"please keep me updated about oximeters "
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Dr Park
I have COPD
I use a Resmed VPAP Auto
I was doing quite well on bi-level at IPAP 13, EPAP 8, PS 4 as titrated despite a rather high leak rate.
But then I started doing less well. I was re-titrated at IPAP 10, EPAP 5 but did NOT do well at those pressures at all. The DVD of the study indicates it may have been poorly done and/or poorly scored.
I developed some minor throat problems, almost constant feeling of phlegm, no choking, but some minor swallowing problems.
Thyroid blood levels were w/in "normal" reference ranges
CT and US of the neck revealed multiple nodules on the right thyroid lobe and one small one on the left. Nodules are not manually palpable.
FNA determined the 2.6 nodule is benign. Not sure if the 1 cm nodule was aspirated or not
Thyroid anti-bodies blood draw results not available yet
How likely is it that worsening COPD would cause the need for bi-level pressure raises?
How likely is it that the thyroid nodules would cause the need for bi-level pressure raises?
I use a Resmed VPAP Auto
I was doing quite well on bi-level at IPAP 13, EPAP 8, PS 4 as titrated despite a rather high leak rate.
But then I started doing less well. I was re-titrated at IPAP 10, EPAP 5 but did NOT do well at those pressures at all. The DVD of the study indicates it may have been poorly done and/or poorly scored.
I developed some minor throat problems, almost constant feeling of phlegm, no choking, but some minor swallowing problems.
Thyroid blood levels were w/in "normal" reference ranges
CT and US of the neck revealed multiple nodules on the right thyroid lobe and one small one on the left. Nodules are not manually palpable.
FNA determined the 2.6 nodule is benign. Not sure if the 1 cm nodule was aspirated or not
Thyroid anti-bodies blood draw results not available yet
How likely is it that worsening COPD would cause the need for bi-level pressure raises?
How likely is it that the thyroid nodules would cause the need for bi-level pressure raises?
Views: 23
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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Judy, Sorry for the delay.
From what you're describing, any kind of inflammation (colds, allergies, weather changes, irritants) can aggravate your COPD, as well as your sleep apnea. If your BiPAP pressure rises, then your leak rate may increase as well, lessening the effectiveness of the xPAP device.
Thyroid nodules are very slow growing, and from what you're describing, it's so small that it's unlikely to cause any problems with your airway.
I would work on optimizing your BiPAP pressures and leaks first, and then worry about the COPD and thyroid issues, if they still exist. Good luck. Hope this helps.
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Permalink Reply by Judy on
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Thank you, Dr Park. I go in for another bi-level re-titration next week.
I'm currently using - and like - the ProBasics Zzz-Mask full face mask which is giving me an excellent Leak rate, but even in VPAP Auto mode we've not been able to determine the proper pressure settings.
The last 2 weeks Leak has been Median 0 L/M, 95th percentile 7.2 L/M and Maximum 27.6 L/M
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