(09-29-2013 05:05 PM)shari Wrote: Hi, my name is Shari... I'm from southern CA. Been having headaches, heart palpitations and extreme tiredness. My less than helpful GP chalked it up to various "things it could be". Lucky for me I happened to see an "on-the-ball" Dr. in urgent care a couple of months back who ordered a sleep study and an echocardiogram. I have a not so great HMO that's big here in socal... and they sent me home with a do-it-yourself sleep study monitor after taking a group class on sleep apnea. They contacted me a couple of weeks later by mail saying I had very severe OSA. Results were basically I stop breathing on average 125.9 times per hour. Average O2 sats were 93%, lowest shows dipping down to 62% 02 sats. They made an appt a few weeks later for me to take home a machine, Phillips Respironics Remstar Plus C-Flex on loan for 5 days for a titration study, giving me Swift FX nasal pillows for a mask. I seemed to tolerate it well, the only negative thing is my lungs and sides seemed to really ache when I took it off it every morning. This HMO that I have loves to drag their feet with everything. They are saying it will be 4-6 weeks before I see my machine. My husband also has sleep apnea... he's had his machine about two years now. It took this same HMO almost A YEAR to finally get him his machine.
Now comes the part where I am scared... I also got the results from my echocardiogram the same week as my titration study. My GP told me I have a heart condition what's called diastolic dysfunction - grade 1. I do not have high blood pressure, so he is telling me it was most likely caused by years of untreated sleep apnea. I asked my GP (and followed up my question via email for a paper trail) if he could possibly please expedite my machine to me, given the fact of this heart condition diagnosis. Nope.... his answer was "unfortunately I have no control over that". Great... so here I sit, night after night... afraid to go to sleep without a machine for fear I won't wake up. To top it off, he's being less than helpful in answering any of my questions re: the DD diagnosis in relation to the sleep apnea... long term prognosis etc. He even said at this point he didn't feel my condition "warranted a referral to a cardiologist". I followed up our appt. with an email saying I REALLY need to see one... so he is finally referring me to one now. Is there anyone else here who has had a diagnosis of diastolic dysfunction due to sleep apnea, and if so... can I hear some of your stories what you have gone through. WHEN I get this machine... I intend to never again sleep without it. This whole experience has me pretty freaked out.
P.S... may I also add that I thank God it's open enrollment time at work!!! Going to be leaving this HMO for good... but I still have to put up with them until Jan 1st.
Thank you for your help! -- Shari
Welcome Shari! I don't have a heart condition, at least that is what my cardiologist said. I am not 100% confident in what she says but that is a whole other story.
Your experience with the HMO is exactly why I refused to go with an HMO even though my premiums are much higher. I don't do well with multiple appointments and for me to pay to see a primary doc just to pay to get a referral doesn't set too well with me. On top of that, if you have medical conditions or develop medical conditions, the extra money that you and your husband pay going to a primary care doctor first to get a referral to a specialist could add up to enough to pay the extra premiums for a PPO. Also, push for them to continue with the rental and that extra expense might push them to go ahead and make the purchase. It is life threatening to be without it. And, this dragging of the feet is something that is a scary thing. I would also recommend, with your problems and your husband's sleep apnea, selecting an internal med doc as your primary care doc.
Any way, I was told that my plan, which I really love, will not be available next year and I have told my agent that I will NOT do an HMO for any reason! She is trying to push me that way. This year, I have paid the $105 medicare premium and $136 for medicare advantage premium and it has been worth it. However, I also have not had to pay any co-pays for any of my doc visits, even with specialists. This plan also included prescription meds which most plans don't and the premiums are high for those plans (with United Health I think). I have been told that there are no plans with any insurance company comparable to what I have right now so that means I am going to have copays next year which is scary b/c I can't budget b/c I don't know when I will need to see a specialist. So, I am now trying to schedule everything I need to do before the end of the year.
Let us know what you find out when you see the cardiologist and hopefully that doc will push the CPAP machine. Also, you can call your insurance company yourself and ask to speak with a supervisor in approval and find out what the delay is on getting a CPAP/BIPAP or whatever type of machine they say you need.
I thought my numbers were high in my sleep study but they weren't anywhere near yours and I was scared to wait for a machine and was even upset that they didn't give me an auto set when I expressed concerns about the pressure not being high enough all the time to compensate for events so I understand you being scared. Don't be silent; push and push....you can't count on the medical doctors or their staff....you have to take control and be your own advocate.
when my child was in the hospital and was given 10% chance of survival, all the hsp personnel except the surgeon hated me b/c I rode their arse all the time. I made them call me when they had their weekly meetings on the patients (we lived 1200 miles away and my child was in the hsp for 2 years so I was not able to stay there the whole 2 years). I spent a week at the hsp every month until discharge though. I called the nurse each day to find out med changes, etc. and once her main doc was on vacation and his father was taking over the care of his patients until he was back and I caught him prescribing medication that had a critical interaction with another medication my child was taking. Had I not watched, my child could have died many times over. Many more stories I could tell but I won't as my point is this: YOU are your best advocate for your health and welfare and I hope you can take control and do what you have to in order to get your therapy machine!
Keep us updated!