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Future BiPAP user.. Which machine to ask for?
#81
(04-25-2017, 05:58 PM)SarcasticDave94 Wrote: Sorry to hear that. Kinda like a Hoover vacuum...it sucks. Seriously though, best wishes this gets DONE ASAP! Just seems like these people want to go lawyerly on you. No negatives towards you whatsoever Herb. We're right behind you all the way here FWIW. I'll have something new after my Friday appointment with new pulmonary group. This is same group handling my back injury but obviously in another specialty division. Very pleased with this WellSpan so far. Great    Coffee week to y'all. Roving reporter Dave signing off...no FAKE NEWS here.

I'm really looking forward to your news.

Looks like you're on your way to an ASV.

If things don't go well with my BIPAP ST, I'll be right behind you.

Wish I lived in your area so I could switch to your doctors.

The ones I've run into here are clueless.

GOOD LUCK!
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#82
Herb, you may have a prescription and not know it. You are being prescribed a BiPAP with backup timing HCPCS E0471. It may specify ST, but the ASV fits that prescription as well. If you wanna try it, do it. All you have to do is ensure you receive the prescription paper. If you want to be cagey about it, ask for your prescription with the HCPCS reimbursement code E0471 and you have every thing you need.
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#83
I wish you were here so I could recommend them. WellSpan being the better of the two. A bonus on going to WellSpan is that I pass the Gettysburg battlefield.
On my ASV path, I just can't get that Blondie song out of my head..."One Way Or Another, I'm gonna getcha" ASV! Period. Docs just don't know it yet.
Sarcasm is a hobby of mine. I am not sarcastic on serious issues, implied or otherwise.
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#84
Next time I'm southeast of Harrisburg I'm checkin' out yur new ASV....or is that a SUV...It's fer shure somthin' like that. Listen do yinz have a yellow belt there?
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#85
(04-26-2017, 02:48 PM)Sleeprider Wrote: Herb, you may have a prescription and not know it.  You are being prescribed a BiPAP with backup timing HCPCS E0471.  It may specify ST, but the ASV fits that prescription as well.  If you wanna try it, do it.  All you have to do is ensure you receive the prescription paper.  If you want to be cagey about it, ask for your prescription with the HCPCS reimbursement code E0471 and you have every thing you need.


Funny you should mention that. 

Just got off the phone with the DME supplier's specialist in such matters.

No dice.

While they can switch manufacturers, they can't jump types from ST to ASV without a new settings prescription. 
The ASV device doesn't have a backup rate setting in the menu, so it's a conflict.

One thing he mentioned, I can ask for a ASV using the AHI report from the machine to support my request.

I mentioned the ST controls breathing not me, so how can it monitor my rate?

He said it does report AHI, so we'll see.

Hope he's right somehow, but I'm not counting on it.


He also informed me the S9 is discontinued, and I'll be getting a AirCurve 10 ST.

That's bad news, it's connected over wireless phone networks to ResMed.

He said I'll have to keep it online for three months so they can monitor compliance.

After that, I can turn off communication.

I suppose it's just the DME doing the monitoring, they just check compliance.

I WILL be making adjustments.

Knowing the sleep center docs, I'm not worried about them checking, even if they knew how.

Guess there's ONE benefit to their ignorance.
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#86
(04-26-2017, 04:02 PM)SarcasticDave94 Wrote: I wish you were here so I could recommend them. WellSpan being the better of the two. A bonus on going to WellSpan is that I pass the Gettysburg battlefield.
On my ASV path, I just can't get that Blondie song out of my head..."One Way Or Another, I'm gonna getcha" ASV! Period. Docs just don't know it yet.

Been to Gettysburg twice on vacations. Grew up in NJ.

Saw two bullets in the museum that were found on the battlefield.

Stuck together.

Maybe one soldier on each side saved that day.
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#87
Herb, what I was suggesting is that an online supplier like Secondwind would probably accept the prescription for ASV. I have said several times the ST will provide data that may ultimately support your need for a different approach. They tend to generate lots of hypopnea. I mean if it works, then there is nothing to complain about. It's not a matter of working as well, it just ends up with endless hypopnea because you are fully dependent on the backup rate and pressure support. Give it a fair shot, but the story does not end unless you are treated. I'm also not sure I would tweak or optimize. Go with the script and if it fails, you move on.
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#88
(04-26-2017, 09:17 PM)Sleeprider Wrote: Herb, what I was suggesting is that an online supplier like Secondwind would probably accept the prescription for ASV.  I have said several times the ST will provide data that may ultimately support your need for a different approach.  They tend to generate lots of hypopnea.  I mean if it works, then there is nothing to complain about. It's not a matter of working as well, it just ends up with endless hypopnea because you are fully dependent on the backup rate and pressure support.  Give it a fair shot, but the story does not end unless you are treated.  I'm also not sure I would tweak or optimize.  Go with the script and if it fails, you move on.

Concerning SecondWind, I was under the impression from posts and their MN location that CPAPLiquidators was the same company. 

A couple weeks ago I called CPAPliquidators about a new AirCurve 10 ASV they had for $2150.

The lady at the sales desk said no prescription was needed for the machine, but when I called about a used one, they transferred me to someone who said I needed a prescription for an ASV, and my ST prescription won't do.

He said the BIPAP and ASV are different from CPAP as far as their prescription requirements go.
(I'm guessing it's PAP vs RAD)

I called again today to see if I might slide by. Different guy, same bad news.


However, your post prompted me to check if both companies are actually one in the same, so I called SecondWind.

Entirely different sounding PBX system gave me the impression they're different companies.

They didn't shoot me down when I mentioned the BIPAP ST prescription for a AirCurve 10 ASV,  but I had to email my prescription.

I called back to see if the prescription was received, and before hanging up, I asked the guy straight out if they are the same company.

He said "Yes they are".

Now I'm really confused about the conflicting answers. They're still working on it, but purchasing an ASV is plan B now.



You mentioned in an earlier post (#4) that hypopnea and apnea go uncounted on ST, so I was under the impression there wasn't any usable data presented. I went over your posts again, but I still don't understand what you meant about ST providing supporting data. 

Are you referring to the waveform data?

Sorry I'm so brain addled, but could you please elaborate?




Yeah, maybe failing ST is the easiest path to ASV and I shouldn't tweak settings and try to make the wrong machine work.

Thing is, they said I have to make it three months or I'm non-compliant.

Don't know if it's just a strike, or I'm out.


Judging by the trouble I had with the ST flow timing during the PSG, I doubt I'll make it three months.

I just couldn't catch my breath and get comfortable with the machine's way of doing things.

Maybe the home ST machine settings will be better, but if it feels like the PSG machine did, I'm in trouble.


I'll just have to ask the doctor to make the changes to keep things legit.



Anyway, I might be on the ST sooner than I thought.

The DME girl said I had it backwards. 

I get the machine first, then Medicare approves payment to the DME each month I'm in compliance.

The paperwork is completed, and they should call tomorrow for an appointment.


Thanks SleepRider.
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#89
As far as I know the ST does provide full efficacy data, but was not compatible with Sleepyhead until about a year ago. The machines did not provide detailed wave-for in the Philips machines. I am unsure if Sleepyhead will work with the new Aircurve 10 ST, but it may, and certainly it will work with ResScan, so I think you will have detailed data on a ResScan ST. There have been so few of these out there that I have been reluctant to advise on any aspect of using the machines. My experience has been mainly people getting relatively poor results and inadequate data support (in Philips) to do much with it. To be honest, I'm not aware of another Aircurve 10 ST user, so I guess we will have to learn together.
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#90
Oh, it looks like the AirCurve ST is a rare bird. 

I have the latest ResScan and sleepyhead loaded on my laptop, so I'll take a look and let you know.


I downloaded the clinician manuals for the ResMed AirCurve 10 ST, and the previous S9 VPAP ST.

All the settings and features looked the same but for the cellular data communication capabilities of the Aircurve 10.

Aside from that, it boils down to appearance and the way the humidifier tank attaches.


Finding out exactly what data is collected is difficult because both manuals combine 3 machines: Auto, S, and ST.


The S9 series has a BiLevel Data Management Guide listing the data presented on the screen, and saved to SD card.

That's great, but the guide states: Not all parameters are available in all devices.

 
I'm assuming the data collected is the same as the S9 since the settings are identical as far as I can see.

I guess we'll both find out when I get the machine.
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