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What tests can my PCP run before sleep doc appointment?
#11
(06-12-2013, 10:54 PM)nila Wrote: I don't believe I will be able to use a machine unless the exhale pressure is zero -- which, as I understand it, it not possible with current technology. (Is that right?)

As far as I know a minimum pressure of 4 cm is necessary to keep the hose purged of exhaled carbon dioxide.

Quote:I think it's also unlikely that I can use an appliance, as I have severe TMJ and all the ones I can find pictures of on the net, anyway, exert some pressure on that joint.

You don't know that yet.

Quote:Do you think I should skip the sleep doc and go straight to the ENT, given that travel and finances are difficult? Not that I want surgery, either... there seem to be no very good answers.

You definitely do not want to skip the sleep doc. There are a number of sleep disorders, with sleep disordered breathing (SDB) being only one. And there are many forms of SDB, with OSA being only one.

Do not pin your hopes on a ENT surgeon until it becomes necessary. There are rare cases where something as simple as tonsil removal will be effective, but situations like that are rare.

At this point focus on the present. Keep your appointment with your sleep doc and see what they have to say.

Quote:My purpose in going to the sleep doc would be to ask expert advice on dealing with this situation where all the normal options are unavailable. But now I'm wondering if you folks are more expert than my small town sleep doc and I should just save my money.

Expertise is only one factor. Physicians can run tests and rule out other complications even if they are less knowledgeable about CPAP therapy than some of us. We are not doctors, we're just a bunch of concerned folks out to help each other. We're a support group.
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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#12
Golly, somehow my response yesterday did not post!

Thank you, Sleepster, for explaining to me which doc does what. The medical system is a bit of a mystery to me Smile.
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#13
(06-14-2013, 11:12 PM)nila Wrote: Golly, somehow my response yesterday did not post!

Thank you, Sleepster, for explaining to me which doc does what. The medical system is a bit of a mystery to me Smile.

You mean they have system?
Does it go beyond the collection of maximum fees?
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#14
Well. I wish I had taken Paula's advice earlier and just bought an oximeter.

I've only dealt with a DME place once before in my life, when I rented an S9 for trial. I didn't realise their pricing was quite so insane. After a couple weeks of phone tag and bother with lost prescriptions and stuff, it turns out they will rent me an oximeter -- for $80 per night! And here I thought renting was going to be the budget option.

Um, so, now I am looking at buying one.

I have a lot of pain/joint/tendonitis issues in my hands and wrists, from a history of manual labour and congenital inflammation problems. I'm peering at photos of the CMS options online, trying to guess what I will be able to manage overnight. So far Paula's suggestion of the 50plus seems best, but I thought I should check back here before ordering. Instead of going off on my own like a doofus :/.

-

Do any of you folks have tendonitis in your fingers? And, if so, have you found one oximeter more comfortable overnight than another?

I realise the 50plus has two AA batteries inside it, which will make it pretty heavy. But I'm thinking that may still be better than velcro around my wrist. Unless I can put the wrist strap somewhere else, maybe just lay it on my stomach? Is there some reason it needs to be on my wrist other than convenience and a short tether?

Thanks a bunch, folks. You are always so awesome, and I am feeling pretty dumb right now for trying to make the local option work.
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#15
I've got a CMS50FW, so I might be able to answer some of your questions.

Firstly, as you surmised, the only reason to wear the wrist device on your wrist is convenience and a short tether. All measurements are done via the finger probe. If you sleep in one position all night, just putting the wrist unit next to your hand will be fine. However, if you toss and turn while you sleep, you'll want to somehow fasten it to your hand/wrist, otherwise you will have a miniature flail.

My wrist device came with a plastic watch band rather than a velcro or elastic strap. You can wear it as loosely as you want, as long as it doesn't fall off. I didn't find any irritation at all from wearing the wrist unit.

With regards to the 50D, which is a self-contained unit entirely worn on the finger, I have to wonder if the extra weight of the device means that the clamp pressure on your finger has to be greater to hold it in place. Or whether the device is prone to falling off your finger. That is why I opted for the 50F, even though it is more expensive.

Now, I did find on my first night of using it that my finger was slightly irritated the next morning. When I first put on the finger probe, it felt perfectly comfortable. But I suspect the constant pressure gets irritating after a while. I don't know how much worse it will be with tendonitis in your fingers. And this was just a finger probe, not the entire unit on my finger.
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#16
>With regards to the 50D, which is a self-contained unit entirely worn on the finger, I have to wonder if the extra weight of the device means that the clamp pressure on your finger has to be greater to hold it in place. Or whether the device is prone to falling off your finger.

Oh, this is a very good question! Thanks, Ron Smile. Can anyone provide an answer?

I sleep very still, and can prop up the extra weight. But if it's too much pressure, the pain would keep me awake.
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#17
I emailed Kevin cooper, and he said that yes, the one does clamp harder. So I will order the wrist one Smile.

He also said that DMEs will often do oximetry for cheap or free. Not mine Sad.
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#18
(06-22-2013, 04:03 PM)nila Wrote: >With regards to the 50D, which is a self-contained unit entirely worn on the finger, I have to wonder if the extra weight of the device means that the clamp pressure on your finger has to be greater to hold it in place. Or whether the device is prone to falling off your finger.

Oh, this is a very good question! Thanks, Ron Smile. Can anyone provide an answer?

I sleep very still, and can prop up the extra weight. But if it's too much pressure, the pain would keep me awake.

Hi nila,

According to info on Supplier 19 web site, the CMS-50F ($130) is far more comfortable than the finger clip-on models.

I have a form of Marfan syndrome and my fingers are very sensitive. I have a wrist-mounted Pulse-Ox similar to the CMS-50F and have had no major problems. I just need to rotate which finger I put the sensor cup on.

Supplier 19 web site says the CMS-50F finger sensor cup contains latex, which can be a problem for a few people. If latex would be a problem for you it would be worth asking which wrist mount models do not contain latex.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#19
Just to be clear, only the 50D PLUS will work for apnea. The 50D doesn't record.

I use the D+ on my thumb and it seems to work OK. It didn't work on the earlobe.

I haven't tried toes or other protrusions.

I think the instructions say not to used the clamp on finger devices for more than two hours or some such. I haven't had problems.

The wrist devices with small finger probe will probably work better and be more comfortable for overnight use.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#20
Thanks, folks Smile.

I have been emailing with Supplier #19 and he has been amazing! Such a nice guy, and so helpful.

Is there a place here to write reviews of suppliers, as opposed to equipment? I looked around but don't see anything. I would like to write a rave review somewhere Smile.
I feel so lucky to have found this forum Smile.
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