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VA Diagnosis?
#11
RE: VA Diagnosis?
Mike, I can't speak to the technical aspects of the ASV or comment on your condition but I can talk about the VA. I use it now and have been very pleased.  I'm over 65 and have Medicare A&B with Tricare for Life as my supplemental. I've always had a military related disability but never used the VA until last June. Used commercial medical practices since I retired in 1990. During my intake PE, I told the provider that saw me that I snored and an appointment at the VA sleep clinic was scheduled. The only down side to using VA health care is that it can be slow so patience is the by-word. There is more demand than they can handle at the facility in Atlanta, GA that I use. So, you're going to wait for appointments and follow-up can be slow.

During my first visit to the VA Sleep Clinic, we got a brief familiarization of the different kinds of apneas by a Pulmonary/Sleep Specialist MD. It was very good. Then we filled out a questionnaire. About a week later, I got a call to come in and pick up a home sleep study device. This approach, as opposed to doing a lab sleep study, is based on the questionnaire you filled out. You might go to the Sleep lab, you might get a home study (you already know this if you know what type device they want). I did the sleep study right away and returned the device for interpretation of the data card two days later.

It took almost a month for me to get a call-back probably because I have a pretty straight forward case of obstructive apnea  (AHI 23) with desaturation. Anyway, when I got called back for an appointment on January third this year, it was really quick and easy to get my new ResMed AutoSense 10 and an Amara View mask kit. I got a walk through from a sleep tech on how to operate the machine and fit the mask and the parameters ordered by the sleep doc were put into it.

The one thing to keep in mind after you get your machine is that if you want to optimize it, you'll have to learn all about it and whole lot more about Sleep Disorders than you ever thought you would ..... your health and longevity depend upon it so, it's worth studying. Apnea Board is a tremendous resource. I don't have a follow-up appointment with the VA Sleep Clinic until March 9th. Everything I've learned about my machine, the mask and OSA I did on my own with a lot of help from board members here understanding the data the device provides and making adjustments to your therapy based on that.  You're going to get healthier on your machine but it's going to take work to get there and most of it will be on your own.
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#12
RE: VA Diagnosis?
Hi Sierra Sleepless,
WELCOME! to the forum.!
I wish you luck with getting the proper machine to treat your sleep apnea, it's sounds like things are going in the right direction for you.
trish6hundred
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#13
RE: VA Diagnosis?
Thank You
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#14
RE: VA Diagnosis?
Good luck and thanks for your service.
I'm just starting the journey, too but am using my regular provider.
VA is slow here and a looooong drive for follow ups...  Smile
Regards.
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#15
RE: VA Diagnosis?
My husband's VA CPAP experience isn't the best. Local clinic has a technician but info sent to the VA hospital in Portland. He did a home study, AHI 77, got a box delivered with a Resmed S9 Autoset to fixed 10 and not any personal help. Luckily he put on the mask, adjusted, and sleeps through the night from the beginning 3 years ago. I do much better with Medicare and TriCare4Life! Have a good sleep doc and great DME.
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#16
RE: VA Diagnosis?
Thanks for the reply's and support. I had my second lab last night at the VA not so good. The doc on the phone said I would be getting the machine last night but the tech said the previous tech didn't do the lab right and stopped at 10 and should have gone higher, and didn't know anything about me getting the machine.

Anyway I went to bed at 9:45 and asleep somewhere between 1 and 2am. I asked the tech this morning how it went when I finally got to sleep and she blamed me for not sleeping and said may not have enough time to complete the lab. First lab the used a resmed airfit p10 this tech said its no good and put a mirage fx on me it was ok until I had one gasp for air she barged in and put a neoprene mouth strap on so tight the pain was worse than when I tore my acl and meniscus in my knee last year. So I should get a call from the doc in a couple days.
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#17
RE: VA Diagnosis?
SS, if you haven't started using the SleepyHead software recommend you do so ASAP and learn how to post your results to the forum. Recommend also that you learn how to make clinical setting adjustments to your XPAP. Sounds like the VA sleep clinic you're using may not be the best option. You can get everything you need as far as recommendations for settings based on your sleep data. You can also get recommendations on masks. I started with FFM from the VA because I am a mouth breather. I had trouble with mask leaks on side sleeping. I've used Supplier #1 to try a nasal pillows mask (ResMed P10). They have a great policy there with regard to test it out and return it if it's not for you. So far, I like mine and have gotten good tips here regarding common problems first time users of the P10 experience.

I've had slow responses or none at all from the VA regarding my OSA management. I'm not a complicated case and my AHI's have consistently been below 7 (avg is 3.0) for over a month now. There are others using the VA Sleep clinic I'm using with more complex OSA that need assistance and close management more than I do so, I can be patient. My only issue is awakening and I'm pretty sure I know why because of the help I'm receiving here so, it's up to me to work on that.

Here are a couple of tips you might want to think about: Even the P10 distorts a bit on side sleeping so I'm still seeing sporadic leaks that almost always produce Hyponeas/flow obstruction. Then, I'll mouth breath rendering the CPA useless and then I wake up. The P10 is producing less of this than the FFM and the P10 is much more comfortable for me. I  tried a chin strap; it added stuff to my face but it stopped the mouth breathing. I didn't like the chin strap at all. I'm using a cervical collar now (Caldera). I like it and mouth breathing is decreased but still happening. That's a matter of adjusting the fit of the P10 and my sleeping and cervical collar positions. I'll get there. The cervical collar may help you a lot. These gently lift your chin, extending your neck, stop head tucking and therefore keep your airway open and keep it from collapsing. Way better than a chin strap for me.

The VA is a good option if you are patient about wait times and don't have other insurance. I actually have Medicare A&B and Tricare for life and I could use commercial medical practices but I have had issues with commercial practices understanding billing codes and end up spending a lot of time on the phone getting things straight. That's what convinced me to try the VA. It's fine for my needs. The more complex your medical care requirements are, the more you need follow-up, the less perfect it probably becomes.

Keep hooked up here and carry on.
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#18
RE: VA Diagnosis?
Hang in there, hopefully you won't have to deal with that RT anymore. I second jbuch002's advice. You can download with the link below. The VA is just like a lot of sleep centers they get busy. So no reason to wait for help when you can get advice here also. Don't be shy about asking.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#19
RE: VA Diagnosis?
Sierra, the thing is, you have a diagnosis. Ask for an auto CPAP and self-titration. There is no reason you should have to put up with this B.S. to get a titration study. I love the Airfit P10. If you feel you were comfortable with it, stick with that. Ask the doctor to issue the prescription for auto CPAP and mask, and get the sleep you need.

For reference, i was deemed intolerant of the clinical environment, and never did a titration following my diagnosis in 2008. There is no legal requirement that you accept another test. Ask for the script and get on with your life. If you can get a Resmed Airsense 10 Autoset, we can help you optimize it, but it should do decentl right out of the box. Let your doctor know you are willing to do the self titration.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#20
RE: VA Diagnosis?
[attachment=4557]Hello All
I had my next appt. yesterday at the VA.  They sent me home with the ResMed Air10 with the F&P Simplus Mask.  I hope my screen shot comes up so I can get input from you folks on the first night.  I think my mask leaks were bad and I had it really tight actually had a bit of a swollen spot on the bridge of my nose.  Thanks for your input.  

Mike
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