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Can DME/Doctor see when I change settings?
#1
I'm very new to all this but I'm a geek so I've downloaded EncorePro and the Sleepyhead beta that supports the PR Dream Machine.

I've been communicating well with my DME rep, he's been great. Pressure is set at 5 minimum to 20 maximum. My best night was the second night pressure was between 5-15 most of the time, AHI was 7. AHI was between 7-24 total with most nights 11-12. I'm just getting started so I'm not going to obsess about these numbers so soonSmile

I'm just wondering, if I do get to the point (after more time on the machine and reading the software) where I want to change some of the settings, can the DME or Dr see that I have made changes? If so, how do people handle this?

Thanks!
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#2
Most Doctors and DME's don't check on whether you change your pressure. Their only concern is if you are compliant for insurance purposes. They can see a pressure change only if you are sending your information to them, but again that's not the first thing they look at. They look at compliance.

If you fall under Medicare compliant rules:
Medicare requires a data report from the patients (PAP) device which documents use of said device for at least 4 hours per night on 70% of nights for a 30 consecutive day period during the first 90 days after starting treatment.

Your goal should be to get your AHI at 5 and under, but changes to your pressure should only be made based on the breakdown of your AHI numbers and also where your 95% and average numbers fall.
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#3
(03-07-2016, 12:33 PM)chrysos Wrote: I'm just wondering, if I do get to the point (after more time on the machine and reading the software) where I want to change some of the settings, can the DME or Dr see that I have made changes? If so, how do people handle this?

I don't know about your machine. With the ResMed 10 series machines, "they" can see and even change your settings via the cellular modem.

I've see several cases where people were offended that their settings were remotely changed without notice.

I've only heard of one case where a person got pushback for changing their settings. IIRC: The doctor was unwilling to continue to treat the patient. This is a very rare outcome.

Considering how wide your present settings are, I doubt your doctor would object, if he/she found that you narrowed the pressure window.

As far as my DME, I won't let them near my machine.
(And my S9 has no remote data interface.)
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#4
I have been on PAP therapy for 5 1/2 years.
I have been adjusting my settings for 5 1/2 years.
It is very rare for a doctor or DME to see or touch my machine after they hand it to me the first time, maybe a total of 4 times.
I have been known to make adjustments exactly opposite of the doctors recommendations and had beneficial results.
It is your life, your health and your machine. The doctors and DMEs are folks you hire to advise and or provide stuff. I am not aware of any law yet, that allows them to decide if you live or die or how you choose to treat your own medical conditions.
It is wise to take council from multiple sources including feed back from your equipment and LEARN to manage your own therapy.
No one cares as much about your health as you do.
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#5
As far as I know the modem only works in the US unless you paid extra elsewhere.

Personal experience with my Doctor. If you change therapy settings AND still have problems AND make an appointment my Doctor will check the settings before he sees me. Then it gets like who is in charge? If you want to do this then fine, he sill back out. If I want/need his help then well let him do his job, or at the very least let him know you are making a change and why. Maybe even ask.

As for comfort settings, he does not care at all.

This is a prescription, if you changed you dosage for a pill or stopped taking it all together, well that, to me, is like changing the therapy pressures. Do people do it, sure all the time. Can a Doctor "walk away" if you consistently don't follow their advice, my guess is yes.
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#6
There are very few doctors out there that take the time to understand pressure settings. Most won't even prescribe an APAP.

They send their patients home with a setting of 4-20, which usually doesn't work out well for the patient, and that's why they end up here...for help.

No one is suggesting not following doctor's advice, but if a DME and/or Doctor do not help you, then you, the patient, would be the best advocate for your health.
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#7
I practice cardiac anesthesia and critical care for a living. My preventive cardiologist scheduled my sleep study and subsequent CPAP treatment. The original settings were straight 8 cmH2O CPAP, ramp, EPR 3. This was a no go. I googled resumed Airsnse 10 autoset clinical manual and found this board. Changed my settings without permission and all is going well. Still need to tweak my settings as my next appointment is 4/22 and I will not be waiting until then to optimize my therapy.

I am impressed by the level of caring, concern, and knowledge that is present on this board. I admit that I do have some prejudices re consumers adjusting their therapy without a thorough understanding of the process. However, I do not find a lack of knowledge prevalent on this board. I find that most are on the correct track although sometimes for not exactly the correct reasons. I may offer some corrections if I feel that people are way off the track.

I am all for dealing with knowledgeable, empowered patients. I salute all of you on this board and I am thrilled to be part of this endeavor
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#8
amazing the amount of support on this forum ..
for the aircurve 10 series, one can run with airplane mode on all the time. this stops all transmission of data.
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#9
I have been a CPAP/APAP user for 12 years and have had a need or have needed someone to invade my machine for whatever reason. The newer machines (have the communication ability) but I think that it would be used in rare cases, such as with a patient request, or used with in conjunction with a patient who is incapable or with certain disabilities.
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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