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[Diagnosis] New and Desperate
#11
RE: New and Desperate
I agree with everything Bonjour has discussed with you so far. Since you have the sleep study pending, it is going to provide very useful information in decision-making. Normally, all patients are diagnosed with obstructive sleep apnea and started on CPAP. Since you are working largely out of pocket, we want to avoid wasting time and money on anything that is not going to work. Your doctor will still play in important role, and we want to keep him on your side to provide the prescriptions that will make maintaining therapy easier, and may eventually migrate to coverage by insurance.

The Resmed Aircurve 10 ASV is an amazing machine for individuals with complex apnea as you appear to have. It stabilizes the airway against obstructive events, and provides pressure support on a breath by breath basis to maintain breathing volume and rate. Do not be surprised if your doctor wants you screened for cardiac function (left ventricular ejection fraction LVEF) before he will prescribe ASV. A 2015 study (SERVE-HF) found a risk associated with ASV for hearth failure patients with LVEF<45%. This finding appears to be in the process of being reversed by a new study (ADVENT-HF), but at this time the cardiac screening is S.O.P. You will need a prescription to obtain ASV from Supplier #2. So hang in there, and post your sleep study results when they are available.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#12
RE: New and Desperate
Thank you both for all the information and taking the time to reply.  I did check my ECG results and my LVEF is 64.  I went a picked up a copy from my primary so I would have it for the Neurologist.  Hopefully I will get the results from the titration study soon and can move forward.  Until then I will just be patient.

Thank you again.
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