Saturday, January 19, 2013

My CPAP Breathing Machine

This is a continuation of The Sleep Study...

Not long after the sleep study, the respiratory therapist showed up at my home for a morning appointment.   This was the exciting day I would start using my CPAP machine, which was programmed to inflate my airway with enough pressure to keep it open all night long.  Tonight would be the first of many nights in my own bed without sleep apnea.

"Jenny" introduced the machine to me -- a ResMed S8 Escape.  She explained the one and only setting that I could adjust -- the ramp-up time to full pressure.  It also came with a humidifier, but since it was August, we decided to leave it unconnected.

She also fitted me for a mask -- the Fisher Paykel FlexiFit.  It felt like the same one that I wore during the sleep study, designed to fit over the nose only.  She explained how to put it on and take it off, as well as how to adjust the Velcro straps to make it tighter or looser.  It felt snug but not uncomfortable, at least for the 30 seconds I had it on for.  And when she started up the machine, it made an airtight seal.

Now I realize it may seem odd that this woman was at my home helping me with a device that I would use while in bed.  So let me pause here to explain that we were seated at the kitchen table, both fully clothed, and my wife was puttering about in the background.

I slept very well that night, despite looking like I had an alien attached to my face, and despite the purr of the novel machine and the Darth-Vadar-like sound of my own breathing.  I felt somewhat refreshed the next morning.  However, I was bothered by the sore spot on the bridge of my nose where the mask was the most snug.  The area was bright red with a few yellow oozing pimples.

"That's a nasty staph infection you got," my wife said.  "You better call the doctor and get some antibiotic."

"Nawh, I'll just wash it and put some ointment on it."

"Don't fool around!  If that gets into your eye you could go blind!" she replied, in a tone that was far from reassuring.

I did not call the doctor right away, but I did call the CPAP machine supplier.  I had read all the literature.  The mask was supposed to come with two seals, but I had only one, which was marked "small."  The other seal, which I did not have, would have been marked "medium."  So I explained the problem of the staph infection and the missing seal.  They promised to send a new seal out to me in the mail.

The literature also directed the patient to wash the mask with warm soap and water between each use and let it air dry.  It's very likely that the mask was contaminated with some bacteria either from Jenny or myself or from whoever placed the mask components into the kit.  Or the bacteria may have been present on my face.  In fact we're covered with all sorts of bacteria just waiting for a break in the skin in order gain a foothold and multiply.

The infection only got worse, so I went in to see the doctor the very next day.  I started on a course of oral antibiotics and kept it covered with a topical, over-the-counter ointment.

Eventually the infection cleared up and the new, medium-sized seal arrived.  I washed everything thoroughly.  At bedtime I carefully readjusted the Velcro to achieve the minimum tightness that would prevent air from escaping.  As well, I turned off the ramp feature.  I found that I could set the fit too loose and sometimes not realize it until after the machine reached full pressure.  It was better for me to start the machine off at the final pressure and then adjust the mask.

I never could get the larger seal to fit properly.  During the night the mask would shift slightly and allow air to escape, usually near one of my eyes.  Every time I'd try the small seal, I get the sore, red mark. So I settled on the medium seal.  However, I should've requested another brand or style of mask.  As I lie on my back, I like to arrange the hose so that it goes straight from the mask under the covers to my belly button, and I hold it in place with my two hands as if clutching a teddy bear to my chest.  This keeps the mask from shifting too much.

After a few months I stopped washing the mask and went a long time nearly without incident.  The incident occurred when we went on vacation to Mount Pocono.  I brought the CPAP machine and mask with me.  In the act of packing and unpacking, the mask probably got contaminated because after the first night in the hotel, I had that infection again.  I wound up calling my doctor from afar.  But because it was the weekend, I spoke with the doctor on call and had to explain the whole business with the mask and the infection.  No problem.  He called the prescription in to the nearby (and ubiquitous) CVS pharmacy, with which I had an account in my home state.  They had all my records stored electronically, even my insurance information.  So I bought the antibiotic, plus some ointment and bandages for the rest of the vacation.

This vacation-infection scenario played out once again.  Then I got smart and decided to wash the mask while on vacation with it.

Anyway, I really like the CPAP machine despite its imperfections.  I have been wearing it for about six and a half years every night for the entire night except when I was too congested to breathe through my nose.  It, along with my special diet, has made a big improvement in my life.


Apu Mridha said...

Thanks for sharing this amazing article with us,,

loved it ! :D


Square Peg Guy said...

Thank you for commenting, Apu.