(05-16-2014 01:39 PM)kderevan Wrote: Well, retired_guy, I am thinking this is what I should do. Honestly, I am so frustrated and near tears over this. I went to this sleep lab and put myslef in their hands for diagnosis and a treatment plan. When the treatment plan doesn't seem to be working quite as well as it should, I call them to ask for help, and instead of helpful suggestions, I am accused of breaking the law and then told that AHI's of 4-9 seem "pretty good, actually." Well, maybe that is pretty good, I don't know. I'm new to this. But since "normal" is supposed to be 5 or less, I'm thinking I would at least like to be in the normal range every night. Is that unreasonable? That's not a rhetorical question--I really want to know if I'm expecting too much. I can't trust the DME guy to be honest with me, which is a damn shame. THEY know all this stuff--they have been in business for 15+ years. I was truly hoping to have a partnership with them for the long term to get this apnea thing under control. Instead, I'm tired, cranky, not thinking straight, and don't know where to turn (except HERE and thank goodness for this place!).
I don't want to be underhanded or screw anybody--I just want to be treated adequately so I can wake up and think straight. If I get my PCP to write the prescription as you said, how does that work with the insurance company and all? They are renting my machine, so it seems like it would be logical to assume that any time in the first 10 months (the rental period) the DME might expect to have it returned. Certainly, if the insurance company found that I wasn't complying with treatment, they would take the equipment from me and return it. The DME told me that I had to be 70% compliant for the insurance to pay. I have been 100% compliant--my stats show a bit less than that, because I had a few sleepless nights this week after trying to quit ambien, so no sleep=not enough hours on the cpap. That is 2 days out of 70 that I haven't put in the required hours on the machine.
Sorry I am rambling. I am a confused mess. I want to call the DME again and tell them how disappointed I am, now that I've had time to think about it, that they are so unhelpful. But I doubt they would care. Also, I'm supposed to send in my SD card for them to read, but I don't know if I trust them to even do that right.
(05-16-2014 01:58 PM)kderevan Wrote: I am sorry to seem like I'm asking the same questions after I've already had good answers. I truly feel like I can't think in a linear fashion right now, from lack of sleep and sheer frustration!
Do you mean I should just go ahead and raise the pressure myself? I understand there are instructions on the site for that. So it seems that I can't count on the DME for any help--I guess I should have known that!
Kathi, all of this stuff and nonsense will work out for you very soon. Just try to un-stress and know you're doing just exactly what you need to be doing.
So yes, by all means go have a quality conversation with your GP. There is no reason on earth why he should not simply write a prescription for an automatic machine for you.
Then, by specifying a limited range around your current pressure of 11, you can use the machine to explore what is right for you, in your own home, in your own bedroom.
The other thing I would do when you get your machine, and the DME dipstick should be more than able and willing to do for you, is to set the EPR on. This feature makes it a little easier to breath out by reducing the pressure on exhale. I think this would be beneficial for you because the one concern I have seeing your current numbers is you are already experiencing central apneas. Sometimes when you start moving the pressure upwards the obstructives will go down, but the centrals will go up. In my completely uneducated opinion setting the EPR on may help ease that transition.
I would agree that a small increase in pressure on your existing machine would seem to be an acceptable thing to do at this time. My only concern is we don't want to simply trade obstructive for centrals, so keep the increase small.
But mostly go see the doc. Get the prescription and let the DME sort out the issues with the insurance company. That seems to be what they like to do best anyhow.