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[Diagnosis] Hi, new here- Question Please
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ShelaghDB Offline

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Location: Toronto, Ontario, Canada

Post: #61
RE: Hi, new here- Question Please
(02-12-2014 05:16 AM)me50 Wrote:  so, what machine did he lend your husband? If I were you, I would find another doctor, take your sleep study report to him/her, and get another machine. The escape does not provide anyone any info other than compliance info. Why, if they did not do the first sleep study right are you having to pay out of pocket for the redo? Usually, they want you to sleep on your back in a sleep study so I am wondering why they wanted you to sleep on your side. Hope you and your husband get it all worked out.




I am hoping to find someone here in Canada that can confirm for me IF the reason I was given was false or not as to why i was turned down for it.

I assume i am screwed.
My health insurance is paying for this and if only allowed two sleep studies, then theres no way I believe they will pay for a 3rd.

He conned me.
I was supposed to take that machine back before the 30 days was up but he phoned me and told me to come for the second sleep study and he would see about getting me the machine.
Had I returned it then, I likely would have been able to do a second sleep study with someone else who might have been more lenient.

I find it hard to believe that with the pressure being 10-11 I can not get the right machine but he won't do it.
I tried everything and he's just arrogant.

At this point i really just feel like throwing it all back at them......seeing if i can phone the health insurance and put a stop to the payment but i doubt i can.

I don't really know what machine he wants the hubby to get nor do I really understand why he's reluctant to set him up with this sleep apnea stuff.
i TOLD Kevin I wanted to come into the room myself on his appointment so i could hear for myself what the problem was but when i got there he wanted his privacy but he came out as confused as the first time as to why-----i seem to recall the first time that he got some idea that Kevin might not use it........and wanted him to try it out first before actually buying one?

If so that does point towards him at least being a careful doctor, about pushing them out anywhere and everywhere and if so, then perhaps I am wrong and he is right and i am not able to get an AUTO SET with my readings, or he really doesn't think they are any better than the one he gave me.

Its one thing to ask an American but i really need to find out from a Canadian more familiar with our system. I am presently on disability for 2 years as I undergo treatment for something else so at this very moment in time, my health care costs are limited. Its not the best plan and they won't be as lenient with plans that are paid for or people receive through their work, etc.

He's apparently one of the leading Respirologists here.


In any event, I have looked at the study myself but don't really know what it all means
(This post was last modified: 02-12-2014 11:10 AM by ShelaghDB.)
02-12-2014 11:01 AM
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SnuffySleeper Offline

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Location: Ontario

Post: #62
RE: Hi, new here- Question Please
Hi ShelaghDB,

I replied to another post you had that related to this about getting a pap machine in Ontario here:

http://www.apneaboard.com/forums/Thread-Mouth-breather?page=2

I can try to help you after reading your story as I understand the BS you're going through, but read that link first.

The process of getting a Xpap machine in Ontario (Canada) and the States is totally different. It no way relates to how insurance works in the States. We have a program here called ASP or Asissted Devices Program, that will pay for 80 percent of the machine OR if your income is in a certain bracket 100 percent of the cost. It's nothing like how insurance works in that States as it's a totally different system.

I linked to the government vendors list in the other post I replied to you. That is a list of government approved vendors that are qualified to process ADP program applications. The government pays them 1050 bucks for what ever Cpap machine (it doesn't even matter which one) so most of the vendors in Ontario will sell you the absolute cheapest machine to maximize their profits.BUT!...

The doctor is king, if the doctor writes on the prescription Auto Set the vendor MUST give you an s9 Auto Set or (some will try and pawn off a s8 the greedy buggers)or they will get in trouble with the government and even lose their vendors license. This is all covered under the ADP program in Ontario. BUT! if the doctor just writes Cpap (which in your case he did) on the prescription the vendor can sell you what ever they want and not get in trouble with the government.

In your case I read the prescription and the writing is VERY hard to make out, but I think the doctor even wrote ON THE PRESCRIPTION which is crazy, Patient can pay for Apap "does not qualify". So the doctor is saying exactly to the vendor do not give you an apap, which is really unbelievable.

Anyways, the system in Ontario works all from the prescrition the doctor writes. If the doctor says Apap you get an auto set, if he writes Cpap you get an escape OR some will sell you an Elite (see my other post).

If you want to get an Apap I think you are pretty much screwed now as the doctor wrote specifically not to give you one unless you pay for it, so you need to switch doctors, but even then that prescription will be in your medical history so the other doctor will have to specifically write Apap machine and override the previous doctor, which would mean more sleep tests and appointments.

I won't even go into how I suspect vendors are giving Doctor's kick backs to maximize profits, that's a whole other topic.
(This post was last modified: 02-12-2014 12:00 PM by SnuffySleeper.)
02-12-2014 11:44 AM
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ShelaghDB Offline

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Machine: S9 Auto-Set +Resmed H5i
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Location: Toronto, Ontario, Canada

Post: #63
RE: Hi, new here- Question Please
Yes SnuffySleeper you are right. That is what he wrote for he told me arrogantly that if i wanted it I would have to pay for it so that is why he wrote it there.

I will have to read that link afterwards so as of this moment, from your knowledge of how it works and what he said, do you think I should have received t he Auto-Set OR is the doctor correct, with regards to our rules?
Bearing in mind, I don't really know what i have, other than a 10-11 pressure........i don't know anything else?

As it is, mine is paying for 100% of it all.....with this Escape machine.

I notice you have t he Elite?
Did you have to pay extra for it?

If you look back at my original post last night i wrote down what he said, as to the reason he wasn't giving it to me......something about 4% H20 ;-)
(This post was last modified: 02-12-2014 12:03 PM by ShelaghDB.)
02-12-2014 11:56 AM
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SnuffySleeper Offline

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Post: #64
RE: Hi, new here- Question Please
(02-12-2014 11:56 AM)ShelaghDB Wrote:  Yes SnuffySleeper you are right. That is what he wrote for he told me arrogantly that if i wanted it I would have to pay for it so that is why he wrote it there.

I will have to read that link afterwards so as of this moment, from your knowledge of how it works and what he said, do you think I should have received t he Auto-Set OR is the doctor correct, with regards to our rules?
Bearing in mind, I don't really know what i have, other than a 10-11 pressure........i don't know anything else?

Your prescription says Cpap 13cm/h2o, so your machine should be set at a pressure of 13.

Doesn't really matter what I think, I'll be blunt. You can't receive an Apap (s9 Auto Set). The doctor even wrote on the prescription to make you pay extra if you want one, which seems a bit spiteful to me and you should change sleep doctors. So legally the vendor could not even give you one if they wanted to unless you pay for it out of your pocket.

(02-12-2014 11:56 AM)ShelaghDB Wrote:  I notice you have t he Elite?
Did you have to pay extra for it?

If you look back at my original post last night i wrote down what he said, as to the reason he wasn't giving it to me......something about 4% H20 ;-)

Yes I have an Elite, but I called around and went to multiple vendors to get it before going through the ADP program forms which gave me a bit of leverage.

I basically had to twist the guys arm and say if you won't sell me the elite I'll go somewhere else, so he finally agreed. It says cpap on my prescription too, so I would need my doctor to write auto set or apap on the prescription if I wanted a s9 auto set, which is dependant on the doctors diagnosis.

In your case you probably have already gone through the system filled out all the government forms and the money has already been issued so it will be very hard to just go back and get a refund and switch. I dunno it might be possible but I am sure they would not make it easy for you.
(This post was last modified: 02-12-2014 12:23 PM by SnuffySleeper.)
02-12-2014 12:21 PM
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SnuffySleeper Offline

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Location: Ontario

Post: #65
RE: Hi, new here- Question Please
Wanted to add to my previous post, to put your mind at ease ShelaghDB. The s9 Escape is still a perfectly capable machine to treat your OSA. It doesn't have the data reporting and all the bells and whistles of the Auto Set or Elite which is important but not vital to the therapy and can still treat you successfully. So no need to worry about that Smile

Sleep-well
02-12-2014 12:39 PM
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ShelaghDB Offline

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Machine: S9 Auto-Set +Resmed H5i
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Location: Toronto, Ontario, Canada

Post: #66
RE: Hi, new here- Question Please
Thanks for your input Snuffy Sleeper.

I fully understand its too late. That was not why i was asking what you thought. I was just curious, as a Canadian IF you think COULD have given me that machine but your answer about how petty he was sums it up.

Unfortunately by the time i checked in here to ask advice about this-----that being at the beginning of this thread, it was already too late as i had done the sleep studies and had the equipment.
HAD I spoken to you first, then yes, I would have done what you did which was to go around to various doctors and say what you said.

Ok, I now know for next time, which i believe is 5 years from now what to do and will do it and in the meantime, I will not be going back to this doctor.

I suppose what I was asking and was curious about from your position, was whether having told you what happened, if you thought this doctor was doing what he had done because he truly is a good doctor and doesn't wish to waste money for OHIP OR IS HE doing this because its a kickback for him sending out the cheapest machine?

Some Americans earlier in the thread suggested as much but because our payment situation is different than the Americans, I felt i needed to ask a Canadian who had a better idea of how it worked up here.

In any event, I haven't been here but will start to ask other q questions and get involved later this week or next when we pick up the hubbies machine/mask and start this therapy.


Thanks for all your input so far.....see BTW you say my pressure is 13? I thought it was 11.....i still don't know how to work this machine and have to sit down and read it properly to see how to set it


Sometimes I find the pressure overwhelming and wanted to have the other machine so it could be adjusted during the night
(This post was last modified: 02-16-2014 10:43 AM by ShelaghDB.)
02-16-2014 10:31 AM
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SnuffySleeper Offline

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Location: Ontario

Post: #67
RE: Hi, new here- Question Please
Hi ShelaghDB,

It's impossible for anyone to say or contradict anything your doctor diagnosed and prescribed treatment for you as (s)he is your doctor (or soon to be former doctor) with all your medical history and sleep study results. Even if you go to another sleep doctor in Ontario here, that doctor will have to do the tests over again and make their own diagnosis so there is no way anyone can override what is written on the prescription pad.

Even if you go to another doctor there is no guarantee (s)he will prescribe an Apap rather than a Cpap. In Canada the system all works off the provincial government, which goes with whatever the Doctor prescribes. I think in Canada some doctors prescribe Apap some Cpap, depending on the doctor and the motives of that Doctor "should" be to treat you the best they can, but the world is not perfect and neither are doctors.

My sleep doctor has a walkie talkie to the vendor across the hall from him and 5 minutes after my diagnosis I was in the vendors sales office and he was trying to get me to sign forms and commit to the machine he wanted to sell me. Luckily I said I'll think about it and come back and do my research first, but I can see why the majority of people would not do that.

Yeah, as far as I can tell from your picture, the first line in your prescription reads "1 Cpap measure to 13cm/h20" so your machine should be set to a pressure of 13, but check with your Vendor (DME) where you got it from to see what they set it at and why. Tell them your prescription says 13cm/h20, they should have set it to that.
(This post was last modified: 02-16-2014 11:32 AM by SnuffySleeper.)
02-16-2014 11:05 AM
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retired_guy Offline

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Post: #68
RE: Hi, new here- Question Please
Edit: Well ShelaghDB I replied to your initial post without paying attention to the fact that you posted it a long time ago. But nontheless, the following is my story and I'm stikin with it...........

.................

Like a lot of the others, I was sent off to the sleep docs because of snoring. You didn't mention that, but I suspect it might be a factor in your case because of your mention of dry mouth issues. In my case I didn't know much of anything about sleep apnea other than I walked past their clinic everytime I went to visit my other docs. I was not aware it was the reason why I could not watch more than 1/2 of a tv show without falling asleep. I did not know it was why I would have a hard time staying awake behind the wheel of the car when happily going 70 mph down the freeway, or just driving home from the grocery store for that matter. I was unaware my treasured tendency to fall asleep at the drop of a hat was really my bodies way of telling me it had had much too much fun.

So it does sound like both you and your hubby need to have a cute little machine and suction cup. I'm thinking that could really be an advantage in the first days to help each other work through the process. For me the process was rather painless. I fought the thing for a couple of nights, then just decided to accept it, embrace it, name it after my first born, and go on with life.

I do not fall asleep behind the wheel of the car anymore. That's a good thing. I get to sleep with my wife now rather than in the soundproof vault in the back yard. That's a good thing. And I have become acquainted (sort of) with a bunch of very helpful folks out here on this website. That too is a good thing.

I have been using a nasal mask and a chinstrap to help keep my mouth shut. I am trying out a full face mask so it will be an option for those times, which for me are many, that my nose doesn't work very well. The biggest advice I can offer when starting with any of the masks is it's not about how tightly you attach them to your face. Gentleness is the thing here. Study up on this aspect of the process and I know you and your husband will join me soon in declaring "My mask and I are one... Our masks and we are one....... I love my cute little machine and suction cup..."
(This post was last modified: 02-16-2014 11:33 AM by retired_guy.)
02-16-2014 11:26 AM
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ShelaghDB Offline

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Post: #69
RE: Hi, new here- Question Please
(02-16-2014 11:26 AM)retired_guy Wrote:  Edit: Well ShelaghDB I replied to your initial post without paying attention to the fact that you posted it a long time ago. But nontheless, the following is my story and I'm stikin with it...........

.................

Like a lot of the others, I was sent off to the sleep docs because of snoring. You didn't mention that, but I suspect it might be a factor in your case because of your mention of dry mouth issues. In my case I didn't know much of anything about sleep apnea other than I walked past their clinic everytime I went to visit my other docs. I was not aware it was the reason why I could not watch more than 1/2 of a tv show without falling asleep. I did not know it was why I would have a hard time staying awake behind the wheel of the car when happily going 70 mph down the freeway, or just driving home from the grocery store for that matter. I was unaware my treasured tendency to fall asleep at the drop of a hat was really my bodies way of telling me it had had much too much fun.

So it does sound like both you and your hubby need to have a cute little machine and suction cup. I'm thinking that could really be an advantage in the first days to help each other work through the process. For me the process was rather painless. I fought the thing for a couple of nights, then just decided to accept it, embrace it, name it after my first born, and go on with life.

I do not fall asleep behind the wheel of the car anymore. That's a good thing. I get to sleep with my wife now rather than in the soundproof vault in the back yard. That's a good thing. And I have become acquainted (sort of) with a bunch of very helpful folks out here on this website. That too is a good thing.

I have been using a nasal mask and a chinstrap to help keep my mouth shut. I am trying out a full face mask so it will be an option for those times, which for me are many, that my nose doesn't work very well. The biggest advice I can offer when starting with any of the masks is it's not about how tightly you attach them to your face. Gentleness is the thing here. Study up on this aspect of the process and I know you and your husband will join me soon in declaring "My mask and I are one... Our masks and we are one....... I love my cute little machine and suction cup..."



Actually no, the reason I was sent was because after years of great teeth all of a sudden I am having some decay issues coming up to fast that had to be dealt with but my dentist said it was due to dry mouth.

I have since discovered that her husband owns a sleep clinic and she sends a lot of people there.
It may sound as if i have trust issues with professionals and i usually don't but with her and now with this sleep doctor I do.

I say with her for I mentioned earlier in the thread that i did follow up going to a sleep doctor to see IF that was the reason for the tooth problems but i had by then lost the referral and just asked my own doctor to recommend one, which is how i came to this doctor i am now seeing.

Long story short, my dentist had an attitude problem when she discovered i had not gone to her husband and then told me i had what appeared to be the beginning of Oral Cancer and that i needed to pay $100 to some woman in her office as a consulting fee.
(Apparently it is now copacetic to let someone believe they have a serious form of cancer so the dentist can pocket an extra $100...LOL )

Instead i saw 1 Dental Surgeon, 3 Dentists one day in Cancer Hospital and another Dentist director in a teaching school and each one checked very closely and said i did not have early signs of Oral Cancer at all.
I mention that for I am not sure I really needed to see a sleep doctor after all but it is what it is...

As for sleeping, as far as I know, I sleep like a baby. I don't fall asleep during the day. I don't feel tired. I don't have any of those factors I hear all of you talking about but apparently I do have sleep apnea.

So, we shall see ;-)
(This post was last modified: 02-16-2014 03:55 PM by ShelaghDB.)
02-16-2014 03:52 PM
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ShelaghDB Offline

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Posts: 267
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Machine: S9 Auto-Set +Resmed H5i
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Mask Make & Model: Quattro Air FF Mask
Humidifier: resmed H5i
CPAP Pressure: 13
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Toronto, Ontario, Canada

Post: #70
RE: Hi, new here- Question Please
Quote:I have been using a nasal mask and a chinstrap to help keep my mouth shut. I am trying out a full face mask so it will be an option for those times, which for me are many, that my nose doesn't work very well

I have a FF mask here but it leaks and at the last sleep test they tried about 7 different ones and everyone leaked.
I have high cheekbones and a somewhat angular face and was told that FF don't work well on faces such as mine so if one has a rounder face or a face that is overweight, it might work better than they are for me.

So I am trying t his one one last time for a few days and if I can't seem to get past the leakage stage, than I have to try the nasal pillows and chin strap.

BUT another thing this doctor I don't like told me, was that chin straps do not work.
He said, have you ever tried snoring with your mouth closed? You can't! Its impossible.

Admittedly I am still wondering why that proves that a chin strap does not work! ;-)
02-16-2014 04:04 PM
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