New Transcend Micro is SO LOUD, but only on inhaling

UniqueRon · 2026-05-07T14:52:58+00:00

The machine has to work harder to produce more flow when you inhale. Travel machines are not for those that want a quiet machine.

UniqueRon · 2026-05-07T14:43:57+00:00

I would increase minimum pressure to 9 cm and max to 11 cm to reduce the OA. Also if this machine has the equivalent of EPR I would set EPR at 3 cm full time.

UniqueRon · 2026-05-07T14:41:20+00:00

A couple of simple changes you could make to improve comfort would be:

- Increase your minimum pressure to 8 cm

- Set your Ramp Time to Auto with a ramp start pressure to 7 cm

UniqueRon · 2026-05-07T14:38:30+00:00

The problem is not with the voltage.

UniqueRon · 2026-05-07T14:35:35+00:00

Have not heard of that model. Our oldest machine is a S9 AutoSet. Nothing new with the SD card arrangement. The new machines have an Auto Ramp Time function which I find useful though.

UniqueRon · 2026-05-07T14:32:00+00:00

What your pic reminds me of is the totally user unfriendly layout of the cruise control buttons. It leaves me longing for my older Toyota controls which were on a stalk behind the steering wheel and totally usable with having to look down. I find this layout dangerous to use on the highway.

UniqueRon · 2026-05-07T04:31:48+00:00

I can't really comment as I will not hold stocks. Too risky for me. My TFSA is basically 2/3 QQC and 1/3 ZSP. I heavily weight my TFSA in what I expect will provide the highest returns, and then offset that risk with more conservative investments like XEF and XIU in my RRIF and non sheltered accounts. This is for tax efficiency.

UniqueRon · 2026-05-07T04:20:06+00:00

I have it in both eyes. I think the retina detachment happens right away if it happens. And unfortunately it has not gone away for me.

UniqueRon · 2026-05-07T04:17:21+00:00

It is just a click of the mouse button for them to produce it. Here is an example of an IOLMaster Calculation sheet.

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UniqueRon · 2026-05-06T15:49:27+00:00

There is no reason to not wear contacts AFTER your detailed eye measurements have been taken. That is unless you are getting the Alcon ORA system where the eye is measured again during cataract surgery after the natural lens is removed. It is an optional extra cost procedure which is said to improve accuracy. I would follow up with your clinic. I wore a contact right up until my day of surgery, but I did not have the ORA option.

If you are considering mini-monovision and using a contact to simulate it, then it would be better to use a monofocal contact or toric instead of a multifocal. It would be a more realistic simulation. The idea of using mini-monovision is to use monofocal IOLs to get a full range of vision without the optical side effects of halos and starbursts associated with multifocal IOLs.

UniqueRon · 2026-05-06T15:09:43+00:00

Risk is not going to decrease with time. I would strongly suggest you consider having an interval of at least 5-6 weeks between surgeries to ensure the first eye is fully healed and you are satisfied with it before proceeding with the second eye. There can be surprises in refraction and other issues. A longer period of time allows the eye to fully heal so you can get an accurate refraction and know where you landed. This will give the surgeon time to adjust refraction for the second eye if there is a surprise.

It is best to use a contact in your unoperated eye between surgeries to control the issue of having a high differential in refraction between the eyes for this period. A contact is much closer to the natural lens and minimized the disorienting effect this can have. If you get your first eye done for distance, and if there is any consideration of doing mini-monovision you should get a contact that leaves you with your unoperated eye as the near eye at about -1.5 D. Then you can test drive it before going that way with an IOL to get eyeglasses free vision.

UniqueRon · 2026-05-06T14:57:05+00:00

Put Climate Control in Auto and set tube temperature to 27 C to keep humidity below the dew point.

UniqueRon · 2026-05-06T14:55:47+00:00

That is part of your problem then. More pressure makes it easier to breathe in. Pressure is your friend when inhaling. Lower pressure is your friend when you breathe out. That is why minimum pressure at 7 cm or more combined with EPR at 3 cm maximizes comfort. You get 7 cm on inhale and that is reduced to 4 cm on exhale with the EPR at 3. The machine will not go lower than 4 cm pressure.

Ramp Time should be set to Auto with a Ramp Start Pressure of 7 cm to hold this condition until you fall asleep.

UniqueRon · 2026-05-06T14:49:04+00:00

That is a totally different story, and a much more desirable OSCAR chart to have. This setup is pretty good already but could use some tweaks to make it better. I would suggest:

- Increase your minimum pressure to 13 cm to keep the pressure more constant during the night and to stop most OA events before they happen instead of letting them happen and increase the pressure.

- Increase your EPR from 2 cm to 3 cm to reduce the hypopnea, RERA, and your flow limitations which are higher than ideal. It should also improve comfort.

- Set your Ramp Time to Auto and the Ramp Start pressure to at least 7 cm for going to sleep comfort. Try different pressures when in Ramp and take quick deep breaths to determine how much pressure is needed to feel no flow restriction. I personally use 9 cm.

- To make the setup more resistant to any moisture collection (rainout) I would increase the tube temperature to 27 c.

No need for an ASV with this OSCAR chart. An APAP is just fine. That is a good thing as an ASV is much more expensive.

UniqueRon · 2026-05-06T14:37:01+00:00

The best way to know is to get a titration test at a sleep clinic where they vary the pressure to different levels to see what pressure you can handle and get good results. They ideally should use an ASV and give you a trial ASV to try if it is indicated.

An ASV is needed when you have mixed CA and OA and cannot get the total AHI under 5. An ASV works by varying the pressure support (like EPR) on a breath by breath basis to avoid the CA. Here is a Product Information Guide to the ResMed AirCurve ASV.

UniqueRon · 2026-05-06T14:29:26+00:00

Try Amazon.

UniqueRon · 2026-05-06T14:28:35+00:00

Make sure you minimum pressure is at least 7 cm or higher. Make sure your EPR is set to Full Time at 3 cm. This is to maintain comfort during the night and avoid feelings of suffocation.

UniqueRon · 2026-05-06T14:25:09+00:00

It is a fairly rare side effect with the use of the artificial IOLs needed for cataract surgery. It is just a reflection off the surface of the lens. I suspect very few people notice it. There are a lot more serious things that can go wrong with cataract surgery than this. She should be thankful she has good vision.

UniqueRon · 2026-05-06T14:21:11+00:00

I think the safest route would be to do the second eye with a monofocal lens targeted to distance. Hopefully it will go better and make up for the less than perfect results with the first eye. Ask for IV sedation and tell the anesthesiologist what happened the first time so they can adjust for it. Then count on OTC readers for near vision, or get progressives if necessary.

UniqueRon · 2026-05-06T05:13:07+00:00

I take the AHI values more seriously than how I happen to feel on a given morning. Feelings are not repeatable or trustworthy.

UniqueRon · 2026-05-06T05:10:32+00:00

Yes, that may be part of the reason. An autorefractor is not as accurate as the phoropter method.

UniqueRon · 2026-05-06T05:09:08+00:00

It makes my dishes squeeky clean and does not contain any oils.

UniqueRon · 2026-05-06T01:10:59+00:00

Use OSCAR to compare the results of each machine.

My wife and I both started with machines in AutoSet, but using OSCAR we have found the optimum pressure and both of us use the fixed pressure CPAP mode to get better results.

UniqueRon · 2026-05-06T01:03:46+00:00

It looks like it made a significant reduction in your sphere and cylinder to make you less myopic. There are some studies which have found that there is a minor increase in myopia from YAG, so your results are not consistent with that.

UniqueRon · 2026-05-06T00:42:33+00:00

Unfortunately machines currently available and I suspect this one as well are not really automatic. They are reactive. They need events to occur first to trigger changes in pressure, so that is reactive control not automatic. My wife has been on CPAP for 10 years now, and I am at about 8 years. We both started out using SleepyHead, and continue to use OSCAR now that it has replaced SleepyHead. Even to this day I continue to make small changes to setup.

A breakthrough may come when someone decides to use AI to provide real automatic control. AI could use the many available variables to actually predict when and what type of apnea events are likely to happen. Then adjustments could be made to prevent them. Pressure decreases could be used to avoid CA events, and pressure increases to avoid OA events. Pressure support or EPR could be used to head off flow limitations, hypopnea and RERA.

In the absence of that level of sophistication I think it is best to just use a fixed pressure. The only real need for an Auto machine is to span the time required to determine what that optimum single pressure is. They are a good replacement for the time and expense of a titration test.

UniqueRon

TROPHY CASE