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Your Cpap Buying Experience?
#1
Question 
Your Cpap Buying Experience?
Would you describe your cpap buying/shopping experience a pleasant one? Could you describe how it went and what you would like to be changed, if possible?

Please don’t name company names. This post isn’t about finding the best or worst DMEs, but to try to understand the business and see what you should or shouldn’t expect from a DME.
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#2
RE: Your Cpap Buying Experience?
My first machine was a BOHICA (Bend Over Here It Comes Again) with everything arranged by my doctor who not so coincidently owned the sleep lab and sold equipment. He promised that he would take care of my insurance and I would owe nothing. Luckily, he was a ResMed Shop and I received an S8 Elite Series II CPAP. I upgraded the unit to add a USB cable connection and the larger modified water chamber unit. I purchased a barely used second one from a private party who was being given a bi-pap. My biggest mistake was not realizing that insurance covered replacement supplies which I purchased off the internet. My impression was that ResMed sent hit men after any discounters -- so I looked primarily at eBay rather than Amazon.

Different sleep lab, different insurance. I was offered a ResMed S9 but I knew enough to specify the machine I wanted, a ResMed AutoSense AutoSet S10. Per insurance rules, I rented the machine for 13 months and then it became "mine" although I never could get the DME to provide a bill of sale.

For my backup machine that was not covered by insurance, I wanted a new machine and used a vendor from the forum list. There were no problems and I provided my credit card (the one with the extended warrantee and cash back program) and everything went without a hitch.

If there is any initial advice that would have made a difference, it would have been access to the forum to ensure that I had a data capable machine, instructions on how to enter the clinical menu and change settings, analysis software, and solid advice about looking out for my own care.

The worst part of the experience was mask selection and I finally gave up on six selections before finding the ResMed Mirage Activa LT -- which my current DME claims is being discontinued.

If I was new to the Sleep Apnea world, I would like my DME to provide me with a comparison chart (complete with bulleted features) of the top machines. Usage videos would be helpful. (Some of the best seem to originate in Australia) And, of course, I would want my CSR to be knowledgeable and not some moonlighting bozo who previously sold electronics at RadioShack.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#3
RE: Your Cpap Buying Experience?
(03-21-2018, 04:00 AM)srlevine1 Wrote: My first machine was a BOHICA (Bend Over Here It Comes Again) with everything arranged by my doctor who not so coincidently owned the sleep lab and sold equipment. He promised that he would take care of my insurance and I would owe nothing. Luckily, he was a ResMed Shop and I received an S8 Elite Series II CPAP. I upgraded the unit to add a USB cable connection and the larger modified water chamber unit. I purchased a barely used second one from a private party who was being given a bi-pap. My biggest mistake was not realizing that insurance covered replacement supplies which I purchased off the internet. My impression was that ResMed sent hit men after any discounters -- so I looked primarily at eBay rather than Amazon.

Different sleep lab, different insurance. I was offered a ResMed S9 but I knew enough to specify the machine I wanted, a ResMed AutoSense AutoSet S10. Per insurance rules, I rented the machine for 13 months and then it became "mine" although I never could get the DME to provide a bill of sale.

For my backup machine that was not covered by insurance, I wanted a new machine and used a vendor from the forum list. There were no problems and I provided my credit card (the one with the extended warrantee and cash back program) and everything went without a hitch.

If there is any initial advice that would have made a difference, it would have been access to the forum to ensure that I had a data capable machine, instructions on how to enter the clinical menu and change settings, analysis software, and solid advice about looking out for my own care.

The worst part of the experience was mask selection and I finally gave up on six selections before finding the ResMed Mirage Activa LT -- which my current DME claims is being discontinued.

If I was new to the Sleep Apnea world, I would like my DME to provide me with a comparison chart (complete with bulleted features) of the top machines. Usage videos would be helpful. (Some of the best seem to originate in Australia) And, of course, I would want my CSR to be knowledgeable and not some moonlighting bozo who previously sold electronics at RadioShack.


Thanks for sharing your experience! I agree, I wish that the DME’s went over the features and let you choose what’s best for you. I mean it’s your therapy so if you need or want a certain feature you should be able to get it (assuming you can afford it).

But - especially when your new to this - your not going to ask without them giving you options!
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#4
RE: Your Cpap Buying Experience?
My first machine was issued in the Spring of 2015 by my pulmonary doctor. It was a CPAP branded REMstar, which I think was a Respironics machine. I do not remember the mask except it was a full face. The doc was rather arrogant and came across as "this is what you need and it will work to fix apnea and you'll be better. Since I said it, it will be this way. If you fail you didn't listen to me..." Then he waved a magic stethoscope and all went...bad. CPAP and Dave did not mix well. I tried it, but didn't have any knowledge. The DME was OK, and to be fair, they did attempt to educate some, but in hindsight, I was on the wrong machine. I failed compliance and returned the machine.

I then had a visit with primary care to seek other directions to help with sleeping and addressing apnea. I did a weight loss surgery that the whole prep and procedure took all of '16.

I started in early '17 with a new apnea therapy attempt on a DreamStation BiPAP, which I failed compliance because of high Central Apnea count. I also enrolled here at Apnea Board to find info on how to get all I could from my therapy. This is the real key to any success I claim now.

Now that I have had 4 total PSGs, mixed apnea was determined to be the hindrance to proper therapy. Once I got past the process to get the right machine, therapy is actually working. I switched to another DME to dispense the ResMed. They typically have bad consumer ratings, but since my interaction now with them is minimal, I can deal with it. I credit my ResMed AirCurve 10 ASV for giving the proper treatment. I have been issued a different doc at the same pulmonary facility, as Doc 1 retired. The new doc is a big help, as he listens much more than the first. I will give doc 1 credit, he tried to help in his stubborn way.

Coffee
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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#5
RE: Your Cpap Buying Experience?
We in the UK normally have no choice.  Not that we pay for the machines these days (though a lot of England did at the start) but we get the machines off the NHS.  Only problem is they are either with one manufacturer or an other.  My first machine was an early Sullivan 1 or 11 I can't remember, but it had no ramp up or EXP at all and was fixed pressure.
I went through quite a few of these machines until I changed hospitals, then the Sleep Nurse took an exception to the Sullivan 5 I had and said it was noisy.  Well, it was, but not as noisy as the ResMed she gave me.  I went through a lot more of those (Bricks) though they did have a carry bag, which the Sullivan's didn't, they were a bit of a let down reliability wise.
I then was partially discharged from hospital care (even though in this country you are supposed to be checked every three years) it was six years and a few machines later that I was called in suddenly and told I had to be seen urgently.
Turns out they could not leave me with the machine I had as it could not transmit data from the card so they could monitor me.
Did I care, not a bit.  I don't know if there has been a change of rules or not, but they can now download the data from my data card.
At least they could if it was turned on, but I turn it off anyway as soon as I am finished with it.
Anyway, I got the choice of two ResMed machines and a Philips Dreamstation (don't know where it came from as they appear to have mostly ResMed machines and masks) but maybe they are trialling Philips out, I don't know.  Anyway, I settled with a ResMed Airsense10Autoset and a great little machine it is.  It is the only time I have had so low AHIs and the only time I have had an APAP.
Makes a huge change and a bit of getting used to after fixed pressure and a high pressure at that.

Most users in the UK just get a fixed pressure machine, though the prices are coming down and if you go back and say you just can't use a fixed pressure machine you might get an APAP.  Other machines are not s common over here, if you need a machine with variable pressure you have a long wait and usually have to go to a specialist hospital to get fitted out with one.
Sleep Clinics have popped up in most hospitals over here now, but some of the doctors leave a lot to be desired.  On saying that, they probably didn't ask for a Sleep Clinic.  Most just got attached to the Chest Clinics in most hospitals and you rarely see a doctor, it is usually a Sleep Nurse.
As for fitting masks, it is very hit or miss, but they have started to use the equipment here that we have to use, just so they have an idea of what the patient is talking about when they phone about a problem they have.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#6
RE: Your Cpap Buying Experience?
The first time I acquired a cpap was in a different century and I wasn't given a choice of machines. And because I had a full beard, I was given a pillow mask.
After several experiences with the DME affiliated with the sleep center, I found that I could buy the machines online, though the hoops for getting reimbursed by the insurance company were a royal pain. I have purchased the last five machines (for several years I had two machines - one for home and another for travel) and all supplies, out-of-packet from Supplier #1. I don't like the crap one has to put up with when dealing with insurance and Medicare.
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.
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#7
RE: Your Cpap Buying Experience?
(03-21-2018, 10:15 AM)SarcasticDave94 Wrote: My first machine was issued in the Spring of 2015 by my pulmonary doctor. It was a CPAP branded REMstar, which I think was a Respironics machine. I do not remember the mask except it was a full face. The doc was rather arrogant and came across as "this is what you need and it will work to fix apnea and you'll be better. Since I said it, it will be this way. If you fail you didn't listen to me..." Then he waved a magic stethoscope and all went...bad. CPAP and Dave did not mix well. I tried it, but didn't have any knowledge. The DME was OK, and to be fair, they did attempt to educate some, but in hindsight, I was on the wrong machine. I failed compliance and returned the machine.

I then had a visit with primary care to seek other directions to help with sleeping and addressing apnea. I did a weight loss surgery that the whole prep and procedure took all of '16.

I started in early '17 with a new apnea therapy attempt on a DreamStation BiPAP, which I failed compliance because of high Central Apnea count. I also enrolled here at Apnea Board to find info on how to get all I could from my therapy. This is the real key to any success I claim now.

Now that I have had 4 total PSGs, mixed apnea was determined to be the hindrance to proper therapy. Once I got past the process to get the right machine, therapy is actually working. I switched to another DME to dispense the ResMed. They typically have bad consumer ratings, but since my interaction now with them is minimal, I can deal with it. I credit my ResMed AirCurve 10 ASV for giving the proper treatment. I have been issued a different doc at the same pulmonary facility, as Doc 1 retired. The new doc is a big help, as he listens much more than the first. I will give doc 1 credit, he tried to help in his stubborn way.

Coffee

Thanks!
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#8
RE: Your Cpap Buying Experience?
Quite welcome.

signed,
snowed in on purpose Dave

Coffee
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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#9
RE: Your Cpap Buying Experience?
It is disappointing to me, and a little unnerving, that so many who come here come for help, are in abject distress, and find that they can rely on nobody but themselves to get help...or on people here.  It was not my experience at all.  I don't know if I live in a microculture where people expect things to unroll a different way, or whether the oversight and regulation of the health care provision is tighter....but I haven't heard of any bad advice or adverse experiences on Vancouver Island.

I attended a sleep lab the first time to determine if I have apnea.  I do, and was prescribed APAP for a trial of six weeks.  Within three weeks I was on straight CPAP.  I returned to the lab to see if I were indeed treated, and that is what they found.  I had three pleasant conversations with a sleep specialist (psychiatrist, neurologist) via Skype.  He asked me lots of questions to ensure I was happy with my experience...I'm guessing because he wanted to ensure that I would continue to be compliant and optimistic. He released me with a PAP prescription.  

Once my insurer had agreed to compensate me, the monitoring DME/clinic brought me in, for the third time in six weeks, and explained the prescription and what they recommended.  The therapist suggested that, since I had been on the same straight CPAP for almost four weeks, it didn't make much sense for me to pay another $400 for the Autoset.  I agreed, and have had no cause to regret 'our' choice now almost four weeks into the use of the Elite that I purchased.  I know I will be monitored weekly, and be invited to a meeting once a year to 'touch base'.

So, my experience has been good, and my treatment is apparently salutary.  I can't complain.

I wonder if too many people undergo too many changes/stressors while they are being assessed and if their subsequent treatment is left inadequate or plainly wrong.  I wonder if the clientele in a given place tend to elicit an indifferent or callous approach to health care.  I wonder about the intent and understanding of ethical and professional behavior in the health world, or maybe it's localized when it's a problem...which is sounds like it is from our American friends.

Lastly, this is an obviously confounding and complex disorder, or series of them compounded, making it much trickier to treat properly than so many 'experts' know how to pull off.  For all we Canuckians have too much government regulation and socialistic policies, we do seem to have a tighter regime of health care across the nation where our standards are widely met.
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#10
RE: Your Cpap Buying Experience?
At the time that I was diagnosed, my brother was getting a new Bipap machine after 8-9 years. We went through the same DME using Medicare. Due to some non-DME related issues, we switched to DME with our health care system.

Since no sleep study was needed for bro, doc just sent in prescription for bipap and mask for what he was already using. They called and went over the details - his supplemental covered 100% what Medicare did not. Made an appointment. Earliest appointment was 2 weeks. He had a new Respironics 560 series bipap. PT went over the operation details. I accessed the machine to check running hours (had to explain to PT that sometimes new didn't mean the same to everybody). It had zero hours. She set bro up with the same mask (there are limited choices for guys with beards) he had. Everything was very smooth.

Since I visited Apnea Board before I bought my machine, I had the doc write a script for an Airsense for Her and mask - patient choice. They told me that they don't keep that particular machine 'in stock' so would have to order. Wouldn't set up followup appointment until machine arrived, which would have been way more aggravating if I had not already bought a used machine and was using that. Realize that without a machine, I could no longer drive and as a caregiver, I can't do that. In any case, it took me 3 weeks to get the machine. She demonstrated how everything worked. I checked the machine hours (zero) and all was well. Brought it home. First night got a bad smoking smell. Couldn't figure out why, so unplugged machine and switched to my used one. Brought machine in the next day. They gave me a loaner (zero hour Respironics 560 cpap). Took 2.5 weeks for the replacement machine to come in. Yes, I HAD to make an appointment to do the switch. Aggravating, but perhaps their protocol.

Now, realize that they don't provide loaners AT ALL unless you are in your compliance period and your machine needs to be exchanged. That's why I was given a brand new machine as a loaner. As patients, we don't know all these things and to not know in advance of a failure is a real hardship for those who aren't canny enough to plan ahead. If a DME isn't going to provide backup when the machine fails in 3 years, then they should have the phone number of several places who DO. Also a main problem with most DMEs is that the turnover of employees is pretty severe. I went back 1.5 years later to get fitted out for a different mask and all the employees, except the receptionist were different. You don't usually get that at a local Mom & Pop shop.
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