced/detailed patient data to "on". There is some data available via the LCD machine under the "results" section. Will this give me the info I need??? He did not want me to have this info anyway. He said that was his job. But I was firm and told him I wanted it. Maybe he pretended he could not do it. I don't know! Am I being too hard on him? He is a nice guy but...?
I'm nervous about going to sleep tonight. I don't know what to expect. It's been over 2 years since I've been on therapy and I feel like I'm a person who is absent in their own life! I'm here but, I'm not here. I so want this to work.
Did I...NO! I balked in the face of authority! I'm the proud new owner of a Resmed Auto Vpap 25 set at a Ipap of 25 and Epap of 15. My therapist, who thinks he is smarter than the doctor, does not know how to set this new 25 so the "rest" period is 8, like I requested, instead of the preset 4. I hope I don't feel like I'm suffocating while I'm trying to go to sleep tonight! He also could not figure out how to set the advanced/detailed patient data to "on". There is some data available via the LCD machine under the "results" section. Will this give me the info I need??? He did not want me to have this info anyway. He said that was his job. But I was firm and told him I wanted it. Maybe he pretended he could not do it. I don't know! Am I being too hard on him? He is a nice guy but...?
I'm nervous about going to sleep tonight. I don't know what to expect. It's been over 2 years since I've been on therapy and I feel like I'm a person who is absent in their own life! I'm here but, I'm not here. I so want this to work.
Replies to This Discussion
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Permalink Reply by Mary Z on -
bonesigh,
You got a good machine. It's similar to the one you requested, but provides better exhalation relief- necessary at your high pressures. It's a BiPap rather than a CPAP machine. Really, you did good.
Now the DME should have known how to set up the machine! I have the same machine and the data I'm able to access (hold right and left arrow buttons down at the same time and follow the menu)- just keep following the menu and use the left arrow button to access- you'll get the hang of it- anyway I can access settings, advance settings, and the one I'm interested in "results". Under this menu you find "efficacy" and "usage". Under efficacy I can see leak, VT or Tidal volumn, respiratory rate, minute volumn, pressure , AHI, AI, %Spont. T, and % Spont. C. The last two I don't understand and my machine is not set in such a way that I use them. Usage tells you the hours/days used. The machine resets at 12:00 noon.
Someone, either your Doctors office will access the data over the period of time since you started, or the DME will access it. I get mine read by techs at the Doctors Office, but I can mail the ResScan card to the DME, he will access the data and mail the report to me.
I record the leak, pressure, AHI, and AI everyday and keep track. My Docs office is really good and they change pressure settings there when needed.
Your pressures are pretty high. I have "settling", very first screen, set at 45 by the doc. Usually I'm asleep before the real pressure begins.
Really, you got an excellent machine, bonesigh. Hang in there. Tell the DME ResMed offers inservices and on line classes for professionals LOL.
Good luck, keep us posted,
Mary Zimlich
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Permalink Reply by Judy on -
Ha! Sounds like you fell in a pile of poop and coming up smelling like a rose!!!! That VPAP Auto 25 in one heck of a good device!!!! Your DME probably got a chuckle out of your asking for a "lesser" xPAP than what you needed or was scripted!!! Since your doctor scripted a bi-level (which is what the VPAP Auto 25 is) your DME provider could NOT provide you w/an AutoSet II. If you can access the Results via the LCD screen, then access to the advanced/detailed menu HAS been turned on. You are not only getting what you wanted, you got MORE!
I suspect your DME provider was just having a little fun w/yuo and feeling you out as to just how much you really do know yet. Give him a break, it sounds like he may well be a pretty good guy just not wanting you to get too far ahead of yourself. You've made it clear to him that you are going to want to take an active part in your therapy and that's good. I have a feeling he is going to be willing to work w/you - one step at a time. So far you sure could have done a lot worse!!!
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Permalink Reply by bonesigh on -
Hmmm, I don't know Dan but my online name comes from the proper pronunciation of the art of "Bonsai". You say "bone" "sigh" which means, plant in pot. Some people say Banzai which is actually the war cry that means, they want the japanese empire to last 10,000 years.
Dan Lyons said:^5 bonesigh, Are they not an arrogant group?
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Permalink Reply by bonesigh on
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Okay, thank you Mary. It's helped a lot. I feel better about it. Heh, heh, online classes! Wish I could actually say that! I was hoping it was a good machine. I'm not sure why the pressures are so high. My original pressure at the beginning of therapy was 18/14 and just recently at a new sleep study they reduced the pressure to 13/9. I wonder why they set the pressures so high? Does the Epap pressure mean that (in my case) 15 is the lowest it will go or will it be more like my usual of 8? 15 is almost as high as my highest Ipap. It's confusing.
Mary Zimlich said:bonesigh,
You got a good machine. It's similar to the one you requested, but provides better exhalation relief- necessary at your high pressures. It's a BiPap rather than a CPAP machine. Really, you did good. Now the DME should have known how to set up the machine! I have the same machine and the data I'm able to access (hold right and left arrow buttons down at the same time and follow the menu)- just keep following the menu and use the left arrow button to access- you'll get the hang of it- anyway I can access settings, advance settings, and the one I'm interested in "results". Under this menu you find "efficacy" and "usage". Under efficacy I can see leak, VT or Tidal volumn, respiratory rate, minute volumn, pressure , AHI, AI, %Spont. T, and % Spont. C. The last two I don't understand and my machine is not set in such a way that I use them. Usage tells you the hours/days used. The machine resets at 12:00 noon.
Someone, either your Doctors office will access the data over the period of time since you started, or the DME will access it. I get mine read by techs at the Doctors Office, but I can mail the ResScan card to the DME, he will access the data and mail the report to me.
I record the leak, pressure, AHI, and AI everyday and keep track. My Docs office is really good and they change pressure settings there when needed.
Your pressures are pretty high. I have "settling", very first screen, set at 45 by the doc. Usually I'm asleep before the real pressure begins.
Really, you got an excellent machine, bonesigh. Hang in there. Tell the DME ResMed offers inservices and on line classes for professionals LOL.
Good luck, keep us posted,
Mary Zimlich
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Permalink Reply by bonesigh on
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Thank Judy! Hmm, gives me an idea to write a song parody of "Rose Colored Glasses". Anyway, thanks so much for the info. It didn't seem like he was messing with me but I suppose it's possible. He seems like a good guy but does not want me to be involved in my therapy. He is pretty firm about his feelings on this.
Judy said:Ha! Sounds like you fell in a pile of poop and coming up smelling like a rose!!!! That VPAP Auto 25 in one heck of a good device!!!! Your DME probably got a chuckle out of your asking for a "lesser" xPAP than what you needed or was scripted!!! Since your doctor scripted a bi-level (which is what the VPAP Auto 25 is) your DME provider could NOT provide you w/an AutoSet II. If you can access the Results via the LCD screen, then access to the advanced/detailed menu HAS been turned on. You are not only getting what you wanted, you got MORE!
I suspect your DME provider was just having a little fun w/yuo and feeling you out as to just how much you really do know yet. Give him a break, it sounds like he may well be a pretty good guy just not wanting you to get too far ahead of yourself. You've made it clear to him that you are going to want to take an active part in your therapy and that's good. I have a feeling he is going to be willing to work w/you - one step at a time. So far you sure could have done a lot worse!!!
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Permalink Reply by Mary Z on
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I tell you, bonesigh, I have no idea why your pressures are as high as they are. Maybe someone more knowledgeable will speak up. Glad we're helping.
Mary Zimlich
bonesigh I just figured out they put you on a respirator! LOL!
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Permalink Reply by Judy on
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BoneSigh - you have a bi-level xPAP. This is not some snuffy little leaf blower. Adjusting your pressure setting(s) on a CPAP or an APAP is one thing, as has been said many times, its not rocket science. BUT - what you haven't yet realized is that bi-level therapy is considerably more sophisticated. I certainly understand his being pretty firm about his feelings on this.
Look, I've been on CPAP therapy CONTINUOUSLY from Oct 2006 to Mar 2008 when I was switched to my VPAP Auto bi-level therapy and continuously on the bi-level from Mar 2008 to today. I don't "play" w/my therapy settings w/o input and discussion w/an experienced RRT or PSGT.
I blythely adjusted my therapy settings when on CPAP and APAP. I do NOT adjust my bi-level therapy settings w/o input from a "sleep professional" I respect. We aren't talking just pressure, ramp, epr - there are a LOT more therapy "options" on a bi-level, ESPECIALLY, a bi-level auto.
My advice? Access your efficacy data results each day before noon. Write them down in a file somewhere. Average them out ONCE A WEEK. Watch the TREND of your therapy results. Contact this DME provider as needed. DO NOT CHANGE any of your settings yourself.
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Permalink Reply by sleepycarol on -
I agree with Judy on the bi-level settings. I have a plan old apap (the M series with c-flex). I did up my pressure by one and feel better, BUT I would not change settings if I were on a bi-pap, especially an auto. Like Judy said there are too many variables that depend upon each other to be effective. If you encounter problems talk to your doctor before having any changes done to your machine.
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Permalink Reply by bonesigh on
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Ummm, I never said I had any intention of changing the settings. I only wanted to see detailed results. He doesn't want me to see detailed results.
As expected I had a horrible night last night. Headache this morning. My pressures were at 13/9 on the old machine so what was especially hard was the Epap being set at 15. My eardrums popped and there was no relief from pressure like there is at Epap 8. Air went down the wrong way. Mask leaked. Only got 6 hrs. I think most of that was not actually sleeping. These are the results that I was able to get, Leak 0.24L/s, VT 340-500 (what does that mean?), Resp Rate 13-17, MV 5.2-7.5 (don't know what this is either), Press 19.0 (does that mean the average over the night?), AHI 0.5, AI 0.0, % spont T 0%, % spont C 0% (don't know what "spont" is either).
Judy said:BoneSigh - you have a bi-level xPAP. This is not some snuffy little leaf blower. Adjusting your pressure setting(s) on a CPAP or an APAP is one thing, as has been said many times, its not rocket science. BUT - what you haven't yet realized is that bi-level therapy is considerably more sophisticated. I certainly understand his being pretty firm about his feelings on this.
Look, I've been on CPAP therapy CONTINUOUSLY from Oct 2006 to Mar 2008 when I was switched to my VPAP Auto bi-level therapy and continuously on the bi-level from Mar 2008 to today. I don't "play" w/my therapy settings w/o input and discussion w/an experienced RRT or PSGT.
I blythely adjusted my therapy settings when on CPAP and APAP. I do NOT adjust my bi-level therapy settings w/o input from a "sleep professional" I respect. We aren't talking just pressure, ramp, epr - there are a LOT more therapy "options" on a bi-level, ESPECIALLY, a bi-level auto.
My advice? Access your efficacy data results each day before noon. Write them down in a file somewhere. Average them out ONCE A WEEK. Watch the TREND of your therapy results. Contact this DME provider as needed. DO NOT CHANGE any of your settings yourself.
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Permalink Reply by Judy on
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Well, you CAN see the results so WHO turned them on??
Give it the ole college try for another night or two. A whole 7 nights if you can, and then trot in to see that DME guy and have another heart to heart w/him.
A little knowledge can be dangerous and I still think this guy is just feeling you out and will be parceling out info as he feels more confidence in you and that he will work as a team w/you over time.
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Permalink Reply by Mary Z on
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bonesigh, Judy posted the link to an excellent article on leaks-
http://www.cpaptalk.com/wiki/index.php/Mask_Leaks
From what I've been told VT is tidal volume- the amount of air you move in and out of your lungs, Respiratory rate is just that, how many breaths you took, Minute volume is the amount of air you move per minute- MV X 60 equals VT, Pressure of 19- I don't know if that's the straight pressure or pressure average for the night. AHI of 0.5 is the number of apnea/hypoxia events during the night and since your AI is 0 that means you have 0.5 HI events during the night- excellent!
Spont T and C only apply in certain cases, maybe a sleep professional could explain and check the rest of my explanations for accuracy, I'm just a BiPap user like you, bonesigh.
Keep us posted and hang in there,
Mary Zimlich
bonesigh said:Ummm, I never said I had any intention of changing the settings. I only wanted to see detailed results. He doesn't want me to see detailed results.
As expected I had a horrible night last night. Headache this morning. My pressures were at 13/9 on
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