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Strategy for trying on masks at the DME?
#1
Strategy for trying on masks at the DME?
When I pick up my APAP from the DME, presumably I will be picking out a mask. I'm assuming the time allotted for this isn't unlimited, and there are so many models..Masks can't be swapped out indefinitely for other models, either, so homing in on likely candidates is important.

I am anxious to have an auspicious mask-fitting...

Where should a newbie even begin the trying on process at the DME?

Did you go to your first mask fitting with a plan?

Did you try on 20 and look more closely at 3? You looked at them on the wall, picked one out, tried it on and BINGO? Or how did the process go for you?

What kinds of manipulations did you experience from your DME regarding mask fitting? I'm anxious not to get ripped off.

Are there elements of mask choice that are specific to Medicare recipients?
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#2
RE: Strategy for trying on masks at the DME?
They will likely have a limited supply on hand. They will ask you some questions and try to steer you towards what they think you need. They'll take some measurements to select the right size. I started with what they brought to my home, then switched. Both were nasal masks, but I decided after that that I wanted nasal pillows. They tried to talk me out of it but I insisted. I had to go in for a fitting for that.

A year or two later I switched to a full face mask and had to go in for that, too. Tried one, then went back for another fitting to make a switch.
Sleepster
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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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#3
RE: Strategy for trying on masks at the DME?
I went in knowing I wasn't a mouth breather and really wanted nasal pillows. They just handed me the most popular (P10).

I don't think there is any limitation by Medicare on your mask selection, but you only get one mask every 6 months. In addition, some DME's do not appear to understand that you are eligible for an ADDITIONAL mask front (no headgear) every 3 months. The Lincare office understood, but I could not get them to understand at the warehouse, so I just got a backup piece through the office.
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#4
RE: Strategy for trying on masks at the DME?
If you are a mouth breather try Full Face Mask, it is THE traditional way to "fix" Mouth Breathing. There are other ways to manage mouth breathing.

Strategy:  Always take YOUR system into a mask fitting.

As you are aware Masks are extremely important to therapy.  They are the portion of the system that you wear, that Interfaces you to the system.  It is extremely important that your mask is comfortable and leek free.  You MUST try masks on,  each of our faces are different and despite how much "Fred" says this or that mask is the new incarnation of a toaster and works extremely well for him it may not work at all for you.  

You mask trying should start at the Sleep Lab/Clinic when they go to put a mask on you for your titration study. This is likely your first time ever wearing a CPAP mask.  
When you go to pick up your equipment the DME will give you a mask (frequently without asking you anything).  This is commonly your second opportunity to try masks on.

From the Mask Primer (read it)

Mask Primer
Getting the right mask is one of the hardest parts of PAP therapy. This article is intended to help guide you through your choice of a mask.
First, all masks can and do handle all pressures associated with PAP therapy machines, this is from 3 to 20 (CPAP) or 25 (BiLevel/BiPAP) cmH2O.
Second, each of us has a different facial structure. This means that what works for me may or may not work for you, and what works for you may or may not work for me. You have to TRY the masks to see what works for you.
Third, You will have to try masks to see what works for you.

I’m going to call out 1 particular online vendor for 2 reasons. First they list masks by popularity within the mask type. This means that you can assume that the more popular masks work for more people. The second is that they offer “return insurance”, some free, some low cost, so that you can return a mask that does not work for you. That Vendor is Supplier #1
Your DME is an excellent resource to try different masks. Use them for this purpose. Make an appointment for a mask fitting, under pressure, and preferably lying down in sleeping position.. If you are using a DME it is their job to help you use your PAP system for effective therapy. If the mask doesn’t fit or is extremely uncomfortable they are not doing their job.

A Mask Trial Strategy
First, even a mouth breather may be able to use ANY style of mask, even the simplest, most unobtrusive, Nasal Pillow. See the Mouth Breathing section to see what to do.

Try masks from the most unobtrusive to the biggest bulkiest of masks. This would typically be starting with Nasal Pillows, Nasal Mask, Hybrid Masks, then finally the Full Face Mask. The smaller masks that you start with leave you with less mask on your face and more visibility.  
Finally, as I have said before, you have to try masks on, under pressure, and preferably lying down in sleeping position.
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#5
RE: Strategy for trying on masks at the DME?
(09-17-2017, 07:13 PM)Mosquitobait Wrote: I went in knowing I wasn't a mouth breather and really wanted nasal pillows.  They just handed me the most popular (P10).  

I don't think there is any limitation by Medicare on your mask selection, but you only get one mask every 6 months.  In addition, some DME's do not appear to understand that you are eligible for an ADDITIONAL mask front (no headgear) every 3 months. The Lincare office understood, but I could not get them to understand at the warehouse, so I just got a backup piece through the office.

If I can get an additional mask front in 3 months, does that mean of the same mask? Or could I get, say, a nasal pillow front, when I currently use a ffm? Then I could just buy the headgear myself and have 2 different masks on hand.
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#6
RE: Strategy for trying on masks at the DME?
Oh boy.

1. Do not count on them fitting you properly. (ask me how I know)

2. Go in informed about mask types and specific ones that look interesting to you.

3. Go in already knowing what size you would be for any mask that you are particularly interested in. Visit the manufacturer's website, there are usually sizing guidelines or templates that you can print out (be sure it prints to scale, which will be printed on the template).

4. Do NOT count on them fitting you properly. I'm nearly 2 weeks into it, ONE DAY of which has been spent with the correctly fitted mask. And I am the one that found out what size it needed to be by looking at the template myself.
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#7
RE: Strategy for trying on masks at the DME?
Check the Mask Primer for the Medicare Replacement Schedule

It also has fitting guides for many masks.
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#8
RE: Strategy for trying on masks at the DME?
Also, forget about being courteous.

My DME was aware of the problems with my first mask (which included, but was not limited to, a sizing issue), and I regret being courteous towards his scheduling issues and time constraints. Which left me disadvantaged for way too long and compromised my therapy. I very much regret the delay in my becoming pro-active and advocating for myself. Please do not make the same mistake that I made.

...and the Mask Primer is awesome!
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#9
RE: Strategy for trying on masks at the DME?
(09-17-2017, 07:13 PM)Mosquitobait Wrote: I don't think there is any limitation by Medicare on your mask selection, but you only get one mask every 6 months.  In addition, some DME's do not appear to understand that you are eligible for an ADDITIONAL mask front (no headgear) every 3 months.

Other insurance companies pretty much follow Medicare guidelines. With mine I get a new hose and a new mask complete with headgear every three months, new mask cushion every three weeks. Water tank every six months.

If you think your DME is not following your insurance company's requirements, tell them that, and contact your insurance company to make sure. The DME may have a very limited selection, in which case you may have to switch DME's or at least threaten to. It's amazing how they can go from a state of ignorance to a state of knowledge when you tell them these things. When it comes to CPAP therapy you really do need to be an educated consumer.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#10
RE: Strategy for trying on masks at the DME?
That is pretty interesting how that, or some similar phrase works wonders. "OK, well I can look elsewhere.." BLING... the DME becomes super helpful... I pulled that one on doc and DME when they were dragging their feet on getting the recent ASV order processed BTW, so I know it works.

As for masks and choices, you've already heard great advice. Read the Mask Primer, find out what your DME has ACTUALLY available, Google to research your list, take possession via the DME. Then get a  Coffee
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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