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New CPAP user by proxy
The "by proxy" means I'm not the CPAP user. The patient is my 83 yr old mom. She's recovering from a nasty spiral fracture of her right femur, going into AFIB and Acute Congestive Heart Failure after surgery to put a rod with pins top and bottom. In the process of all of this, an (at home) sleep study was recommended based on her high BP in the am.

There were actually two studies: The first one was just a pulse/oximeter. Mom called her PCP and got a copy of it. It said that she spent about 5 out of 8 hours with her Spo2 under 88%. Dr set up another test, once more a home study but this time with chest band, nasal canula, and pulse oximeter. Because this test was to be mailed to us then mailed back to the company, we called mom's PCP concerned about the low O2 level and the fact that this all was going to take some time. Doctor DID take the time to call us back and said this has been going on for a long time, was probably the cause of her CHF and AFib. However, mom wasn't going to die right away so not to worry!

So, mom did the second test and mailed it back to the company about two weeks ago. Last Friday, the nurse at mom's PCP called and said that Lincare would be calling mom to set her up with a CPAP. THAT's all she told mom.

The next day (Saturday, office open till noon), mom called back and asked for a copy of the sleep study. The nurse was a "fill-in" nurse and she said she couldn't find it. OK.. Mom calls on Monday to speak with the regular nurse. SHE says that she is really behind and will get to making a copy of mom's sleep study as soon as she can. And we never heard from her. I'm getting the feeling that the doctor doesn't want us to see the sleep study until mom is set up with her equipment because she doesn't want mom to be upset.

But, we ARE upset. One of the questions both nurses asked mom was "you're on O2 therapy, aren't you?" Well, NO! She's not. So we were concerned not only with the CPAP prescription and exactly what type of CPAP it would be,but also if we were going to end up with an O2 converter.

Finally, I called and asked for the nurse. I cornered her as best I could (they are all such a slippery bunch!) and said "We want to know WHAT kind of CPAP therapy you are prescribing for mom and if it includes oxygen therapy. I KNOW that will be in mom's chart in your computer" She said she would go look, was gone for several minutes and came back and said, "No oxygen just yet, but your mother is prescribed auto CPAP.

So, I called Lincare (since they hadn't called us) and they mentioned mom using Res Med 10 Elite and that they would have to order it. From what I understand, the ResMed 10 Elite is NOT auto CPAP. (And Lincare said something to the effect that they didn't offer the ResMed 10 Autoset.) I gotta say, I am so confused.

I'm thinking this a.m. to call Lincare and ask them to FAX or Email me the info on the types of AUTO Cpap machines that they offer because the Resmed Elite 10 is not AUTOCPAP. I know we don't want the ResMed Escape auto...that it is termed a brick and has only has compliance data (Mom is covered by Medicare and supplemental insurance.)

Does anyone have any advise for us?

PS I'm very good at computers and such and can handle software like Sleepyhead (maybe with a little help). I'm hoping to be able to monitor mom's therapy to make it as successful as possible.
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Stick to your guns. If they have to order the Elite, they could just as easily order the Autoset. So they're having their way with you. Medicare pays the same amount whether you are provided an Elite, an Escape or an Autoset. So they're trying to play "let's make a deal" with your mothers health.

Time to call your doc again and tell them you want to pick up a copy of mom's prescription, or have them write another one. Then you can get ahold of one of our online suppliers who will work with you to get you what you want and need, and work with you on the medicare as well.

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Thanks for the advice. Mom's doctor's office is close to my work office. I'm going to stop by and get her prescription. At least then, I have some leverage.

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You never have more leverage with a supplier than before you take acceptance of equipment.
If Medicare + a supplement is paying, you may have to use vendors who are medicare approved.
Still, you should be able to get what you want. Since the S10 is new, you might consider the S9 series.
If you're willing to pay out-of-pocket, you have more choice.

Stick to it on getting a copy of the report and the Rx. Stand there and make yourself a pest if that's what it takes.

Best wishes on your mom's recovery,


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Hi suedanem,
WELCOME! to the forum.!
Your mom is very fortunate to have you looking out for her.
Keep up the good work.
Best of luck to you and your mom and I wish her much success with her CPAP therapy.
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Read the links in my signature line for help on not getting screwed by the DME (CPAP seller).

In particular, find out which DME is "in network" for your insurance. If you have more than one choice, you have a lot more leverage if you walk out of DME #1 and tell DME #2 they get your business if they give you what you want.

Avoid Lincare if at all possible. There have been many reports of problems with Lincare and Apria. Don't give them your credit card number, because you'll get lots of supplies you didn't order and will have to fight them over it. Some people have suggested getting a Visa/Mastercard "gift" card and giving that to them so they can't keep billing you that way.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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Thanks Archangle and everyone else. Sheesh! Guess which are the two closest DMEs that are Medicare approved (contracted DME) closest to our little town.... yup, Lincare and Apria. When I dropped by mom's doctor's office today, I was told they were having "computer problems." I just said, OK, I be back tomorrow. I just work around the corner!

I did call Lincare again. They insisted that the CPAP machine would be an autoCPAP. Anything I read about the "ResMed Elite" says it's a straight CPAP only machine. (They said it was the S10 model. I can't find anything on the S10 Elite, but they also told me it has a modem in it. Oh great!)

I just want mom to have the best chance of success with this therapy. She's definitely not real thrilled about it, that's for sure. I have a co-worker who uses CPAP (don't know what kind yet) who said she'd come over and give mom a pep talk. Before mom broke her femur, she was a very feisty 83 yr old. She could (and did) change the oil in her own car and put on/take off her snowtires. I think I've convinced her that CPAP therapy is the best chance she has for getting her "old self" back.

Thanks all for your help and good wishes.

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My father-in-law (Papa) lived with us for 8 yrs and I was his full-time caregiver for the last 6 yrs of his life.

You have a fantastic resource group here, stay with it and you will learn a lot.

By the way, sleep apnea is hereditary, make sure you check out any possibility for you having sleep apnea. My dad had it, my sister and I both have it.

Being a caregiver/offspring support advocate is NOT EASY!

Ideas that may help: (if you have not already done so)
= your mom should sign a "Permission to disclose" with the Dr. office and any DME (Durable Medical Equipment) supplier she deals with, and with Medicare and the insurance - so that you can talk with them about her care
= be nice but STUBBORN - be willing to stand/sit and wait, be a pain in the a$$, and write down who you spoke with, the time and notes on the conversation - having the medical staff SEE you do this works wonders, suddenly they realize that you are NOT going away and they had better take of you
= you have embarked on one of the hardest jobs, being a caregiver for a parent, Take Care of Yourself!!

Best wishes to you and keep in touch.

You on the right track!!
Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
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Next time you go see the doc's office, mention the HIPPA. That law entitles your mom to a copy of any and all of her medical records. They can't be having a "computer problem" to that degree and remain open. Tell them you'll wait for the problem to be resolved and take a seat. Get the forms so that you have full rights to your mom's records too, if you do not already, like Evpraxia suggested.

In the meantime, if the company calls you and says the machine is in, go see it first. If it is the A10, in the lower left corner where it says "AirSense", below it should be the word "Autoset". If it says "Elite", it is not an autoPAP. Refuse acceptance of it.
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Breathe deeply and count to zen.


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(11-12-2014, 07:02 PM)suedanem Wrote: I did call Lincare again. They insisted that the CPAP machine would be an autoCPAP. Anything I read about the "ResMed Elite" says it's a straight CPAP only machine. (They said it was the S10 model. I can't find anything on the S10 Elite, but they also told me it has a modem in it. Oh great!)

1st of all, there is no such thing as an S10 anything. The new Resmed models are called A10's. As far as the Elite is concerned, it is definitely a straight cpap device.

From Mr. Resmed's site:

"The AirSense 10 Elite is a premium fixed-pressure device that features an integrated humidifier and built in wireless communications, allowing you to stay more connected to your patients than ever before. It also features advanced event detection – giving you advanced insights into patient compliance and therapy efficacy."
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