Hi Pal, The baby is doing well, but for some reason, I am not. I'm wondering if it it is connected to my Cpap - I have been lurking occasionally and read your posts - they are like you, they sparkle with personality. I hope to be feeling better soon. your buddy, Ruth

Judy,
I tried every PAP machine available in 2001 with no success. It was only then that my sleep doc. sent me out into the ENT surgical world whereupon I underwent a UPPP and hyoid myotomy followed by two rhinoplasties each consisting of turbinate reduction, septoplasty, and placing cartilage in the alar region. The first two procedures were performed together, followed by two separate rhinoplasties. In the beginning my AHI was 27. After four years and all of the above my AHI was 47. The details are in a booklet I put together for former patients, students and friends at www.stopsanow.com.

SAAN stands for Senior American Academy of Neurology which replaces FAAN, Fellow American Academy of Neurology upon retirement. FAAN is a catagory of Academy membership where one is elected from among Active members who have met stringent requirements on length of membership and Annual Meeting attendance and have demonstrated substantial achievements in the neurosciences.

paging our local ResMed expert

Thank-you for the compliment Judy! allot of people think I have a bit of a strange out look on some things, Like those hand for instance. Actually the fingers on the base are copies of my own fingers, I made plast er cast of my fingers and then put clay into them and put the clay fingers on the base. I really do like doing the sculpture, but anymore with my hands and arms I just can't do it! I do have quite a few other pieces that I have done, but these ones were less controversial than some of my other works! Actually the self portrait one is pretty close to reality when I am standing I look just about ecactly like that! Even with the cup of coffee in my hand! Anyway so where ar your pictures, I am sure you must have some of your dogs, and what about horses? And what are your hobbies?

I realized the UPPP was of no significantl benefit to the OSA patient a number of years ago. Putting my own negative experience in 2002 aside, check the literature on the subject and you will find what, in my opinion, is frequently misleading information. The use of the word "success" really means varying degrees of reduction in the AHI, but never complete resolution of the problem. If one could weigh the true risk of the procedure vs actual benefit nobody would agree to the procedure. The procedure should be abandoned for the so-called "treatment" of OSA. A recent study from Europe came to the same conclusion.

Judy,
I thought I was dead or dying and was open to the recommendations of the "experts" and what was considered the accepted therapy of the medical establishment at the time. It was an area outside my field and I had to learn from the inside out, which is not the preferred way to learn about a life threatening disease.
I sympathize with you regarding your cataract surgery. I had a similar experience, but not quite as drastic as yours. You did the right thing by reporting the surgeon. It's a shame the problem can't be corrected without taking what I assume would be even greater risk to your vision.

Judy,
You are right. Tracheostomy is not a consideration unless you have proven PAP resistant OSA. Sounds like you are doing pretty well. Wish you the best.

Judy, you've always got the perfect advice for folks trying to adjust their masks against leaks. can you respond to this newbie? http://www.sleepguide.com/forum/topics/are-minor-leaks-normal-how-to

judy, there's a young lady who lives not too far from you who's looking for a new DME. know of any? http://www.sleepguide.com/forum/topics/dmes-sure-can-suck

I use a Resmed card reader, but when I was in the market, the ACS reder wasn't on ebay. I have been watching them. I have taken my Resmed reader apart and "mic'd" the deminsions to make the credit card tray. It does work well.

hi Judy - got another ResMed patient for ya! http://www.sleepguide.com/forum/topics/i-am-new-hereintro

Hi Judy, jnk said you might know the answer to the question i raise at the bottom of this thread: http://www.sleepguide.com/forum/topics/mask-question

any idea about this ResScan question: http://www.sleepguide.com/forum/topics/res-scan?

Judy, can you tell me where you live near in Michigan? It's a big state! I know of a couple of docs, I think, but I can try to look and see if I know anyone in your area.

Dave

My nephew left our house at 6 tonight to drive back to the U of M in Ann Arbor! He's in a Chemistry PhD program, though, not sleep, so I won't recommend him!

Let me look and maybe talk to some contacts and get back to you. It might be a few days. I have an A.W.A.K.E. group meeting Monday night; we're opening bids on a new $44M library (I'm a library trustee) on Tuesday and a major board meeting on Thursday night.

Dave

check it out: http://www.sleepguide.com/forum/topics/spo-7500-users

any help you can provide to Wooly regarding his comment on the bottom of this thread: http://www.sleepguide.com/forum/topics/resmed-data-report

false alarm. i found this user manual and left the link at the bottom of the thread. thanks anyway!

this gets my blood boiling: http://www.sleepguide.com/forum/topics/our-socalled-right-to-medical

Judy, can you help this guy out ? http://www.sleepguide.com/forum/topics/resmed-software-options

Hi Judy... and thanks for the welcome :)

Hi Judy -- can you help this guy? http://www.sleepguide.com/forum/topics/resmed-s8-autoset-vantage-1

Judy, Thanks for visiting my site! I will take a look at the Cpap wizard post and let you know when it is fixed. I have an excellent resource as far as Resmed equiptment is concerned. My friend Kieth Actually works in the field for Resmed. If you have a question and I cannot answer it, he will get the answer for me.

Judy, Please post the details of your problem in a comment to me. Please include the Model number and name of your unit. There have been multiple times I have counted on Kieth to answer such problems, and will be happy to help.

Judy, I just left Kieth a message, he is at the national sales meeting and won't be back until Monday. I just did not want you to think I forgot. It may take a while to get a clear accurate answer / solution. I do see that it is a problem for those who are in S mode.

I really like the Pro Life Mask. The old one I had made my face raw from rubbing so bad. This comment wall will really help me I hope.

It must be contagious (wicked grin) !!!!!!!!!!!

I do believe you and I stepped on a few toes and hit a hornet’s nest with the broom.

I LOVE IT when a good debate is started.

I am not opposed to their position, but I love making someone defend their existence. It makes them a better practitioner of their trade.

what are your current settings? and what mask are you using ? all thsi factors in to what is teh most effective comfort setting for you.

sounds like you are having leak issue with the zzzz mask, I use the Resmed Quatro primarily with my patients that require full face masks. As far the rise time and I:E ratio your home care provider ( preferably a respiratory therapist) should be able to set those parameters based on your comfort. Do you have any other respiratory problems such as COPD or asthma? those can change how the rise time affects you. Often i have to decrease the rise time to produce a more laminar flow of air, and COPS can cause problems on the expiratory side of the breath due to airway resisitance, rather have another titration I would go back to my home care provider and ask for help, also have your VPAP downloaded, they will be able to see if you are having leaks and what your AI is currently on the settings you now have. Hope this helps.

fortunately I have not had this problem with any of my patients, I spend about an hour to an hour and a half with each one on initial set up and we try various rise times, ti max etc. if you do better in the auto mode why are they insisting on putting you in spontaneous? I don't understand the rationale behind the spontaneous if your AI improves in auto and you feel better in auto.

first off you are the patient and the one wearing the BiPap so you should have the ultimate say in which mask you prefer, I don't have any experience with zzzz mask but I do with the simplicity, wear the one you prefer that works best and I think auto would be best if you improve in auto, the whole point is for you to be able to maintain a good AI and be comfortable doing it , our company has a mask fit guarantee, so sometime i may change out a mask 2 or three time more if needed until our patient is compliant and showing improvement, it is essential that you and your therapist maintain a close relationship until you reach your goals. The biggest obstacle we face in the CPAP/ BiPap world is achieving comfort , once we have that licked it's normally smooth sailing for the patient and overall improvement in the patients health and well being.So stand your ground and make them help you, it is after all their job.

God morning Judy. The problem with your VPAP Auto 25 is the TI max. The inspiration max time is too low. I don't ave the machine in front of me at this moment to recall what the factory default time is. But time vs flow is the issue.

Neal

Hi Judy, nice to meet you. I'm glad to see that you are so active in your treatment for your OSA. I wish I could treat more patients like yourself. I am a Registered Respiratory Therapist who works in Akron, OH @ a company called Visiting Nurse Service Equipment & Supply. I just started working there about 2.5 months ago. Prior to this, I have worked in hospitals for the last 5.5 years in which 2 of them was being a Clinical Instructor for The Univ of Akron's Respiratory Therapy program. If there is anything I can ever help you with please do not hesitate to ask.

Hey Judy,

Our company uses ResMed CPAP, VPAP S, VPAP Auto, and VPAP Auto 25. We also have Fisher & Paykel Sleepstyle200 CPAP units. I am a firm believer that patients and their families need to be educated about their therapy to get the most out of it. Any questions you have, please don't hesitate to ask!

Judy, I will be speaking about the role of Sleep Apnea and Psychology in the April AWAKE group in NYC. Lisa Brateman

Thank you, Judy, you've been a blessing.

Sure. But you will need to PM me your e-mail address.

Thanks for that, Judy. My daily results are given as L/s for leaks, HI, AI, and AHI are just numbers with no indication of the time involved. Are they all derived from the time I sleep, or is some other math involved? And the printed info I get is for a number of days with a number for each category, I take these to be averages. Is that correct? Any input you can give will help figure this out. I've been on CPAP for two months and I know it has helped me, but I really want to be able to make sense of the data, rather than just to see it go up or down Thanks again.

Of course, the lower your leak rate the better, but a leak rate under 0.4 L/s or 24 L/M is considered okay. A Leak rate over 40 L/M can distort your data. My math is not good enough to "translate" that 40 L/M to L/s (L/M = litres per minute and L/s = litres per second). Yes, the data is derived from your sleep time.

Why not white out your IDing info and post your printout so we can better understand and answer your questions.

Judy,

I feel like I'm totally in the dark. I tried this mask just one night, at home, and the pain in my sinueses and the headache was horrible.

The DME now says she'll order the mask I was using, with no problems, in the Sleep Lab. I've let the doctor's office know what's going on.

What I don't understand is why I don't have a copy of my report and know what pressure I need, etc. I'm quite disgusted at this point.

Thanks for the information.

I should learn a lot from this site.

Judy,

I'm responding to a message you left for me on January 29th. I jsut saw it again and saw my lame answer. I intend to call the Pulmonologist's office tomorrow and ask why I haven't received anything in writing from him. He siad I would but I've been slow in calling his office to find out wehre it is.

I did call my insurance company and they gave me names of several other DME's they cover. Unfortunately they don't cover the one my Sleep Tech thinks is the best.

I am at my wit's end. I slept well for two nights in a row and thought I was out of the woods but last night, the back of my head, where I have arthritis and the top of my face, above the eyebrows hurt so badly that I took the mask off for several hours. Later I put it back on but al in all, I don't think it's the right mask for me.

I know, due to some strange problem with my sinuses, especially my left one that the only mask I can handle is the nasal masks that are vented. My DME rep was the one who gave me my choice between two masks. She's a very difficult, disagreeable person with whom to speak and I haven't called her at all, although I intend to write a letter and also tell both my PCP and my Pulmon about her. I will also register a complaint to my insurance company about the firm.

I am stuck with the mask but I think that I may go out-of-network and use the firm that my Sleep Tech recommended and see if they can find a better mask for me or at least help me so that my forehead and the back of my neck don't ache constantly.

I'm on pain management for Inflammatory Osteoarthritis, a delightful combination of Rheumatoid Arthritis and Osteoarthritis. My neck hasn't hurt like this in a long time. I'm sure there are other masks for me to try.

I've been rather laid back about all this, which is not my style, but I've had other matters, like my recalled Toyota, to deal with but now I can give it my full attention.

I thank you for all your help and suggestions!

It still will be worth your while to check out your other DME options. One or more of them may well have a good RRT willing to help you. Its gonna be a tough road to hoe for you I think as most masks have a lower strap that goes around the back of your neck at the base of the skull. Of course, I haven't seen EVERY mask and its headgear.

I wonder if the PAPCap would be of any help in this regard? Try a google search on it and see if it looks like it might help to avoid a lower strap around the back of the neck at the base of the skull.

I wonder too if maybe Karen (Padacheeks) has something or could come up w/something to pad that area for you. She's been known to custom make things and her prices are always reasonable. Try a google search on Padacheeks for her website

Or search the forum members list for Padacheeks as that is the ID she uses.

Thanks Judy for responding. You asked if I will have to pay out of pocket for the CPAP machine and the answer is yes. Also I'm definitely getting an APAP machine. The Apex CPAP machine that I tried before the ResMed caused problems. I'd wake up more than once during the night, feeling like I was suffocating. I think the ResMed demo machine I’m using is the one you recommend. I really like it. However, one of the reasons why I'm considering the S9 is the climate control feature. This is a concern because Taiwan, gets really humid in the summer and damp in the winter. For example, one morning I woke up and the mask was full of water. I’ve been told that the humidifier has been improved on in the S9 series.
All CPAP machines are double the price in Taiwan. When I asked the local ResMed sales rep why it was so expensive, he said because they give more service in Taiwan. Unfortunately, there’s no way to check up on this. He said, they constantly monitor the readings on the machine and come and adjust the machine. Because of the high price and the fact that the CPAP.com operator said they don’t have problems with ResMed machines, I’ve pretty much decided to buy online CPAP.com. What do you know about CPAP.com? I like the fact that they answer calls after I get to work and they will ship to Taiwan (I’m sure at a premium price).
Thanks Judy for all your help,
Kim

I'm very lucky. The electrical current for Taiwan and the States is the same. Judy, I have another question. I've been using the ResMed APAP S8 Elite feeling my nose was dry. Should I increase the humidity level. By the way, I'm a mouth breather. My friend says that the dry nose could be caused by it having to work for the first time. Thanks for any suggestions, Kim

Hi Judy, Thanks for the info. I thought the CPAP S8 Elite was an automatic machine. Oh well, LOL.
Maybe this explains why this morning I woke up with the tube completely disconnected from the machine. This makes me feel that I'd better get the S9 auto-set.

You're very welcome. Sorry it went so long, but it was worth it. What other topic related to sleep apnea are you interested in hearing about?

I'll have someone check on your order to make sure you got the recording. If you don't hear from us in 1-2 days, please let me know.

Thanks for the great idea. In fact, I have in mind to bring back Chip and Brian to talk about xPAP machines, to complement their great talk on masks (if they're willing).