First visit to a Pulmonologist in a few days

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Thank you Laurie and all. I will start with the bipap saturday night. Tonight. Friday. We are doing an overnight pulse oxmeter test that i will then send back to the lab in the am.
 
Tomorrow, try out the bipap a couple of times just for 5-10 mins when Tom is comfortable. Maybe watching a movie or listening to music he likes or something. Help him get a little used to the feel of the mask and that you are confident with setting it up and getting it running etc.

Much easier than starting it at bed time.
 
Tom's wife...you have such patience. This pulmonologist would be getting on my last nerve!
 
I have the bipap on Tom. I watched 2 youtube videos on fitting the mask. It is a f&p vitera full face mask. He is doing fine. Listening to Trevor Noah's memoir Born a Crime.
This is just a first try. Its 3pm here. Will have him wear it tonight. The night aide has completed her nursing ed and just has to take the exams. She is very knowledgeable.
Thanks everyone.
 
That's a great start!
 
When Steve first started with bipap he wanted me to take it off a few hours after bedtime. It took a little while for him to get comfortable wearing it all night long (oh happy day). So...patience, but sounds like it's starting out well. I hope Tom feels much better!

Great choice of book, by the way, Kathy - very entertaining but also eye-opening. l learned a lot while laughing.
 
How did you go last night Kathy?
 
Tom wore the bipap Saturday night for about 4.5 hours (10pm to 230pm). After I removed it, he coughed for about 3 hours. He had not been coughing. So we have to assume the bipap disturbed something. Needless to say, neither one of us got any rest.
I talked to him about it and we agreed to wait and call the pulmonologist office Monday to get advice.
 
I wonder if the better airway promoted the movement of mucous and secretions from down in his lower lungs.
Maybe the coughing was beneficial in that it was helping to bring mucous up. Any talk with the pulmonologist about a cough assist?
 
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Why did he want the bipap removed?
 
Couple of things re masks:

It's a good idea to alternate a full face mask with a mask which fits just under the nose. The full face masks can cause redness and irritation to the bridge of the nose quite quickly. If you are using the full face mask more often, you should apply a strip of duoderm dressing across the nose where the mask seal sits. You can double up the strips if they are too thin. You can also get silicone pads that do the same job but a duoderm dressing will give you multiple strips. The strips can stay on the nose for several days.

The under-nose masks are especially helpful if the PALS wears glasses and are generally less bulky and more comfortable as a greater field of vision is preserved.

Finally, if you are alternating masks, the full face is better for night time as it is less likely to dislodge.
 
It does sound like the bipap got his lungs moving more. The coughing would have been unpleasant, but a cough assist will really help shorten the coughing episode and be more productive.
Then the bipap will work even better!
 
I would differ on any blanket statements about alternating FF and nasal masks. Some PALS do well 24/7 on one or the other. As regular readers know, I'm partial to the Circadiance "parachute-like" one because of its low weight and ability to use narrower tubing for less pull. Pull can significantly affect sleep quality.

I do agree with paper or nylon tape on the nose bridge if a mask is rubbing, but would also advise to really look at fit and other masks because there are more options than there used to be and some masks do not touch the nose bridge at all. Like anything else, nose bridges differ than we might think. Cpap.com offers free 30-day returns on many masks.

Cleaning the face and mask before applying is also a big help, which calls for having extras to swap out if someone is BiPAP-dependent.

Kathy, that much coughing suggests the possibility of target volume, IPAP max, and/or PS max being set too high, which is very common from the jump, so I'd be happy to help you dial those down and titrate back up. Also, just confirming that you are using a heated humidifier with distilled water?
 
I was alternating a full face mask and below-the-nose mask until recently, when we found a full face mask that did not irritate the bridge of PALS' nose. It is the ResMed AirTouch F20, which has a foam cushion around the mask instead of inflated plastic. The earlier ones left sores on his nose but this one seems to be completely comfortable and non-irritating.
 
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