[CPAP] Beyond ASV with Overlap Syndrome!

[RayBee]

Dave, I have been following your journey and have been getting quite an education. I don't have COPD, but am concerned that you do ultimately receive the therapy you need once all the hurdles have been overcome.

I thought I would throw something out there. Have you considered the PR DreamStation autoSV? I don't recall any mention of it in this thread. But I seem to have recalled reading somewhere else in the forum that it has a back-up respiration rate unlike our ResMed ASV machines.

I also seem to recall from other posts that the PR autoSV is less responsive than the ResMed ASV and seems to be a less favorable solution to treat centrals, but for some, more comfortable.

From what I have read in this thread, it sounded like you like and prefer ASV therapy, but were looking for something with a back-up resp rate to help with your COPD complications.

I could be way off here, but I didn't know if this had been considered yet as a viable solution.

All the best and keep up the sarcastic quips.  

[SarcasticDave94]

That RT video was helpful to me in that I believe I'm on the right track on AVAPS (Respironics) or iVAPS (ResMed). I still think a ResMed is my better option.

ResMed iVAPS is available in the AirCurve ST-A, then the bigger Stellar 100 or 150 is included in being iVAPS mode under my current HCPCS code. All three have the medical HCPCS code E0471 on the script, same as my ASV and even the VAuto I think. My understanding is if I were to pay cash, the theory is my Doc could issue a new script with current code E0471 but Dispense ResMed ST-A iVAPS instead of ASV Auto.

I do think for the most part, it's the time controls I'm needing to adjust that I can't now. Why this issue now? Dunno.

[SarcasticDave94]

Dave, I have been following your journey and have been getting quite an education. I don't have COPD, but am concerned that you do ultimately receive the therapy you need once all the hurdles have been overcome.

I thought I would throw something out there. Have you considered the PR DreamStation autoSV? I don't recall any mention of it in this thread. But I seem to have recalled reading somewhere else in the forum that it has a back-up respiration rate unlike our ResMed ASV machines.

I also seem to recall from other posts that the PR autoSV is less responsive than the ResMed ASV and seems to be a less favorable solution to treat centrals, but for some, more comfortable.

From what I have read in this thread, it sounded like you like and prefer ASV therapy, but were looking for something with a back-up resp rate to help with your COPD complications.

I could be way off here, but I didn't know if this had been considered yet as a viable solution.

All the best and keep up the sarcastic quips.  

Yes, I've thought about it, and I'm not refusing to go that way. PR SV Auto has the controls as I recall. That'd most certainly be cash, swapping ASV to SV Auto, so maybe that's why I've not mentioned it. Appreciate the comments.

[SarcasticDave94]

FWIW folks, because I'm one that practices what I preach, AKA if I suggest to any on AB "you should be like Yoda, do or do not, there is no try", be assured when it comes to me and my dysfunctional ASV therapy relation, I'm still Doing. I've not gone to Do not mode. I haven't hung up the mask.

In my maintaining "Do" mode, the mask on time is quite limited when compared to the first year and a half with this ASV. And any comment on ResMed ASV being a good choice to combat central apnea still stands. On that prior time segment of mine, therapy was near excellent once dialed in. However, now there are some sessions I mask on and can't sleep, and some it's short sleep sessions akin to naps. But those 4 plus hours mask on sleep sessions don't exist right now. I still do not know definitively why. For lack of that answer, I'm supposing it's that lack of timing control settings I don't have with this ResMed ASV.

And a side note, this why may be unrelated to the ASV. My upcoming Spinal Cord Simulator Implant to address chronic severe lumbar pain may remedy my dysfunctional ASV sleep sessions status. I know it can't hurt, excluding the SCS surgery install pain.

As is, my belief is strong enough in a necessary machine change, that when funds are available, I'll be buying a different device sans insurance assist if I must. I have a few device options, and the ongoing research helps define my direction. I believe AVAPS or iVAPS mode is needed in whatever platform I go with to gain setting control. And I'm leaning towards staying with ResMed, but it's not absolutely that or nothing. I'll get the tool that makes the most sense to regain excellent mask times. Now if it includes an invisible, hoseless mask, I'll let y'all know.

[SarcasticDave94]

Today, I got the answer that will give me entrance to my next apnea treatment phase regardless of insurance. God has honored my prayer for help, and I've been unofficially declared Disabled with the U.S. Social Security via a remand hearing. The molasses coated gears are turning and my projected payments for this will be out soonish.

I had to accept 12/2017 as my onset date instead of 8/2014, due to medical evidence not supporting the earlier date. However, I will get disability and its supplemental with Medicare.

[jaswilliams]

Dave that’s great news it seems weird to be congratulating someone on being disabled ???

[SarcasticDave94]

Thanks jaswilliams, to me it is about getting an "income" again, my COPD and pain limit ability to concentrate on job function, that's in spite of that SCS implant, was a goal on that implant that psychologist and I discussed, in my case it cannot bring back job level functions but it will, as demonstrated by myself, add functional abilities to life...perfect as that was my goal, a great day to each

[SarcasticDave94]

OK FWIW I recently had a new sleep study as I had little else going on. I'll see the nurse practitioner next week to review that.

My SSA account shows I'll start Medicare A & B this May and that SSDI checks start in March. The info I'll get next week should at least arm me with which machine to get. If I can, I'll process this through insurance. If not, I'll buy one myself, probably through Supplier #33.

[Sleeprider]

Dave, you might want to look in on this thread by Brandon80 http://www.apneaboard.com/forums/Thread-...s-terrible He has a ST-A and probably need ASV. He has complex apnea and is experimenting with iVAPS after the titration study put him on ST mode at very high pressure and pressure support.

[SarcasticDave94]

OK thanks Sleeprider. I'm reviewing the thread link.