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Future BiPAP user.. Which machine to ask for?
Herb, just a thought towards insurance or Medicare. You should probably document your concerns in a complaint that the doctor failed to obtain an acceptable titration result on BiPAP ST, and further refused to consider numerous medical studies citing the efficacy of ASV in cases like yours, and contraindications for ST therapy. Include citations. Be sure to summarize your untenable relationship with Doctor X moving forward, his refusal to include your input on therapy decisions, or to consider alternatives. You may get coverage for the Second Opinion. https://www.medicareinteractive.org/get-...d-opinions
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Hope you're enjoying the skiing!

Thank you for taking the time on your vacation to get back to me.

I'm in the process of getting the sleep center waveform disk so I can take it for a second opinion.

As far as going to the other sleep center, I think my original doctor will pitch a fit, so I'm not going there.

Especially after my Doctors.com / Aetna review.

I contacted Medicare, and they will cover a second opinion, so I'm good to go.

Just need to screen them for a doctor who has recommended ASV more than 4 times in his life like this one.

(That's what he said BTW)
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(03-30-2017, 03:13 PM)Sleeprider Wrote: An interesting aside, it is not known if ST treatment is any safer than ASV.  There just hasn't been a study.  The Resmed study results were completely unexpected, and I'm sure a large part of it was the admission to the cohort of terminal CHF patients.  I lost my dad to CHF and I'm not sure the normal course at end-stage is something I would encourage someone to take rather than have the relief of ASV.  Respiratory failure vs sudden heart infarction it a tough choice, and the doctors will side with not introducing something that "might" be causative.

Glad you are not in that boat, and you really can't go with ST with what you know to be the best medical option that can contribute to your quality of life.

The latest study I linked to is the closest thing to a direct recommendation of ASV over BiPAP ST I've found.

It stated BiPAP ST is recommended only after CPAP, ASV and oxygen therapy have failed, as these latter options have substantially more evidence supporting their use.

Cardiologists cited ASV as a possible breakthrough treatment for CHF and needs more study.

There is a strong correlation between CSR, CSA and CHF. 

Since I fall into that category with CSR, I want something that has shown promise of improving heart function, and possibly slowing CHF.
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I have done a localized search, he's average or OK I guess. He kinda gives the impression to me that it's his way or no way though. Which of course I can't stand.  Crazy

At least I stumbled onto a DME that provided a great DreamStation that with tweaking ought to fill my requirements.
Sarcasm is a hobby of mine. I am not sarcastic on serious issues, implied or otherwise.
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Ya know, I'm smacking myself in the head.

I drive someone with COPD to their pulmonologist appointment every couple months.

Doctor's a nice guy. Easy to talk to, sharp.

It never dawned on me.... sleep study - pulmonologist - sleep study - pulmonologist.... DUHHHH.

So I called to make an appointment to see him.

The girl on the phone said all I need for a ASV prescription is the sleep study results, no waveform disk needed.

Turns out they even has a sleep center.


I see him April 6th.
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I like the way you work. I figured to have another month of, "look at the trouble you got me into"!
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(03-30-2017, 08:54 PM)Sleeprider Wrote: I like the way you work. I figured to have another month of, "look at the trouble you got me into"!

Nah, you're keeping me OUT of trouble.

I'd be suffering every night for who knows HOW long.

One heck of an experience today, but things are looking up

Enjoy the slopes!  Thanks
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Great to hear! Sometimes things just go right. Good stuff.
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Kudos again Herb, best to ya, glad the doc didn't need to see a doc after your visit  Bigwink
Sarcasm is a hobby of mine. I am not sarcastic on serious issues, implied or otherwise.
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(03-31-2017, 09:54 AM)SarcasticDave94 Wrote: Kudos again Herb, best to ya, glad the doc didn't need to see a doc after your visit  Bigwink

Judging from the reviews, aggravated patients storming out is a regular occurrence.

He must be used to it!

I know people who have something to complain about are the ones most likely to post reviews, so it's skewed.

But they were right.

Seems to me the only happy patients there are the ones who just go along blindly trusting the doc, not asking any questions.

I'm just so grateful I found this forum.

The generosity and sincere caring shown here, for not only myself but so many others, has given me a sense of hope in these current troubling times.
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