Before the hacking stuff, a bit about the mask itself:

- silicon facial pillow

- quick-latch feature allows rapid opening and resealing of mask for easy access to sips of water, food, etc

-sits firmly and comfortably on the face with adjustable head and neck straps

- no metal, so safe for X-Rays, MRIs, etc.

2/x

I wear a silicon mask at least 8/24 hours for my CPAP, and I understand how a good fit is extremely helpful for compliance.

If the mask is comfortable for the patients, patients are more likely to wear them and use their CPAP as prescribed.

Alas, while there are dozens (hundreds?) of different CPAP mask designs, the same does not seem to be true for #ElastomericRespirators

#CPAP
#mask
#respirator

3/x

So of course, my preferred respirator might not be the best choice for someone with a different facial structure or different needs/abilities/disabilities.

Bottom line: just like when fitting a #CPAP mask, an #ElastomericRespirator needs to feel comfortable in all necessary positions while in use.

4/x

I tried a couple of other #ElastomericRespirators before I settled on this one. The other ones fit generally okay but weren't great with my glasses, and I had to remove them completely for eating or drinking.

While I have been mostly alone throughout the pandemic, physical limitations due to being #ActuallyDisabled means I can't necessarily manage doffing and donning a zillion times if I am out.

5/x

And those same disabilities mean that I also have to be careful about staying hydrated and having sufficient food, which can be tricky if an appointment is delayed for some reason, or the pharmacy is backed up, or traffic jams, or the store's lineups are moving slowly, or whatever.

A respirator that I can easily--just one hand!--open to take a drink or a bite of food before resealing is a godsend for my needs. 🙂

6/x

But regardless of respirator style, there is an odd problem I've run across. I've never seen anyone else mention this, so perhaps it's just a 'me' thing, but wearing a respirator for more than 30 minutes can leave me vulnerable to an asthma attack (well, what *feels* like an asthma attack … no idea if that's what it is or not).

7/x

It took awhile to figure this out as, well, I *have* asthma.

I first discovered the issue wearing a CAN99 disposable respirator. These are wonderfully lightweight devices, similar to many that are made by other manufacturers.

Comfortable, easy to breathe in, easy to be heard in! Yay!

… but after a couple of hours, my bronchia would hurt. They would hurt almost exactly like how they would feel when shovelling snow at -25°C.

Ouch! 🥶😢

8/x

So I tried a bunch of other disposable N95s and even KN95s and they all ultimately resulted in the same problem: comfortable to wear at the time but later in the day, very sore bronchia and at some point, as asthma-style* attack.

*rescue inhalers helped but not completely stopped these, which is partly why I am unsure if the reactivity is actually asthma-related or just something that feels similar

9/x

That's when I switched over to #ElastomericRespirators mostly-exclusively.

Just like my #CPAP mask, these were very comfortable to wear and seemed to reduce--although not completely eliminate--this bronchial reactivity.

But then I noticed something else …

10/x

Because my #ElastomericRespirators have separate valves for inhalation and exhalation, and because those P100 filters do a great job filtering, my nose was inhaling very, very dry air.

Even though I'm exhaling into the same mask pillow, the exhalation valve directs all my warm, moist breath out of the mask.

Yay for a dryer face under a mask! Boo for rapid dehydration! 😱

11/x

Again I remind you that I am #ActuallyDisabled and manage multiple #ChronicIllnesses.

I have taken large amounts of many medications for most of my life, and many of these mess with my body's moisture. My tissues are dry from the inside out, ugh.

I've even started losing teeth due to this dryness, despite nearly-obsessive levels of dental hygiene on my part! 😬

So it's possible I feel dehydrated faster than many/most folks would in the same #ElastomericRespirator.

12/x

All this leads us to #MaskHack1: Humidification!

Since the valve design of the #ElastomericRespirator precludes saving much of my own moisture, is there some way I can add humidity into the mask pillow? 🤔

13/x

Answer: Yes. Thankfully, YES!!!

Using a silicone* 'lipstick saver'** and some folded paper towel with a few drops of water, I was able to add humidity into the mask pillow.

* very flexible, easy to cut down to a better shape ❤️
** seriously, that's what they're called; check Amazon if you don't believe me 😛

14/x

I shape the lipstick saver to fit the #ElastomericRespirator pillow, then insert it atop a piece of folded paper towel. Damp or dry, this arrangement keeps the wet material from touching/irritating (or even freezing! ❄️) the nose.

15/x

Environmental temperatures matter a lot for this approach:

- indoors or warm outdoors, add at least two drops of water (soaking is TOO MUCH)

- cold outdoors, none: the paper towel will capture some moisture from exhalation (adding water in extreme cold can freeze your skin--guess how I know??!? 🥶)

16/x

You might find other materials work well, too. Indeed, I started off with cotton makeup pads, but found that they shed too many tiny fibres when using and made my nose itch or even set off a sneezing fit.

I do not recommend sneezing inside an #ElastomericRespirator, or indeed, ANY mask. 😛

17/x

Something resuable such as flannel might also work well--the material does need to be fairly absorbent.

But, if using a reusable material, ensure you can wash it thoroughly between uses!

18/x

Indeed, I wipe my #elastomericRespirator clean after every use. All valves, the inside and the outside of the mask pillow.

And I remove the lipstick protector to wash with soap, then air-dry, and dispose of the used humidifier material.

19/x

So, wearing an #ElastomericRespirator solved my asthma-like attack problem, amd adding humidity to it solved my extreme dryness problem.

But I suspect anyone who has used an elastomeric in public is well aware that they can be difficult to be heard through.

20/x

It may well be that my lungs are just particularly feeble, but I have been a college instructor, classroom teacher, and public speaker, and have had generally good control* over my voice and projection, so I'm leaning towards this being more of a mask-problem than a me-problem.

* Occasional extreme-even-for-me medical issues notwithstanding.

21/x

Some people have even told me that since they can't hear me, *I* should learn sign language.

As a former ASL-English interpreter, I quickly instruct them in the fallacy of this logic, as they never understand my answer of:

"I already know ASL. The problem is YOU DON'T KNOW ASL." 🙄

A you-problem, but one that hasn't improved at all as we trickle into the final days of the fourth year of the #COVID19 #pandemic.

22/x

Sometimes, though, I need to be heard by people who don't know ASL and that I actually care about enough to either take on the personal pain arising from wearing a disposable respirator, or do #MaskHack2: amplification.

23/x

How can I make myself heard despite wearing an #ElastomericRespirator?

It turns out you can buy things called 'teacher amplifiers' which are microphones and a small portable speaker worn on a strap or the belt.

And these have … possibilities.

24/x

The trouble is that the microphones they come with seem to do an excellent job improving my #DarthVader impersonations, but not so great with the voice part.

If I affix the mic on the exterior of the #elastomericrespirator, it either picks up nothing or mostly picks up breathing.

Voice gets lost amongst all this.

25/x

The same mic does a lot better tucked inside the mask, but is still fairly thick and ends up brushing between the skin and the interior of the mask.

More voice, the same #DarthBreathing, but some discomfort against the skin (possibly a LOT of discomfort if worn long enough--I confess that I haven't tried).

26/x