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cindyY
Unread post  Post subject: Update on titration study  |  Posted: Sat Jun 10, 2017 1:01 pm

Joined: Sun Apr 23, 2017 8:34 pm
Posts: 439
Location: Southern California
PAP Mask: AirFit P10, Swift FX, Swift FX Nano, Eson2
PAP Machine: Resmed AirCurve 10 VAuto in S mode
Humidifier: Integrated set to 5 @ 81F; ClimateLineAir heated hose
Pressure Setting: IPAP 19 EPAP 15

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So I went for my second sleep study the other night, just for titration. In my first study, they went through CPAP to 16cmH2O, then switched to Bi-Level, but only had a little over an hour to try to find the appropriate pressure for me. So the recommendation was to start me on bilevel therapy for at least 30 days hoping that any snore related edema would have time to heal, and maybe lose some weight, then do a titration study. Soon after starting therapy, I acquired the flu. I was sick for weeks, so I put off calling for the second study because I figured since I had a sore throat for a couple of weeks, I would give my throat more time to heal. So after 50 days of therapy, where I struggled with leakage with my recommended FFM, the Simplus, and with a FFM that I got online, the AirFit F20, but had pretty good success with my Swift FX Nano Nasal Mask, which I called my doctor to order from the DME for me. Even though I tend to be a mouth breather, with the aid of a chinstrap, and I use a mouth guard for bruxism, the nasal mask gave me the lowest AHI.

So at the study, I had the same tech as the first time, which was nice. I don't know if he actually remembered me, or if he worked off of notes taken from the first study, but he even "remembered" where I work. We discussed my first study, how I was adjusting, he was glad I had switched to a nasal mask, and felt all the FFMs have leakage issues, and nasal masks or nasal pillows are preferable to FFMs. I asked if I could try the nasal pillows for this study, because now that I have adjusted to my 20/16 pressures, I felt that maybe I could tolerate them this time. I did, however ask for a ramp to be used since I'm not used to nasal pillows, but asked that we start higher than the 10/6 that was prescribed because when I was using that at home, I felt like I was suffocating until it went up a little, which is why I was only using a 5 minute ramp after the first week of therapy, until I stopped ramping altogether. Apparently, my doctor had asked for a higher starting pressure, also.

We started with the Nuance Pro Gel nasal pillows, but it kept leaking, so we switched to the Swift FX nasal pillows. There was leakage with the small size, but when we switched to medium, they fit like a charm and I kept them in almost all night. When I woke up just before 4am, I asked to switched to a nasal mask, mostly because I wanted to try one other than my Nano at home. I asked if they had the Eson 2, but they only had the original Eson. I remembered Jason's video and that there wasn't that much difference between them, so figured if I like the Original Eson, I would probably like the Eson 2. I really liked it, it was SO quiet. I got a tiny bit of leakage because I was really trying to test it out and shoved my face into my pillow (which I brought from home for a realistic result). I wiggled the cushion a little to readjust, and the leak stopped, it was amazing how different it was from the Simplus, which is basically the Eson's big brother. I only spent a couple of hours with it, but I would definitely recommend it, I think I will probably still try the Eson 2, but if my DME doesn't have it yet, I can at least add the Eson to my Swift FX Nano, and probably Swift FX pillows.

It's really amazing how with only 50 days of therapy under my belt, and a couple of months on this forum, I was not only fixing my leaks this time, unlike the first time (when I was afraid to touch the mask, didn't know how the hose was hooked up, and agreeing that a mask that leaked all night was comfortable and fine) and this time when I was asking for a different style (which was actually the first style tried the first study), a larger nasal pillow size, a different starting pressure, and asking for recommendations on different masks.

So here's the takeaway: YOU DON'T KNOW WHAT YOU DON'T KNOW! Don't beat yourself up if you're a timid person and you allowed someone to put you in an uncomfortable mask or style. Do some research, know yourself enough to know what you can and cannot live with for the rest of your life, and ASK FOR WHAT YOU WANT! THIS IS YOUR LIFE, YOUR THERAPY, ADVOCATE FOR YOURSELF! I am a shy person, and I like to be accommodating to people, however, I am in my mid-forties, and if I live to be in my mid to late 80's like my grandmother did, that means I will be on this therapy for the next 40 years! Unless, of course, something new is developed. Luckily, I have a wonderful, supportive, husband who doesn't care if I have a mask and hose strapped to my face at night, because it is saving my life, and making our life together better because I have more energy, I am less grumpy, and not sleeping all day! My friends at work are supportive and interested in learning more about sleep apnea.
Not everyone has this support system, and I think everyone needs one. That's what makes forums like this so great, and so necessary, so there is a place for everybody to go for nonjudgmental, nonpartisan, nonexploitative advice and even just to vent.

Good Luck Everyone! And keep posting.

Cindy


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diamaunt
Unread post  Post subject: Re: Update on titration study  |  Posted: Sat Jun 10, 2017 2:08 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2010
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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it's awesome to see how much better you did... and your advice paragraph is great, words to live by.

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cindyY
Unread post  Post subject: Re: Update on titration study  |  Posted: Sat Jun 10, 2017 3:42 pm

Joined: Sun Apr 23, 2017 8:34 pm
Posts: 439
Location: Southern California
PAP Mask: AirFit P10, Swift FX, Swift FX Nano, Eson2
PAP Machine: Resmed AirCurve 10 VAuto in S mode
Humidifier: Integrated set to 5 @ 81F; ClimateLineAir heated hose
Pressure Setting: IPAP 19 EPAP 15

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Thanks, I still have to take my own advice when I talk to my doctor. :D
I'm usually really tentative and will just do as directed. I'm not crazy about my doctor, though, he took a phone call while in the room with me at my last appointment, and that was after barely glancing at the sleep study, I really like his staff, though, so maybe I can just see another doctor in the practice if he doesn't shape up.


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