Ventilator-Assisted Living©

Fall 2002, Vol. 16, No. 3

ISSN 1066-534X

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Read selected articles from this issue ...

On the Road with the Newport HT50 Ventilator
Debbie Perlman

Ventilator Users' Perspectives on the Important Elements of Health-Related Quality of Life: Final Report
Funded by The GINI Research Fund, Saint Louis, Missouri, USA

Home Mechanical Ventilation in Taiwan
Meng-Chih Lin, MD

Charcot-Marie-Tooth: A "Breath Taking" Reality
Susan Wheeler, BSW

Homebound Restriction Eased

Potpourri: MDA Clinical-Research Chat on Respiratory-Ventilation Issues;
Book: Noninvasive Ventilation by John R. Bach;
MiCASSA Update

Interfaces and Equipment


On the Road with the Newport HT50 Ventilator

Debbie Perlman (www.HealingPsalm.com)

Twenty-four years ago, at the age of 27 and with a husband and 5-month-old daughter, I was diagnosed with advanced Hodgkin’s disease, a form of lymphatic cancer. The following years of surgery and chemotherapy, radiation treatments, side effects, and cancer recurrence left me physically disabled and oxygen dependent. A lung resection for recurrent cancer in 1988 decreased my vital capacity further. In addition to my respiratory problems, various treatments caused muscle wasting in my hips. I walk with a cane and use a manual wheelchair, pushed by someone else, for distance. After a year of continuous oxygen by nasal cannula, I began using a transtracheal oxygen catheter.

In early July 1996, my summer cold developed into pneumonia, complicated by a pleural effusion (a large accumulation of fluid) below my left lung. In the ICU, using a ventilator for the first time, my breathing was monitored and quantified by physicians, nurses, and respiratory therapists, while I was supported by the healing energies of family and friends.

Eventually, as my respiratory system continued to fail, a tracheotomy was performed (the surgeon enlarged the existing stoma for the transtracheal oxygen). Since the autumn of 1996, I have used a ventilator for about half the day, mostly for sleep and an afternoon nap, but increasingly to help me perform such daily activities as showering and dressing.

I had been using an LP10 ventilator, a heavy and bulky machine. But we live in a tri-level house, and I became interested in a smaller ventilator that I could move between floors, knowing that my time using the ventilator would gradually increase.

Our daughter’s marriage in September 2001 was the catalyst for the search for a small, portable ventilator, because her new in-laws live in Naples, Italy, and invited us to Italy to return the hospitality we showed them during the wedding.

I have always been a nervous traveler, and my husband Reid’s anxiety during travel had grown as I became increasingly disabled. We had not traveled since December 1999, when two weeks in Florida with friends ended in an emergency hospitalization for respiratory failure due to a stress and infection-induced sodium imbalance.

If the idea of a three-hour plane ride sent me gasping and sweating into a panic attack, how could I manage to fly to Italy? I would never survive a 10- or 11-hour flight without being ventilated. I also knew that being able to relax and sleep on the airplane while using the ventilator would allay my anxiety.

My Internet research led me to the HT50 manufactured by Newport Medical Instruments, Inc. In addition to its small size and weight (about 15 lbs.), what impressed me the most was its internal battery that lasts for 10 hours. The HT50 recharges while it is running and plugged in, and can accommodate both American and European current. Through my home care provider and with my physician’s consent and prescription, a trial with the HT50 was arranged. I took as deep a breath as I could, called my travel agent and purchased airline tickets to Italy.

“It’s so cute!” I reacted when Dependicare’s head of respiratory services, Luis, and Troy, an experienced respiratory therapist who had studied the HT50 manuals, brought the unit to my house. It is a wedge-shaped baby ventilator, small and lightweight enough for me to move around. It accommodates the disposable circuits my pulmonologist prefers and has a system for blending in oxygen. Troy familiarized me with the settings and alarms; they were easy to learn. The alarm is loud enough but not “screaming,” and the alarm cancels immediately when the problem is fixed. The quiet noise the HT50 makes is more of a warbling sound, compared with the LP10’s whoosh and groan.

I tried the HT50 while Troy monitored my oxygen saturation. It felt a little different from the LP10; the breaths seemed deeper to me, but I easily adapted. Naples seemed closer and more beautiful than ever.

A week before Reid and I were to leave for Italy, Reid had a heart attack, followed the next morning by coronary artery bypass graft surgery. The portability of the HT50 was immediately put to the test. In the eight days that followed, I took the HT50 with me to the hospital each morning so I could spend as much time as possible with Reid. A couple of times we even settled in for afternoon naps together, presenting I am sure, a confusing picture to hospital personnel. Just who was the patient?

Home at last, healing and healed, Reid has recovered well. I continue to appreciate the portability of the HT50 (our private insurance covers the HT50). I use it in the car on internal battery, although I have a cigarette lighter plug that can also power it.

We have planned a trip to Sanibel, Florida, and although I will not need it for such a short trip, the HT50 was approved by Delta and American Airlines for inflight use, thanks to its gel cell battery. I expect the HT50 to provide good service as my ventilation need increases … and if we someday fly to Naples.


Interfaces and Equipment

Masks

7600 Series VMask is a full face mask, recently approved by FDA for use with CPAP/NPPV, available in five sizes from Hans Rudolph, Inc. (800-456-6695, www.rudolphkc.com). The face piece and sealing flange are made of silicone in a new anatomically contoured design with ribbed support for a leak-free comfortable fit. The mask has an anti-asphyxia valve and CO2 flush holes. Quick-release headgear is available in two sizes.

Oracle™, the new oral mask from Fisher & Paykel Healthcare (www.fphcare.com), has received an enthusiastic review from ventilator user and respiratory polio survivor Doug Martin who lives in Los Angeles. Doug uses mouth intermittent positive pressure ventilation (MIPPV) during the day with a mouthpiece and old LIFECARE PVV. He also is using the LTV800™ (Pulmonetic Systems, Inc., www.pulmonetic.com) on a trial basis and finds it very satisfactory.

Doug had trained himself to use MIPPV during the night (without a seal), finding nasal and facial masks claustrophobic and causing skin breakdowns. Diana Guth, RRT, Home Respiratory Care Sleep Solutions (diana@hrcsleep.com), introduced him to the Oracle for nighttime use. She secured the Oracle with a Puritan Bennett chinstrap because his cheeks inflate so much that the outside flap of the Oracle pops out.

The advantages of the Oracle for Doug are: comfortable fit, tight seal and less leakage, low maintenance, and sustained and consistent ventilation. Doug finds the Oracle a bit disconcerting upon awakening because he cannot call for his attendant or take a drink of water as he used to, but he expects that awakening with the Oracle will become second nature. Doug believes the Oracle is the simplest and best interface he has ever used.

Batteries

For external batteries to power ventilators, many people recommend and prefer MK Batteries for their long life: 7-9 hours (800-372-9253, www.mkbattery.com).

The Bemes Leg-Bat29 battery is often used with the TBird® Legacy (800-969-2363, www.bemes.com).

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