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New Guy Now On CPAP
#11
I really did notice last night that I'm getting a lot of air into my belly. Had a lot of gas along with the stomach discomfort. Because I have GERD I'm wondering if that sphincter is so weak that's why it happens. I tried a chin strap during the previous CPAP trials but, as I recall, it didn't really help. My nasal passages are so tiny I frequently have some difficulty breathing through my nose at night. So, I mouth breathe.
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#12
Well, still getting a lot of air in the belly. I end up with my stomach hurting and a lot of gas. I spoke to the CRT and he said a chin strap might help but has proven to be about 50% effective. I remember I went through this before in the previous cpap trials. So, I talked to the sleep center and the lady who specializes in problem patients like me. Big Grin She's going to speak to a doctor about a bi-level. If I can't even tolerate this pressure with the EPR there's no question I would be a candidate. We shall see.
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#13
No bi-level. Insurance will not cover it. They have tweaked the settings on the current machine to be very close to what a bi-level would be. They say if I can't tolerate that they don't know what else to do.
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#14
I have never heard of using a chin strap to treat aerophagia (swallowing of air). Also, a bi-level machine is THE recommended treatment for aerophagis, so someone -- either the doctor or the equipment provider -- is not communicating properly with either you or your insurance company.

I suspect fraud because likely your insurance company has a contract with the equipment provider that requires the equipment provider to upgrade the machine at the expense of the equipment provider. I recommend you report this problem to your insurance company. I also recommend that you contact other equipment providers and see if they can furnish you with a bi-level machine. Meanwhile, put the machine in auto mode with a pressure range of something like 6 to 9, make sure EPR is set to its maximum value of 3, and install SleepyHead on your computer so you can monitor the effectiveness of the therapy being delivered by the machine.

Sometimes you have to take charge of your own health care. This is one of those times.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#15
(05-04-2016, 07:13 PM)Sleepster Wrote: I have never heard of using a chin strap to treat aerophagia (swallowing of air). Also, a bi-level machine is THE recommended treatment for aerophagis, so someone -- either the doctor or the equipment provider -- is not communicating properly with either you or your insurance company.

I suspect fraud because likely your insurance company has a contract with the equipment provider that requires the equipment provider to upgrade the machine at the expense of the equipment provider. I recommend you report this problem to your insurance company. I also recommend that you contact other equipment providers and see if they can furnish you with a bi-level machine. Meanwhile, put the machine in auto mode with a pressure range of something like 6 to 9, make sure EPR is set to its maximum value of 3, and install SleepyHead on your computer so you can monitor the effectiveness of the therapy being delivered by the machine.

Sometimes you have to take charge of your own health care. This is one of those times.


I don't k now about fraud. The tech at the sleep center (doctors office) turned in the order for the bi-level. She later called to tell me Medicare is refusing to cover the cost of the bi-level because it hasn't been shown that I need it. She said, going forward, we have to prove to Medicare the need and document everything. She adjusted the machine to a pressure of 7 with the EPR at 3. Ramp is 15min.. I don't understand the numbers but she said this would be the lowest they could go, speaking about both pressure and the EPR. She said that if I can not even tolerate this there would be no reason to push for the bi-level.
Well, last night was rough. I had the mask on for 2.17 hours. All the other nights were 8 hours and more. My events went up to 22. I still had some air in the belly but not near what it was. Plus, my breathing through the nose was restricted. After the mask was off that seemed to clear up.
At this point I am super frustrated. This is my third try with cpap. We've tried everything.
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#16
(05-05-2016, 06:17 AM)Mike208 Wrote: I don't k now about fraud. The tech at the sleep center (doctors office) turned in the order for the bi-level. She later called to tell me Medicare is refusing to cover the cost of the bi-level because it hasn't been shown that I need it.

The doctor needs to examine you and send in a prescription for a bi-level. I recommend an auto bi-level, such as the one I have. It's the only thing that treats both my aerophagia and my obstructive sleep apnea effectively. I still get gas, but it no longer hurts. It just causes some flatulence.

Quote:She adjusted the machine to a pressure of 7 with the EPR at 3. Ramp is 15min.

Like I said, try auto mode with a range of something like 6 to 9.

Quote:Well, last night was rough. I had the mask on for 2.17 hours.

Ouch! That won't work. Aerophagia, like most problems, fades as you adapt and you can't ever hope to adapt unless you commit to wearing the mask every time you sleep, all the time you are sleeping. The alternative is life-threatening damage to your cardiovascular system, and a lousy sleep-deprived life.

Quote:All the other nights were 8 hours and more.

That's really good. Build on that. Don't give up.

Quote:My events went up to 22.

Is that 22 per hour? (In other words, was your AHI 22?) Were most of those events obstructive apneas and hypopneas?

Quote:I still had some air in the belly but not near what it was. Plus, my breathing through the nose was restricted. After the mask was off that seemed to clear up.

Setting the range to 6 to 9, or even 7 to 9, should help with that. You can also turn off the ramp, as that may help, if you want.

Quote:At this point I am super frustrated. This is my third try with cpap. We've tried everything.

You haven't tried everything, and you can't give up and let this happen to yourself. These problems are entirely temporary. They will go away, you will feel better than you have in years, but you have to persist.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#17
Here is the machine report.    
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#18
I have already seen the doctor. He said Medicare will not pay for a bi-level machine without documented evidence it is needed. The sleep tech told me yesterday that if I can not adapt to the machine with the settings she made a bi-level will not work. I had been wearing the mask every night for at least 8 hours since I got the machine. Last night was the first night I took it off early. I was waking constantly trying to get a breath. My nose was somewhat plugged up and my stomach hurt. I couldn't tell for sure if that was air or just the GERD. I looked at the machine and saw the events were 22. I took the mask off because I can get that number with the dental appliance.
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#19
(05-05-2016, 01:56 PM)Mike208 Wrote: I have already seen the doctor. He said Medicare will not pay for a bi-level machine without documented evidence it is needed.

Your complaint to the doctor of a bloated and painful stomach IS documented evidence as soon as he notes that it's true!

Quote:The sleep tech told me yesterday that if I can not adapt to the machine with the settings she made a bi-level will not work.

Total rubbish. Your AHI is 22 with the settings she made. No one can sleep through that! A bi-level machine set at, say, 10 over 5, for example, would lower your AHI and reduce your aerophagia below what you'd have with a constant pressure of 10 and a EPR of 3.

You need to get a second opinion from a qualified doctor who specializes in CPAP therapy.

Quote:I had been wearing the mask every night for at least 8 hours since I got the machine. Last night was the first night I took it off early. I was waking constantly trying to get a breath. My nose was somewhat plugged up and my stomach hurt. I couldn't tell for sure if that was air or just the GERD. I looked at the machine and saw the events were 22. I took the mask off because I can get that number with the dental appliance.

Then wear the dental appliance and use the CPAP machine at the lower pressure. I understand that you keep waking up with the feeling that you're not getting enough air and that your nose is plugged. You're wearing a full face mask so just breathe through your mouth. The feeling of not enough air is an illusion. You're getting more air as evidenced by the fact that air is being pumped by the machine.

It takes time to adapt to this new way of sleeping. You've spent a lifetime sleeping a different way, so give yourself the time you need to adapt.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#20
Medicare is very specific as to who qualifies for bipap. I have OSA which is not a qualification. CSA is. COPD and other serious disorders of the lungs are qualifications. I have none of those. Swallowing air is not a consideration.
I remember, during my other trials, they tried various pressure settings and it was the same result.
I asked my ENT if he had any ideas as to why cpap seems to be a challenge for me. He said the shape and size of my throat and sinus cavities play a huge role. I'm one of those unique individuals.
This current trial has been the best of the three. I have been able to keep the mask on all night, well, up until last night. But the air in my stomach is a killer. I already have stomach issues and this just compounds everything.
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