MrGadget Wrote:Going to add to the descriptions here. I was referred to St Elizabeth's in Belleville, IL for a Sleep Study. Dr. took one look at me and said I had Sleep Apnea due to the shape of my jaw. Did a split night and the Nurse woke me up to start trying on several masks, saying she was worried that I was going to die in her lab, because my Apnea's were so severe; such a nice thing to mention to the patient. Anyhow, meet up the Dr. a week or so later, he circled some stuff on the printout and proscribed a machine, but didn't really go over anything with me like Obstructive or Central and such, except that I should loose some weight, maybe the fact that I was retiring in 9 months and moving from the area could have been a factor?
My DME is Optigen (in FL) who handles all of the Military/Tricare accounts, I think all of them around the world. The RN that they sent over with the machine happened to work in the clinic I had the study done in; or had, she had just quit the clinic to work for the DME, and now covers a lot of area in the midwest, very nice lady. She was outstanding, spent time with me and we worked on several masks for a week or so to get one that worked at my high pressure and didn't give me pressure sores on the bridge of my nose. I noticed a huge difference in quality of life once I was getting proper therapy. I guess it helped that I wanted to learn as much as I could. DME has been great so far, sending masks regular and even when one went missing from my doorstep, the immediately sent a replacement. I've since moved and am about to try a new mask and will see how it goes in my new location.
I'm also dealing with the local VA hospital and they seem nice, trying to help, but they were a little surprised at how knowledgeable I am about the machine I have, they don't have the software or capabilities to download my machine, so when I brought the printout in they were surprised and happy to add it to my file, or at least happy to add the compliance data .
Biggest thing is it really depends on the people that you interact with. Some are great, some are OK, and some are hesitant if you know more info then they do. As long as someone doesn't try to keep me from learning or tries to obfuscate or hide info from me, I really don't care. But it is nice to deal with nice people who genuinely care and try to help you, and you always get more with honey then with vinegar.
wesnkat Wrote:My dme was ICare of Arkansas in Little Rock,Ar
Sleep Doc was Paul E. Wylie
DME people were a little slow understanding I had to have a FF mask, After trying 2 nasals I had my doctors nurse give me a script written for the ff mask.
The tritration study was super,great tech,super clean and comfortable room.They had shared bath but that was no problem.
The doc came in the next morning and explained what had gone on with study pretty well. Then asked if I had a dme that I prefered,but not having the least idea I just went with the closest one. I'm glad they gave a fully data capable machine since I wouldn't have known the difference. Since that day I have read and listened and learned mostly thru these forums from the educated hoseheads of which I am one now.
The answer to hoseheads many problems are to read,read,read and read some more.
Mari Wrote:I'm rating my second DME. The first was Garden City Home Medical in Michigan. I knew nothing and just accepted the striped down machine they gave me and they said my insurance was covering everything. One I did my due diligence I realized, 1) my machine was only able to record compliance data and 2) this DME was not 'in network' and there were going to be major charges. I took back the machine and, to their credit, they agreed not to submit any charges to my insurance company.
I called around and went with Binson's - which I think is only in Michigan - but is pretty big. I don't know what I would have gotten if I had gone in without doing homework, but I just asked if they could get me a ResMed S9 with humidifier and Climateline hose and they had one for me in a couple of days. They replace the mask and headgear every 3 months instead of just the cushions (said the cost to them is about the same) and have been professional and helpful. I have to call for replacements but they are sent directly to my house unless I change masks.
jeffy1958 Wrote:Summer 2010 had heart issues and cardiologist set up the sleep study, October, with Belin Hospital in Green Bay, WI (Go-Packers). Good place, staff was friendly. Severe (65+ episodes per hour lasting up to 40 seconds - YEAH). Sent to NEW E.N.T. just up the street. Was treated very well and was given a list of DME's to choose from. I picked the first one on the list which happened to be - imagine that - Bel-Regional which is affiliated with Bellin Hospital!!! Treated very good by "Dan" who was and is very helpful with setting up my S9 AutoSet w/H5i, climate hose and Zest Standard Nasal Mask. The only issue I had was his recluctance to share detail information and he wasn't to happy when I said I found the details on the Web. Like he is afraid he will loose his job to me. Not bloody likely!!! And the issue of "over pricing". Wow. I went to purchace an extra mask - just in case. Several days later I found the exact same mask for $100.00 less. Tried to return but no luck - health issue - whatever. All in all it was a painless and somewhat pleasant experience.
I did have a problem with my insurance company and getting them to approve purchace instead of renting. It's amazing how far a "guil" trip wil go if used on the right person. Not to mention 95% compliance from 13 Oct. to 20 Dec. Despite the fact I had to have my nose cauterized because of bleeding issue due to heart medications and a very severe cold, thanks to Afrin, Neti Pot and many OTC drugs!!! I was notified on the 23rd that they approved the purchace.
Now I'm ready to dive into this 100%.
Muttley Wrote:Sleep study was done by Merit in the Chicago area. The sleep study/titration was done in one night. However, the doctor would not fax the report to my primary doctor for about 2 months. My doctor finally got him to forward the report to his office. He gave me a copy and the doctor in the sleep center had the audacity to say that he would be glad to be my "sleep doctor." Moron!
My first machine arrived Fedex and from the instructions, I was able to make it work.
The latest machine (S9 Autoset), I ordered through the local RoTech affiliated medical supply company. They normally deal with Respironics equipment. However, they were willing to order the equipment for me. When it came in, I picked it up and took it home.
End of story. At least it was not a LinCare horror story. Do no harm, I guess. We learn to be self sufficient and use Boards too.
Now all I have to do is deal with an online CPAP equipment supplier whom I love to work with for hoses, filters, and mask parts.
edmoreh Wrote:Hopkins in Baltimore is more than helpful for standard cases. They call you every 3 months for supplies and preformed maintenance on my cpap for mininal cost out of pocket.
Hopkins Sleep Center ( Howard County General Hospital) is great all except for the shower facilities, I can report more on that when I come back from my sleep study on Tuesday.
Dpm708 Wrote:My first sleep study was in Jan of 2007 at my local hospital where I happen to be employed coincidently on the night shift. They were great. Went to Dr. in about a week and told about obstructive apnea and that I would need a CPAP. That's about all I can recall.
My DME provider must have a deal with the hospital/Doctor because they contacted me about setting up an appointment. There were 3 DME's in my area at the time. If I had a preference, I wasn't asked at that time. DME came to my home with a RemStar Pro 2 w/humidifier and full mask. Person was very good, explained a lot more than the Dr. did and was very helpful. Had mask trouble at first but made an effort to use machine, especially on the night I was at home. (no brusied ribs ! ) I shouild add that my wife did complain alot about my loud snoring and sudden frequent apnea. Fortunately for me, my Ins paid for everything. I put 618 hrs on the machine......
Flash foreward to Jan 2011. After much coaxing (complaining) I submitted to another sleep study. Same hospital sleep center but in a new off site building. Same really nice folks.(Yes, thank God, I am still employed, 34 yrs this year at the same hospital) Study went well and I still have obstructive sleep apnea. Staff did a little more explaining about AHI events and such. Still waiting to see Dr. Have same DME provider because the other two went out of business. Actually these folks turned out to be pretty good anyway as my son needs DME supplies on a monthly basis and they have been fantastic with the help they have given him. Anyway they came Feb 20 with new ResMed S9 and H5I Humidifer. RT person was good and answered my question accurately. Machine setup was easy and straight foreward. Since I like technology, I wanted the means to look at my CPAP info which is how I found the Apneaboard !!!!
Hopefully I can maintain therapy consistantly enough to keep my wife happy so as not to keep her awake too much and to persue my personal goals and lose a few pounds to maybe reduce my obstructive apnea.
Best of luck to all.
PtownKev Wrote:Had a split night sleep study at SleepMed in Hyannis, Mass. They have a small satellite office there with just two patient rooms. It's not luxurious but it was very clean and pleasant. The tech was very nice and had many years of experience doing sleep studies. He explained everything very thoroughly. I had expected to wait several weeks after the first study to find out the results and next steps, but my doctor had the report in a few days and called to tell me he was referring me for a follow up for titration. I ended up having the same tech the second time around which was nice--everything was quite familiar by this time.
A few days later I got a call from my doc that he had written a prescription for a CPAP and the same day the DME (also SleepMed) called to set up an appointment. After reading horror stories on this site and on other boards, I got concerned about what kind of equipment the DME was going to set me up with. A couple of days before the appointment I called and spoke with the respiratory therapist that I was going to be meeting with. I asked her what machine she planned to bring for me and she told me the REMstar Pro. I was very relieved! I was already pretty familiar with the machine from reading about it online, but she went over all the features, had me try several masks, explained all the cleaning and maintenance of the equipment and made sure I had all of the contact info in case I had any questions. SleepMed handled everything with my insurance and since I had met my deductible for the year, I had no copays. SleepMed has a program where they'll send me replacement equipment automatically according to my insurer's replacement schedule, which I plan to sign up for. All in all, it's been a very easy experience.
zimlich Wrote:I am in Norfolk, Virginia. The DME I use is in Newport News, VA., Roberts Home Medical. They also have other branches. The RT that takes care of me is why this a 100% match. He took a lot of time getting me settled with a mask, sometimes bringing over three or four to let me try them out. He also responds to my level of education and interest. He understands I know how to change my own settings and is comfortable with that. He keeps up with the latest equipment and has a thorough understanding of the different machines I have used. He knows I only want a data capable machine and makes sure I always have one. Everthing I need is taken care of in a timely manner. He keeps up with his education and goes to many seminars
The Sleep Center I use is Bayside Sleep Center in Bayside Hospital in Virginia Beach, VA. They are totally professional and explain everything that will be going on during setup and the night. If you have to use the BR they are right there. The rooms and beds are comfortable. The temperature is adjusted to your comfort. I've had three sleep studies there and was pleased with the staff.
My Doc works at this Sleep Center, and though I think he's very good he's having trouble getting me properly titrated. He's very attentive and listens to my concerns for the most part. I sent in a data card with dismal numbers- AHI near or over 20, AI high single digits (this was after a titration in the lab) and he decided not to adjust anything at that point. The next thing I hear from my DME is that he has ordered a two night pulse ox which didn't make any sense to me as I had not desaturated below 95% during my recent sleep study. I just finished that so we'll see...He's kind of scratching his head and I've taken over my own titration at this point without his knowledge since he did not respond to my last request for help with any adjustments, just the pulse ox.
I did not rate this Doc or Sleep Center-I also went to Dr. I.A. Barot in CHesapeake, VA. He runs his own sleep center. I found them less than professional, though they are accredited. During one of my sleep studies the pulse ox didn't work so they just
didn't use it. I had a great deal of trouble getting Medical Records from them, and in fact records that were requested were not sent out though they assured me they were. I left his practice when he just kept jacking up my pressure and I started to get the bumbs rush out of the office. He would go straight to the tech and tell him in front of me what changes to make while not saying a thing to me. I believe his practice just got too large with long waiting times and short office visits. He fired me for being "rude" to his staff over medical records. I prefer to think I was being assertive, as there were many unreturned phone calls, as as I said before the records did not go where they needed them (to my ENT).
moeschmoe Wrote:My DME is very thorough and will take the time to listen and answer your questions. They want to make sure you're happy. They even cut me a deal on an auto cpap machine because the insurance wouldn't pay for it. Which leads me to my doctor...ahem former specialist...
During my adjustment sleepover, the tech told me that I probably was not titrated properly the first time. And you know what, I posted the story of my doctor on another thread because I didn't know this thread existed. So if you haven't already read it, it's here:
moeschmoe (copied from another thread) Wrote:Hello
Okay so my story is a little irritating and I'll describe my situation before getting to the topic title of this thread. I was titrated last August to a fixed pressure of 7 cmH20. I was always interested in my stats and I paid attention to the AHI setting. I was unaware of what that number meant in terms of the categories of ranges that would have you labeled as having no OSA, mild, moderate, or severe OSA.
So my AHI was around 7 or 8 and sometimes it would spike to 10 or so but that spike was due to me having a cold. As cold and flu season loomed, I noticed that my AHI got worse but it would typically go back to normal after feeling better. I remember it going lower than 5 for a seven day period. Then I got bronchitis and my AHI went through the roof (49 in a 7 day period). One month after, my AHI was still at 10-15 and it was very difficult to function throughout the day.
So I get an appt with my doc and he increased the pressure to 8 and ordered a sleep adjustment. Before the adjustment session, he consulted with my DME to order an Auto Titration machine. The DME got back with me and said that the insurance won't pay for it because they already paid for one, and they'll pay for one every five years.
The fixed pressure setting of 8 felt better but it wasn't enough. So I go to my sleep study and the technician tells me the morning after, that I was snoring at 10 cm h2o and that I did my best at 12. About a week later I get a call from the sleep specialist, and they said that the doc ordered a permanent auto cpap with a pressure range of 8 - 11 cm. I am also to meet with him this Tuesday.
Can you already tell I'm approaching wit's end?
I decided that I'd pay for the auto machine out of pocket because if that's what the doctor ordered, I'm going to get it even if it is expensive. The DME worked with me and gave me a $300 discount, so I decided to go ahead. I really want to ask my sleep specialist if he'll help me pay for it.
Now comes the question relating to my topic title. Every so often, my DME sends me a new card and I submit my current card back to them. With my fixed pressure machine, I did it a couple times at the beginning and then I never heard back from them until they gave me a card that increased my prescription. Now with my new machine, I have to send the card back to them in May. And I still have my fixed cpap machine.
Thanks to this site, I learned how to adjust my settings. My concern is, if I do end up changing my settings, WHO will notice WHAT changes based on the data card, between the DME, specialist, and insurance company? What if I do not send the card in? I have my own machine I paid out of pocket that I can adjust myself without the card in it.
I've made a decision to try to grab a copy of my test results and find a new sleep specialist whenever I think I need to see one.
The technician who worked with me during my most recent adjustment said that I was likely not titrated properly the first time. Also when I met with my doc that got him to increase the pressure to 8, he was busy typing while I was talking. Noticing that his mind was elsewhere, I asked him what information was pertinent to him, and he said that it didn't matter to him--he took my word for it.