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Finally the TRUTH from my doctor
RE: Finally the TRUTH from my doctor
(01-03-2020, 12:37 PM)Osiris357 Wrote: Just got back from my appointment with the doc. As soon as she realized I knew what i was talking about, the conversation went as smooth as butter.  In the end she will gladly write me a script for a Vauto when I have the cash because the “AutoSet should go up to EPR 5 to handle flow limitations more effectively if needed without having to spend almost $1000 to get more pressure support”. She agreed that since my body adjusted quickly to the ventilation that was causing co2 based centrals  and the remaining centrals are post arousal I shouldn’t have any major issues with centrals while gradually increasing PS. 

It’s going to be awhile before I’m able to get the Vauto but at least I know I’m not going to have a hard time getting the script.

Some may be asking why do I want a Vauto if the AutoSet works good enough. The answer is “Good enough” isn’t acceptable to me when it comes to my heart health. The way I see it is if it wasn’t for insurance requiring at least an AHI of 5 to even considering paying for a more capable machine, I would already have it. The doctor who originally prescribed the AutoSet reminded me of what he said when I went in for my sleep study review. He said “you’re probably going to need a more capable machine but we have to wait and see”. In other words as a lot of us know you have to fail at CPAP for insurance to pay for BiLevel. 

So I guess I’m all buckled in for this ride finally.

Interesting medical approach, this failure principle. I wonder if it also applies to cardiac and cancer issues?
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RE: Finally the TRUTH from my doctor
Probably not, holden4th. If one fails to treat cardiac or cancer patients in a correct and timely manner, the next step could be the funeral home and not another doctor or treatment type. It seems like apnea patients are treated as though apnea events are not that serious.

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RE: Finally the TRUTH from my doctor
To some extent I believe so because I’ve known people who have died of cancer because their insurance refused to pay for a more advanced treatment. My mom saw it first hand. She’s a retired nurse who worked in cancer research. It’s an awful feeling watching someone wither away because their bought and paid for insurance does nothing. I’m 44 now and I’m starting to get a very clear view of just how disgusting this healthcare system is in the states. The bottom line is even with insurance you will not receive the best care unless you have enough cash to fix whatever ails you.
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RE: Finally the TRUTH from my doctor
My departed wife had metastatic breast cancer. I “learned” quite a bit from the insurance companies (my employer changed providers several times):
- Chemo for brain tumors does not need to cross the blood-brain barrier.
- Lungs are not medically necessary.
- Chemo doesn’t cause anemia. It just happens that everyone starting chemo was already iron deficient.

I wish that was tongue-in-cheek hyperbole.

Her doctor was excellent, but to a great extent her healthcare decisions were controlled by some kid with a flow chart in another country. Even when appealing their decision, the final call was made by (at best) a general practitioner instead of an oncologist.

Many of her “cancer buddies” died while still fighting for the treatment they needed to be approved by insurance. Time is critical.

I have since remarried. My wife is a nurse. She convinced me that it was time to start CPAP. In return, I convinced her that it was time to get hers out of the closet. She had been told that it probably wasn’t working for her because she just had UARS. Nope, that is a factor, but she CLEARLY has OSA, and it was still pretty bad even at her prescription setting. I switched her to Resmed, and we’ve been slowly getting her adapted to settings that actually help her.
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RE: Finally the TRUTH from my doctor
Sorry for your loss. It’s terrible what insurance companies are allowed to do.

I’m glad you got your wife back on hers. I’m trying to get my girl to go for a sleep study because I always see her twitching and choking from flow limitations and I believe hypopneas and obstructives but she’s stubborn. Just this morning she woke up with a choke and a huge inhale. She’ll go eventually I hope.
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