What should a RT be able to do for you?

[Desperate_in_DM]

Called to see my doctor. Was told I couldn't see him before my regularly schedule appt. They said I could see a RT. So off I went dragging my machine. I've been using the machine for a little over two weeks. I feel worse now and my morning symptoms are worse now more than ever. My Provigil isn't helping with fatigue any longer and only give me the shakes and palpitations, but I still fall asleep.

The tech said there are no leaks and that my AHI with the machine is great, 0.5 on average. She said I should be feeling much better. I'm not.

She said I'm not getting enough sleep. No kidding? I said the nostril pads tickle and wake me up. She said the mask wasn't tight enough in that case.

I was told that I need to get more sleep, tighten the mask (that already leaves red marks on my face for the first hour I'm awake), and go back in a month where the doctor might change the pressure.

Is this normal? Do they not do anything? Then why didn't the receptionist just tell me I had to wait ? What SHOULD happen during these appts?

[DoriC]

Did you ask about trying another mask? There is usually a 30 day exchange policy and most people try several different masks before finding the one that works best for them. Good luck.

[Hospiceangel]

Hmmm, if I remember correctly elena posted about having a AHI of 0.1 but feeling really bad in the am. Her problem was stuffing the pillows so the exhalation ports were covered up by pillows. That increased her Carbon Dioxide (CO2) retention so she felt really bad. I think she had the same headgear as yours. Is it possible that could be part of your feeling bad? Just a thought. Re: Mystery! got a 0.1 ahi and felt HORRIBLE in the am? I don't know whether I did the link right.
As far as the RT they are there to make sure the machine is functioning and your mask fits right. They can't really do much else. You need to see the MD.
Hope that helps.
Shar:)
Don't give up.

[Desperate_in_DM]

I asked about that. She said it was the best mask with the best results. She asked me a bunch of questions about the sleep and my mask and then determined the mask wasn't the problem, other than I'm supposedly not wearing it tight enough. Oh, and it didn't occur to me until I left that she never even had me put the mask on to see if it was too loose or if the pads were the wrong size!

So now I'm not sure what to do. I was told it was MY fault I don't feel better because I'm unable to get a whole night's sleep and that I do n't have the mask tight enough.

Oh, I was using a contour pillow for neck pain. The chiro said I should continue to use it as it helps with apnea too. I don't think it would e possible for the vent to get covered.

[cpapqueen1]

who in the world is using the simplicity mask as a first mask! That mask is in the back of the armory! There are so many other better masks out there. Demand a refit.

[Hawthorne]

The Simplicity is actually a very good and easy to wear mask. It is a very simple design, hence the name. It is so light you hardly feel it.

I wore it at my titration study almost 8 years ago and still keep one around to fall back it when I have mask troubles with other masks. It's been available for a long time which says something for it, in my opinion.

I'm certainly not excusing the behavour of the RT. She certainly should have had you put the mask on with a machine going at your pressure and made any adjustments that she thought might help. Ske did nothing whatever for you.

Everyone is so different when it comes to masks and the "latest" may not be the best. Experience with a lot of masks has taught me that. Just being the "latest" does not mean anything. A person can still have a lot of mask problems with any mask, especially when just starting therapy.

I would suggest that you look at http://www.padacheek.com and get the strap covers made for the Simplicity. This really helps with strap marks on any mask and, if you need it a little tighter, you can do that with thses pads and not have the marks. I wear it quite loosly myself.

In my opinion, the mask straps will help you use the Simplicity and any mask. All masks can cause the same mask mark problems.

[Hospiceangel]

Oh dear,
That RT really wasn't helpful at all. I'm sorry if I freaked you out. No, your special pillow won't cause the problems. Elena was sleeping on her tummy and she had her head snuggled in the pillow. BIG difference. I was trying to think outside the box and got waaay outside of it I guess. I think I would call the RT tomorrow and ask if they will check the seal on mask.
Chin up girl and keep trying.
Shar:)
Sorry I got interrupted with my teenagers or I would have finished this sooner.

[cflame1]

Let me know if I can help Desperate...

I've got a few other mask options if you'd like to try something on or can read your card (there might be a hint as to what the problem is on it).

Drop me a line if you need it!

[NotMuffy]

Well, "IMHO", given the numbers you're presently putting up, your SDB has nothing to do with your present symptomology.

In addition to getting a download from your machine, can you get both Long Reports from your sleep studies?

NM

[Desperate_in_DM]

Well, "IMHO", given the numbers you're presently putting up, your SDB has nothing to do with your present symptomology.

In addition to getting a download from your machine, can you get both Long Reports from your sleep studies?

NM

SDB? I'm sorry, I'm still fairly new and not familiar with all the terminology used here. Can someone enlighten me?

I asked for the sleep study report. Once again, I was told I would need to discuss it with the doctor at my follow-up on 9/15. Will try again with more insistence this time. I'd be very grateful to get anyone's input into my study if I can get the report. I have to admit, while I'm sure I have sleep apnea, it's relatively minor and I don't think I should be feeling this badly given my numbers and the fact that my AHI went from 14.8 to 0.3 in the first week.

[Desperate_in_DM]

Just called and again receptionist was dismissive stating that I could discuss my sleep study at my follow-up. I insisted and she forwarded my call to records. First person said I need to fill out a release (which I expected) and then said it would take 4 weeks and would be mailed. I got a little....erm...animated. A supervisor was found and said my study would be ready for me to pick up within the hour.

I guess I'm usually too nice. I need to channel my rage more.

[LoQ]

SDB = Sleep Disordered Breathing, a much better term than OSA because not everyone with SDB has obstrutive events and not everyone with OSA has apneas.


As for your AHI of 0.3, I will be less suspicious of that number if you can pull it off with a full face mask. Also, even if it is truly 0.3, a few hours of 0.3 sleep each night is not going to make you feel rested. As I said in another thread, you need to get a sufficient quantity of sleep. Quality and quantity of sleep both matter. You've been focussed only on quality; you need to work on quantity, too.

[Tired Linda]

I got a little....erm...animated. A supervisor was found and said my study would be ready for me to pick up within the hour.

I guess I'm usually too nice. I need to channel my rage more.

WAY TO GO!!! Hopefully you can pick it up this morning and get the results posted here soon. I'm too new at this to be able to interpret all that "stuff" but there are plenty of people here who ready and willing.

She said it was the best mask with the best results.

Personally, I think that is a load of crap. Yes, it may be a good mask with good results, but that doesn't mean it's the best mask for you...
Sounds to me like he/she may have been either uneducated or too lazy to take the time to fit you properly.

Hang in there Desperate, we're rootin' for ya, and somehow things are gonna work out...

L

[Janknitz]

Did the RT actually look at your detailed data charts, or just the AHI and leak rates on the machine screen?

I would expect the RT to do the following:
1. Actually look at the detailed data charts.

2. If she felt that you were having mask leaks, she should have had you try on the mask there, hopefully lying down in your normal sleeping position, and worked with you on the fit, OR tried other masks. The statement "the best mask with the best results" is baloney. Best mask for whom? I love that mask, personally, but everyone's face is different, and what works for one person is not necessarily the best for another. Perhaps you need a larger or smaller pillow. I can tell you that this mask should NOT be worn tightly--that smashes the nasal pillows so that they cannot inflate and do their job to seal well and deliver pressure efficiently. She was being dismissive when she should have actually checked the mask fit and made sure it was working for YOU.

3. Even with low numbers something could be going on. I was having great numbers like yours, but I was starting to wake in the middle of the night with panic attacks (a big pre-CPAP symptom for me). When we (a good RT and I) looked at my detailed data, it was clear that the pressure was too low because I spent a good deal of the night up against the "ceiling" of my pressure. The pressure was increased, and the panic attacks stopped, my sleep improved and I felt better. The RT should have listened to you carefully, checked the data, and then reported to the doctor (there are ways the RT can make "suggestions" for needed changes, although prescribing changes remains the doctor's call in the type of setting you are in).

4. OK, the doctor is busy, and you can't get on his schedule. You certainly won't die while waiting, but you may throw up your hands and give up on CPAP out of frustration (don't do that--this is NOT a suggestion!). So if they can't get you in still for some time--and you are already an established patient whether he's actually seen you or not--he's not doing you a whole lot of good.

That's why so many here take charge of their own therapy. They study up, learn the terms, get the data and learn how to read it, and do what needs to be done to optimize their own therapy. If you wait for the RT and this doctor to "fix" things, you may wait a long, long time, feeling miserable in the process.

You have taken the first step by demanding your sleep study report. Now it's time to learn what it all means. You should think about getting Encore Viewer so you can see your data and learn for yourself what you need. And then you need to keep "channeling that rage" to insist that you get the best therapy. Go girl!

[Desperate_in_DM]

No way she looked at everything, it seemed like a mere glance.

I'm posting what I DID get from the doctor. Not thrilled. It gives a tiny bit of insight though. I got one page, ONE PAGE! I got the same thing they forwarded to all my other physicians. I was told that if I really needed my full study results, it takes a month.