Pressure sore.

[yoyoyomonica]

Well it happened last night. I have a sore now. I have about a 1/2 in spot near the middle of the nose. The nose feels bruised and it is even uncomfortable to wear glasses. I am so bummed out. I dont think I can wear it anymore. I want to be compliant but fear this is going to set me back.

Things that are noticed since starting cpap 17 days ago.
I was very lively for 3 days last week.
heartburn is very well under control (believe it or not) This is HUGE for me.
headaches have been less frequent.

So far that is all. I dont want to loose the progress I made. Tonight I am using a different fabric but still think the mask is to small.

[Phil_in_CA]

Hi Monica!

I use that same mask... hmmmm. My nose doesn't touch the top of the mask at all, and there is a gap between where my nose touches the cushion and the upper edge of the mask. The bridge of my nose is well within the cushion and the bottom reaches to just below my lower lip, resting on my chin.

From what you say, it seems as if your mask is too small... I'm getting a deja vu moment here. Did you say before that your mask was too small?? Maybe I dreamed it.

Anyway, I can imagine that if the mask was too small, my nose would push against the hard plastic of the mask itself and it would hurt like mad!

Another thought... maybe you could adjust the top control to tilt the mask away from your forehead a bit? I found that getting the tilt correct was "trial and error." If it is tilted too much, air would leak into my eyes. If it wasn't tilted enough my nose felt pinched.... try tweaking that upper tilt control and see if that makes a difference.

I am thinking about posting a picture of my nose inside my mask, but it would be soooo huge, as to rival Mt. Everst...

[Sheriff Buford]

I gotta say, the same thing happened to me. I got a sore on the bridge of my nose during the second sleep study test. I was given a full face mask to take home, and after the first night the sore got worse. On the second night, I placed a bandaid on my nose and the next morning, I awoke with blood on the sheets and pillow. The knot on my nose (my honker...) will not allow me to wear a full face. I immediately went to the DME and got the Mirage Liberty hybrid mask. I fussed with it for about a month, but my left nostril is about 80% plugged, so my leak rates were thru the roof. I went into our host, cpap.com store (while I was in Houston)... saw the mask I have now (Respironics Total Face Mask) and told myself, "now there's a mask that you don't have to worry about nose sores and plugged noses... honkers..."). The mask is intrusive. Looking at it... I wondered if I could get used to the size of the mask. I tried on the mask, hooked up a display machine (set at my setting), laid down on the floor, and rolled around on the floor. No leaks. I bought it and have never looked back.

The reason I'm telling you this is because I've been following your posts and the statements you've made are similar to mine. My experience is that a person will seem to know when they are DONE with a mask. I sense you may be close. I don't like suggesting a person to get a new mask until they are ready to move on. We all experience the mask journey, but it is unique to all of us. Some struggle more than others. Keep us posted!!

Sheriff

[yoyoyomonica]

Thank you guys for following me and keeping tabs on me. I kind of get lost on this forum. I am reading like mad and learning everything I can. I want to be successful at this.

Shouldnt this mask be up between the eyes?

I am contacting my DME by email today. The reason we are with this DME is because it is my husbands work. I am going to get on the floor and roll around this time with these masks. and I want mediums. NO more smalls.

I forgot to mention. my forehead hurts too. but I dont wake up gasping anymore. So I know this is working.

[Denial Dave]

try following the guidance on this link.... it made my cpap life bearable and a success

http://maskarrayed.wordpress.com/taming ... e-quattro/

[Phil_in_CA]

>>my forehead hurts

I found that I could loosen the upper straps a bit and ease the pressure on the forehead pads... try that.

[bjcyorkiemom]

Two or three options for you - 1. try the gel piece that goes over the bridge of your nose 2. they make pad (pad-a-cheek is one option) to cushion stuff 3. try a chin strap and a cloth mask (SleepWeaver)

[hyperlexis]

Well it happened last night. I have a sore now. I have about a 1/2 in spot near the middle of the nose. The nose feels bruised and it is even uncomfortable to wear glasses. I am so bummed out. I dont think I can wear it anymore. I want to be compliant but fear this is going to set me back.

Things that are noticed since starting cpap 17 days ago.
I was very lively for 3 days last week.
heartburn is very well under control (believe it or not) This is HUGE for me.
headaches have been less frequent.

So far that is all. I dont want to loose the progress I made. Tonight I am using a different fabric but still think the mask is to small.

Sorry to hear -- nose pressure sores are actually much worse a problem with the Amara. The Quattro has one of the best cushion systems on FF masks, with a cut-out for the nose bridge to prevent sores. Same for the Quattro FX.

You most likely have the top bridge tightened down too much. Repositioning the mask higher up and loosening the top setting with the adjustment knob should help -- once the sore begins to heal. I would recommend using ointment and a band aid on the area to help it heal.

Regarding the size, who fitted your mask? Did the DME use the ResMed size guide? You can always print the size guide out from online and try to measure the size that way. Because remember -- a larger size that doesn't best fit your face may actually make things worse, with leaks.

[Suddenly Worn Out]

Im gonna be honest with you. Unless you use nasal pillows, some degree of skin irritation on the bridge of your nose is almost inevitable with about all of these masks. I mean, its silicone resting with some pressure on the bridge of your nose 8 to 10 hours a day. Duh. The odds are youre going to initially develop some redness there especially at first. Mine even calloused/blistered over the first month I was on CPAP.

I began experiencing a full blown pressure sore on the bridge of my nose about a year into CPAP use. It was caused by a really tight Quattro full face mask. I went around with the pressure sore for close to a year and a half. It looked bad but I was not employed during that year and a half I was just going back to college in my late thirties at the time.

I was later diagnosed with very low vitamin D. My primary care doctor prescribed me high dose prescription vitamin D. 50,000 IU drisdol pills, twice a week for months. The high dose vitamin D got rid of pretty much all dermatological irritations caused by wearing a CPAP mask. I found some of the skin irritations gradually came back to some degree after my doctor discontinued the vitamin D.

I hate to say this, but I mostly ignored the pressure sore I had developed. I was so glad to get a decent night of sleep, a pressure sore was small potatos compared to what I had been thru before CPAP. Now if I was diabetic, I would have a different attitude. A pressure sore is seriously bad news for a diabetic. Also, there are many jobs where a weird looking pressure sore on your nose would not go down and youd get weird looks and comments about it.

If you are not adjusted to a mask yet (full month to six weeks of continually wearing a CPAP mask), Id "go with it." If you are diabetic, you should contact your doctor immediately, though. If you are not diabetic and your skin adjusts to the mask and still have a pressure sore, consider getting tested for low vitamin D and if low, take vitamin D supplements regular.

Good luck,

Eric

[BlackSpinner]

Or get an Innomed/respcare Hybrid mask. It leaves the whole top of your face free.

[yoyoyomonica]

Thanks for all of the advice. I am seeing my DME on Thursday. I took a break from the mask on saturday and used a bandaid last night. it worked ok. Having a sore on my nose isnt a option and a callous isn't going to happen. I will quit cpap before I start developing scars. I take vit D already but only 2000 iu 2 times a day. So maybe I need to increase it.

[Pugsy]

I don't think any mask should cause pain, sores or scars. I would never just "accept" that as an "okay" outcome. There are just too many masks out there to try and hopefully find one that works.
The need for a full face mask does create the problem of the extra surface area that needs to maintain a seal. So it is more potentially problematic but not impossible to deal with.
So different size cushion maybe. Or maybe just a different mask entirely...if one is found that is "close"...maybe one of Padacheek's mask liners or maybe try making your own liner.

Don't be afraid to try a different mask.

[hyperlexis]

Thanks for all of the advice. I am seeing my DME on Thursday. I took a break from the mask on saturday and used a bandaid last night. it worked ok. Having a sore on my nose isnt a option and a callous isn't going to happen. I will quit cpap before I start developing scars. I take vit D already but only 2000 iu 2 times a day. So maybe I need to increase it.

Yeah I would agree. You don't want to tear up your skin or develop scarring from an untreated pressure sore. Totally nuts to do that.

If you fit the mask properly, and once the sore heals, you should be able to tolerate it well without further pressure sores. Just get it fitted properly. No, do not worry, you should not develop a 'callous' on your nose. That, as far as I know, does not happen, even with long term use. Your face will adjust to CPAP masks it in the same way that people adjust to having glasses sitting on the bridge of their noses. Eventually you wont even feel the mask on your face.

[BlackSpinner]

Thanks for all of the advice. I am seeing my DME on Thursday. I took a break from the mask on saturday and used a bandaid last night. it worked ok. Having a sore on my nose isnt a option and a callous isn't going to happen. I will quit cpap before I start developing scars. I take vit D already but only 2000 iu 2 times a day. So maybe I need to increase it.

Yeah I would agree. You don't want to tear up your skin or develop scarring from an untreated pressure sore. Totally nuts to do that.

Yes because scar on the face is so much worse then strokes or heart attacks. Must keep the outside pure while the inside disintegrates - makes for a prettier corpse.

[yoyoyomonica]

Thanks for all of the advice. I am seeing my DME on Thursday. I took a break from the mask on saturday and used a bandaid last night. it worked ok. Having a sore on my nose isnt a option and a callous isn't going to happen. I will quit cpap before I start developing scars. I take vit D already but only 2000 iu 2 times a day. So maybe I need to increase it.

Yeah I would agree. You don't want to tear up your skin or develop scarring from an untreated pressure sore. Totally nuts to do that.

Yes because scar on the face is so much worse then strokes or heart attacks. Must keep the outside pure while the inside disintegrates - makes for a prettier corpse.

:O OH wow. I didnt expect this from you. That really hurts my feelings.