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Results input sought before visit to (untrustworthy) DME on Tuesday
#1
Results input sought before visit to (untrustworthy) DME on Tuesday
Greetings all!

I'm due for a followup visit with the DME technician on Tuesday. I have half a mine to cancel the appointment because this person has already tried to pass off a used machine as brand new. (I purchased it out of pocket, not through insurance). So, I'd like to be armed with more insight before I have my appointment. The machine is a Resmed A10 set for pressure of 4 to 12. 

So, with that in mind, I'm posting a screenshot of a night of sleepyhead data for expert review. If anyone has time to glance over it, I'd appreciate it.  I'm not sure I'm posting the best view of the data, and if there's a better way to organize/upload it, I'm happy to do so. 

Best regards,
Doug

   
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#2
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I would probably set the minimum pressure to 8cm just for better airflow. That would give you a EPAP of 5cm and I think you would notice it's easier to exhale.

Otherwise your numbers are good and you don't need any adjustments for events.
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#3
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
Your AHI is under 2, Awesome!!.  
With this success you want to make your changes slowly.  My thought was to raise o 6 min which would make no difference in your therapy and maybe to 7, with the possibility of going to 8 after seeing how that worked out.

Normally I would suggest no changes over .5 because of your results but you are low enough that 7 would really be about that much change.  Did I say that I tend to be a bit more conservative than others here.

The question is How do you feel?  How is your mask working for you? (I didn't see any significant leaks)

And why are you going in?  I'd expect an atta boy (you are under 5 AHI), you are doing great, goodbye visit.


Fred
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#4
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I agree with minimum pressure of 7, because you are using EPR 3 Full time, so that would make your starting pressure 7/4, and your EPAP pressure will rise -when you need it to. Your current starting pressure of 4 with EPR 3 keeps your exhale pressure too low to respond quickly to OA events. Auto mode at 7-12 with EPR 3 should be very comfortable and effective, and your pressure will not move around so much.

Your therapy looks pretty good, and other than the obstructive cluster around 02:15 your night looks pretty tranquil. The higher minimum pressure may well resolve that issue. If not then we can look at a positional issue. What is the objective of this follow-up visit?
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I suspect the objective of the followup visit is so that they can take more money from me... If that seems overly cynical, it's only because I have had essentially zero value from them and one attempted fraud!
Part of the deal in buying the machine from them (as distinct from online) was that they offered free mask swaps until I got one that worked well. What they failed to mention was that a visit costs $60, which is well on the way to the cost of a new mask! I *hate* being nickel and dimed by small print. I did get one swap over-the-counter without cost and I'm reasonably happy with the one I have now (Airfit P10).

I do sometimes waken with a painful sensation in the back of my throat. I think it may be dryness. A drink of water helps, and I think I may have improved that by increasing the humidifier almost to the max setting.

This board is a much better, more caring, resource than the two DMEs I've had experience with.
Doug
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#6
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
(02-18-2018, 02:07 PM)DougM Wrote: What they failed to mention was that a visit costs $60...

What the... ?! That is the first time I've ever heard of a DME charging for their service. The device costs more to purchase from them because you are paying in part for their service. But to pay again?? I've gone to 2 DME's and neither one charged anything for their service.

edit: If you do not have a defined goal (of your own) for this appointment, then I would consider not going at all. Of course please read the guidance from the other more experienced (and probably more reasonable) people here. I can be a little hot headed at times.
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#7
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I believe you have been taken for a ride around the park with this DME.  I suggest you cut your ties now before handing over any more money.  

You can use the Supplier list above and order masks for trial for 30days minus shipping costs.  You can also find masks reasonably priced on Amazon.

Your graph looked good, but I agree with the suggestions above of raising your minimum presssure to 7cm.  You can keep EPR at 3 or lower to 2.

Good luck and hopefully you ditch the DME, especially since you didn’t use insurance.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I did cancel that appointment after establishing that they had no intention of doing a detailed review of data. What a rip-off. 

Later in the day, I received an email offering an on-line follow-up by skype (or similar). They really really want more of my money!

I passed on that too...

cheers
Doug
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#9
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
I think you need to name and shame so other forum members can avoid this particular DME.
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#10
RE: Results input sought before visit to (untrustworthy) DME on Tuesday
In due course. I've asked a message to be passed to the owner to give me a call to discuss my experiences. We'll see if they call...
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