Trilogy Users

[KimT]

I finally started using my Trilogy and have it set up in my bedroom. I just can't get used to it. Actually, I've been sleeping fine without it flat on my back or turning on my right side. I don't wake up with headaches but I know I will eventually need it so I'm trying to get used to it. Laurie has helped me so much with my first BiPap which had to be returned because it was denied because my numbers were too high. Now, the Trilogy is approved and the RT is coming once a month to check on me.

I'm still having the issue of it cutting my inhalation off. And it seems to be out of synch with when I breathe in and out. Honestly,it feels like I breathe much better without it. I've had so much pain in my trunk and ankle that this has taken a back seat.

Here are my settings. I am a naturally slow breather but do breathe somewhat irregularity.

Mode: Avaps-are
Ava's rate 1.0 cm
Tidal volume 450 mg
Max pressure 20
Pressure support max 12
Pressure support min 4
EPA max pressure 8
Pap min pressure 4
Breath rate 8 bum
Inspiration time 3 sec
Trigger type flow
Trigger sensitivity 4
Flow cycle sensitivity 20%
Rise time 6
Ramp length off

The main problem I'm having is that it seems hard to breathe out. I have no problem when I'm not wearing it. It seems like I have to struggle to breathe out when I'm wearing it. Like it's forcing against me and I'm not getting enough of the air out of my lungs.

 

[Aussiemndcarer]

Hello, I'm no expert but My Pals has been using his machine for about 2 years now. It took a lot of adjustments to get right but he has been on the same settings for ages now. He started using it just for afternoon naps,then overnight, and now it is 24/7. Looking at your readings It looks as if you have too high a max pressure (20). Perhaps you need less pressure going in? I wouLd imagine that your respiratory specialists should monitor you more. We have the ability to read the machine and send a report via a thumb drive to our respiratory specialists. Initially , when they first set it up, my Pals did an afternoon session whilst they monitored the pressures. We live remote,away from clinic,so sending a report via a thumb drive has been reassuring that all is ok. Our biggest problem has been getting a mask to suit. I think that we r comfortable at the moment!! I'm glad Laurie is on this forum for advice. I read with interest. Hope this helps.

 

[JimInVA]

Kim,

I just looked at Darcey's Trilogy settings. Here are some of her first settings which are different than yours...

Mode - S/T
Circuit Type - Passive
AVAPS - On
AVAPS Rate - 3.0cmH20

It then has IPAP MAX and MIN... followed by EPAP MAX and MIN... then

BREATH RATE - 7 BPM
Inpiratory Time - 1.5 seconds
Trigger Type = Auto-Trak
Rise Time - 3
Ramp Length - Off

I don't know if any of these will help you... but I did want to note the differences. Darcey uses her Trilogy 24/7 now.

Jim

 

[lgelb]

Hi, Kim, on the road so don't have all my files but first move I would suggest is drop the EPAP min/max to 4 for both, then inch up if/as you need to for the airway to remain open. Most PALS never need that high an EPAP (that would be for people w/ pure obstructive apnea) and that is the pressure you breathe against. That will also reduce the max pressure as the PS max will remain 12. You may need to change the max pressure first. Your lungs as I recall have air exchange impairments so that is one good reason why you are naturally a slow breather, which may require adjustment of the trigger sensitivity and/or rise time.

We can do sync next.

 

[KimT]

Thanks. I will make those initial adjustments and try again tomorrow.

 

[Kathy K]

Kim,
Could it be the mask? Even though I don't breathe through my mouth, I need to use a mask that covers my mouth.
Kathy

 

[KimT]

Kathy, I tried the full mask and the nose mask last time. I'm now using the nose pillows.