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Is a DME absolutely necessary?
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Route67 Offline

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Posts: 68
Joined: Aug 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Resmed
Humidifier: Resmed
CPAP Pressure: Auto
CPAP Software: SleepyHead Other Software

Other Comments: On CPAP for 2 years, still can't sleep. Edit; make that 4 years now, still can't sleep.

Sex: Male
Location: New Hampshire, USA

Post: #1
Is a DME absolutely necessary?
Hello all, I have been using my CPAP for about a month now, and all seems well. Thanks a lot to Paula and others who helped me to get a good model from a great company [Secondwind in Minnesota]. I was diagnosed at a sleep clinic in Mexico where I spend my winters, so I didn't have a US-based prescription and have yet to see a DME or sleep clinic here in New Hampshire - but I feel that the time may be here.

Sometimes I sleep great with the mask; tuesday night I slept 9 hours and only got up once to urinate; but last night I was up 4 times [ugghh] between falling asleep and getting up for good; that was bathroom trip number 5. So my nocturia seems to only be halfway fixed, because some nights I still wake up often, and other nights I sleep right through; weird.

Overall I feel much better, and I DO believe the CPAP is working well for me, just as everyone said it would. But I think if I go to a sleep clinic and work with a DME they may be able to set the machine perfectly for me, whereas now it may not be just right. I am just nervous that they may have me start the whole process again, with an overnight sleep study, etc.......I have already done that.

I have my paperwork from the hospital in Mexico, shows I was waking up 28 times an hour and have "severe" apnea; do you think that would suffice if I get started with a clinic around here?
09-20-2012 10:08 AM
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JJJ Offline

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Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #2
RE: Is a DME absolutely necessary?
(09-20-2012 10:08 AM)Route67 Wrote:  Hello all, I have been using my CPAP for about a month now, and all seems well. Thanks a lot to Paula and others who helped me to get a good model from a great company [Secondwind in Minnesota]. I was diagnosed at a sleep clinic in Mexico where I spend my winters, so I didn't have a US-based prescription and have yet to see a DME or sleep clinic here in New Hampshire - but I feel that the time may be here.

Overall I feel much better, and I DO believe the CPAP is working well for me, just as everyone said it would. But I think if I go to a sleep clinic and work with a DME they may be able to set the machine perfectly for me, whereas now it may not be just right. I am just nervous that they may have me start the whole process again, with an overnight sleep study, etc.......I have already done that.

I have my paperwork from the hospital in Mexico, shows I was waking up 28 times an hour and have "severe" apnea; do you think that would suffice if I get started with a clinic around here?

As far as I know there is nothing that requires a US doctor to disregard clinical evidence from outside the US. Some may refuse to consider the data from Mexico, but I say, if they do, move on to another doctor.

When you bought the machine from Secondwind, did they accept the prescription from Mexico?

As for whether you really need a DME, if your machine is an APAP then you can do a pretty good job of titrating your needs by yourself. One month is not long enough, but eventually you will get it as good as a doctor or DME can.
09-20-2012 05:15 PM
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zonk Offline

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Posts: 7,908
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Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: Is a DME absolutely necessary?
Whats the machine settings
Whats the stats, breakdown of AHI, leak and pressure (med, 95P and max)
What software are you using (profile: other)
Not everyone take to PAP like duck to water, For most it can take weeks or even months
Its recommended to followup with the sleep doctor once in a while and more often if you,re having some sort of problems
09-20-2012 05:46 PM
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Route67 Offline

Preferred Members

Posts: 68
Joined: Aug 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Resmed
Humidifier: Resmed
CPAP Pressure: Auto
CPAP Software: SleepyHead Other Software

Other Comments: On CPAP for 2 years, still can't sleep. Edit; make that 4 years now, still can't sleep.

Sex: Male
Location: New Hampshire, USA

Post: #4
RE: Is a DME absolutely necessary?
(09-20-2012 05:15 PM)JJJ Wrote:  [quote='Route67' pid='19319' dateline='1348153698']

When you bought the machine from Secondwind, did they accept the prescription from Mexico?

No 'script needed........actually, the asked me of I had one and I said no; I was worried they wouldn't sell me one at that point but they said no problems and that they would set it for me, at a general setting which was common.

I do have a 'script if needed, and if I start with a clinic I can show that......I definitely would like to avoid doing the whole sleep test process.
09-20-2012 08:09 PM
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Route67 Offline

Preferred Members

Posts: 68
Joined: Aug 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Resmed
Humidifier: Resmed
CPAP Pressure: Auto
CPAP Software: SleepyHead Other Software

Other Comments: On CPAP for 2 years, still can't sleep. Edit; make that 4 years now, still can't sleep.

Sex: Male
Location: New Hampshire, USA

Post: #5
RE: Is a DME absolutely necessary?
(09-20-2012 05:46 PM)zonk Wrote:  Whats the machine settings
Whats the stats, breakdown of AHI, leak and pressure (med, 95P and max)
What software are you using (profile: other)
Not everyone take to PAP like duck to water, For most it can take weeks or even months
Its recommended to followup with the sleep doctor once in a while and more often if you,re having some sort of problems

See, these questions are the main reasons I think I need a DME! I have it set up based on the advice of secondwind, but I may need completely different settings based on my sleep test results. Not sure about these settings, I haven't played with it since I got it because they set it at what they said were common settings based on the majority of their sales.
09-20-2012 08:16 PM
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PaulaO2 Offline
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Posts: 8,057
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #6
RE: Is a DME absolutely necessary?
Do you have the clinician manual or software to view the data?

With an autoset, it is super, super easy to titrate yourself.

First, check the settings and find out what the pressure range is set to. That's why you need the clinician manual.

Then, check the data. What is the AHI and the highest pressure used and the lowest pressure used?

If the machine is set to, say 6 - 20 but you never go over 10, you can bring that upper number down to 12 or 11. If the lowest you go is 8, then you can raise that lower number to 7. That would mean your new pressure would be 8 to 10.

It may sound complicated but it's really not. And you have the right machine to do it, too! An APAP is the best to have in this situation.

Do you need a DME? If you are having mask issues, yes, you do. And you do not need a sleep doc prescription for one, either. Get your regular GP to write a prescription. Ask what the DMEs mask trial policy is. Some allow you to try a mask out for 2-4 weeks.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
09-21-2012 04:03 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #7
RE: Is a DME absolutely necessary?
(09-20-2012 08:09 PM)Route67 Wrote:  I do have a 'script if needed
Whats does it say?
Any other sleep disorder beside vanilla type OSA
09-21-2012 04:13 PM
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JJJ Offline

Advisory Members

Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA 97217

Post: #8
RE: Is a DME absolutely necessary?
(09-20-2012 08:09 PM)Route67 Wrote:  
(09-20-2012 05:15 PM)JJJ Wrote:  [quote='Route67' pid='19319' dateline='1348153698']
When you bought the machine from Secondwind, did they accept the prescription from Mexico?

No 'script needed........actually, the asked me of I had one and I said no; I was worried they wouldn't sell me one at that point but they said no problems and that they would set it for me, at a general setting which was common.

That's very interesting. When I tried to buy a machine from them several months ago they wouldn't sell it to me without a prescription. I bought one from a local guy on Craigslist instead. Later I got a copy of the prescription from the doc, so now I can buy anything anywhere.

I wonder if they didn't require a prescription because they are sort of outside the loop. I mean, they sell only used equipment, rather than new products directly from the manufacturer. But then, why did they require a prescription from me? Very interesting.
09-21-2012 09:04 PM
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PaulaO2 Offline
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Moderators

Posts: 8,057
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #9
RE: Is a DME absolutely necessary?
Or could be he ordered it while in Mexico? If Mexico does not require a prescription, they wouldn't need it.

PaulaO2
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www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
09-21-2012 09:13 PM
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