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Interesting follow up Doctor's Appointment
#1
Had an interesting doctor's visit, thought I would share my experience.

I like my sleep doctor, he's older and has his moments. Anyways, I took my Sleepyhead data in for him to take a look at. I decided to print the Sleepyhead Data reports because I really wanted to introduce it to the sleep lab people and clinic. I printed out the overview, statistics, and two daily reports.

My Doctor was intrigued by it, I told him it was open source software called Sleepyhead. He asked what machines it works on and took a look at the data. It was cool because he looked at everything and answered my questions about CA events and he gave me my original sleep study data and we compared the graphs and he told me what all the definitions where on my sleep study report. It was pretty cool. I de saturated down to 74 percent, which I never knew and he actually spent a good 15 minutes explaining and answering my questions and said anymore and he is going to charge me for the education..lol

Anyways, my Doctor went around showing the lab techs the Sleepyhead data, they all seemed to think it was cool until the "Boss" of the sleep lab, not sure what her title is but she seemed to be in charge there and collects the data from the sleep study reports. I overheard her say to my doctor after he showed her and I quote: "looks like a high school student wrote it" and she starts saying "it's a waste of trees"....arghh...

I understand she probably felt threatened as if everyone had the data like that she would be out of a job, but man, people like that just get my goat. So closed minded and automatically criticizing without actually understanding. It's half the reason (or maybe the full reason) patients are left in the blind and not "trusted" to set pressure and be responsible for their treatment.

Does anyone know what that position would be? Would she be a Nurse, or a lab technician?

Anyways, it didn't seem to phase my Doctor. He was still good about it and was even going to up my pressure based on the Sleepyhead data, but I opened my fat mouth and said I don't mind a second sleep study so he booked me for a second study to adjust my Cpap pressure.

Anyways, though some people would find that interesting Smile


*note for Ontarians about S9 Autosets and Apap*

My Doctor told me that to get an Autoset or Apap that the government sets a certain guideline that the patient MUST meet to be prescribed an Apap. ALL doctors must follow this guideline. Basically if your OSA can't be managed well enough by normal Cpap determined by your doctor then he will prescribe an Apap. He said Doctors can't prescribe all Apap's or they would get in trouble by the government and possibly a Doctor's board discipline. Oh Canada....
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#2
It sounds like the doctor you have is what I would call a "keeper". If he even looked at your reports and your data, that is a big plus (in my book). The lab tech you mentioned could be a nurse OR she could be just someone that applied for a job, got some training and is now working in the 'tech' department. My first sleep doctor had just such a person for his tech department. The second sleep doctor that I have now has a registered nurse downloading the data from the cards from the machine.

Good luck to you at your 2nd sleep study.
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#3
Hi SnuffySleeper,
It's good to hear that your Dr.s appointment went well and that, for the most part, your reports from Sleepyhead were well received. Unfortunately, there is always one spoiler in the crowd, though it is very upsetting, don't worry about her, as long as the Dr. didn't bulk, that's what counts; just ignore the "spoiler." Keep on educating with those "open source" reports.
Good luck to you with your next sleep study.
trish6hundred
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#4
I have my first follow up coming up in a few weeks and plan to take my laptop with me with the Rescan software and data in order to discuss with the technician and the doctor. Hope they are positive about it. I personally think when a patient is engaged about their treatment its a good thing, they're taking ownership of the problem.
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#5
Hi ThatOtherGuy,
Good luck to you at your follow-up appointment, hopefully they will receive your reports well.
trish6hundred
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#6
(02-28-2014, 04:17 PM)ThatOtherGuy Wrote: I have my first follow up coming up in a few weeks and plan to take my laptop with me with the Rescan software and data in order to discuss with the technician and the doctor. Hope they are positive about it. I personally think when a patient is engaged about their treatment its a good thing, they're taking ownership of the problem.

Each doctor is different obviously, but I think a laptop would be overkill and they would just not want to get envolved with it as it's not their routine. They just want to look at that brown file holder, open it up (it's their routine they been doing for years) read the files and diagnose you.

I am positive what helped me was a little detail, I put my printed pages on top of the file holder on his desk well waiting for him, so when he came in it was the first thing he saw and it looked similar to the sleep study data he looks at everyday but with color and a little sheep with a mask, it probably got him curious without putting him off his routine Smile

That's my theory on why I was successful with it...lol
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#7
(02-28-2014, 03:59 PM)GrammaBear Wrote: It sounds like the doctor you have is what I would call a "keeper".

Yeah, too bad I think he is going to retire anyday now, he just gives off that vibe of he would rather be on the beach in Mexico! But he has his moments Smile
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#8
(02-28-2014, 03:45 PM)SnuffySleeper Wrote: My Doctor told me that to get an Autoset or Apap that the government sets a certain guideline that the patient MUST meet to be prescribed an Apap. ALL doctors must follow this guideline. Basically if your OSA can't be managed well enough by normal Cpap determined by your doctor then he will prescribe an Apap. He said Doctors can't prescribe all Apap's or they would get in trouble by the government and possibly a Doctor's board discipline. Oh Canada....

Hi. I've been recently diagnosed with apnea. Still gathering info and learning from this site and messages like yours. I found the Respiratory Equipment Policy and Administration Manual for OHIP.

Quote:335 Medical Eligibility Criteria for Positive Airway Pressure Systems (CPAP/APAP/BPAP)

The ADP provides Funding for positive airway pressure systems for individuals with a diagnosis of obstructive sleep apnea syndrome (OSAS) and the presence of significant symptoms or medical risks without treatment, and the absence of symptoms or risks with treatment.

The ADP has additional Medical Eligibility Criteria for APAP (see 335.01) and BPAP systems (see 335.02).

335.01 Auto-Titrating Positive Airway Pressure Systems (APAP)

Individuals requiring APAP systems must meet the Medical Eligibility Criteria for a positive airway pressures system (see 335) and the Medical Eligibility Criteria outlined below.

The individual must have polysomnographically documented OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more; and the change must occur between REM vs. NREM sleep or supine vs. sleeping on their side.

The issue I'm struggling with right now is that I found it really hard to sleep at the lab for the initial test and subsequent titration follow-up. Honestly, I don't know how they measured much of anything. I didn't sleep much.

Currently I'm at the step in the process where I will get a loaner CPAP machine for a month. Will insist on an advanced machine with data logging capabilities. Maybe I can help the doctor by being prepared and by supplying useful data once the trial is complete.

Really wish I had been better informed during my initial consultation. I didn't ask any questions other than "I want to be fixed!" Not really certain what kind of apnea has been diagnosed. Will do better next time.

Cheers and good luck to you! Thanks for sharing.
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#9
Hi SleepWrangler,
WELCOME! to the forum.!
Hang in there for answers to your questions and best of luck to you as you get started with CPAP therapy.
trish6hundred
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#10
(02-28-2014, 04:17 PM)ThatOtherGuy Wrote: I have my first follow up coming up in a few weeks and plan to take my laptop with me with the Rescan software and data in order to discuss with the technician and the doctor. Hope they are positive about it. I personally think when a patient is engaged about their treatment its a good thing, they're taking ownership of the problem.

I did take my laptop in case the doc wanted to see detail on any individual days, but Rescan has REALLY NICE REPORTS.

Rescan has quite a few pre-defined reports, including the "all data" so I created that one and gave it to the sleep doc (his assistant) for the records, but I printed my own custom report in color to show and discuss during the visit.

Rescan has 3 or 4
major advantages over SleepyHead:

1) Excellent reports

2) Doesn't LOSE the day if the card isn't in the machine that night (SleepyHead doesn't seem to work from the always available "summary" data, while Rescan can at least include the totals and averages once the card is cycled back to the machine and then the computer.)

3) Must easier to review "selected days", e.g., 1 week, 1 month, 10 days, etc.

4) ? The docs expect to the the manufacturer's program, data, and report. ?

SleepyHead has several advantages over Rescan:

1) Free, open source

2) Much better viewing, including zoom in on the actual events

3) Must easier "locating" and finding each event to view it (#2)

4) Nicer summaries and individual event detail (on the left)

5) Weight, notes, bookmark, Excellent vs. zombie tracking

6) Much easier to select and deselect individual sessions (within a day) to see how that changes AHI or other summaries and averages.


Each day it is easier to quickly and completely understand my results by looking at BOTH than to use either alone.

Each program is good as things which the other is not.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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