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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Nov 24, 2020 9:00 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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I'd leave your PS as is to try one edit at a time.

Unless you have COPD, a more serious lung disease, or something similar, It's not recommended for your circumstance as far as what we've been told.

I have a very complex set of breathing issues, with high central apnea and COPD at the same time. Each day I have to combat fatigue from both illnesses. I have shortness of breath associated with COPD. And I have 2 daily inhalers plus a rescue inhaler, and a nebulizer to get a medication deeper into the lungs. This isn't nasal congestion. No intent to sound negative, but you're already doing fairly well with the ASV, and you'd not be able to compare congestion to obstructive disease like COPD. Realistically, I see the ASV doing well for you, but you have to give it a chance to do its job and more time is needed.

Since you are on a full face mask, does mouth breathing help any with airflow? Yes you'll likely get dry mouth, but if it helps airflow, it may be worth doing when a full face mask is in place. Consider this stuff called xylimelts that will combat the dry mouth.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Nov 24, 2020 2:15 pm

Joined: Mon Nov 16, 2020 11:02 am
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I know a couple of people with COPD. They struggle everyday. Not sure you know this but I've been using the ASV for maybe a couple of years now. No relief at all. I explained my situation in an earlier post. It's hard for my doctors to understand what's going on because they see my episodes way down and they automatically think I should be feeling better. I'm not. Like you, everyday is a struggle but the difference is, they don't know what's wrong. Is it the Lyme causing neurological issues? Is it the pain meds causing breathing issues while sleeping? Is it that my allergies are so bad? All I know is I wake up every morning feeling like someone beat the smurf out of me while I was sleeping.

I'm hoping your help with the settings will be the answer. Most of my doctors didn't even look at my readings. Here in Florida, I've seen three and not one asked about the settings on my ASV machine.

Question. Is the NIV machine the same as a BIPAP machine? Thanks.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Nov 24, 2020 3:31 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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No the NIV is the ventilator, a completely separate class of machine. In CPAP class it's CPAP & APAP are variants on single pressure even though APAP can vary the pressure as I understand it, this is varying a single pressure, BPAP machines are ST or single EPAP and single IPAP, other BPAPs are like VAuto that is variable 2 pressure, ST-A is like a mini ventilator, ASV is BPAP also that can be variable EPAP and PS which makes IPAP variable. ASV has backup breath rate, I think ST-A does as well. Then the NIV has modes as in PAC SMV AVAPS & others that are geared towards much more like life support types.

OK, you had said about pain meds and Lymes. Can you go a bit deeper in explaining, maybe naming the meds? Some medications do interact with breathing and may be a reason. Lymes itself may be something too. I think maybe that's an are of uniqueness to your situation that may be worth highlighting.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Nov 25, 2020 7:13 am

Joined: Mon Nov 16, 2020 11:02 am
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I take Hydrocodone with Acetaminophen. However I can't take more than 5mg at once because if I do I get loopy. Not a good feeling. My doctors say the dosage I'm taking isn't concerning. Easy for them to say. I would like not to take them at all but I've tried several different therapies and nothing works. I'm actually researching stem cell treatment but it's very expensive and my insurance doesn't cover it. There was a report back in 2018 by a Dr. Bernardo Selim at the Mayo Clinic who says breathing issues during sleep could be a side effect of opioid use. He mentions taking Ampakines as an alternative to the opioids but I can't find any info on Ampakines.

I need to research the mask you mentioned because I'm not liking the F30. Too tight on my big noggin.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Nov 25, 2020 9:25 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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I know I keep saying it, but it is true, I've had Hydrocodone at some point in time during the past 6 years since I became to sick to work a job. I had severe back pain that came from being on prednisone as a medication to help with the back pain I already had and it set me up for osteoporosis and breaking 6 or more vertebrae over 9 months. I eventually was able to get a spinal cord stimulator implant device in the thoracic back to mask the pain. I have a Boston Scientific implant to electronically block pain, so now I've got a built-in TENS that's double powerful compared to a TENS. The electrodes for my SCS are implanted in the epidural space next to the spinal cord. And I walk with a rollator/4 wheel walker everywhere. I do have a $29K insurance paid wheelchair but it's impossible to take it anywhere since it weighs 345 lb.

As for the F&P mask here is their website https://www.fphcare.com/us/products/homecare-products/masks/

Depending on your DME, these may be in stock. I'm using Lincare now and they do have both Vitera and Simplus full face masks. I like the Simplus as it has a top of head adjustment that affects the height of where the mask sits on your face. Both are almost identical otherwise. And I would rank these above F20 etc. My F20 was my best mask until these F&Ps. F20 is 8/10 while either F&P is 10/10 in comfort and in leak free use and in ease to get a leak free fit.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Nov 25, 2020 10:38 am

Joined: Mon Nov 16, 2020 11:02 am
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Wow. Sorry to hear you've been through so much. I've taken prednisone in the past and I find it only provides temporary relief. That's why I'm looking into stem cell treatment. Look up Neil Riordan. He's supposedly the best. Only problem is the good ole USA doesn't allow certain types of stem cell therapy so Riordan took his clinic down to Panama City, Panama. It's expensive but at this point of my life, it might be worth the $10,000 to get through the next 20 years. But who knows.

I'll look into the different masks. F30 headgear only come in small and medium. I need a large.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Nov 25, 2020 10:46 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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My pain issue is under control with SCS so I'm OK with it now. All my surgeries and tests were insurance paid, so that was a nice bonus I suppose. One isn't to take Prednisone for 3.5 years so they now say. Eh it's in the past. Thanks for the concern.

OK on the masks, those F&P I mentioned has the standard headgear stamped M L so I am assuming medium large. Mask cushions are very close to same sizing as F20. My Medium on either ResMed or F&P are very close to same sizing. FWIW the Vitera headgear has a wider "web" covered rear area with cushioning that I think makes it more comfortable, but either Simplus or Vitera are very nice and I would say a better overall mask than F20 in every aspect. Near instant minimal leaks, my F20 can't compete.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Nov 25, 2020 11:14 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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Here's 2 shots of F20 Simplus and Vitera (l-r) the cushion and the headgear, maybe you get a feel for what the differences are via seeing these.

Attachment:
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Attachment:
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3 masks image 2 (5).jpg [ 548.26 KiB | Viewed 549 times ]


I'd forgot to put the elbow back on the F20, but it may help you see differences from a user of all. Hope it helps.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Dec 01, 2020 9:55 am

Joined: Mon Nov 16, 2020 11:02 am
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No AHI's for two nights in a row. Here's last nights. Not sure if it's accurate or if there's something wrong with my machine? Still having trouble getting images on to one screen.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Dec 01, 2020 11:34 am
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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FWIW I have regularly seen zero AHI with my ASV that is identical. It's likely correct in the report.

So how do you feel during and after therapy? Is it going well?

On OSCAR if for example you look at your right screenshot, see the faint line dividing the Flow Rate and Pressure? Right along that area should be where your cursor will change to indicate you can click and drag. Click there, drag it up a bit. Repeat at other division lines between other segments. That's all that's needed.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Dec 01, 2020 11:47 am

Joined: Mon Nov 16, 2020 11:02 am
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Feeling a little better. Trying not to get ahead of myself with expectations. I know it will be a long road to recovery. One day at a time. Can't thank you enough for your help. Much appreciated.

How are you doing these days?


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Tue Dec 01, 2020 12:57 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

Offline
Doing OK, have entered in the fight to move up to NIV ventilator approval with doc. Since I have COPD, it's taking over as the treatment need over CAs. I'm sure to win sooner or later. I had to bull my way to get the ASV when it was clearly needed with symptoms and test results, same now just another machine as end goal.

Trust me on the ASV, it will serve you well. I typically would get 0 AHI 2-4 times a week when I'd gotten the settings optimized the first month of treatment in fall of 2017. I felt best results if AHI was 2-3, a 0 didn't make things better or worse.

BTW for me on beginning ASV therapy, and I'd had apnea severely for 5 years or so, it took a solid "good" therapy month and it started to pay off a little then it progressed quickly to being beneficial...like a snowball effect. You'll really notice benefits soon.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Dec 02, 2020 7:01 am

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Good luck with getting your new machine. It seems we have to fight for everything these days. You'd think they'd just go by your doctors recommendations.

I sure hope I start feeling better. Last night was a rough one. Now I'm having another issue which seems to be getting worse. Two or three times a night I'm waking up with severe cotton mouth type symptoms. I'm so dried out that it seems to be making my headaches worse. I've tried both auto and manual on the climate control, all different settings on the the tube temperature and humidity levels and nothing works. So my first question is do you use the heated tube on your ASV? I live in Florida so our AC is pretty much on all the time. We keep the temperature between 73-75. With that said, what would you recommend for my settings? Auto vs manual? Tube temp and humidity levels? Or can I turn the heated tube off and just use a regular tube? Seems like when I take a step forward I get knocked back two steps with another issue. As usual, your thoughts are appreciated. Extremely frustrating.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Wed Dec 02, 2020 4:06 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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I've almost always used Manual Mode for my ASV humidifier. I didn't like the output on Auto. I found it to be too low for me. I've always used a heated hose for the ASV.

My settings are always Manual Humidifier, the ResMed humidifier on these 10 series is Off and 1-8. I am between 4 and 8 and I vary it depending on seasons, sometimes how I feel, like if nose is stuffed up, I'd back it down a notch or 2. Heated hose I think is 60-86 degrees F, and I go between 75-86. If I back the humidity down, I tend to turn the hose temp. down a bit too.

If you disconnect the heated hose and swap in the non-heated the ASV will auto switch off the heated setting. I am not sure if it blanks it out or if it disappears, but no issue in swapping back and forth as often as you need. You'd see a notice on the ASV screen for connection or disconnection of heated hose.

The dry mouth aspect is air flow into the mouth, possible via mouth breathing. It doesn't wreck therapy if you're on full face mask, but dry mouth results. If you're on other mask, it's probably hindering therapy as well. I can't recall if I mentioned it, look for this xylimelts at your pharmacy. They combat dry mouth. I can't say how effective as I've not used it, but others have on these forums, and reports are good.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Thu Dec 10, 2020 11:53 am

Joined: Mon Nov 16, 2020 11:02 am
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Still feeling like crap with the ASV. Went back to my dental appliance and it's seems to be helping. I'm going to stick with this to see what happens. Thanks for all your help and if I decide to go back to the ASV, I'll certainly look you up. Good luck with everything you're going through. Happy Holidays and stay safe. Thanks again.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Thu Dec 10, 2020 5:18 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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Safe and happy holidays to you.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Sun Dec 27, 2020 6:56 am

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Well I'm back. I hope you had a safe and happy holiday. Since going to the dental appliance for half the night and the ASV the other half, I've begun to experience significant chest pain. Mostly feels like muscle strain. Happening on both sides of my chest. So much so I went to the emergency room to make sure it wasn't heart related. It wasn't. I've noticed this increase in pain since I changed my pressure settings. My current settings are EPAP 4-10, PS 3-12. As for the dental appliance, it's hard to tell if it's working or causing the chest pain. I have an oximeter on order that has an alarm on it so I can test my oxygen levels while using the dental appliance. My AHI's are down to almost zero events. I'm wondering if the increased pressure is putting a strain on my chest muscles? Another concern with the ASV is is it working correctly? I've read some reports that the ResMed ASV sometimes puts out more pressure than the settings ask for. Any thoughts.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Mon Dec 28, 2020 5:24 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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Christmas was great, time with family always is.

I've had discomfort when first on the ASV. Maybe a chest exercise ish thing with the ASV, but glad you had doc's input.

Not derogatory, but your pressures shouldn't be causing this, they're not at the top of the ASV settings.

I'm always questionable on dental appliances FWIW.

I've got a new pulse oximeter, a Contec CMS50F. It records and loads into OSCAR. It is a watch looking meter with a wired finger probe.

Let us know how to help, and update us on the pulse oximeter.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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millssteve21
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Sat Jan 02, 2021 5:57 am

Joined: Mon Nov 16, 2020 11:02 am
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Good morning. Happy New Year.

Still having problems with chest pain. I finally received the pulse oximeter. Wore it three nights while using the dental appliance. Set oxygen level alarm to 88. The alarm only went off one time since using it. So I'm thinking it's not a low oxygen problem.

I was wondering if you ever heard of GI issues affecting sleep. Again, my problem is not getting sleep but more how I feel when I wake up. I'm wondering if my acid reflux is causing my chest pain and my breathing problems during sleep? I had surgery years ago called Nissen Fundoplication. It's a wrap put below the esophagus which is designed to stop acid from entering the esophagus. I'm starting to wonder if the wrap is coming undone and allowing acid to get into my lungs, especially while sleeping. I guess it's possible. Need to make another appointment with my GI.


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DeltaBravo3.8
Unread post  Post subject: Re: ASV Machine IPAP Setting  |  Posted: Sat Jan 02, 2021 5:19 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 473
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: NIV ResMed Astral 150 soon
Humidifier: To be included with Astral & heated single limb leak circuit
Pressure Setting: Will run iVAPS, ResMed's variant on AVAPS

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I'm a guy with an answer to most everything, and sometimes I'm even right.

I've got GERD rather severely (from hiatal hernia that's returned), especially when trying to sleep. I'm on Protonix and sleep with a bit of head elevation and sleeping on left side. Don't eat at least an hour before bed or it'll get you.

My GERD can be so bad it'll burn all the way up my esophagus, feels like a heart attack. It can cause burning in the jaw too. And yep I've had my heart checked, not a heart attack. Diagnostic imaging and blood test says nope.

GERD tips if you'd like, limit coffee, chocolate, mint candy, colas, and no lying down until at least 1 hour after eating.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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