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
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
But a wacky thing I learned about a year ago is that any speaker can also be a microphone. 😳
And you know what? Headphones are just tiny speakers!!! 😀
27/x
So, for #MaskHack2, swap out the teacher amplifier's mic for a pair of small headphones/earbuds.
If you thread the headphones/earbuds through the lipstick protector, you can also position them just below each edge of you mouth--and coincidentally further from your nose!
#speech
#amplification
#SpeechAmplification
#microphone
#earbuds
#repurposed
28/x
For me, this made my speech quite easy to understand when wearing an #ElastomericRespirator and visiting with elders who otherwise could hear me about as clearly as the kids from Charlie Brown can hear the teacher.
My breath was still audible, but not overpowering the words. Less #DarthVader, more #TiredYoda. 😀
29/x
So here it is, my #ElastomericRespirator with #MaskHack1 (#humidification) and #MaskHack2 (#amplification), plus bonus #beautification of the lurid magenta P100 filters by using blue fabric slipcovers.
Hope these ideas help folks who might be facing similar challenges when using respirators! 🙂
30/fin
-- 30 --
@likelyjanlukas Thank you for all these details. I spent a lot of time looking at those 3M masks last summer as a smoke solution. The disposable N95s work for me for everyday aerosol filtration, but the bigger respirator should be better for extreme particles, plus you can get filter pads with carbon organic-vapour filters as well.
The humidity issue is an interesting one. In the heat, the extra humidity in my N95 is a bad thing, but it sure was nice not to need my nasal saline on an airplane!
@AmeliasBrain @likelyjanlukas The amplification solution is quite clever! Because I work as an imaging tech, I need to speak a lot to patients, many of whom are hard of hearing or have difficulty with comprehension. This has kept me from trying an elastomeric at work. I'm going to have to look into the teacher amplifier solution!
Thanks!
You're welcome! There are a LOT of different ones avail and mine is pretty cheap. I recently 'upgraded' when I misplaced mine, and the new one was terrible, lol! So, prepare to try stuff out thoroughly. 🙂
As I am home alone, I tested mine by using my camera to 'film' me talking with whatever setup I was using, then moved away to the distance I would normally be at when visiting and kept talking for another minute or so, trying different volumes.
1/x
To my ears, every mic setup I tried sounded fine, as the mask pillow is a small echo chamber, so to speak. But the phone's video was able to give me a very good way of objectively assessing what someone else would hear in that configuration.
What sounded best to me when doing each test was usually the worst on video; what picked up best often didn't sound awesome to me when I was speaking.
2/x
You may have additional complications due to interference from the machinery you work with, so once you figure out something that works at home, run the same tests in your work environment (if you can).
I can't offer help there because I haven't worn this to MRI or X-Ray as a patient, as the metal and wires and stuff would definitely interfere with being imaged.
3/x
I tried out the little headset mic the amplifier came with, a 'proper' tieclip mic, and several different headphones.
IMO, the headphones all performed MUCH better, picking up relatively less of my breathing and a lot more of my speaking.
The smaller headphones seemed to perform better, and the ones in my pic were the best of all.
4/x
I *think* the ones I've been using are actual iPod earbuds, lol! I didn't end up using them back in the day because like most of that sort of thing, they hurt my ears. 😬
Today you'd likely have to acquire wireless ones and a wireless amplifier, which (I'm guessing) might be more prone to signal interference at work.
5/x
One additional thing I tried was a throat mic, but what I was able to buy on Amazon (that didn't have special connectors for police radios) didn't work *at all*. 😐
OH -- if you go the headphone-as-microphone route, it needs to be headphones that don't have an interrupt button (for hands-free call answer).
London Drugs still had some cheap wired earbuds last time I checked. 🙂
6/x
Finally, credit where credit due: I got the idea from a gas station employee who disn't understand that I wanted to buy hotdogs.
He said he was having trouble understanding me because I "was dressed like an #astronaut" and *zing* a bulb lit over my head with an idea. 😂😂😂
Please keep me posted as to how this goes! I hope you are able to make something work! 🙂
7/7
PS: The pic I shared in thread was of my original amplifier. I found it again, yay! 🙂
And I returned the much-more-expensive-but-actually-crappy-one for a refund.
@likelyjanlukas @AmeliasBrain Cool! Thanks for the extra detail!
Interference for me won't be an issue, as I work in NM/PET, although I'd imagine that the wired route -- although it would require some care to maintain the face seal -- would be the better way to go, if using headphones as mics. If nothing else, it's way easier to plug a headphone into a mic port than to try to convince BT to connect a headphone as a mic.
As an N95 is *relatively* hear-able (compared to an elastomeric), perhaps trying the headset mic the teacher amplifier systems come with would be adequate, by just wearing it as if you weren't also wearing a mask.
I find N95s very wet inside when wearing, so I would be worried about either the mic getting damaged or a shock hazard.*
*I know almost nothing of electronics so perhaps this isn't a realistic fear, but I figure avoiding facial burns is good.
@likelyjanlukas @AmeliasBrain Proper elastomerics, on the other hand, occlude and echo to the point where it doesn't work well. I have an old full-face respirator from when I worked as a chemist that works well, as it has a specially designed speech-improving exhalation system, but it's unfiltered, so that's no-go for work.
It's also a LOT. Like, almost a WW2 gas mask, or a fire fighter's SCBA mask.
Yeah I was going to mention that PAPR systems like firefighters use *may* also have built-in links for comms systems (purchased separately), but while they are great for showing the full face, they're fantastically expensive.
At least, beyond what I can scrape together on AISH.
Excellent! 🙂 Unfortunately, I've found that my elders are just having too much trouble hearing. One genuinely can't even make out most of what I say even in an N95.
They're the reason I dug up my amplifier this week: the senior's facility has a building-wide flu outbreak so no way in hell was I swapping out of my P100 to wear an N95. But then I knew I wouldn't be hearable at all.
And alas, none of my elders speak ASL either, so we're limited for options.
@likelyjanlukas @cthulku @AmeliasBrain so many people need to lip-read, and they don’t recognize that they need to. Nowadays I slip one ear and move my CAN99 when I speak, so people can watch my mouth. Then pop it back on, and inhale while slipping the earloop back on (ideally)
(CAN99 made in Canada, also from London Drugs)
@sueellenfast @cthulku @AmeliasBrain
I've tried the CAN99 but unfortunately, like all other disposables I've tried, something in the material makes my lungs try to evacuate my body.
I can manage perhaps 30 min in those before the coughing is guaranteed to last more than 24 hours.
My #ElastomericRespirator, otoh, is generally very comfortable and only seems to contribute to increased coughing if I have to wear it for more than five hours without humidification.
I'm glad they are working for your needs! ❤️
Something that I've come across that you might be interested in: https://forgedair.co/
It's a hybrid elastomeric respirator (with optional safety glass attachment) that has sound transparency comparable to N95. I've picked one up, with N99 filters, and it's pretty comfortable, on par with the usual 3M respirators. They're working on a P100 as well. It's designed for industrial/fabrication/welding, hence the low profile and optional eye shield, but the rating is the same as other medical respirators.
The main benefit, I think, is that since it uses a large filter medium, it would be more easily customizable, and would generate far less echo than a classic elastomeric, with your amplifier system. I've yet to try it out at work yet, but it seems pretty solid, although I don't think that it'll be much less material waste, as the filter medium is essential a 3M Aura.
That looks awesome and yes, with a full-face filter profile, easier to #MaskHack by adding some nifty #bling or #art. ❤️
For me, I really value the 3M #QuickLatch design because I can access both food and liquids rapidly without having to doff and re-don my respirator.
With #diabetes (possibly actual #BrittleDiabetes according to one healthcare worker I was speaking with prior to a procedure where this mattered a lot), having physically-simple and quick access to my mouth for glucose tabs and/or a bite of food is critical for my own #disability management and safety.
Yes, there is some risk for a quick opening like this but even my crappy lungs can usually manage holding my breath for the 5-10 seconds this takes. I couldn't do the same with something that requires more time to get re-sealed.
So I LOVE the ForgedAir profile and design and I'm sure it would work brilliantly for many, but key for me remains physically simple, quick mouth-access with minimal time exposed prior to resealing.
🙂
Likely Jan Lukas
Amelia Bellamy-Royds 
Cthulku
Sue Ellen Fast