RE: You CAN Adjust your own CPAP Pressure
Please don't get me wrong, I do get and see the point you are making here and I did go back to read your post and clarified that you were speaking of an individual changing the pressure on their own machine. I have to say that I strongly disagree with that, also. Not because that I feel that a person doesn't know their own body and/or needs or that a person should not be able to receive appropriate help and care due to costs and affordability. I disagree, because the lay person does not know how much pressure their airway requires without causing other issues, such as inducing central apneas and/or cardiac arrhythmias. Just because the machine belongs to them, doesn't mean that it is ok for them to self diagnose and treat themselves. If they have a prescription from a doctor for a pressure change and they change the pressure themselves to that prescribed pressure, then more power to them, I really don't have a lot of problem with that, but if they are a patient with a DME provider who provided the machine and whom they get regular service and supplies with,,the change does have to be documented in that pt's medical record for purposes, such as, Joint Commission reviews. They can walk in a DME at anytime and pull a chart randomly and request to visit with that patient/person and everything must match up with the documentation....that's another trail to go down...lol. Anyway, I do get what you are saying, but that person's condition changing that makes them feel they need more pressure really should be evaluated by a medical doctor,,just to make sure that there is not bigger issues that wouldn't require more than a slight pressure change on their current machine. They could've nailed their issues and what they need on the head, but then again, their condition could've progressed to the point of needing a completely different type of machine or possibly even requiring supplemental oxygen to be bled into their current machine. If a pharmacist gives someone a whole bottle of pills, that doesn't mean it is ok to alter the dosing just because the desired results are not being obtained. Taking more or less than what is prescribed, may achieve the desired results, on one hand, but create other problems on the other hand. The same with an emphysema patient who becomes short of breath and they check their own O2 levels with their own pulse oximeter and find it to be low....their symptoms and oximeter reading makes them feel that increasing the amount of oxygen, prescribed by the doctor for them, needs to be increased....that would make common sense to many people and why go to the doctor and create more expense when the oxygen delivery device has been purchased or rented for them and is in their own home, so they manipulate the settings to what they feel is best for them. What they don't know or see in this, is the entire picture, and increasing the oxygen even just a tiny bit, can be a very deadly mistake. CPAP pressures are not something to be played around with or taken lightly, just because they are simple and easy to change. Odds are, if their machine is that old, their condition could have progressed gradually over the years, to much worse than they think, and as I said earlier, may require much more than a small pressure change. I once had one man come into our store begging me to either increase his pressure or show him how to do it, and he was positive that all he needed was just a little more pressure to solve his problems. I will admit, that in my mind I agreed with him, but I knew that I couldn't change or teach him how to change his pressures....he BEGGED me and even got a little upset because I refused to show him how. It ended up with him going to the doctor like I advised him to and he was found to have a malignant tumor in the upper part of his esophagus and it was pushing against his airway when he laid down at night. That man had flowers delivered to me, from his hospital bed, with a card thanking me for refusing to give into his requests and stated that the tumor was caught and removed in time, before it had spread to far. It was an aggressive cancer, also. I know that this situation is rare, but you can't just assume what can't be seen or verified. You also can't determine who is going to act responsibly and who is not, and believe me, I have seen many who do not, even though they think they know what they are doing. A person's change may also require them to be switched to a BIPAP or to an ASV. So just assuming a pressure change is needed and making it themselves, is not the best thing for people to do or be encouraged to do. There are reasons people are kept from the clinical menu, and most machines I deal with, say Clinical Menu, not just Clinical Set Up. Most DME companies of any worth, are more than willing to provide an auto adjusting machine for a 2-4week trial, free of charge, to assist the physician in determining the correct pressure for a patient and that company will also have their RT to adjust the pressure changes prescribed by the doctor, also free of charge. It's just good business and care for the patient to provide services like this. Each DME company I have worked for, provides free services like auto trials and pressure changes, even if the patient has never purchased one item from them. Like I said it's just good business and common courtesy for the community, so there are ways to obtain a proper pressure and pressure change for someone's current, older machine, without encouraging them to assume what they need or it costing them an arm and a leg. It's not something to play around with or tell somebody that it is ok to do.