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Doctor Response - As Many of You Predicted
#11
RE: Doctor Response - As Many of You Predicted
Agreed, Nelson.  See Sleeprider's suggestion and my reply, which echoes your concerns.
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#12
RE: Doctor Response - As Many of You Predicted
I honestly think many of these guys do not respect sleep medicine as a specialty. A pulmonologist could be very engaged and interested in a patient with severe pulmonary disease or thoracic deficiencies, yet view his role in sleep medicine as signing off on technician reports and following insurance protocols, rather than engaging his valuable expertise in something that (let's be honest) lay-persons like the Apnea Board participants can actually do better, because they take the time and have the interest. Put another way, his focus and interest is in a very challenging specialty, and it's not sleep medicine. He could literally do this in his sleep, and he does.

Why would a cardiologist of neurologist have a side-practice of sleep medicine? Because it takes very little of his time or expertise and can return significant income with little to no risk. Only a few individuals view their CPAP therapy with personal engagement and have educated themselves to try to make it better. Most assume the equipment they got, is as good as it gets. No questions, no time required. If the doctor has your AHI at an acceptable level as defined by his profession, insurance and anyone else he thinks matters, why should he expend time and effort to fix what is not broken? The only person you will get to even begin to listen to you, will be someone actually engaged and concerned with how you feel and that is vested in your health and well-being.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#13
RE: Doctor Response - As Many of You Predicted
This is just another go by the book and disregard patient input. You have great therapy because your AHI is now below 5. You're doing great they say. But doc I'm not feeling better. Don't worry you're treated so they say and believe.

You're not getting any further with this duck, Dr. Dolittle has his result, AHI 5 or less so you're treated. Nothing else but boat payments mean a thing to him.

Repeat after me, you're fired. Talk with your PCP/Primary Care.
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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#14
RE: Doctor Response - As Many of You Predicted
Sleeprider - I believe that you nailed it regarding pulmonologists and sleep medicine. Well put, and it makes perfect sense. With every profession and job comes some drudgery, so why don't they just suck it up and do the right thing? Wishful thinking.

Dave - you called it early on when you first responded to my issues. You said that it was going to unfold this way. Yes, it's time to move on!

Thanks.
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#15
RE: Doctor Response - As Many of You Predicted
Sleeprider -- I agree with you about the sleep medicine being a cash cow sideline leaving energy and attention to the specialty they are really interested.

But in my case my fancy specialty sleep clinic is called <place name> Neurological Institute, and I have a family history highly suggestive of hypersomnia/narcolepsy. (We call it the family sleep gene.) I -- and my whole family -- should be fascinating to a real neurologist, and probably worth a couple of journal publications.

But the jerk had already made the snap judgement that I'm just a silly hysterical woman. I brought my card in and the night before my appointment with him I had an AHI of 13.79. So follow the logic here -- I was foggy and not real coherent and when I tried to argue with him that I really do have some sort of sleep disorder I was not a very effective debater. In other words, my obvious sleep deprivation symptoms were somehow proof that I do not have a problem sleeping?

The moral of the story in Faust is that when you sell out to the devil on a whim it changes you inside, and you can't just take it back on another whim.
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#16
RE: Doctor Response - As Many of You Predicted
You're up to bat, Sleeper396. We'll help pick a bat for you. Just go down swinging ok.
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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#17
RE: Doctor Response - As Many of You Predicted
Cathy’s, great post and a good example of why you are an advisory member. Like many of us here, you had the answer, and simply grew tired of trying to persuade someone that refused to hear you, so you self-treated. The results prove your knowledge is way ahead of the sleep medicine practice that pretended to know better than you what you need. Holy cow! Nearly all of us are in the same boat. How did this happen?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#18
RE: Doctor Response - As Many of You Predicted
(08-11-2021, 07:40 AM)Sleeper396 Wrote: One further question on EPR.  If I am not experiencing any exhalation difficulties with higher APAP pressures, should I hold off EPR? Would I be better off moving the min pressure up from 8 to 9 (and perhaps 9.6) and wait to see if I need relief on exhalation, or do you think that I should try EPR immediately, and if so, what settings?  I am currently at 8.4 on minimum and 14 for max, with no EPR or ramp. Thanks.

EPR is called expiratory pressure relief but it also acts as inspiratory support by increasing pressure during inhalation. 

I would start with min pressure 9, EPR of 1. Then depending on results would consider min pressure 10, EPR 2.
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#19
RE: Doctor Response - As Many of You Predicted
Thanks, Geer.  Will give it a shot.
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