Pulmonary Embolism Support Group
By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.
I didn't want to hi-jack a thread so----
Jean,
Good to hear that you 'love' your cpap ! (grin) So many people won't consider one.
Here's a document I found for a friend whose husband just would NOT consider one.
Using an oxygen concentrator and the less 'invasive' nasal cannula.
A Nasal Cannula Can Be Used to Treat Obstructive Sleep Apnea
Brian M. McGinley1, Susheel P. Patil1, Jason P. Kirkness1, Philip L. Smith1, Alan R. Schwartz1 and Hartmut Schneider1
1 Johns Hopkins Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Correspondence and requests for reprints should be addressed to Hartmut Schneider, M.D., Ph.D., Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Room 4B47, Baltimore, MD 21224. E-mail: hschneid@jhmi.edu
Rationale: Obstructive sleep apnea syndrome is due to upper airway obstruction and is associated with increased morbidity. Although continuous positive airway pressure efficaciously treats obstructive apneas and hypopneas, treatment is impeded by low adherence rates.
Objectives: To assess the efficacy on obstructive sleep apnea of a minimally intrusive method for delivering warm and humidified air through an open nasal cannula.
Methods: Eleven subjects (age, 49.7 5.0 yr; body mass index, 30.5 4.3 kg/m2), with obstructive apneahypopnea syndrome ranging from mild to severe (5 to 60 events/h), were administered warm and humidified air at 20 L/minute through an open nasal cannula.
Measurements and Main Results: Measurements were based on standard sleep-disordered breathing and arousal indices. In a subset of patients pharyngeal pressure and ventilation were assessed to determine the mechanism of action of treatment with nasal insufflation. Treatment with nasal insufflation reduced the mean apneahypopnea index from 28 5 to 10 3 events per hour (p < 0.01), and reduced the respiratory arousal index from 18 2 to 8 2 events per hour (p < 0.01). Treatment with nasal insufflation reduced the apneahypopnea index to fewer than 10 events per hour in 8 of 11 subjects, and to fewer than 5 events per hour in 4 subjects. The mechanism of action appears to be through an increase in end-expiratory pharyngeal pressure, which alleviated upper airway obstruction and improved ventilation.
Conclusions: Our findings demonstrate clinical proof of concept that a nasal cannula for insufflating high airflows can be used to treat a diverse group of patients with obstructive sleep apnea.
Key Words: treatment with nasal insufflation, TNI pharyngeal pressure
AT A GLANCE COMMENTARY
Scientific Knowledge on the Subject
High levels of continuous positive airway pressure (CPAP) are needed to alleviate obstructive apneas; low compliance with CPAP impedes its therapeutic effectiveness; and, because hypopneas can be treated with low levels of CPAP, nasal insufflation of air might effectively treat mild obstructive sleep apnea.
What This Study Adds to the Field
Nasal insufflation can provide distinct clinical advantages over CPAP for a substantial proportion of the patient population with sleep apnea.
http://www.medscape.com/viewarticle/559811
Jean,
Good to hear that you 'love' your cpap ! (grin) So many people won't consider one.
Here's a document I found for a friend whose husband just would NOT consider one.
Using an oxygen concentrator and the less 'invasive' nasal cannula.
A Nasal Cannula Can Be Used to Treat Obstructive Sleep Apnea
Brian M. McGinley1, Susheel P. Patil1, Jason P. Kirkness1, Philip L. Smith1, Alan R. Schwartz1 and Hartmut Schneider1
1 Johns Hopkins Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
Correspondence and requests for reprints should be addressed to Hartmut Schneider, M.D., Ph.D., Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Room 4B47, Baltimore, MD 21224. E-mail: hschneid@jhmi.edu
Rationale: Obstructive sleep apnea syndrome is due to upper airway obstruction and is associated with increased morbidity. Although continuous positive airway pressure efficaciously treats obstructive apneas and hypopneas, treatment is impeded by low adherence rates.
Objectives: To assess the efficacy on obstructive sleep apnea of a minimally intrusive method for delivering warm and humidified air through an open nasal cannula.
Methods: Eleven subjects (age, 49.7 5.0 yr; body mass index, 30.5 4.3 kg/m2), with obstructive apneahypopnea syndrome ranging from mild to severe (5 to 60 events/h), were administered warm and humidified air at 20 L/minute through an open nasal cannula.
Measurements and Main Results: Measurements were based on standard sleep-disordered breathing and arousal indices. In a subset of patients pharyngeal pressure and ventilation were assessed to determine the mechanism of action of treatment with nasal insufflation. Treatment with nasal insufflation reduced the mean apneahypopnea index from 28 5 to 10 3 events per hour (p < 0.01), and reduced the respiratory arousal index from 18 2 to 8 2 events per hour (p < 0.01). Treatment with nasal insufflation reduced the apneahypopnea index to fewer than 10 events per hour in 8 of 11 subjects, and to fewer than 5 events per hour in 4 subjects. The mechanism of action appears to be through an increase in end-expiratory pharyngeal pressure, which alleviated upper airway obstruction and improved ventilation.
Conclusions: Our findings demonstrate clinical proof of concept that a nasal cannula for insufflating high airflows can be used to treat a diverse group of patients with obstructive sleep apnea.
Key Words: treatment with nasal insufflation, TNI pharyngeal pressure
AT A GLANCE COMMENTARY
Scientific Knowledge on the Subject
High levels of continuous positive airway pressure (CPAP) are needed to alleviate obstructive apneas; low compliance with CPAP impedes its therapeutic effectiveness; and, because hypopneas can be treated with low levels of CPAP, nasal insufflation of air might effectively treat mild obstructive sleep apnea.
What This Study Adds to the Field
Nasal insufflation can provide distinct clinical advantages over CPAP for a substantial proportion of the patient population with sleep apnea.
http://www.medscape.com/viewarticle/559811
Even after my PE, and my pulm doctor wanted me to go have another sleep study, I dragged my feet on it. Last summer however, my partner was also diagnosed (mild apnea) and began using a cpap. When I saw the difference, I knew I had to go through with it. So glad I did! It really isn't nearly as bad as most think it is/will be, but again, I understand the hesitation. And now, knowing it may have played a role in clotting, I won't go without it. I am almost uncomfortable NOT using it!
I use a nasal cannula at night and for naps---- they were rx'd quite a while before I got my first PE and even though I was put through a bazillion pulmonary tests and passed with flying colors (even the leg doppler one) they couldn't find the reason for SOB\ so I think this was rx'd just ---- because. (I also keep one of the cute little pulse oximeters by the bed and test it each morning. Always about 98 %.
I'll never know if the doppler missed something then but doubt it. Two years later --- PE.
I fought the overnight sleep test they suggested. I'd had one years before when I had insomnia so bad. A very arrogant neurologist performed it and rx'd Klonopin for my 'restless legs'. I declined but my then husband, same test same doctor, accepted the Klonopin and was on it for about 2- 3 years!!!!!
Now I'm snake bit about overnight sleep tests and I'm looking into the home ones------- all I want is a cpap (I won't mind wearing one) but have to get my doctor and insurance company lined up in a row.