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Thread: From Vent to Diaphragmatic Pacing System (DPS)...

  1. #81
    My husband uses Bivona 7. He had a Shiley 8 before that. He said the Bivona is much more comfortable and he can not even compare it. He only has the cuff inflated when on the vent at night or if needs an occasional rest.
    He could not tolerate the Passey Muir speaking valve at all with the Shiley.
    He tolerates it now about half of the time depending on how his breathing is that day.
    When he was in rehab he had silver Jackson like Scaper1 described.
    The other people here know much, much more aobut these things than I do.
    How is your dad doing Tracey?

  2. #82
    Senior Member
    Join Date
    May 2009
    Location
    portland oregon
    Posts
    128
    I switched to a bivonna size 8 TTS about 3 years ago and have been free of respiratory infections since making the switch.I rarely use the cuff,but because of the design of the cuff it fits close to the shaft when deflated and does not interfer with my breathing or cause problems when changing it out.I also find that it is softer and more comfortable.

    My ENT showed me how to change the trach,since it is singlewalled and does not have an innercannula.I have a clean trach placed everyday and I'm able to clean my stoma site more completely.My ENT is very happy with my stoma/trachea hygenie.

    Presently, I am off the vent 4-5 hours a day.I alternate between a passymuir,cap or HME.I've been able to wean my vent down to a pressure support of 9 during the day and 12 at night.This was done primarily because my PH balance had become too acidic from blowing off too much C02(hyperventilation).So, the only assitance I'm getting from the vent is the pressure support...volume and breath rate are controlled by me.I am able to talk comfortably on these settings...much to the dismay of my BF...LOLOL

    When i was first placed on the vent in jan 2007.I was on assistcontrol with a shiley trach.I was not able to speak for the first 8 months.

    I think having a supportive ENT/respiratory therapist and ADVICE FROM BILL have been huge in helping me adapt to the vent........THANK YOU BILL!

  3. #83
    Thanks all! I have ordered a bivona number 7 trach and will switch out his Shiley 6 next week. No one in Canada seems to have any experience with it but we're going to try it anyway. I've chosen the one with the talking port which supplies air in hopes that I can at least start getting him accustomed to air in his oropharynx again. Great idea about having one and changing it out frequently!

    Dad is having botox tomorrow to help with his secretions and his neck spasms (thanks to a drug error in hospital - because of it he can't operate switches etc so again incredibly frustrating.). We are really hoping this works - he did have it in hospital just as we left and it seems to have been a bit helpful, bu there was so much going on it is hard to remember. ENT will do it this time so hope we get even better success.

    His pacer trials are static at between 120 and 180 minutes a day (4 sessions of 30 -45 minutes). I just can't get him to do more frequent sessions so am happy enough with this.

    I can't thank you all enough (yep esp Bill!)... please keep the advice coming! Anyone had a bad experience with the bivona? Tried the talking port?

    Tracey

  4. #84
    Is a talking port the same as a passey muir valve? We have just stumbled along with all of this. A specialist in Denver put the Bivona in and was like magic he could use the speaking valve.
    The scope shows his "pipes" are clear and the granuloma just around stoma. The silver (nitrate?) the doc put on the raw spots made it more comfortable.
    Some days he just not have enough ooomph to get enough air through the PMV which is frustrating.
    I am excited to hear how this works for your dad.
    Sure wish I had more advice.
    Last edited by LindaT; 03-10-2011 at 01:33 PM. Reason: sp

  5. #85
    Senior Member
    Join Date
    May 2009
    Location
    portland oregon
    Posts
    128
    Yes keep us posted.

  6. #86
    One Of A Kind are you in the Okanagan Area of BC still? I might have a contact for you, waiting to hear back before i pm his info to you.
    Formerly Canuck but lost my password and changed e-mails because of a move.

  7. #87
    Hi Canuck2!

    Back in the Kootenays, but would still be interested in the info! Not sure how to access my pm but will keep an eye out for your message. Regarding Linda T's question the talking port is different than the PMV - it is simply a port above the cuff through which oxygen can be piped to potentially allow or assist the patient in talking (the valve needs to be closed to do so -usually occluded with a finger but I think it coulb be taped off). This way his cuff can be inflated and he can still potentially vocalize. Not sure how well it works but will see. The plan is get used to air again then slowly put the cuff down, add the pmv +/- supplementing oxygen through the port as needed to aid in vocalization and secretion evaporation. Will keep you all posted!!

    Tracey

  8. #88

  9. #89
    I might not be much of a help then, this person is working in the North Okanagan so out of travel reach for both of you basically.
    Formerly Canuck but lost my password and changed e-mails because of a move.

  10. #90
    Senior Member
    Join Date
    May 2009
    Location
    portland oregon
    Posts
    128
    WOW! botox for secretions i didn't know about that...i'll have to check it out

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