Urgent care ?

[JAM]

Hello,
It looks like my husband has a skin infection next to his nose. (Deep bruise that he must have scratched and it is not healing). It looks infected to me. I think he will need an antibody. Any suggestions how to get a prescription without dragging him to urgent care? I have started to out neosporin on it. It’s located where his bipap mask sits so I’m thinking he should skip bipap until it clears up??
Help.

 

[Nikki J]

Televisit? Does your pcp offer them perhaps with a pa or np if t is last minute? Mine does. So does the urgent care near me. You probably can use any provider in your state that takes your insurance

 

[JohnnyMags]

Isn't it always something ... If you have a good working relationship with your pcp maybe he will write one for you if you contact him/her by phone. Hope you get this taken care of it sounds like this infection is being made worse by the mask.

 

[lgelb]

If it's the mask, "gentle paper tape" on the bridge helps, there are different masks, also fabric liners all on sites like RespShop.

You could try a prong or fabric (Circadiance) mask till it heals.

Of course, it's good to be careful with cleaning the nose and mask liner before connecting the two.

I'd try alternating A&D or grapeseed ointment and Neosporin for the lesion if it's still localized.

 

[jamieinaz]

Consider contacting your bipap equipment provider and request immediate shipment of a mask that covers mouth only. Also, if he's using a silicone mask, his skin might be getting irritated, thus the scratching. If this seems possible, request memory foam alternative. Better yet, get one of each. That should hold him over until he heals up. Hope this is helpful.

 

[JAM]

I am feeling very lost with the bipap. He had it about a week and the first mask left the bridge of his nose black & blue. He is a mouth breather so he needs it to cover his mouth. Last week the rep brought him a new mask which seems to fit better. He had a scrape next to his nose (not sure from what) but it got worse bc of the pressure of the new mask.

I’ll get hold of his PCP tomorrow & hopefully get a video appointment.

Bipap questions though.,, I see everyone talk about settings, our rep only went over leak/ mask fit/ humidity settings. No ratio settings or height weight?? Dr wanted at least 4 hours a night. He typically goes 5-6 hours. His reports have said no events per hour. I assume that’s the goal?? Our rep was not super impressive. Talked about sleep apnea and cpap’s a lot.

Any help (Lauri I feel like you’re an expert) in this area is appreciated. TIA

 

[TLARRI1]

Kandy has all kind of skin rashes since ALS, we’ve tried steroid creams, antibiotics, but someone told us to try coconut oil, and to my surprise it had worked better than anything else. It won’t hurt to try.

 

[lgelb]

Coconut oil is another solid option to try -- same caution about oil vs. mask. I prefer GSE for less residue -- you can leave just a dab under the tape.

Was the first mask a full face mask (over nose and mouth) like his current one?

I wouldn't necessarily conclude that if you treat during the day and use tape (both NexMed Transpore and the paper tape are good) that you have to wait out healing, but you can go slow and see. Be careful about overtightening any mask, a common cause of bruising and sores. You want the suction to hold it on, not the headgear, so you let it settle in by itself once the air flow is on, like when you close anything that's soft-close.

That said, a FF mask is trapping more moisture and potentially bacteria from exhalation over the lesion, even if you tape it. So you just want to make sure to disinfect his mouth before using the BiPAP.

Re the settings, yes, events are not important and there should be no CPAP or apnea talk (unless he already had it pre-ALS). So it does sound like the tech is not ALS-savvy, pretty common. I'll PM you re the mask/settings stuff.