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The following pages will be dealing with the issue respiration, especially in a domestic surrounding.

My name is Eduard Frasch; I'm 29 years old, an industrial plumber by occupation, and I have been married since 1995. In November 1998 I had an automobile accident on the way home. Since then I have been paralysed from the neck down and must be ventilated. I spent six months in an intensive care unit in Hamburg, in the Traumatology Hospital Boberg, followed by around a further year in its paraplegic centre. I have been at home since June 2000 and am being cared for around the clock by a team of carers. I have put together a few photos, so as to give a brief insight into my present life. I have now been ventilated since 1999 with a PLV.This device has a somewhat peculiar appearance, but it operates problemfree regardless of how it's handled. (proven technology!); it can even tolerate minus temperatures without any problem. The setting always ranges between 850ml x 9 breaths per pro min (lying down) and 900ml x 10 (in a sitting position). Depending on the level of exertion, I do not hesitate for long and have the parameters changed. What is important, I believe, is to be conscious of ventilation and to have the values regularly corrected downwards. One can quickly become accustomed to hyperventilation and the subsequent weaning process is not quite as easy! Initially, I very often measured the CO2 value of the expired air and noted that this did not change essentially. The value fluctuates in my case for the aforementioned values between 27 and 37mmHg As regards the respiratory pacemaker (diaphragm pacemaker), attempts were made in my case a few times to activate the phrenic nerve (diaphragm nerve). A surgical test is still to be conducted. If the diaphragm can be electrically stimulated via the phrenic nerve, there is no reason not to use an implant. I have asked for some time to ponder this matter. The PNS (phrenic nerve stimulator) is being marketed by the Finish company Atrotech. Below is a pdf file with the operating instructions for the diaphragm pacemaker