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Unsure How to Deal with DME Today
#1
Unsure How to Deal with DME Today
Hello all,

As a brief summary of my case, I am a 28 year old male that has been battling sleep apnea since 2013. I was diagnosed with severe sleep apnea (AHI > 90) in 2013. I did a trial of AutoPAP therapy before deciding to have my tonsils and adenoids removed. A subsequent sleep study showed resolution of the apnea after the surgery, but I feel the quality of the study was awful; I barely slept that night. I recognized some improvement in my sleep, but I have not had a period of remission. I was and am constantly fatigued and suffer from depression, anxiety, brain fog, headaches, and concentration problems. I recently had at home sleep study after connecting with another sleep doctor. The home sleep study found mild OSA (AHI = 8.5), but my doctor remarked that all events were clustered during particular stages of sleep. He predicted that it was during REM sleep.

Today, I have an appointment with a DME to get set up with an AutoPAP. Yesterday, I stumbled upon this forum and have been reading about how to advocate for myself at my appointment to be sure I get the best machine for me.

I called the DME and was told that my doctor wrote a prescription for "Philips Respironics Dreamstation AutoPAP 5-15". I would prefer the ResMed AirSense 10 AutoSet. The DME carries both these machines.

I have called the DME a few times. One time I was told that I would be dispensed the machine that the prescription was written for. Another time, I was told that "I have more control than I think", and that if I'm dead set on a machine, then I can get the one that I want. So, I'm rather confused. I have messaged my doctor asking for a new prescription specifying the ResMed machine, but I doubt it will be sent before my appointment today.

I'm not sure what to do. Do you recommend that I go today anyway and try to get the ResMed? Or is that a losing battle? Is it still valuable to go if I refuse to take the machine? Have people been able to be dispensed a different machine when the prescription specifies a particular machine?

Thank you for you help!
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#2
RE: Unsure How to Deal with DME Today
Go, and tell them that if it isn't a new Autoset you are leaving.
Because of the EPR implementation, I strongly feel that the ResMed is by far the better machine. We will work with you either way.

Ask if the prescription says DAW (dispense as written) if it does the DME cannot provide you a different machine, if it doesn't they can provide any APAP (but not a basic CPAP) including the Autoset.

So when you are there ask them which machine are they delivering?
If not ResMed ask does the prescription say DAW?
If no Then say then you have the leeway to provide the Autoset right?
Now let them KNOW that you are either leaving with the ResMed Autoset or without a machine.
Ask them to call the doctor, and say that you will wait.

the final line is to actually walk if they don't provide the Resmed Autoset.

Do Note that with the prescription stating
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#3
RE: Unsure How to Deal with DME Today
I totally agree, do NOT take any other than a ResMed S10 autoset or autoset for her. If you walk they get no money!  They only get paid after you sign and take possession of the machine. 

If you take one you maybe stuck with it for 5 year unless you pay for it out of your own pocket. 

It may take a day or 2 to get the RX but that is a lot better than 5 years of poor therapy.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Unsure How to Deal with DME Today
As if you needed to hear it a third time. The Airsense 10 Autoset provides EPR which is identical to bilevel (BiPAP) pressure except it is limited to a pressure difference of 3-cm between inhale and exhale, and has a much more proactive and responsive auto-CPAP algorithm. In my nearly 21k posts on this forum I have had plenty of opportunity to see the real-life differences between the Philips and Resmed machines. I even live in the town where Philips Respironics is headquartered and manufactured, but would not recommend the Philips over Resmed. You will sleep better and have better therapy. The bottom line difference is that the Philips auto CPAP is reactive, and the Resmed Autoset is proactive in stopping events.
Sleeprider
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#5
RE: Unsure How to Deal with DME Today
Ok, a fourth time....
Your doctor must write on the script... ResMed Airsense 10 AutoSet (DAW)

It cannot say Airsense 10 Cpap or Airsense10.
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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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#6
RE: Unsure How to Deal with DME Today
I'd call the doctor's office and ask for a revised script. As others have said, go with the ResMed unit. Even if you have to wait an extra few days, you won't regret it.  Bigwink
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#7
RE: Unsure How to Deal with DME Today
Ditto. ResMed is far better and just demand ResMed or walk. If they can't dispense ResMed, ask why not. Try to remedy it. One way is as you've already asked for a modified script. So yes see if the DME's going to grant your demand for ResMed or not. Don't be fearful in walking out without ResMed. If you sign for the Respironics, your power of choice is gone.
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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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#8
RE: Unsure How to Deal with DME Today
(04-28-2021, 09:30 AM)hyphicti Wrote: Hello all,

As a brief summary of my case, I am a 28 year old male that has been battling sleep apnea since 2013. I was diagnosed with severe sleep apnea (AHI > 90) in 2013. I did a trial of AutoPAP therapy before deciding to have my tonsils and adenoids removed. A subsequent sleep study showed resolution of the apnea after the surgery, but I feel the quality of the study was awful; I barely slept that night. I recognized some improvement in my sleep, but I have not had a period of remission. I was and am constantly fatigued and suffer from depression, anxiety, brain fog, headaches, and concentration problems. I recently had at home sleep study after connecting with another sleep doctor. The home sleep study found mild OSA (AHI = 8.5), but my doctor remarked that all events were clustered during particular stages of sleep. He predicted that it was during REM sleep.

Today, I have an appointment with a DME to get set up with an AutoPAP. Yesterday, I stumbled upon this forum and have been reading about how to advocate for myself at my appointment to be sure I get the best machine for me.

I called the DME and was told that my doctor wrote a prescription for "Philips Respironics Dreamstation AutoPAP 5-15". I would prefer the ResMed AirSense 10 AutoSet. The DME carries both these machines.

I have called the DME a few times. One time I was told that I would be dispensed the machine that the prescription was written for. Another time, I was told that "I have more control than I think", and that if I'm dead set on a machine, then I can get the one that I want. So, I'm rather confused. I have messaged my doctor asking for a new prescription specifying the ResMed machine, but I doubt it will be sent before my appointment today.

I'm not sure what to do. Do you recommend that I go today anyway and try to get the ResMed? Or is that a losing battle? Is it still valuable to go if I refuse to take the machine? Have people been able to be dispensed a different machine when the prescription specifies a particular machine?

Thank you for you help!


Prescription does take precedence. Have doctor write an open prescription if you don't have one.

If its open and you request and they give you any guff.. walk out.

Do not get a dreamstation. It is awful. I can't tell you how much better Resmed is. Its not only more comfortable but my numbers went from 1-3 to .1 to .5
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#9
RE: Unsure How to Deal with DME Today
your event clusters may or may not be in rem but afaik the solution is the same & it's not likely you doc knows what it is. (it's a soft cervical collar to keep your airway from 'kinking'.)
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#10
RE: Unsure How to Deal with DME Today
Call your doctor's nurse and tell her what you want. If she is any good, she'll know how to get a new prescription and fax it to the dme. If she can't or won't do that for you, you need to shop for a new sleep doctor.
First Diagnosed July 1990

MSgt (E-7) USAF (Medic)
Retired 1968-1990
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