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ONLINE home testing?
#41
(03-20-2012, 07:40 PM)nila Wrote:
(03-20-2012, 06:49 PM)SuperSleeper Wrote: Nila, whoever is going to set up the home sleep test for you will undoubtedly have certain requirements... I'm not sure how those home tests work, exactly, so you need to talk to them on whether they can use your existing machine or they provide one themselves for the test.

It looks like it will have to be my primary care doc, who knows nothing about apnea. She will write the prescription, but I will have to be the one who tells her which machine to prescribe.
Quote:Also, if your titrated pressure is 10 cmH2O, I'm not sure you'll need BPAP... even using a standard CPAP or APAP, if your pressure is 10 and you set the EPR at 3, your exhalation pressure will be 7, which is very, very low.

If you can't breathe out against a pressure of 7.0 something is wrong

Oh, yes, something is very wrong.

I have a bad injury to my midback/diaphragm area. I can only stand or sit up for about 5 minutes per day. It's been 25 years and it has not healed. One theory is that apnea may play a part in the difficulty healing, along with a congenital problem with connective tissues and childhood exposure to dioxin.

My doctors are still trying to determine exactly what is preventing healing of that and other injuries. Treating my apnea is part of figuring it out and getting me back on my feet.

In that case, your doctors will probably assist you in getting the device you need, even a bilevel APAP. If you can not tolerate exhalation pressure, then the bilevel devices are what you need. You seem to have the medical history to back up almost any claim.

Trying out various settings while awake is quite revealing. Just imagine waking up to discover high exhalation effort required. I test my mask every night before sleep at 14 cm/h20, and I really do not like to breathe out at that pressure. I can do it, but it annoys me. In fact, this discussion just stimulated me to decrease my settings from 6-14 to 5-13 to try to increase my comfort, now that I seem to have controlled my obstructive apnea for the time being.

I just googled for "requirements for bpap", and found this, from the notorious provider Anthem, formerly Blue Cross I think: http://www.anthem.com/medicalpolicies/gu...053668.htm and this doc suggests that sleep oximetry (measurement of blood oxygenation) can be used to justify BPAP. The document also mentions the partial pressure of Carbon Dioxide (paCO2).

If you have a problem healing, then I predict your docs are going to want to maximize your blood oxygenation, particularly during sleep when much healing occurs.

Good luck.
My age is none of my mind's business. --- Netskier
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#42
(03-20-2012, 05:38 PM)greatunclebill Wrote: wow.... i went from totally clueless to totally overclued. thank you very much for this.

you're correct about bipap/bpap now that i understand it. my old second generation respironics cpap with c-flex says bipap on the bottom of the machine. of course i knew it wasn't what i thought was bipap and had read that bipap was a respironics name. i wondered about that.

Overclued, eh? I love your term. I aspire to be overclued when I grow up.
My age is none of my mind's business. --- Netskier
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#43
(03-20-2012, 09:05 PM)Netskier Wrote:
(03-20-2012, 05:38 PM)greatunclebill Wrote: wow.... i went from totally clueless to totally overclued. thank you very much for this.

you're correct about bipap/bpap now that i understand it. my old second generation respironics cpap with c-flex says bipap on the bottom of the machine. of course i knew it wasn't what i thought was bipap and had read that bipap was a respironics name. i wondered about that.

Overclued, eh? I love your term. I aspire to be overclued when I grow up.

LOL........
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#44
(03-20-2012, 09:03 PM)Netskier Wrote: In that case, your doctors will probably assist you in getting the device you need, even a bilevel APAP. If you can not tolerate exhalation pressure, then the bilevel devices are what you need. You seem to have the medical history to back up almost any claim.

Quote:One would hope. The problem i keep running into is that, because the docs don't know exactly what is wrong, they can't give me a diagnosis code. And, to the insurance company, no diagnosis means nothing is wrong. The fact that I can't walk is irrelevant.

In fact, this discussion just stimulated me to decrease my settings from 6-14 to 5-13 to try to increase my comfort, now that I seem to have controlled my obstructive apnea for the time being.

I'm glad it was helpful to someone besides me Smile)). Plus, now greatunclebill is overclued Smile).

Quote:I just googled for "requirements for bpap", and found this, from the notorious provider Anthem, formerly Blue Cross I think: http://www.anthem.com/medicalpolicies/gu...053668.htm and this doc suggests that sleep oximetry (measurement of blood oxygenation) can be used to justify BPAP. The document also mentions the partial pressure of Carbon Dioxide (paCO2).

Thanks!!!

Quote:If you have a problem healing, then I predict your docs are going to want to maximize your blood oxygenation, particularly during sleep when much healing occurs.

Good luck.

Thank you Smile)). I hope some good will come from tomorrow's appointment.

BTW, does anyone know why the smilies vanish from my posts? The extra parentheses are their remnants. I have NOT checked 'disable smilies'.

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#45
Well, my Dr. appointment was cancelled due to an overnight snowpocalypse, so I will have to wait a week or two. Just in case any of you were waiting with bated breath <winky>.

It just gives me more time to pester the DME folks!
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#46
Hi everyone Smile.

After many, many calls, I got a hold of someone at the DME place. They have both the PR System One REMstar BiPAP Auto with Bi-Flex and the S9 VPAP Auto BiLevel machines available for rental, at a cost of $350/month (out of pocket).

So I can get my doc to prescribe one of those for the home test. I have an appointment with her 3 hours from now.

Any suggestions on one over the other? Does one have a lower minimum for exhale pressure? That's my main concern. I will be looking for the answer online, but just figured one of you might happen to know -- plus you will know differences i don't even think to ask about, that matter for users Smile.

You folks have been awesome Smile. I look forward to the day when I am an expert user and can help other newbies the way you have, me Smile.
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#47
These questions are important but with so little time Im not sure you will get the help. I havent used any of these machines so my advise is write down your questions now so you wont forget when the time comes to ask, also dont be hurried look over both machines and ask as many questions as you like as its you who's using it. Good look and I hope all goes well.

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#48
Well, my doc was 2 hours late for a one-hour appointment, spent 10 minutes with me, and said she 'did not have time' to write the prescrip for a test machine. This after no-showing for 3 appointments and cancelling the 4th.

She has been our family doc for 25 years, but I don't know what is going on with her right now.

Sigh.

I have another appointment for two weeks from now. But maybe I should start looking again for online options.
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#49
(04-06-2012, 12:40 AM)nila Wrote: Well, my doc was 2 hours late for a one-hour appointment, spent 10 minutes with me, and said she 'did not have time' to write the prescrip for a test machine. This after no-showing for 3 appointments and cancelling the 4th.

She has been our family doc for 25 years, but I don't know what is going on with her right now.

Sigh.

I have another appointment for two weeks from now. But maybe I should start looking again for online options.

How frustrating, to put it mildly. There has to be something wrong because writing a prescrip is part of a doctor's duties and shouldn't take more than 30 seconds. Changing doctors isn't always easy but you might want to look into it since this doc has not been reliable for the past few appointments. You need a doctor who will be there when you have health issues.
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#50
Thats shocking! Not sure about the states but that doc would be in deep water if she was over here, with a risk of being struck off for such behavour. I would drop here like a stone. What is the point of having a doctor that doesnt have the time for thier patients, Cant believe that a doctor could behave so badly......Thumbs-down-1

Get another doc
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