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Can use some advice on what to expect and what to do first.
#1
Can use some advice on what to expect and what to do first.
       
Hello

Im a 40y/o male with history of Multiple Sclerosis (MS).  I had a sleep study recently and the Dr said I have sever apnea and prescribed a CPAP machine.  Im waiting to hear from the local DME but I have some questions while Im waiting.  Ive attached portions of the data (baseline and with therapy mask) for review.  

1. Is a CPAP machine able to address my apnea with numbers this high (63 episodes per hour)?

2.  If Im looking at the data correctly, my obstructive apnea is reduced with CPAP treatment but the central apnea is greatly increased (x40) while on the CPAP machine.  Is it normal for central apnea to increase with a CPAP and would I benefit more from a BiPAP?

3.  I was referred to a local DME who will provide the machine and supplies.  The prescription calls for "ResMed AirSense 10".  Ive read on this forum that a AUTOSET machine is preferred.  Should I contact my Dr to change the prescription to include the word "AUTOSET"

4.  Is there anything I should look for while speaking to the DME?

5.  On average, how long does it take to see positive results while on CPAP?

6.  How long should I use the CPAP machine as prescribed before using OSCAR to make modifications?

I appreciate any advice/guidance you guys cans provide.
Thanks
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#2
RE: Can use some advice on what to expect and what to do first.
(09-23-2020, 08:38 PM)triemferent Wrote: Hello

I'm a 40y/o male with history of Multiple Sclerosis (MS).  I had a sleep study recently and the Dr said I have sever apnea and prescribed a CPAP machine.  I'm waiting to hear from the local DME but I have some questions while I'm waiting.  I've attached portions of the data (baseline and with therapy mask) for review.  

1. Is a CPAP machine able to address my apnea with numbers this high (63 episodes per hour)?
Easily, mine was over 90 AHI

2.  If I'm looking at the data correctly, my obstructive apnea is reduced with CPAP treatment but the central apnea is greatly increased (x40) while on the CPAP machine.  Is it normal for central apnea to increase with a CPAP and would I benefit more from a BiPAP?
Maybe, but not just any BiLevel, an ASV.  It is normal to try a CPAP first.

3.  I was referred to a local DME who will provide the machine and supplies.  The prescription calls for "ResMed AirSense 10".  Ive read on this forum that a AUTOSET machine is preferred.  Should I contact my Dr to change the prescription to include the word "AUTOSET"
Do NOT accept the 'CPAP' model, it does not log detailed data.  'Elite' is a CPAP only model that does include detailed data.  Not a bad idea to state AutoSet.

4.  Is there anything I should look for while speaking to the DME?
Call them NOW and ask when can you pick up my AutoSet?  Could you please confirm I'm getting the AutoSet I'm expecting?
While there, ask them to show you the different styles of masks and can you try them with your machine.
Also, verify TOTAL run hours, (in the about menu) NOT the therapy hours, in other words is your machine really new?


5.  On average, how long does it take to see positive results while on CPAP?
Seriously it varies, I saw the results immediately, that is the exception. It depends on how badly you are sleep deprived.  The typical Apnea Patient has had apnea for years, recovery does not come overnight.

6.  How long should I use the CPAP machine as prescribed before using OSCAR to make modifications?
After the first night.  We want to get you comfortable and bring you to near optimized quickly.  I would say to post your OSCAR charts nightly for at least the first week.

I appreciate any advice/guidance you guys cans provide.
Thanks
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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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#3
RE: Can use some advice on what to expect and what to do first.
Ditto the above. And welcome to Apnea Board.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#4
RE: Can use some advice on what to expect and what to do first.
First of all, thanks for the speedy reply and welcoming comments.

Now for the update:  I spoke with the DME today who said she will be sending me a AirSense 10 ELITE.  I told her I prefer the AUTOSET version and she said she cant provide that unless the prescription specifically said AUTOSET.  She also said since I already got a titration exam when I had my sleep study, the AUTOSET is not necessary.  After  abouit 15 mins of going back and forth, the conversation ended by me putting a hold of my current machine while I speak with my sleep Dr to see if I can convince them to change the prescription.  

She also insisted on giving me a A7030 full face mask and that is what my Dr has prescribed.  After I told her I have a copy of my prescription which list other types of masks, she agreed to schedule me for a fit test.  

Now my question for you guys is ..... Is she correct when she says that I dont need a AirSense 10 AUTOSET since I already had a titration study during my sleep study?   Im just trying to get my facts straight so I can properly convince the Dr to change my prescription.  

copy of my prescription:   

   

Thanks in advance
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#5
RE: Can use some advice on what to expect and what to do first.
You want an AutoSet because you will get older and PAP therapy needs will change in the future. So what if the titration was done.

Get on your Docs good side and have him/her put AutoSet on the script, and do yourself a favor in asking Doc to add Dispense As Written. With DAW and AutoSet on the updated script, the DME cannot substitute. The mask choice does include Patient Choice, so you decide it too. I'd not let the DME dictate anything.

Oh, BTW don't give the DME your banking info. They don't need it, just the insurance info. Some DME types try to swindle or otherwise double dip the pay.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#6
RE: Can use some advice on what to expect and what to do first.
(09-25-2020, 06:51 PM)triemferent Wrote: First of all, thanks for the speedy reply and welcoming comments.

Now for the update:  I spoke with the DME today who said she will be sending me a AirSense 10 ELITE.  I told her I prefer the AUTOSET version and she said she cant provide that unless the prescription specifically said AUTOSET.  She also said since I already got a titration exam when I had my sleep study, the AUTOSET is not necessary.  After  abouit 15 mins of going back and forth, the conversation ended by me putting a hold of my current machine while I speak with my sleep Dr to see if I can convince them to change the prescription.  

She also insisted on giving me a A7030 full face mask and that is what my Dr has prescribed.  After I told her I have a copy of my prescription which list other types of masks, she agreed to schedule me for a fit test.  

Now my question for you guys is ..... Is she correct when she says that I dont need a AirSense 10 AUTOSET since I already had a titration study during my sleep study?   Im just trying to get my facts straight so I can properly convince the Dr to change my prescription.  

copy of my prescription:   



Thanks in advance

Alert!  Alert!  Alert!  This is going to be a VERY BAD DME. Going forward, every step will be miserable with them.   Run far far far far away from this DME! Find a different DME. You do not have to use just this DME. You have a choice in where you take your business. Find any other DME. Do not take a machine from this one. They do not dictate what you accept and bring into your home.
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#7
RE: Can use some advice on what to expect and what to do first.
If they have already lied to you, and didn't have the grace to redden, or cough, or look away with some shame over being discovered, it means they are indifferent to you and to the fact that you caught them in a lie.  It won't improve on subsequent occasions.

They wouldn't deserve my patronage.
Serial Tapist
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#8
RE: Can use some advice on what to expect and what to do first.
The CPT codes for billing insurance for the Elite and autoset are the same and the DME is paid the same amount for both. But the DME pays less for the Elite. So guess why your DME insists on giving you the autoset? My prescription did not say autoset but that's what I was given.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#9
RE: Can use some advice on what to expect and what to do first.
I do not understand why they would not give a person what they want. Sometimes different models are very expensive but the Resmed Air sense 10 Elite and Airsense10 Autoset are basically the same price, with in $50.00. The Autoset will do everything the Elite will do and a lot more if needed.
And if down the road a person wants to sell his machine it would be worth a little more anytime than the Elite model IMO.
When I talked to my doctor I made sure he put Resmed Airsense 10Autoset on the prescription because that was the machine I needed and wanted.
When I paid for the machine myself it seems I have a whole lot more say, It seems DME's in the USA have a lot more say and will of course try to make as much $ as possible off a person and not necessarily give the best machine to its customer.
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#10
RE: Can use some advice on what to expect and what to do first.
I got the same feeling while I was speaking with her.  I think when I speak with my sleep Dr, Ill ask them to refer me to a new DME along with updating my prescription to say AUTOSET.  

QUESTING:  Dose a DME need to be referred by a doctor or can I just take my prescription to a DME of my choice.  If its the latter,  is there a list of reliable/trustworthy DME that I can use to search for one in southern California (Orange county)?
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