The irony of justifying CA therapy
As someone who is now faced with the herculean task of documenting, justifying, and obtaining the appropriate equipment for treating Complex Apnea, I must say how disturbing it is to read this in the Wiki page
http://www.apneaboard.com/wiki/index.php...P_Machines
"The new member that has been advised they have central or complex apnea needs to be aware that optimizing may provide significant immediate relief from symptoms and improve AHI, but improved therapy results can [b]disqualify them from higher levels of therapy[/b] (ASV), that might be possible without this self-optimization. Sometimes individuals resolve central and complex apnea with CPAP and find long-term comfort, however, if results are inconsistent, or produce good AHI but not comfort or relief from other symptoms, The forum optimization should be [b]discontinued as soon as possible to avoid disqualification from higher levels of therapy."[/b]
It is an excellent wiki page, and very useful. And I know what it says is accurate as well. But the irony in what its suggests we must do to get proper treatment is truly disturbing. What a shame the healthcare industry is tailored to the almighty $ instead of getting people the therapy they really need.
RE: The irony of justifying CA therapy
Ultimately, the insurance company is in control. Unfortunately, it is game-like that people who choose to take charge of their own health care, and still have to play by the insurance and doctor rules.
Best thing about this forum is that much experience exists here and is free for the taking. Anyone that wants to play the "game" will have all the strategy provided to him or her so that the chances of getting the best possible treatment are as high as possible.
Jesse
07-21-2019, 04:06 PM
(This post was last modified: 07-21-2019, 04:07 PM by Croweater.)
RE: The irony of justifying CA therapy
The "strategy" you refer to involves pretending like I am trying to do everything the doctor wants me to do with my cpap machine, while at the same time avoiding the actual steps that might render that cpap useful in any way?
In the interim, which may take months, I must continue to suffer sleep deprivation that has plagued me my entire life. And ultimately, they may decide to not give me the ASV at all.
(Sigh)
07-21-2019, 07:11 PM
(This post was last modified: 07-21-2019, 07:16 PM by Gideon.)
RE: The irony of justifying CA therapy
Sorry, I just said it like it is.
I felt that it is important to understand the journey you may be traveling down.
I do like the concept of somewhat leading your doctor. "When do you feel it would be appropriate to "trial" the ASV? What do "WE" have to do to get there?"
"How should WE treat this Central/Complex Apnea?"
RE: The irony of justifying CA therapy
(07-21-2019, 04:06 PM)Croweater Wrote: The "strategy" you refer to involves pretending like I am trying to do everything the doctor wants me to do with my cpap machine, while at the same time avoiding the actual steps that might render that cpap useful in any way?
In the interim, which may take months, I must continue to suffer sleep deprivation that has plagued me my entire life. And ultimately, they may decide to not give me the ASV at all.
(Sigh)
I wish it weren't the way which you have spelled out, but it is. I can write all day long on this topic but it's mostly been written in other posts and threads. The important thing to note, is that you know about what the system is going to run you through, and in order for you to get the machine you need, you have some upper hand in doing the manipulation that may be necessary.
(07-21-2019, 07:11 PM)bonjour Wrote: Sorry, I just said it like it is.
I felt that it is important to understand the journey you may be traveling down.
I do like the concept of somewhat leading your doctor. "When do you feel it would be appropriate to "trial" the ASV? What do "WE" have to do to get there?"
"How should WE treat this Central/Complex Apnea?"
Doctors need guidance from patients. I think doctors should recognize the importance of having an informed patient and welcome the informed patient.
Jesse
RE: The irony of justifying CA therapy
On the other hand, quite a few members have simply purchased the ASV out of pocket and let the doctors catch up when they may. It's a huge investment. Knowing that you're playing a game with rules designed to make you fail, gives you an advantage, very few have. At least you know what you need, you just have to show the "professionals" what they don't want to acknowledge.
RE: The irony of justifying CA therapy
I had a conversation with a DME once concerning the purchase of machines and specifically, we talked about patients buying machines such as the ASV. Resmed ASV machines have a fixed CPAP mode. Technically, if a patient has a prescription for a fixed CPAP pressure, the DME can sell the machine at a fixed pressure CPAP setting, and still be within legal bounds. So long as the machine goes out the door with the proper prescription settings, DME is doing their job.
So, for example, if you have a fixed CPAP pressure prescription, theoretically you can buy any machine you choose. Let's say you need 12 cmw fixed pressure, you could select any Resmed machine, as they are all capable of supplying fixed CPAP pressure. I discovered this technicality in my search for a laboratory machine which will produce any mode at nearly any pressure. If I had the $8000 necessary to buy the machine, I could have bought it, as it will be set for APAP 7-20cmw, which is what my prescription reads.
The snags include; getting a doctor's order for a fixed pressure CPAP, and working with a DME to purchase the machine.
I know there is plenty of debate possible on this method, but, I want to put it out there. It's possible.
Jesse