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Thank you for your support.

Thank you for all your kind words. I really appreciate them. I hope everything goes well for your mom. All my best.

I am glad it was helpful.

I do not know.

Thank you for your support.

Thank you.

Thank you for sharing. I am sorry your doctor retired, but I am glad you were given notice. Each state has its own procedures and rules. So there may be a state which has a law regarding this, but as far as I know, there is no law which requires a clinic or doctor to notify patients ahead of time of a doctor's departure. It is courtesy to do so to give patients time to find new providers. There are legal implications which can arise when a doctor does not warn a patient of the termination of the relationship such as a patient suing for medical abandonment. Medical abandonment occurs when a patient feels a doctor-patient relationship was terminated improperly. Medical abandonment falls under malpractice. Most legal experts advise giving patients a 30-day notice about the termination of a doctor-patient relationship to give the patient time to find a new provider. It is generally thought 30 days is enough time for a patient to establish care with a new provider. (Most medical abandonment cases are dismissed if a notice of 30 days or more is given to the patient to find a new provider.) However, this is not a law, just a safeguard to prevent a medical malpractice lawsuit.

@@LifewithaVent I'm not sorry he retired. He's a great doctor, but he had wanted to do this for a long time.

Hello. I keep breathing. Thank you for your question.

Thank you for sharing some of your story with me. I am so sorry this happened to you. I am glad the hospital was able to properly diagnose you. Thank you for your well wishes. All my best to you.

Thank you. I appreciate your support.

Thank you.

It goes to the person to connect the person to the ventilator.

@@LifewithaVent Should you keep the HME connected while using a heated humidifier?

@@thanos1000000fc If using a heated humidifier, the HME should not be used.

Are the hiccups a frequent occurrence or do they only happen once in a while? If they only happen once in a while, doing anything which changes the breathing pattern (such as laughing, holding one's breath, scaring someone, etc.) will help get rid of the hiccups. If it is a frequent issue, it may require an evaluation by a medical provider. There are medicines which can help with frequent, persistent hiccups.

The office sent out a letter which I just received. It is a very strangely worded letter. I will paraphrase what it says. It states the clinic is making changes. It lists five doctors and says they will be moving on from the clinic. The clinic thanks them for their service and wishes them the best of luck. The doctor who will be staying in the area and who will be moving to a clinic in the same hospital system, for that doctor it says the doctor will continue seeing patients until June 30. On July 1, the doctor will be moving to the following clinic. It then gives the information for the clinic. It states if you need your medical records to please contact the medical records department at the following number. It does not say anything about any of the other doctors. It also does not say the clinic is closing. If I would not have called and found out the clinic is closed, I would have assumed from reading the letter the doctors who are not mentioned in the letter are still practicing at the clinic.

Thank you for your support.

Thanks so much. I appreciate all your support.

Thank you.

Thank you so much for your comment. I do have Ehlers-Danlos Syndrome (EDS). Whether it is the hypermobile type or a different type is not clear. Some fun statistics, 80% of people with Mitochondrial Disease (Mito) have dysautonomia-with the most common form of dysautonomia being Postural Orthostatic Tachycardia Syndrome (POTS). Some studies have suggested ninety percent of people with POTS have the triad of POTS, EDS and Mast Cell Activation Syndrome (MCAS). So, many with Mito have Mito, POTS, EDS and MCAS. In short, many with Mito have MCAS symptoms. However, not all Mito patients have MCAS. Multiple Sclerosis (MS) affects the nervous system. The most common symptoms of MS are fatigue, memory difficulties, mood changes, mobility issues, numbness, pain, tingling and vision impairment. Mito is a disease which inhibits the body’s ability to produce energy. All organ systems can be affected. Mito is suspected when three or more organ systems are showing signs or symptoms of disease. Although every person with Mito is different, symptoms can include: muscle pain, muscle weakness, GI issues affecting the mouth through the colon, migraines, kidney disease, heart disease, liver disease, blindness, deafness, cognitive issues such as intellectual development disorders or mental regression, seizures, respiratory impairment/failure, droopy eyelids, misaligned eyes, muscle wasting, failure to thrive, hypoglycemia, diabetes, an inability to maintain electrolyte levels, strokes and stroke-like episodes, metabolic acidosis, unrelenting exhaustion, etc. Stress and fatigue greatly worsen Mito symptoms and can cause Mito progression. Surgery, heat, medicines, sleep deprivation or stressful situations can cause the person’s body to go into crisis mode, or the opposite happens and it completely shuts down. Sadly both situations may lead to death. While someone with Mito may have the same symptoms as someone with MS and/or someone with a Mast Cell Activation Disease, there are many symptoms which a person with Mito has which are not usually part of MS or Mast Cell Activation Diseases.

There are metal tracheostomy tubes. Those trach tubes are made from stainless steel or sterling silver. The Bivona is the only non-metal trach tube which has metal in it.

Thank you for watching.

Thanks so much for sharing.

Thank you for sharing. I am sorry your husband has been through so much. I am happy to hear the home where he now resides is much gentler. Thank you for your kindness. I am glad the videos have been helpful. All my best to you and your husband.

Shiley Flexible Trach Tube

@@LifewithaVent But how you can speak?It has fenestrated version?I'am using the 8FEN and i'am wondering if i can use the model you use.

Thank you for the update. I am not sure if the Stellar 150 would be useful or not. I am not familiar with BiPAP or ASV settings. I use the AC mode on my machine. The only settings in the AC mode which can be adjusted are the tidal volume, breath rate, inspiratory time, flow pattern, trigger type and PEEP. Perhaps this article may help you find the information you are looking for. Article summary: "While much attention has focused on the inspiratory phase, the purpose of this report is to examine the cycling and expiratory phase of the mechanical ventilator breath. Other important topics include premature cycling, delayed cycling, and the ramifications of expiratory asynchrony." Here is the link to the article if you wish to read it: rc.rcjournal.com/content/56/1/52

@@LifewithaVent it might be "flow pattern" that im thinking of. What model are you using? Are the breaths natural, comfortable and "wavy"? Not abrupt when inhalation moves to exhalation? I couldn't fall asleep with Bipap bc the jump from ipap to epap was too abrupt, Im surprised not much info is out there for this Thank you again!

Hello. Here are some things I forgot to address in my last comment. Stale air: This might be from the ventilator. Whenever I get a ventilator, I allow the ventilator to run for 1-2 days outside to get rid of any dust or smells which may be in the machine. One machine I had to run for 7 days to get rid of the smell. Regarding the abrupt exhalation: It is not flow pattern. Flow pattern is the pattern in which the flow of air is given. There are two basic patterns. First, the machine can give a strong blast for the inhalation and sustains this pressure for a certain timeframe. Once the inhalation part of the cycle is over, it abruptly drops the pressure. This is called the square flow pattern. It is used for people with COPD. The second flow pattern is called ramp. It gradually gives the inhalation until it reaches the desired pressure or volume over a certain timeframe, it then drops the pressure to allow for exhalation. Ramp flow pattern is used for most people. Continuing on, there are two general forms of ventilation. They are pressure support and volume support. BiPAP (S, T, S/T) and ASV are pressure support ventilation. Pressure support ventilation only cares about the pressures which are being delivered. The patient is responsible to get the proper volume of air during ventilation. Pressure support ventilation works as follows: preset pressures are programmed into the device. The machine gives the appropriate pressure for inhalation and then drops the pressure to the exhalation pressure. The volume of air is not taken into account. The person is responsible to adjust his breathing to get the proper amount of air into his lungs. Volume support ventilation has a preset volume the machine needs to give. The machine makes constant calculations (based on the amount of air exhaled) how much volume the person is receiving. The pressures the machine delivers are constantly adjusted to make sure the person is always receiving the same volume of air. There are modes called AVAPS and iVAPS which are technically pressure support ventilation, but they also taken into account the volume of the air being delivered. In these modes, a range of preset pressures are entered into the device. It is called IPAP minimum and IPAP maximum. Also, a preset tidal volume is entered. The machine calculates the amount of pressure needed to deliver the tidal volume. The pressure delivered will only be within the minimum IPAP and maximum IPAP. Please note, some machines such as the Trilogy can incorporate AVAPS into the S, T, and S/T modes. There is also another mode called AVAPS-AE and iVAPS with auto-EPAP. This is an even more advanced setting in which the EPAP is also adjusted. Based on what you have told me, it seems you have only tried BiPAP in the S and S/T mode and also ASV. I do not believe you have tried AVAPS, iVAPS, AVAPS-AE or iVAPS with auto-EPE. These may be a better option for you. It might be worthwhile to look into these other modes. (Due to the length of this message, I am going to start another comment.)

I will copy down the options available for the S, S/T and AVAPS-AE on the Trilogy. This will hopefully help you decide if the Trilogy may or may not be the right machine for you. S mode IPAP, EPAP, Trigger Type, Flow trigger sensitivity, flow cycle sensitivity, rise time, ramp length. It also has the ability to incorporate AVAPS into the setting. If incorporating AVAPS into the S mode, there are additional parameters such as AVAPS rate, tidal volume, IPAP max pressure and IPAP min pressure S/T mode IPAP, EPAP, breath rate, inspiratory time, trigger type, flow trigger sensitivity, flow cycle sensitivity, rise time and ramp length. It also has the ability to incorporate AVAPS into the setting. If incorporating AVAPS into the S/T mode, there are additional parameters such as AVAPS rate, tidal volume, IPAP max pressure and IPAP min pressure AVAPS-AE mode AVAPS rate, tidal volume, maximum pressure, pressure support maximum, pressure support minimum, EPAP max pressure, EPAP minimum pressure, breathe rate, trigger type, flow trigger sensitivity, flow cycle sensitivity, rise time, and ramp length

I am using a Trilogy 100. The way my machine works is it gives me a slow steady inhalation until the tidal volume is reached. Once the tidal volume is reached, the pressure is cut off and drops down to the PEEP. (PEEP is positive end expiatory pressure. This pressure is need to prevent the lungs from collapsing.) For me, the pressure during inspiration reaches a peak inspiratory pressure of about 10 cm H20 in 1.7 seconds. During this time, the tidal volume of 500 mL of air is delivered. After 1.7 seconds, the machine drops the pressure down to 5 cm H2O. It does this abruptly to allow my lungs to naturally exhale. It feels normal to me. I have never had any issues with it.

Thank you so much.

Hello. Thank you for your comment. I am not sure what your mean by "upgrading" the ventilator. Do you mean you are to stop using the ventilator? Are you changing to different settings on the ventilator? Or are you changing from one ventilator to another? My apologies. I am not sure what you are asking about.

Yes, a stainless steel tracheostomy tube needs to be changed every month. A stainless steel tracheostomy tube can be washed, sterilized and reused. Since it takes some time to wash and sterilize the tracheostomy tube, it is best to have two stainless steel tracheostomy tubes. Every month, replace the stainless steel tracheostomy tube with a clean one. And then clean and sterilize the dirty stainless steel tracheosotmy tube and set it aside for use the next month. For information on how to wash and sterilize a stainless steel tracheostomy tube, please watch the following video: ruclips.net/video/_kuYXsAeMqY/видео.html I have never used a stainless steel trach tube. I have only used plastic and silicone trach tubes. I do not know if stainless steel tracheostomy tubes are easier to get out than plastic ones.

@@LifewithaVent Thank you so much for being so detailed in your answer! I appreciate you very much! Your channel is super helpful! God bless you. Wish you a beautiful week! Hugs! ❤

@@mirosderegil Thank you so much.

Yes I do.

Thank you.

Oxygen saturation on a pulse oximeter is often normal during hypercapnia.

When I stood up, my heart rate went into the 170's.

I traveled on the plane alone. I can do a video about what I pack when flying on an airplane. I do not need oxygen on the plane.

Thank you for watching.

Thank you for your kind words. I am sorry to hear you have progressive Multiple Sclerosis. All my best to you.

Thank you for the video suggestion. I will add it to my list. I do not know when I will be able to record it and upload it. If you have not done so, please subscribe and hit the notification button to be notified when new videos are released. This way you will know when the video is released on my channel. (I try to notify people when their requested video is released, but of late, there have been many requests, and I have been losing track of who requested which video.)

Hello. If you have a trach and the airway above the tracheostomy tube closes, then yes, you can still breathe via the tracheostomy tube. Regarding what is your next step if your throat happens to completely close, please discuss this with your medical provider. He/she will discuss what you should do if this should happen to you.

Thank you for watching.

Thank you.

Thank you.

Thank you.

Thank you.

Thank you.

The ambu bag is used the same way with a broken tracheostomy tube cuff.

Thank you for your kindness.