(02-04-2015 02:17 PM)Sleeprider Wrote: With your respiratory problems, you may have a valid concern about exhalation pressure. You may be best served by an auto bilevel machine. It wouldn't hurt to discuss your concerns and respiratory medical history with your doctor. No one wants you to fail, or put you in a position where the machine actually causes problems. It can't hurt to discuss it either way.
As mentioned above, APAP and CPAP have the same billing code. The APAP will have full data capability, and can be configured to minimize pressure, but provide increased pressured when you need it. That has some advantages in your case. Even though machines have EPR or Aflex for pressure relief during exhale, they are not true bilevels, which can provide a great deal of pressure relief if needed.
With deductibles and 80/20 copay, you might want to find out what your total out of pocket will be with whatever DME they set you up with. I had the same arrangement, and just bought a couple good machines off Craigslist. Both the BiPAP and APAP I got had less than 200 hours and are the newest models for much less than my costs of a single machine going through insurance.
Thanks for the info. I can't do anything the normal way. I have to have a funky form of asthma complicating things. I guess now I just wait a week or two to get the results and then see where things so with the insurance company. The DME's here charge rent of 129.00 to 150.00 per month on the units up to 13 months when you purchase them so they are double the price I am seeing them online. I would be afraid to purchase off craigslist without solid advice because I would end up getting a piece of junk knowing my luck.
My breathing is not the best when I am awake so I don't need it dropping when I sleep.
Not sure what all of this means except I suck at breathing.
Spirometry demonstrates a severely reduced FVC of 1.46 liters, 41% of
predicted and severely reduced FEV1 at 0.99 liters, 35% of predicted. This
yields a reduced FEV1/FVC ratio of 68%. Findings are consistent with a
severe ventilatory defect. Following bronchodilator administration, there
is a 31% rise in the FEV1 representing an improvement of 310 mL. There is
also a 31% rise in the FVC, representing an improvement of 460 mL. MVV
maneuver at 55% of predicted is appropriate for the FEV1. Lung volume
assessment shows a preserved total lung capacity at 5.15 liters, 100% of
predicted. There is an elevated RV and TGV however, at 178 and 123% of
predicted respectively consistent with air trapping. DLCO at 26.11 is
preserved at 104% of predicted and a gas transfer coefficient of 7.01 is
elevated at 144% of predicted. Flow‐volume loop contour shows reduced
amplitude of deflections plus concavity in expiratory limb.
IMPRESSION: Comprehensive pulmonary function tests are consistent with a
severe obstructive ventilatory defect. There is substantial response to
bronchodilator administration. There is evidence of air trapping on lung
volume assessment and gas transfer reflected in the DLCO is preserved. Gas
transfer coefficient is elevated and this likely reflects the effects of