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Who fit your mask?
Mask fitting is an art! Any Sleep Tech or Respiratory Therapist can tell you that. So here is the problem... I keep hearing about companies that "Drop Ship" their Cpap machines to the patients. How are these patients sure they have the correct mask. The Sleep Techs in the lab are the first people to put a mask on your face during titration, but often times they are limited in the options they have for masks. As an RT at a DME company, I fit hundreds of masks, many patients required two or three mask fittings until they found a mask they were happy with. So I would like to hear from the forum on how they started out. How did they find the right mask? Were they fitted by a proffesional at their home? I do not work for the DME company any more, but when I did, I had a coworker fit my mask. Who fit your mask?
Views: 44
Replies to This Discussion
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Permalink Reply by BeeAsleep on
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Hi there Jim. I had a RT from a DME come to my house over the lunch hour. He showed me how to plug in the machine and put the hoses on. He looked at my face and told me because I had a certain size nose I would need a certain size nasal mask. He handed me the mask left without me ever trying it on. That night when I put it on and got in bed the mask was covering the inner part of my eyes....I didn't wear it. I called the next day and asked for a different mask. He stopped by when I was at work and left a box on my front doorstep. Inside was a full face mask and a Swift LT for her nasal pillows. I messed around and tried to read the manuals and finally ended up with the nasal mask. I actually had the nasal pillows on upside down for a few nights. Long and short of it...I didn't "get fitted". I did it myself. And I have continued to be the one to manage my therapy with the help of this forum.
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Permalink Reply by Jim Nadolny, BS, CRT on
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The RT should have had you lay in bed, put the mask on with the machine running, and check for leaks. I hear your story all the time. They days of good service, and not quiting until the job is done, are fading away. A lot of people give up on Cpap because they are never fitted properly. You are one of the lucky ones that take matters into their own hands...GOOD FOR YOU! If you are a faithful user, you know that the reward is worth it!
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I love my CPAP. Because I got good advice on this forum about which kind of machine to ask for, and now that I have my ResMed S8 Autoset II with the EPR setting I am a happy camper. I love my nasal pillows, I have a 0.00L/S most nights! I guess it just comes down to being responsible for your own health care. I have learned that with all health care issues in my life. I am just glad that I have found something that works for me. :>D
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Permalink Reply by sleepycarol on
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A DME fitted me for my first mask -- a Fisher and Paykel 431 full face mask. The sleep doctor prescribed a size small and I told the RT at the DME that I thought a medium would fit better. She tried it on, me sitting in a chair, turned on the machine for about 30 seconds, declared I was leak free and sent me on my way. I used that mask for several months before embarking on my journey to find THE mask best suited for me. After much trial and error, with the vast majority of my masks coming from other hoseheads and thus slightly used, I found one that I like very much. It is the Headrest/Aura mask.
I used a local posting want ad site to obtain some of my masks, others from eBay (prior to them banning them), and still others came from cpapauction.
In my opinion, my quest was well worth the effort and money spent.
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Permalink Reply by Chris on
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A DME stopped by showed me how to use the machine put the mask on me and said " everything looks good" and he was on his way. After a few unsuccesssful night of trying to get my mask to be leak free and comfortable I looked into things and found out I needed a large. I called them and they mailed me a large mask that still drives me up a wall and leaks. Think I am going to try a nasal Pillow. I am reluctant to call the DME I got the machine from but I may have no choice.
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I feel much better about your experience than some others. Everyone will have to do some searching, upgrading, and testing. It is far better to get started with a mask that at least fits, and go from there. My blog has some interesting reviews give it a look http://cpapcritic.com
sleepycarol said:A DME fitted me for my first mask -- a Fisher and Paykel 431 full face mask. The sleep doctor prescribed a size small and I told the RT at the DME that I thought a medium would fit better. She tried it on, me sitting in a chair, turned on the machine for about 30 seconds, declared I was leak free and sent me on my way. I used that mask for several months before embarking on my journey to find THE mask best suited for me. After much trial and error, with the vast majority of my masks coming from other hoseheads and thus slightly used, I found one that I like very much. It is the Headrest/Aura mask.
I used a local posting want ad site to obtain some of my masks, others from eBay (prior to them banning them), and still others came from cpapauction.
In my opinion, my quest was well worth the effort and money spent.
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Nasal Pillows are a good option for many users. You should go to Resmed.com and read about the Swift line of masks, I found them to work well for me. Puritan bennett and Respironics also make good, quality nasal pillow style masks. You can see reviews on some of these masks at http://cpapcritic.com . As for your DME company...get a new one! it is your choice! (depanding on insurance). Also if you are comfortable with it, you could buy a mask from an online company like ApneaLife.com and buy a mask that you research ahead of time.
Chris said:A DME stopped by showed me how to use the machine put the mask on me and said " everything looks good" and he was on his way. After a few unsuccesssful night of trying to get my mask to be leak free and comfortable I looked into things and found out I needed a large. I called them and they mailed me a large mask that still drives me up a wall and leaks. Think I am going to try a nasal Pillow. I am reluctant to call the DME I got the machine from but I may have no choice.
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Permalink Reply by RockRpsgt on
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I try to do a mask orientation for all of my pt's. At least let them try on one of each style mask before a titration. I show them the proper way to fit a mask themselves. i try to arm my pts with as much knowledge as i possibly can.
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Permalink Reply by Judy on
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Well, lets see. The sleep tech at each of my titrations, of course. NONE of which fitted me whilst I was laying down. AND who had a tendency to tighten the headgear too much. Then, there was the RT at my first local DME suppliers. I had to keep an appointment to get my equipment and mask selection and fitting. No fitting was done w/me laying down nor were there the "facilties" to allow me to lay down for a fitting. The first fitting she never even had a CPAP on hand to fit the mask at pressure! That RRT and I had problems. She was either "less than truthful" or dumber than a rock. When I broke a part on my mask, she tried to tell me that Medicare wouldn't pay for the part. I had to print out a download from Medicare substantiating when they would pay for what and shove it under her nose. She tried to tell me Medicare wouldn't pay for a nebulizer my doctor scripted and I had to rub THAT one under her nose too.
My second local DME supplier delivered the equipment to my house. He arrived w/a "boat load" of masks and allowed me to try several. I forget how many. He would leave the one or two that were promising and check back w/me in a week to see if the mask(s) I had kept that week were satisfactory. I probably went thru 10-12 masks before "we" found the one that was the most comfortable and relatively leak free for me.
My last titration I was asked what mask I used. On the basis of that the sleep doctor called the RRT in who suggested the OptiLife. He brought in a medium, laid it on my face whilst sitting up, decided the small would be a better fit, brought it in and held it to my face. On the bases of that when I went to the titration itself, an EXCELLENT RPSGT came in for mask fitting, discussed several masks w/me and those I had already tried and we agreed on the OptiLife and my own Simplicity. The actual fitting was done by the PSGT who actually did my titration. Whilst it seemed to fit okay when I first went to sleep, when I woke during the night it was DEFINITELY too tight and I asked to switch to my own Simplicity. I didn't want to sit up being fitted again for fear of getting too awake and not being able to get back to sleep. He did suggest a chin strap which we used the rest of the night.
All in all, I do better doing my own mask fitting w/the help of an extra set of hands if I need them. And I am not above cutting my headgear straps and using velcro to reattach the cut ends. I don't think one fitting of ANY mask is enough. Some that feel comfortable for 1-2 nights may be cutting into the face or bridge of the nose by the 3rd night or leaving a bruised feeling at the bridge of the nose, etc.
Rock Hinkle is SO RIGHT. Its IMPORTANT that the patient be shown the proper way to fit a mask themselves. Because in the end that is what we ALL end up doing. In my opinion it takes AT LEAST a week of sleeping w/a mask to really know if it is going to work for you or not. Unless, of course, it is obvious from the get-go that it NOT going to work for you at all. I always give the promising masks AT LEAST a week before deciding to keep it or try another.
And I really think that probably some of the masks that I first tried or even declined I would have better luck w/now that I've had the experience of sleeping w/a mask and CPAP for better than 2 and a half years. But I prefer and keep going back to my Simplicity w/a chin strap for comfort and acceptable leak rates.
Ah, but I FORGOT to mention the two best mask fittings I've had. One was by my sleep lab manager when I got so exasperated w/my first DME supplier's RRT. She was an RRT, RPSGT and had been in the field some 20 years at least. The other was her sleep lab's daytime PSG scoring RPSGT. A relatively young man I've no idea how long he has been working in sleep medicine.
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Rock, I was hoping you would comment on this. I have seen some of your other comments and know that you are a Sleep Tech that knows the ropes. What you are doing is setting these patients up for success! My question is what happens when they leave the lab? A good homecare / DME company can make a big difference, a bad one can have a negative effect. Rock, do you have anything to do with the referral process? What company do you use? What input do you have?
Rock Hinkle said:I try to do a mask orientation for all of my pt's. At least let them try on one of each style mask before a titration. I show them the proper way to fit a mask themselves. i try to arm my pts with as much knowledge as i possibly can.
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Power to the people!!! I agree with you that learning how to fit your own mask is a valuable skill in the long run.
Judy said:Well, lets see. The sleep tech at each of my titrations, of course. NONE of which fitted me whilst I was laying down. AND who had a tendency to tighten the headgear too much. Then, there was the RT at my first local DME suppliers. I had to keep an appointment to get my equipment and mask selection and fitting. No fitting was done w/me laying down nor were there the "facilties" to allow me to lay down for a fitting. The first fitting she never even had a CPAP on hand to fit the mask at pressure! That RRT and I had problems. She was either "less than truthful" or dumber than a rock. When I broke a part on my mask, she tried to tell me that Medicare wouldn't pay for the part. I had to print out a download from Medicare substantiating when they would pay for what and shove it under her nose. She tried to tell me Medicare wouldn't pay for a nebulizer my doctor scripted and I had to rub THAT one under her nose too.
My second local DME supplier delivered the equipment to my house. He arrived w/a "boat load" of masks and allowed me to try several. I forget how many. He would leave the one or two that were promising and check back w/me in a week to see if the mask(s) I had kept that week were satisfactory. I probably went thru 10-12 masks before "we" found the one that was the most comfortable and relatively leak free for me.
My last titration I was asked what mask I used. On the basis of that the sleep doctor called the RRT in who suggested the OptiLife. He brought in a medium, laid it on my face whilst sitting up, decided the small would be a better fit, brought it in and held it to my face. On the bases of that when I went to the titration itself, an EXCELLENT RPSGT came in for mask fitting, discussed several masks w/me and those I had already tried and we agreed on the OptiLife and my own Simplicity. The actual fitting was done by the PSGT who actually did my titration. Whilst it seemed to fit okay when I first went to sleep, when I woke during the night it was DEFINITELY too tight and I asked to switch to my own Simplicity. I didn't want to sit up being fitted again for fear of getting too awake and not being able to get back to sleep. He did suggest a chin strap which we used the rest of the night.
All in all, I do better doing my own mask fitting w/the help of an extra set of hands if I need them. And I am not above cutting my headgear straps and using velcro to reattach the cut ends. I don't think one fitting of ANY mask is enough. Some that feel comfortable for 1-2 nights may be cutting into the face or bridge of the nose by the 3rd night or leaving a bruised feeling at the bridge of the nose, etc.
Rock Hinkle is SO RIGHT. Its IMPORTANT that the patient be shown the proper way to fit a mask themselves. Because in the end that is what we ALL end up doing. In my opinion it takes AT LEAST a week of sleeping w/a mask to really know if it is going to work for you or not. Unless, of course, it is obvious from the get-go that it NOT going to work for you at all. I always give the promising masks AT LEAST a week before deciding to keep it or try another.
And I really think that probably some of the masks that I first tried or even declined I would have better luck w/now that I've had the experience of sleeping w/a mask and CPAP for better than 2 and a half years. But I prefer and keep going back to my Simplicity w/a chin strap for comfort and acceptable leak rates.
Ah, but I FORGOT to mention the two best mask fittings I've had. One was by my sleep lab manager when I got so exasperated w/my first DME supplier's RRT. She was an RRT, RPSGT and had been in the field some 20 years at least. The other was her sleep lab's daytime PSG scoring RPSGT. A relatively young man I've no idea how long he has been working in sleep medicine.
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I will say that due to pt needs and time constraints that only about half of my pts are getting all of the info that I feel they should be getting. Sometimes there is just to much to do in so little time. I find myself driving home everyday thinking what could i have done better to prepare them for the PAP journey.
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