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New to ASV (Last night 1st Night) Need Help
RE: New to ASV (Last night 1st Night) Need Help
Good Morning! My second night even better than the first night....Ahi of 2.1, no obstructives or centrals, just hypopneas and a few apneas of unknown origin. Most importantly.....no desats!! Also I slept for over 8 hours. This is just unheard of for me! I will raise the PS max up to 13 tonight, as the pressure at times, probably in Rem, is hugging the red line.

Yes, Ron I know how important it is to keep the nasal mask clean and free of oils. I don't have any leaking at all, but I know what you are saying when the pressures get really high, I will probably have a harder time keeping the seal.

You guys will not believe what happened with the DME!!!!!!!! I have Medicare (original, with a supplement) so everything is covered 100%.....but, I have to deal with "Competitive Bidding". My sleep doc who operates out of the local hospital's sleeplab went ahead and ordered my equipment with a DME that I am not familiar with, American Home Pt. nor were they, as they were just trying them out. ( The story of this is above in another post. ) Anyway what happened yesterday was very interesting. I called the DME and asked them what they were going to do as I am not going to accept this used, old equipment that you delivered to me. What they said to me, "Yes we know it is used, it is all we have, "take it or leave it, we are not changing your equipment out for anything else". So I called the sleep lab and told them the story. I gave the gal the name and phone number of the person I spoke with at American Home Pt. Well the sleep lab called them and was told the same thing that I was told in a very rude manner. So now the sleep lab is finished with AHP. What has to happen now is that AHP has to come and pick up this machine and we both have to sign off on the contract before I can start dealing with another DME. I told the sleep lab to have my RX detailed with the item # on it for the newest model of ASV, so I don't have this problem again. I just hope that AHP contacts me today and sends someone out to pick up their machine.....I am hamstrung until that happens. I also called medicare to ask if I was intitaled to new equipment.....they were appalled, and said you certainly are....do not accept this as you are intitaled to new, unused equipment. The waiting game is on.........will keep you posted!

Love Dog
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RE: New to ASV (Last night 1st Night) Need Help
I'd sue the DME; and call the Medicare fraud line. Turn up the heat.

This is a good lesson on CPAP DME. Get the Rx from the doc; then arrange to get your equipment from a DME of your choice.
Yes -- US Medicare has now gone to having to use approved DMEs -- but, you still have rights and choices.
You never have more power than when you hold the Rx in your hand.

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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RE: New to ASV (Last night 1st Night) Need Help
Guess what??? My third night on ASV and events were 00. This is amazing for me!! I have been having a little party all by myself Smile

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RE: New to ASV (Last night 1st Night) Need Help
(10-19-2013, 04:38 PM)LOVEDOG Wrote: Guess what??? My third night on ASV and events were 00. This is amazing for me!! I have been having a little party all by myself Smile


that is awesome to hear!! do tell about your party! lol

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RE: New to ASV (Last night 1st Night) Need Help
WOW - in all my years (when I've checked), I have never had a ZERO - congrats to you!
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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RE: New to ASV (Last night 1st Night) Need Help
CONGRATULATIONS on your third night of success with your ASV and enjoy the party.
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RE: New to ASV (Last night 1st Night) Need Help
[Image: Untitled_zps3ed13049.jpg]

Here it is.....Been doing the "Happy Dance" all day!!!

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RE: New to ASV (Last night 1st Night) Need Help
I'd check the flow graph to make sure it didn't miss anything! Tongue
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RE: New to ASV (Last night 1st Night) Need Help
(10-19-2013, 08:31 PM)LOVEDOG Wrote: Here it is.....Been doing the "Happy Dance" all day!!!

Hi Lovedog,

It's great you were able to get the type of machine you need.

But I suggest you might want to stop using the model 36007 and take it back, or make the DME pick it up immediately. Otherwise, the bad DME who provided it to you may be able to claim it is no longer in the condition in which it was delivered it to you, and your use of it may imply your acceptance of it. There may be a short time limit on how long you can use it before it becomes too late to take it back. But I am no lawyer, and maybe I'm just being overly cautious here.

By the way, the newest model S9 VPAP Adapt is 36037. Ordering number 36047 includes the 36037 plus the humidifier. Ordering number 37057 includes the 36037 plus humidifier plus heated hose.

The plot of your data does not show the IPAP Pressure going above about 14 cmH2O, yet the Statistics area says the IPAP pressure was at or below 18.62 only 95% of the time, meaning 5% of the time it was 18.62 or higher. In the plots, I do not see the 5% of the time when the IPAP was above 18.62. An IPAP pressure around 14 cmH2O represents a Pressure Support of around 8. (EPAP + PS = IPAP, or 6 + 8 = 14.)

I read somewhere on ResMed website that a Pressure Support of 10 is usually sufficient to keep a patient with Central Sleep Apnea fully ventilated, so I think ResMed recommends the max PS should be at least 10.

According to the Statistics area, 5% of the time the PS must have shot up to 12.62 or higher, but these high pressures may have occurred mostly (or only?) when you were swallowing rather than breathing.

On an ASV machine, the way to spot a swallow is that the Flow plot will go to zero for a breath or two, while the pressure spikes up to maximum. If you zoom in on the Pressure plot (or, in ResScan, if you zoom in on the "High Rate Pressure" plot), you may find that the only times when the PS is anywhere near 13 are times when you are swallowing. (We swallow from time to time during our sleep, which temporarily creates a 100% complete obstruction for a few seconds.) Unless there is a complete 100% obstruction (such as caused by a swallow) if the pressure support shoots up very much, there will be a significant amount of Flow.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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RE: New to ASV (Last night 1st Night) Need Help
Vaughn........I am so new to ASV that I don't understand what your point is, or what you are trying to say to me. Is there something on my sleepyhead report that is concerning? I had another night of zero events last night. My way of thinking (and I could be wrong) is that once you reach the golden numbers of 00 you should not mess with anything. The numbers I am using are: Epap=6 PS min =4 PS Max=12.6. If there is something else that I need to do or look at please let me know.

As far as my machine goes......I have contacted Medicare and informed them of what American Home Patient did to me. So they have that documented. I have also told AHP that I do not want their machine and to come and get it......this was on Thursday. I also called Lincare, my present DME and told them of what happened.....they assured me that once they get the RX from my doc they will get a new machine out to me #36057. Resmed told me that the 36057 was the # to use for the machine, humidifier and climate line hose....I also have a cataloge here with that # on it for those items. I am just thinking that they did not come for the machine yet because maybe they wanted me to have use of it over the weekend???? I don't know....I cannot force them to come get their machine....I feel safe because medicare will not accept billing from them because they know I am not accepting their used machine.

My doc will send over the RX to Lindcare tomorrow....this is my understanding of it, and of course I will follow up every minute of the way on this to make sure all of this happens. Not much more I can do.

For all I know the machine is malfunctioning because 00 two nights in a row is suspect to me, but I have never had experience with AVS, so many questions........

In the meantime I am going to enjoy these numbers......and most importantly the fact that I am no longer not breathing for long periods of time and desating all night is very exciting to me........and I feel better!
I have gone over my graphs for the past two nights in detail and do not see anything of concern to my eye from what I have learned from reading the graphs from the S9 Autoset for the past year+.

Vaughn....By the way I also have chronc bradycardia. Thanks for helping me, and if you could clairify what it is you want me to know I would appreciated it.


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