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[CPAP] Beyond ASV with Overlap Syndrome!
RE: Beyond ASV with Overlap Syndrome!
AHI of 20 or less is accepted as treated as a result at home 

What kind of nonsense is this?   Insurance companies re-writing medicine?  I feel incapacitated at numbers over 3.  At 7, I really was totally out of it.  At 20, I'd be effectively in a coma and bed bound.  It's utter rubbish, written, or floated by individuals who have never had apnea.  This kind of grade inflation is unacceptable...

Time to find another doctor...  This one is a clear fail.  Hope you find one soon, as you've been stretched out on this way too long.
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RE: Beyond ASV with Overlap Syndrome!
(04-06-2021, 11:06 AM)SarcasticDave94 Wrote: The newest pulmonary doctor wanted me to try my ASV in CPAP mode and 7 cmH2O. Here is the OSCAR with results that are not acceptable. The positive is I slept through the night for 4.x hours, so a lower pressure set certainly has some merit. Negative is high untreated AHI and not well rested. I know there can be a time period to get back to being well rested, even so the OSCAR results are not good IMO.

You might be a good candidate for EERS. The extra rebreathed CO2 can help some people with centrals, so that they can use a boring CPAP.

But it doesn't sound like your doctor is really at the leading edge of, well, anything.
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RE: Beyond ASV with Overlap Syndrome!
Yep, the backup rate on the ASV is OK for the Centrals but I need another similar with timing controls, ti Min/Max, trigger, cycle... EERS may work but it'd not answer timing.

I've told the CPAP coordinator that since doc isn't listening I'm getting my charts and going elsewhere. She's trying to talk him into giving me what I asked but eh dunno if it goes well. So fire em DaveO is incoming.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
New update, yep great the UPMC test messed up anything other than APAP scripts. The tech for diagnostic and titration stated before either test was started that I don't have CA and other Apnea events will be so low they can treat with CPAP at 7. Results? Did great on straight CPAP at 7. So their report says. I told them all that despite the results I felt terrible for it. They tuned me out entirely. UPMC called to edit my follow-up with Dr. Viramgama, and when I called in I asked why we're even needing this visit. He failed to treat me. OSCAR showed 12.75 AHI that one night I tried 7 CPAP mode. I was worse then terrible that day. Oh I told Dr. Viramgama's assistant I'm cancelling the appointment as he failed bigly in listening and treating. Her argument was that insurance required the cost when new machines are dispensed. Ma'am, what new machine? Doc sent a script revisal to run CPAP on my ASV at 7. So again what new machine? Since he's not listening, he's failed to treat me, cancel that appointment. I'll not be there or any future ones. He's fired.

Yesterday I was back to WellSpan, but the new messed up reports interferes with ANYTHING other than CPAP. I was ready to leave that in-person visit a few times. Then at the end Dr. B said what can we do to treat this?... iVAPS as I've been told in the past. Sorry we can't with this result. I'll order a ResMed APAP on pressures 4-14... I agreed to try it. Because I must be treated with PAP. I told him I'll try it a month, and I'll edit settings if it needs it with notes on why.

And when the Tbird's sold I'll have to buy my own something, assuming the AutoSet doesn't treat successfully.

Still colored skeptical. Almost 2 years to maybe get undertreated. Mark it well AB, the duck doctors are a waste of time and money.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
The ducks stand between you and coverage. Other than that, you are very proficient at knowing what you need.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
Like I said I'm forced to buy my own after I get the car sold. At least the doc at WellSpan is trying. If I could go back and never have done those tests this year, maybe he'd edit the ASV script to ST-A.

I'm OK with not having the symptoms if it's a real result, but I do find it very suspiciously odd that CA and COPD both disappeared. COPD to Asthma titling didn't change the treatment. Oh well, when I'm outnumbered by morons, it's time to get out of the room fast.

C'est la vie.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
(04-28-2021, 08:29 PM)SarcasticDave94 Wrote: Like I said I'm forced to buy my own after I get the car sold. At least the doc at WellSpan is trying. If I could go back and never have done those tests this year, maybe he'd edit the ASV script to ST-A.

I'm so for not having the symptoms, but I do find it very suspiciously odd that CA and COPD both disappeared. COPD to Asthma titling didn't change the treatment. Oh well, when I'm outnumbered by morons, it's time to get out of the room fast.

C'est la vie.

Dave,

You should talk to your tech-savvy kid(s) / grandkid(s) to start a go-fund-me account to help pay for your new machine. Unless you really don't like your car.

Coffee
RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
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RE: Beyond ASV with Overlap Syndrome!
Well I've got one too many cars with the Thunderbird and a minivan. Not bad for a poor guy. But I can't keep both road legal, county housing allows me 1 parking space besides. I'd try the go fund me, no kids or grandkids to do that one. For good or bad no wife either yet. That last may change sometime though. Just have to see how humorous and merciful God is, which I have an idea on that too. That'll be an interesting post... Here's an image of Dave's better half...
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
Here's the first night's attempt on the AutoSet. Settings Auto 7-14, EPR 3 Fulltime. Bad trainwreck. Am trying tonight minus EPR. Only had CAHI of 19.19. I am convinced the diagnostic and titration didn't represent my real apnea status. That tech had predetermined I had no CA, or that I had 2 years of treatment emergent. No crazy lady it was not treatment emergent. Results on both were bogus reports.

The big leak spike was intentional, about 0321 I think, I had a nose itch and had to break seal, wanted it to stand out so I took hose off to create the spike.

How do I feel? TERRIBLE! Fatigued, low grade headache. Truck ran me over-ish. This won't last the month I promised. I will give it a few days and send it back, I don't see it as turning out well at all. I'll hook up the ASV and try it again when the AutoSet goes back.

If there's other OSCAR shots you'd like ask away. But AutoSet therapy is already broken. At least the whole process is uniform, Dr. McQuacks and techs are all uninformed and do not understand anything. The only real person who wants to help is Lincare's RT, but she can't do what needs done. She even asked me on Tuesday when I picked up the AutoSet if I had RT training. No but I've seen a lot of cases of bad therapy.

[attachment=32043]
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: Beyond ASV with Overlap Syndrome!
You did pretty well on ASV, and while that machine may not be ideal for your suite of respiratory concerns, it's a lot better than this. Why are you starting over? Didn't we go through this several years ago?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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