"please keep me updated about oximeters "
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I Need Some Help From The Sleep Professionals Here
My last foiled bi-level titration study the sleep doctor recommended I use my VPAP Auto at 17/8. I was experiencing some mild aerophagia.
I switched to trialing a PR S1 BPAP Auto thinking I could understand PR's method of Pressure Support better and thus better auto titrate.
The PR S1 is indicating 15/11 as the 90% pressures. I was experiencing mild aerophagia w/the PR S1 as well and the longer we ran at the initial 17/8 in auto mode the more aggressive the aerophagia became. The sleep doctor recommended switching to straight BPAP mode at 15/11. I tried. I can NOT do it!!! He said if I couldn't handle 15/11 to drop the pressures to 13/9.
I was so burpy, then so bloated, so nauseous, and little burpy I almost went to ER Wednesday night. I can NOT afford the bloating and gas. I have Crohn's disease and a high grade partial obstruction at my old resection anastomosis. The ileum above the stricture dilates to as large as my stomach during a CT Endoscopy. I am at high risk for full obstruction and perforation. I didn't dare use my VPAP or BPAP at all Thursday nite and slept w/just 2L of 02. I will only use 2L of 02 and no PAP tonight as well. I can't bring myself to try PAP at 13/11 until Sunday night when I know my doctors will be available on Monday.
What do we do if I can not tolerate anywhere near the pressure needed to treat the OSA and hypopneas? 9.6 cms seems to be the highest pressure I can tolerate w/o encountering aerophagia.
History for those who aren't famliar w/it: COPD, started CPAP Oct 06, switched to VPAP Auto Mar 08 titrated at 13/8, re-titrated at 10/5, insufficient titration and 17/8 recommendation this year. Using a ProBasics Zzz-Mask full face mask. Recent upper endoscopy revealed NO INFLAMMATION, etc. awaiting biopsy results, tentative Dx NERD.
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Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Sorry I have not gotten back to you Judy. I do not know what to tell you. Have you looked into an oral device to use in conjunction with your PAP? This may lower your pressure needs. In the meantime I would say that some presure is better than none. You may be one of the few that just has to be happy with getting your AHI as low as possible.
How are you feeling on the o2 by itself?
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Permalink Reply by Judy on
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Tired but a h*ll of a whole lot better w/o the bloating and nausea. Still couldn't eat much this morning. Had to go in for an EKG and some lab work early so stopped at MickyDs when I got outta there. Was barely able to eat 1/2 an Egg & Bacon Biscuit w/no cheese and 1/2 a small OJ. 1/2 a tuna fish sandwich for supper w/a couple of bites of pasta salad. Needed a nap this afternoon w/just the 2L of 02. I'm glad you mentioned the dental appliance of some sort. My dentist mentioned trying one if this kept up. Maybe I'll give him a call and stop in and see him.
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Sorry. I just went to bed. I was tired. I'm going to try the cervical collar to see if that will help to keep my mouth shut when I get to sleep. I know my mouth falls open as I drift off to sleep. That is the easiest and quickest possible solution to try Sunday night.
Monday I'll ask my family doctor about trying Amoxicillin for intestine bacterial overgrowth as I had that problem once before shortly after the Crohn's returned back in 1998 or so. Bacterial overgrowth can cause bloating and gas altho usually it causes gas at both ends of the spectrum. Or at least it did back then. A standing abdominal xray should show free air in the intestines.
And I'll go back on a good probiotic. I have no other symptoms of Crohn's activity so that is the last thing we'll need to check out. We did include the Sed rate in the blood labs I had done but that could be elevated due to COPD or Crohn's so that won't be too much help. I forgot I do have a fecal calprotecin kit here so I can collect and ship that out Monday. That would be more indicative for Crohn's. As a last resort we can do a CT Endoscopy but I've had so darn many xrays and CTs thru the years between the COPD and the Crohn's that I ought to glow in the dark as it is. There's also the option of a Ceretec WBC scan. I'm not sure which is the least expensive or if one provides less exposure during the scan than the other.
All I know is right now I DREAD the thought of donning my mask and turning this PAP on Sunday night!!!
By the way - ResScan 3.11 is out now. I got a copy last night. I didn't feel up to installing it though and have no idea of what the differences are between 3.11 and 3.10 and will have to go back to my VPAP Auto after installing to explore what differences there are.
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Whew! Another night of just 2L of 02 and no PAP and I feel so much better, tired but not nauseous or bloated. I think all the gas and bloating is gone now. And my teeth feel so much cleaner this morning!!! They did yesterday morning too.
I don't know. A full face mask tends to push the jaw backward. I can't breathe comfortably if the humidifier air is too warm. Even w/a chin strap w/a nasal cushion while I don't open my mouth I do still get too high a leak rate due to the "lip flutters".
I'm terrified at the thought of donning mask and PAP tonight even at 13/9. I can't bear the thought of more bloating and nausea again. I'm more and more convinced it is the aerophagia and NOT bacterial overgrowth, NERD or Crohn's.
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