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[CPAP] New to OSA/CPAP's lots of Questions!!
#31
(04-23-2017, 03:30 AM)DeepBreathing Wrote: It's been my experience (and observation on the forum) that many doctors have a blind spot about central apnea. I would certainly raise it with them, and show the chart you posted above with the duration of the events.

I'll let the American members talk about insurance requirements etc. However ASV machines are about the same price in Australian dollars here as they are in US dollars over there. And the Australian dollar currently buys about US 75c, so if you can't get your insurance to play ball it might be worth checking out the Australian on-line suppliers. ie If it costs US$4,000 there, it will be AU$4,000 here, but that's only about US$3,000. ASV machines are the one thing we can get cheaper here - everything else is bloody expensive.  Some of the dealers might be reluctant to ship the device as Resmed usually have an in-store only clause in their supply agreement, but it's worth asking the question.

I wasn't sure if I should show the chart I made because I don't want the doctor to think I'm trying tell him how to do his job, but I definitely what him to see just how bad it has been. So I'm glad you don't think I'm being overzealous! 

That's interesting about Australia being a bit cheaper for the ASV I never would have thought of that! It's definitely something to consider/ask about.
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#32
If you don't show your doctor the data, he won't look for central or complex apnea. Other things to emphasize is the correlation between worse results and higher pressure or variable pressure; both solid indicators of central apnea. The efforts you have made to do the right things to treat this as obstructive apnea, as originally diagnosed, then transition to trying to treat complex apnea is important. One thing you may have to be prepared for is if the doctor won't acknowledge that this is likely complex or central apnea. As hard as it may be, you would have to move to a different more competent physician if that happens. Since you intend to self-finance, if possible, you should try to get a prescription for a BiPAP SV (ASV) machine without any further study. If he is cooperative, you can continue to work with your doctor to implement the option below:

Another approach to this problem is to contact Supplier #2, SecondWindCPAP. They currently have at least two listing for a Gently Used Respironics System One BIPAP Auto SV Advanced DS950 Machine with Heated Humidifier at $1299-$1399. If you don't get a prescription form your existing doctor, you can discuss what assistance they can provide to help you get a prescription that will allow them to sell you the SV. They may be able to use the existing home studies and Sleepyhead data to refer the material for review by a physician, and get the prescription for you. You may also be able to get this done using your primary care physician. All you need is the script that calls out a BiPAP with Backup Rate E04071 ASV. If you go through SecondWindCPAP, you can also discuss the sale or trade of your Dreamstation.
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#33
Another lead I found is a ResMed S9 CPAP/VPAP Adapt listed in the Boise, Idaho Craigslist for $475. This is a very good machine, but you will need to work with the seller to verify it is what is represented and take appropriate precautions in closing the sale and getting it shipped. If you can mitigate the risk, this is one of the finest machines available and is the one used by DeepBreathing. This option does not require a prescription, but you must ensure the offer is authentic.
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#34
Quote:Sleeprider
If you don't show your doctor the data, he won't look for central or complex apnea.  Other things to emphasize is the correlation between worse results and higher pressure or variable pressure; both solid indicators of central apnea.  The efforts you have made to do the right things to treat this as obstructive apnea, as originally diagnosed, then transition to trying to treat complex apnea is important.  One thing you may have to be prepared for is if the doctor won't acknowledge that this is likely complex or central apnea.  As hard as it may be, you would have to move to a different more competent physician if that happens.  Since you intend to self-finance, if possible, you should try to get a prescription for a BiPAP SV (ASV) machine without any further study.  If he is cooperative, you can continue to work with your doctor to implement the option below:
I know we should show him the data I just wasn't sure if showing him the chart I made up that pieced together all the CA's from one night would be helpful, but I know you are right that we need to show him the evidence, and I thought by isolating the CA's its much easier to see than just looking at the big picture.  I just get paranoid that doctors think you are trying to be a "google doctor" and won't take us seriously... But I know we just need to do whatever needs to be done, and if the doctor doesn't like it, so be it....

Quote:Another approach to this problem is to contact Supplier #2, SecondWindCPAP. They currently have at least two listing for a Gently Used Respironics System One BIPAP Auto SV Advanced DS950 Machine with Heated Humidifier at $1299-$1399. If you don't get a prescription form your existing doctor, you can discuss what assistance they can provide to help you get a prescription that will allow them to sell you the SV. They may be able to use the existing home studies and Sleepyhead data to refer the material for review by a physician, and get the prescription for you. You may also be able to get this done using your primary care physician. All you need is the script that calls out a BiPAP with Backup Rate E04071 ASV. If you go through SecondWindCPAP, you can also discuss the sale or trade of your Dreamstation.
That is a really great idea, I didn't even think that they might be able to help facilitate getting a RX... I saw that they would help you with sale of CPAP and even if we took a loss on cost it would be worth it for a cheaper ASV machine..... I think we should try this method if working with our current doctor fails... If we can avoid paying for a Sleep Study that would be awesome!!  Lots of things to think about, but I feel that hopefully we are finally getting somewhere and can hopefully positively impact my husband's health without months and months in between. like
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#35
I'll update with 2 more nights of CPAP:

[Image: 0M8y9lRl.png]
A very short night, he really struggled with the pressure.....

And last night:
[Image: nBt5agVl.png]
He did better with the pressure and kept it on much longer, but it was a very low pressure... we had it fixed at 8 but I hit the EZ Start function so it never got very high, he thought maybe up to 7? Still lots of clusters of possible CA's:
(Not all of the CA's but just a grouping of a few)
[Image: ZvUZODVl.jpg]
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