Hello - help with Remstar Pro AutoIQ

[Margali]

Hello I'm Margali and my husband is RockApe on the forums. He is the Darth Vader wannabe and I'm the OCD medical researcher.... Anyway hubby is severely overweight and has obstructive sleep apnea. He had a CPAP with pressure set to 11 which unfortunately did a 3 story swan dive during recent move. RockApe had a new sleep study which confirmed he has sleep apnea still but $@$ wouldn't write a script for new machine. 

So... I purchased a used Remstar Pro C-Flex+ AutoIQ from relative that is upgrading to a different machine. She only used it for about 6 months. I have a new hose and filters coming for the Remstar. RockApe still has his Opus mask that works well. I need some help for initial settings for the AutoTrial period. Do these look okay knowing his CPAP pressure was 11? He hated humidifier on old cpap and is tummy sleeper. ETA: Our bed is also on decent slope with head about 4" above foot. This helps some.

A-Trial 5 days
A-max 20
A-min 6
Ramp start 6
Ramp 30min


Thanks for the help!

[OpalRose]

I would turn the ramp feature off as it can't ramp up to a minimum pressure that is the same.

Other than that, he may have a hard time inhaling at a low minimum pressure of 6cm, especially if he used a Cpap prior at a setting of 11cm.

I would set the A-trial at 8 min and 20 max, and see where it settles. Curious to see if it settles at 11cm.

If I remember right, after the A-trial is over, the machine will go automatically to C-check mode with the new pressure and do a check every 30 hours and reset the pressure if needed.

[chill]

Hello I'm Margali and my husband is RockApe on the forums. He is the Darth Vader wannabe and I'm the OCD medical researcher....

I like you already!  Welcome and please stick around.

[Sleeprider]

Margali, since Rockape's pressure on his CPAP was 11.0, I recommend you start the Remstar Pro trial pressure at at least 9.0. He won't have trouble with that pressure and it is much more likely to get him in his therapeutic "zone" sooner. A starting pressure of 6.0 would be too low for him, even with a fully auto CPAP.

I'm curious that although your husband went through another sleep test (completely unnecessary) but why would the physician refuse to issue a prescription? Were they looking to get more money for a titration study? You need to get a complete copy of that sleep study for your personal records. You can insist on it since you have a right to this record under federal law (HIPAA). This will accomplish three things; it will aggravate $@$ since they are required by law to comply and provide the records; you can take the record to your primary care doctor who can, and should write the script for an Auto CPAP and supplies; and finally, it will prevent the need for any future health study.

My primary care doctor takes care of all my prescription needs for CPAP, masks etc. As long as he has the report in your records, he is free to do whatever he feels is best for you. This is a great way to take control of your therapy and dump the specialists and clinics. Good luck.

[Margali]

The move was from Iowa to Texas for my job change. His old machine was ~4yrs old and he hadn't had a sleep study since he got it. I was actually okay with the requirement for new sleep study on new insurance. I was NOT okay with doctor taking forever to decide he needed a additional sleep study and not giving us a script. He pushed it out end of calendar year which is bad news since we have high deductible plan with $4k after we specifically said it needed to finish in cal. 2016. He was aiming for more money and currently fighting us on release of paperwork.

[Sleeprider]

First, you were treated badly. As long as you have a valid diagnosis, it is not going to change, and you could have asked your insurance to back you up on that since it cost them money. You can insist on a prescription based on the diagnosis. Does your doctor also have a conflict of interest and want to sell your equipment through an attached DME? I assume this is not your primary care doctor. If it is, find a new one. If not, talk to your doctor about the treatment you received from the specialist and inquire about getting a prescription before your new deductible begins. Since your husband is an existing patient he should be able to be dispensed a machine on a sale basis rather than rental. Talk to an insurance representative to verify. Never take the doctor's work for this, especially when he is as apparently conflicted as whoever you have dealt with.

This is the law concerning records. Don't let this jackass jerk you around. https://www.hhs.gov/hipaa/for-profession...index.html

Individuals have a right to access PHI (Protected Health Information) in a “designated record set.” A “designated record set” is defined at 45 CFR 164.501 as a group of records maintained by or for a covered entity that comprises the:

Medical records and billing records about individuals maintained by or for a covered health care provider;
Enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or
Other records that are used, in whole or in part, by or for the covered entity to make decisions about individuals. This last category includes records that are used to make decisions about any individuals, whether or not the records have been used to make a decision about the particular individual requesting access.

The term “record” means any item, collection, or grouping of information that includes PHI and is maintained, collected, used, or disseminated by or for a covered entity.

Thus, individuals have a right to a broad array of health information about themselves maintained by or for covered entities, including: medical records; billing and payment records; insurance information; clinical laboratory test results; medical images, such as X-rays; wellness and disease management program files; and clinical case notes; among other information used to make decisions about individuals. In responding to a request for access, a covered entity is not, however, required to create new information, such as explanatory materials or analyses, that does not already exist in the designated record set.

[trish6hundred]

Hi Margali,
WELCOME! to the forum.!
I wish you and your husband good luck as you work through getting the CPAP machine straightened out, hopefully, the next machine won’t take a 3-story swan dive, (Ha-Ha.) Hang in there for more responses to your post.