Pressure Sore with Resmed FX Quattro - for 2 months.. help!

[SolisQuaesitor71]

Hi all, thanks to the advice on the forum here before i've been slowly adjusting to life with a Cpap machine (and i didn't realise how much of a life changing event if would be). I haven't been without hiccups, but i now accept that we sometimes have to put certain things in perspective and treatment with a Cpap machine can be considered minor compared to some life threatening treatments that are currently offered for other issues.

I have a nice tube cover to prevent rainout which has worked brilliantly but only after an accidental experience of laziness. The machine is a Resmed System one with a humidifier, however these are both functioning fine.

My problem lies with my face (yes, many people say that but i was born with it lol

For 2 months i've had a pressure/moisture sore at the top of my nose where the mask sits. I do get (upto) 7 hours sleep per night but the pain caused by the mask sometimes results in only a couple of hours until i have to remove it. Additionally i find that in the morning when i wake and remove the mask, the wound has opened up and i have blood streaming down my face. I've spoken to my healthcare advisor and they concluded that the mask was too tight.. well i find that if it's comfortable when fitted and the pressure ramps up in the night, it forces the mask to leak resulting in a nightmare night resulting in mask removal or retightening of the straps

This is the only problem which i'm currently facing.. its amazing how people can adapt despite the consequences and can tell when i have a good sleep.. it's just a shame that i'm slowly being disfigured by the mask.. can anyone help please???

https://imgur.com/a/wxFHb

[RiverDave]

2 things come to mind.
1. Try dialing the forehead adjustment to pull the mask away from the nose/forehead.
2. Use a bandaid (plaster) over the wound at night as a cushion. Just be sure there is a pad over the wound, so it won't pull the scab off.

Good luck,

RiverDave

[LSAT]

There are mask liners and nose pads available...check padacheek.com for liners and cpap.com for nose pads.

[Wulfman...]

The post is confusing. It asks about an FX Quattro which doesn't have a forehead support, but the mask selected in the profile does have a forehead support. There are also several masks with the name "Quattro" in them.

Which one is it?

https://www.cpap.com/productpage/resmed ... dgear.html

https://www.cpap.com/productpage/resmed ... dgear.html

https://www.cpap.com/productpage/quattr ... esmed.html

And, if it's "hurting" you, you either have the wrong size, the wrong adjustments or the wrong mask.
No mask should hurt the wearer. PERIOD! Full face masks need to "float" on the face.

Den

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[SolisQuaesitor71]

Hi all, first of all i'd like to wish you all a very merry christmas!!

Thank you so much for your comments and input.

Firstly the mask is a Quattro and does have a forehead adjustment (or as i call it a knob on my head lol) so i am in error stating that it was an FX as i did see that there was one available. I've tried dialling the forehead adjustment outwards however it results in a very loose fit which starts to leak when i try to turn onto my side. I was made aware by my healthcare worker that the mask should float like a hovercraft however i don't see how this can work when the machine changes pressure levels throughout the night. If i set it so that it 'floats' all is well until i go to sleep and the pressure ramps up or i have apneas then i'm awoken by whistles of air leaking everywhere as it's pushing the mask off my face, hence which i tighten it for some peace and quiet.

I have tried a plaster over the wound and it initially seemed to me working, however it also means that the wound cannot dry out and stays continuously wet and raw, though to date this has been the least painful option.

There was a template online to create a mask liner so i tried it with an old cotton cloth and it was quite comfortable until one night it must have moved somehow and resulted in my having to remove the mask so i abandoned that idea. I'll check out the nose pads idea though so thank you for that suggestion.

@den Sorry for the confusion. i wasn't 'sized up' for the mask at all. The healthcare worker simply unboxed a 'medium' size mask and helped me put it on the said that it looks fine. It didn't feel uncomfortable at the hospital either so i had no reason to question if the size was correct.. maybe it should have been a large?? It is however possible that its adjusted incorrectly. I've tried the only other masks available to me without success and the Quattro by far has given me the best sleep experience to date.

Typically last night i didn't sleep at all sadly. the mask was pressing on the sore on my nose causing a throbbing pain so after suffering it without sleep for 2 hours, removed the mask only to find that i couldn't sleep without it either (insomnia).. oh well at least its christmas !

[ajack]

I don't think anything will fix it while it is under pressure every night. Go to your DME and find a mask that doesn't press where the sore is. Then swap the masks around so you don't get pressure sores. eventually it will toughen up, the same as people wearing glasses.

[Pugsy]

Get a mask that doesn't tear up your nose or put pressure on that area so that area can heal.
Something is wrong for it to be causing open wounds on your nose.

There are a few full face masks that don't come up and even touch on the nasal bridge area.
https://www.cpap.com/productpage/respir ... -mask.html

and a whole lot of other nasal inter face masks that don't.

[SolisQuaesitor71]

Get a mask that doesn't tear up your nose or put pressure on that area so that area can heal.
Something is wrong for it to be causing open wounds on your nose.

There are a few full face masks that don't come up and even touch on the nasal bridge area.
https://www.cpap.com/productpage/respir ... -mask.html

and a whole lot of other nasal inter face masks that don't.

I thought something must be wrong but the healthcare staff don't have a solution apart from offering a plaster. The link that you supplied i've already tried that and it resulted in my nose slipping inside the mask and subsequently causing a similar problem to the lower part of my nose (hence the scar tissue there).

I don't really know what to do tbh.. seem i can't win either way

[RiverDave]

Another thought comes to mind. There is a product sold here in the states (I'm assuming you are from Great Britain) called moleskin. It is a compressed flannel used to provide relief from blisters. Perhaps a piece of this material on the mask on either side of the injury would provide a little pressure relief over the sore and allow a little airflow around it to dry it up. If you try it, beware of the adhesive - it works extremely well.

Good luck

[Pugsy]

If the Amara View isn't to your liking look at this one that uses nasal pillows.

https://www.cpap.com/productpage/RespCa ... -Mask.html

or the similar ResMed

https://www.cpap.com/productpage/resmed ... dgear.html

Any special reason you just have to use a full face mask? Might be worth it to try a nasal mask of some sort that doesn't touch the wound area at least until the wound area can totally heal.

[Soothest Sleep]

i wasn't 'sized up' for the mask at all. The healthcare worker simply unboxed a 'medium' size mask and helped me put it on the said that it looks fine.

Clearly, "looking fine" just doesn't work as a fitting technique.

Here are some links to look at if you're DIY-inclined and want to check you have the right size. Cut out the fitting templates; hold up to your face while looking in a mirror; follow the instructions to determine correct size. I included the FX sizing info for comparison purposes.

Quattro Air Fitting Guide (includes sizing template):
https://www.google.ca/url?sa=t&rct=j&q= ... gp85m0D-su

Mirage Quattro Fitting (sizing) Template:
https://www.google.ca/url?sa=t&rct=j&q= ... A40Deju56N
and a guide to good fit:
http://www.sleep-apnea-guide.com/resmed ... attro.html

Quattro FX Fitting (sizing) directions:
https://www.google.ca/url?sa=t&rct=j&q= ... 4GOtbmG0Uw

That wound looks nasty [layman's medical term, lol]. I hope you can find your solution soon so it can heal.

Merry Christmas,
Jean

[Neicy]

I had the same thing happen but it was caused by trying to use a Remzzes mask liner ONE NIGHT. Caused it to slide around and the irritation caused a friction burn that turned onto a huge blister. Luckily I had just ordered the Amara View to try the week before, and switched to that. It has been almost a month and it is almost healed. It was interesting going to work and seeing others' looks when they noticed it though .

[Okie bipap]

When I had that happen, I changed masks and used a Band aid on my nose at night until it healed. Then I started using a piece of moleskin on my nose at night. The RT I was seeing at that time told me about the moleskin. She said her husband used it every night to keep his nose from getting sore. If you want to try the moleskin, it is available at local drug stores and Walmart and is found in the foot care area. If you decide to use it on a regular basis, you can find rolls of it on the internet for a very reasonable price.

[SolisQuaesitor71]

Hi, again thanks for your input.

I haven't heard of Moleskin patches to be honest (certainly not in the uk). I'll check tomorrow though.

Again, the liners don't seem to be readily available in the uk.. Remzzz seem to be primarily in the US only with expensive delivery charges.

The healthcare professional asked how the mask felt and of course they usually feel fine upon first fitting.

Thank you for the person offering the fitting links. It isn't something that was done at my hospital. The guy just grabbed a medium mask assuming that as it was the middle of the road option that it'd be fine.

Although i'd like to look at other alternatives for masks the UK NHS only have a contract to supply 3 full face models of masks at the moment.. and i've used all of them.

[Diamondminek]

You need a new healthcare professional, you don't mess around with pressure sores (and that looks like it needs proper attention).
Practice nurses are normally the best for pressure sores, there's a variety of creams and dressings available depending on what stage it is at. If you can't change mask the proper management will be vital.
I'd want a different mask to let the area heal as it's the pressure that's the issue (I rotate between 3 to help avoid issues, amongst other reasons). They might only stock 3 (tends to vary by clinic but id be surprised if it's really only 3) but they can special order in cases like this. You can make or buy liners or get gel pads like the gecko (some clinics proved them, or look on hope2sleep website which is UK based) . Things like moleskin and plasters can help provide some protection too, people make liners from socks or tubigrip too.