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Have you SEEN the doctor (at all)?
#1
Question 
Have you SEEN the doctor (at all)?
Group,
I am in the Ft Worth area, and have been told that Sleep Apnea has caused major health issues for me. Diabetes, Heart Disease, high blood pressure. I was sent to a Sleep doctor by my GP, and promptly diagnosed with OSA and Central events. I was placed on an APAP, and it has definitely helped my consciousness in the daytime. My wife also has asthma, high blood pressure, and OSA. She has been placed on an APAP as well. We have been watching her data and mine in RESCAN. I noticed that her data shows a lot of air "restriction" in her data. We asked for a appt with the actual SLEEP doctor, and not the PA. Interestingly, I never saw the doctor and they wont even offer to make her an appt with him at all. We don't feel that a PA is qualified to make pulmonology decisions about her. They just gave me a form to transfer out of the practice. I see the lack of physician care troubling, when they wont accommodate when we ask for it. Is this a COMMON problem? Isnt there a real physician dealing with patients? I feel we have been cheated and don't know where to turn. All they seem to want to do, is get us hooked into their DME. Have you done better?

Frustrated in Ft Worth
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#2
RE: Have you SEEN the doctor (at all)?
I have seen this to be a growing trend with a lot of specialists. They have a PA who sees the bulk of the patients while they see the special cases and the background work. This allows them to see more patients but at the same time, THEY aren't seeing more patients, their practice is. Big difference. In some specialties, the "real" doc isn't needed anyway.

But, seriously, neither of you probably need a sleep doc. If she is seeing a restriction, then the pressure isn't right. How is her AHI? Have you tried SleepyHead software instead? I tried ResScan and found it confusing as heck.
PaulaO

Take a deep breath and count to zen.




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#3
RE: Have you SEEN the doctor (at all)?
My pulmonologist's nurse practitioner understands CPAP therapy much better than he does. Plus she will look at the data and consider changes. In 8 years he never showed any interest in the data. This forum is probably your best resource. It has been for me.
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#4
RE: Have you SEEN the doctor (at all)?
If you give us a chance you will be stunned at the support you get from this forum.

We need data. And I mean detailed data including info from your sleep studies.

Please keep the data for your wife in a separate thread to avoid confusion.

Please download SleepyHead software. It is the best and it's free.
Pay attention to the section on organization because some charts are more important than others. And post your charts screenshot with imgur.
Please see my Sig for how to do it.

Seriously the forum will respond and give you what you need to talk with your Dr.
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#5
RE: Have you SEEN the doctor (at all)?
yep, sorry to say, my Doctor was not much help and in the end he let me make any changes I needed and I have not seen him since. I have a PA that is a close friend and would trust her with my life, already have. I also have a cardio Doctor that is about the best I have ever seen.

If you don't trust the PA, then find another. Don't go just by the title. The Doctor may or may not be any better.
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#6
RE: Have you SEEN the doctor (at all)?
I have had a mixed bag of doctor care. To most of them they try to balance how they work with the human cows that trample their efforts. They have bills to pay and jobs to do. A lot of us cows think we are seeing yesterdays small town doctor who would come to our home and see us. Carrying that little black bag of cures to go along with healing hands.

I have gone through many doctors and found several that are close to my history of home doctor visits. Doctors today have much more information in their heads, many new and changing tools, drugs and paperwork. The problems I have today would have me in a grave using yesterdays doctors.

I would like a better life but must work with this one. The care from my doctors has helped a lot, this forum and the internet have helped me help myself.

This forum and it's members are like yesterdays doctors. They come into your home with information and helping hands. It is up to each of us to take advantage of the resources at our fingertips.

"Service to Humanity is the Best Work of Life"

Sleep-well

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#7
RE: Have you SEEN the doctor (at all)?
I guess I am in the minority - I have an awesome sleep doc who sees me in person every time I go. We get into the data and generally, he is ok with changes. The best part is he doesn't push his brand preference (respironics) and let's me choose what I prefer.

That said, it doesn't really matter how good your doc is: optimizing sleep Apnea therapy is, and will always be an ongoing process, and your doc will not have enough time to help on a daily basis. As others have said, this forum provides significant support and experience and in my opinion is necessary to great sleep therapy!
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#8
RE: Have you SEEN the doctor (at all)?
It appears to be a trend in most places where you don't get to see the Sleep Doctor.
Here is Scotland in Aberdeen you only ever see the Sleep Doctor (Who does have other duties as  they are a Chest Clinic as well) we see a Sleep Nurse at every appointment.  I have not even seen her in about 8 years.
They are so busy that they took the people that do very well on CPAP and told them that they didn't need to see them for 5 years unless they have a problem.  They send spares after you request then, but before they do we always get a phone call to check what spares we require.  The Sleep Nurse always makes a point of asking how you are and if you have any problems.  She also asks if you need filters and runs through a shortened spares list for the equipment I have.
I was in hospital a couple of years ago with cancer and found the humidifier could not cope with the dry hot air in the hospital.
I got the number for her answering machine and left a message saying I was in hospital and that I needed a stand alone humidifier and a small hose.
That afternoon the ward got a phone call to say she had looked out the parts but was busy with patients and didn't have the time to come up with them if I needed them that night, someone would have to collect them before the ward closed.
My first visitor was dispatched to pick the items up.
The Sleep Nurse came in to see me the next day before her department opened, to see how things were and if I was now coping.
She is very busy, but still found the time to check up on me, she didn't need to and it was way above her call of duty.

The only time you see a doctor at this clinic is if you have a problem she can't deal with, or you ask to have your pressure changed or something she is either not allowed to deal with or can't deal with.

To be honest, I think she knows more than the doctors when it comes to Sleep Apnoea.

She is very down to earth, but the doctors are abrupt, almost to the point of being rude.

I was treated in Edinburgh for a while or Aberdeen was set up properly, the Professor there couldn't have been nicer, he always tried to see me when I was down, if he couldn't see me personally, he would speak to me when I arrived in the waiting room and ask if I minded seeing one of his assistants.  Some of them were on a tight learning curve back then, but if they didn't have an answer they would go to ask the Professor.
If the answer was not straight forward, he would come to see you himself.

Not all clinics over here are so good though.
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#9
RE: Have you SEEN the doctor (at all)?
" But the doctors are abrupt, almost to the point of being rude".

My experience has been exactly the same.

The first(only) doctor I saw was an eastern european, most abrupt, and threw a hissy fit when I denied I had a blood pressure problem. I should point out that despite numerous BP checks no problems have been indicated.
Despite being contrary to procedure she put me on medication anyway, this was binned shortly afterwards.

In utter desperation I paid £175 to see the consultant, and yes, he was rude, patronising, and up his own back passage.
I more or less said as much when I paid his bill.



"Not all clinics over here are so good though".

Agreed, I put a formal complaint in to the hospital management about my bunch of drones.
Having since found that they have a Facebook page, I am working on a suitable comment that is scathing but that will not get me arrested.
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#10
RE: Have you SEEN the doctor (at all)?
I only saw my sleep doc for the initial assessment, then all else through the two in-lab studies were done by subordinates. I have my first follow on assessment in May, we will see what happens there. I can say that I am very pleased with the Dr., and he spent nearly an hour with me on the assessment, answered all my questions.
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