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New on Bipap ASV, have a few questions
#51
RE: New on Bipap ASV, have a few questions
ok, I'll increase the Ipap max too.

I think the DME I went to might only have Phillips stuff, didn't see any Resmed there, I don't think I get a say in the brand anyway ? 

Another reason to find another DME though, but they seem to be very tied with the sleep clinic, in fact they seem to always have a rep there during business hours, at least every time I went there (3x)
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#52
RE: New on Bipap ASV, have a few questions
(09-24-2019, 08:34 PM)bonjour Wrote: I am surprised at how slow this machine works.  I'm going to slightly disagree with SleepRider on which machine is best for you.  The BEST machine for you is the ResMed AirCurve 10 ASV.  It reacts faster than the PR models.
Increase the Max IPAP to machine max.  Just to allow it because we are starting with a higher PS, I doubt you will use it.

If you read post #42, you'll see you have no disagreement:


Quote:I think your current H events are inadequately treated CA. The Philips Auto SV is unfortunately less responsive with pressure than the Resmed Aircurve 10 ASV.

I have to bite my tongue every time we are stuck with a Philips Dreamstation and there is nothing we can do about it.
Sleeprider
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#53
RE: New on Bipap ASV, have a few questions
A few questions for when I return that machine (maybe Friday)

- Can I return that machine, get a receipt, and decline a new one ?
- Can I then go to a different DME of my closing (has a patient can I chose ?)
- I haven't seen the actual prescription with equipment code, can I request that from the clinic or DME ?
- Assuming yes to all the above, I could go to a DME that carry Resmed ... they might still try to give some ST machine raher than ASV though, if my prescription says that.
- Do you think I can prove to my Dr I need an ASV, since I clearly have centrals ... I haven't seen the full results of the sleep study, but the summary said complex apneas with central as I mentioned before.

Basically just not clear what are my rights as a patient here, is that documented somewhere ?

Thanks again.
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#54
RE: New on Bipap ASV, have a few questions
Any DME can get a ResMed, if they choose. They likely will not have an ASV in stock. You can use ANY DME you wish, however I suggest you call your insurance to see which ones they cover/are in network.
HIPPA is your friend. You are entitled to a copy of your prescription and test results including a full copy of your sleep study. They may charge you a copy fee.
You could even purchase online. Ask your insurance what the reimbursement policy is for an online purchase.

Have you read the article on justification for advanced CPAP? The normal path is to

Fail CPAP
Fail BiLevel without backup (S or VAuto)
Fail BiLevel with Backup (ST)
Succeed with BiLevel with Backup (ASV)
The last two are the same billing code.

We rarely, like never, have a situation where an ASV machine is requested back.
You are tolerating the ASV exceptionally well, as a duck takes to water so to speak. Our goal is for you to prove that ASV works for you by your results prior to your returning it.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#55
RE: New on Bipap ASV, have a few questions
Hopefully this info will help:

In 2017, I was pushing to get the ResMed AirCurve 10 ASV but was still on a Respironics DreamStation BiPAP.

Issuing DME was subsidiary of Rotech for BiPAP; they stated they issue Respironics (read they have contract with Respironics and don't carry ResMed) but would issue ResMed IF script specifically says Dispense ResMed. I wasn't sure if I could get the doc to specify ResMed, so I went to Apria and got my ResMed ASV there. I chose Apria because they were nearby, in network for insurance, would issue ResMed.

1. Yes the patient can choose brand if you get doc to state it on script

OR

2. Yes you can choose your DME by taking your business to a DME that issues ResMed.

You should discuss if a DME will dispense ResMed if you choose or if they handle it as their decision.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#56
RE: New on Bipap ASV, have a few questions
BTW I skipped over use of the ST. It wasn't discussed period. On purpose on my part. It could have been my sleep study numbers of CA 124 OA 24 that helped. While on BiPAP, I requested an urgent care visit with pulmonary doc's office as the BiPAP was making me sick. The nurse and I discussed my sleep study results and I asked something like "With many CA events like this, shouldn't I be on an ASV?". Nurse confirmed and was troubled I wasn't on ASV already. That started me on the path to getting an ASV script.
Dave

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Standard OSCAR Chart Order
Mask Primer
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#57
RE: New on Bipap ASV, have a few questions
Thanks Dave, very relevant info.

Didn't have the best night, though I feel a bit more rested than yesterday.

TLDR; woke at 1:30 with bad bloating, the painful kind where I can't sleep until I release some air.
I thought I put the mask back on ~30m later, but apparently that was 2 hours later, I must have fallen asleep cpap free Smile
Anyway mask back on ~3:45 to 5:15, then again woke up with bad aerophagia.

You can ignore completely anything after 5:30, i lowered the pressure and turned off backup at that time, but I don't think I slept after that time anyway, so probably all swj. 

If you take after 5:30 out, there are no centrals which is good, but the hypopnea situation seems to not have changed (I'm planning to leave backup off tomorrow because this juts seems to make things worst).

 BTW, anyone knows if is there a way in Oscar to cut out a section (ie when cpap was off), or alternatively select multiple sections at once ?

           
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#58
RE: New on Bipap ASV, have a few questions
See your post above and the third graph. You can choose sleep segments like those to be on or off. Those that are on will show as your totals on the left panel.

And you're welcome. Hope you are successful in the ASV fight. Myself and others here can give pointers when applicable. We want you to win this.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#59
RE: New on Bipap ASV, have a few questions
leaving backup off prooves that you don't need ASV.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#60
RE: New on Bipap ASV, have a few questions
Bonjour, 

My main goal is to get restful sleep and a lower my AHI, the specific machine type is secondary to that.

The reason I wanted to try one night without backup, is that the first night it was off and hypopnea were not an issue, it seems like my breathing rate was in the 9-13 range but unless that itself is a problem, it felt fine.  Also had little issues with Hypopneas on the Abap machine(no backup).

Furthermore on the ASV, you can see on my graphs that my hypopneas count and Backup breaths are very clearly aligned together.

I don’t think the ASV has been useless regardless, because it’s been treating the CA’s great and without having to be set to use a constant high pressure causing aerophagia (as the Abap was).  But as far as I can tell the Backup feature is something  that have caused worst results so far, hence why a Bipap ST sounds like a poor solution.

Does that make sense ?

Another question I have is do people typically find out the root cause of the sleep apnea, besides treating it ?
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