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asv machine without csa
#11
archangle
Perhaps my migraine is testimony to being "beaten up". Don't usually get these. my sleep deprivation quotient is such that (even using the machine) I fall asleep within 10 seconds and than wake up 5 to 6 hours later, so I don't notice shifting or uncomfortable air pressures, just how I feel the morning after.

It says ASV on the front of the machine, therefore it is an asv machine, so I don't need to wait for the first bill to see what I am paying...
My intuition says...DMA a sneak! I should known that...I was thinking prior to your message, contact my physician to let her know I get an ASV, is that what she wanted me to have. I'm pretty sure she said ASV would not be right for me since I do not have CSA...

(01-17-2015, 07:16 AM)archangle Wrote: Find out what you're being billed. If you're paying a percent copay, you're probably paying a lot more than necessary. ASV machines cost a LOT more.

Per this page http://www.resmed.com/us/en/consumer/pro...0-asv.html, the AirCurve 10 ASV only does CPAP and ASV modes, not Auto CPAP or S or T mode bilevel. i.e. it can't be made to work like a normal bilevel or APAP.

If you don't actually need ASV, I suspect the ASV machine is going to "beat you up" because it will try to decide when you need to breathe if it sees something it doesn't like. You'll occasionally feel it bumping up the pressure to make you breathe when you're not read and this may be uncomfortable.

I suspect you should ask your doctor if he wanted you to have an ASV machine. Sounds a bit like a dumb DME, or maybe one doing something sneaky.

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#12
(01-17-2015, 06:57 AM)leiko49 Wrote: You make it sound like the asv machine would in fact help osa better than a non asv machine, though the marketing states asv for csa. Still not sure what is true.

The marketing materials emphasize the ability to treat centrals, but if you reread the marketing materials, you will see they do say the ASV machine treats both obstructive and central apneas.

What were the pressure settings on your old machine? If you haven't already done so, I think you can request the setup manual for your old machine, too.

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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#13
No one defined pressure support for the OP. PS = IPAP - EPAP. On my machine, that relationship is constant. When my machine, an auto bilevel, decides to increase pressure, it maintains the above relationship between IPAP and EPAP and hence, PS is constant.

The third pressure I referred to for an ASV machine is the limit setting for how much it may increase PS. That is widen the difference between IPAP and EPAP. It does cycle between IPAP and EPAP at a timed rate; but increases IPAP to maintain ventilation.

The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.

The real question is: What did you doctor intend for you to have; and why?
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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#14
(01-17-2015, 07:32 AM)vsheline Wrote:
(01-17-2015, 06:57 AM)leiko49 Wrote: You make it sound like the asv machine would in fact help osa better than a non asv machine, though the marketing states asv for csa. Still not sure what is true.

The marketing materials emphasize the ability to treat centrals, but if you reread the marketing materials, you will see they do say the ASV machine treats both obstructive and central apneas.

What were the pressure settings on your old machine? If you haven't already done so, I think you can request the setup manual for your old machine, too.

Take care,
--- Vaughn

Good point. If it's "happy" with your breathing, it will deliver "normal" bilevel and won't hit you with any high pressure pulses to try to stop an apnea in process.

If it does decide you need a quick pulse of high pressure to stop an apnea in process, it may or may not be that uncomfortable. I think a lot of people find it disconcerting at first, especially if they're having "sleep wake junk" as they fall asleep or if they're still awake.
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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#15
Just Mongo
You said
No one defined pressure support for the OP.

Not sure what you are saying here. Are you saying the prior responders to my post did not define pressure support? I also looked up in apnea glossaries "OP" but could not find what it stands for...


You say,
The third pressure I referred to for an ASV machine is the limit setting for how much it may increase PS.

OK, I get that.

You say:

The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.
Not sure why setting the PS to zero would make it act like a bilevel machine. I thought bilevel machines have a predefined and constant ps. .., I could try it though.

you said
The real question is: What did you doctor intend for you to have; and why?
I said in one of my other posts, I'm pretty sure my doc said I do not have csa, and should have a auto bipap, but I plan to double check. I believe the DMA may have been looking for an increased kickback/bonus for selling me a more expensive equipment that I do not need. Just noticed in the New York Times yesterday an article about the real life partner of the Wolf of Wall Street Guy, currently working as the CEO of a medical supply company, arrested for selling patients medical equipment that they do not need. I am wondering if my supplier is affiliated with the same company...me thinks i've been snookered again.
[/quote]

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#16
(01-17-2015, 08:17 AM)leiko49 Wrote: Just Mongo
You said
No one defined pressure support for the OP.

Not sure what you are saying here. Are you saying the prior responders to my post did not define pressure support? I also looked up in apnea glossaries "OP" but could not find what it stands for...
Yes, I am saying they did not define PS. OP stands for Original Post -- common shorthand used one many forums.

You say,
The third pressure I referred to for an ASV machine is the limit setting for how much it may increase PS.

OK, I get that.
(01-17-2015, 08:17 AM)leiko49 Wrote: You say:
The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.
Not sure why setting the PS to zero would make it act like a bilevel machine. I thought bilevel machines have a predefined and constant ps. .., I could try it though.
I said the additional PS -- i.e. That which an ASV supplies when breaking the equation: PS = IPAP - EPAP. i.e. if additional PS can be zero, it would maintain PS = IPAP - EPAP. However, during a central apnea, it would still switch to IPAP at a timed rate, which is how an ST mode machine works. It would still act as a bilevel.

(01-17-2015, 08:17 AM)leiko49 Wrote: you said
The real question is: What did you doctor intend for you to have; and why?
I said in one of my other posts, I'm pretty sure my doc said I do not have csa, and should have a auto bipap, but I plan to double check. I believe the DMA may have been looking for an increased kickback/bonus for selling me a more expensive equipment that I do not need. Just noticed in the New York Times yesterday an article about the real life partner of the Wolf of Wall Street Guy, currently working as the CEO of a medical supply company, arrested for selling patients medical equipment that they do not need. I am wondering if my supplier is affiliated with the same company...me thinks i've been snookered again.

Possible. But the ASV carries a different prescription code than a bilevel, non ASV. The ASV is more expensive. The suppliers usually try to sell a machine that meets the Rx; but maximizes their profit.
You should ask your doc for a copy of your prescription.

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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#17
Just Mongo
Thanks for your patience with my questions!

I have a copy of the prescription: diagnosis is osa, requests auto bipap/bilevel. My diagnostic code is listed (osa) but no "prescription code". Intead, a checklist, where "autobilevel" is checked, and bipap ASV is not checked...

Curios, in the receipt from the DMA, he wrote in "airsense", instead of aircurve, the former of which is not asv. However, in our conversation, he did say it was an aircurve asv, and it says so on the front, and the model number is an asv model...

Obfuscation is often used to cover from an illegitimate practice...tend to be a conspiracy theory kind of guy. I find it also a bit weird that I read the article about overselling medical equipment the day I purchased the aircurve. Someone was trying to tell me something, but I did not listen...

http://www.businessinsider.com/r-exclusi...ses-2015-1

Med-care sells cpap equipment, and an hour ago I read on another apnea forum someone from Med-care calling them to sell them apena equipment they did not need.




(01-17-2015, 10:31 AM)justMongo Wrote:
(01-17-2015, 08:17 AM)leiko49 Wrote: Just Mongo
You said
No one defined pressure support for the OP.

Not sure what you are saying here. Are you saying the prior responders to my post did not define pressure support? I also looked up in apnea glossaries "OP" but could not find what it stands for...
Yes, I am saying they did not define PS. OP stands for Original Post -- common shorthand used one many forums.

You say,
The third pressure I referred to for an ASV machine is the limit setting for how much it may increase PS.

OK, I get that.
(01-17-2015, 08:17 AM)leiko49 Wrote: You say:
The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.
Not sure why setting the PS to zero would make it act like a bilevel machine. I thought bilevel machines have a predefined and constant ps. .., I could try it though.
I said the additional PS -- i.e. That which an ASV supplies when breaking the equation: PS = IPAP - EPAP. i.e. if additional PS can be zero, it would maintain PS = IPAP - EPAP. However, during a central apnea, it would still switch to IPAP at a timed rate, which is how an ST mode machine works. It would still act as a bilevel.

(01-17-2015, 08:17 AM)leiko49 Wrote: you said
The real question is: What did you doctor intend for you to have; and why?
I said in one of my other posts, I'm pretty sure my doc said I do not have csa, and should have a auto bipap, but I plan to double check. I believe the DMA may have been looking for an increased kickback/bonus for selling me a more expensive equipment that I do not need. Just noticed in the New York Times yesterday an article about the real life partner of the Wolf of Wall Street Guy, currently working as the CEO of a medical supply company, arrested for selling patients medical equipment that they do not need. I am wondering if my supplier is affiliated with the same company...me thinks i've been snookered again.

Possible. But the ASV carries a different prescription code than a bilevel, non ASV. The ASV is more expensive. The suppliers usually try to sell a machine that meets the Rx; but maximizes their profit.
You should ask your doc for a copy of your prescription.

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#18
Just Mongo,

You said
The ASV may not have a true bilevel auto mode setting. However, if the additional PS can be set to zero, it would act like a bilevel machine in what ResMed defines as ST mode.

I now have possession of the manual, and indeed the additional PS can be set to zero.

I was able to set the min ps to 0, and the max ps to 5 (the lowest setting it allowed me).

If I do this, will the machine function virtually like an auto bilevel? I ask this question because I do not follow all of the complex scientific description you had shared. Beyond my area of expertise.

Thanks!
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#19
I'd bet good money you were dispensed the wrong machine. Could be an error, or intentional, but error is looking more likely. The ASV machine is generally dispensed to people that lack respiratory effort through a chronic illness, use of opioid therapy or who have diagnosed central apnea Cheyne Stokes respiration or complex apnea. With everything you've posted so far, this is simply an error.

Consider what is likely to happen when the DME submits an invoice to insurance, where the diagnostic code does not fit the dispensed (much more expensive) equipment. Someone is going to get rejected, and it's likely to land in your lap.
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#20
Sleeprider
You stated
I'd bet good money you were dispensed the wrong machine.

A bet I will not make with you, cause I agree.

You stated
Could be an error, or intentional, but error is looking more likely....With everything you've posted so far, this is simply an error. ...Consider what is likely to happen when the DME submits an invoice to insurance, where the diagnostic code does not fit the dispensed (much more expensive) equipment. Someone is going to get rejected, and it's likely to land in your lap.

Now this is a bet I might consider. Not sure the insurance company is on top of this. The FBI investigation regarding similar matters is current (several days ago), suggesting the few (dishonorable medical equipment providers) have been able to take advantage of the many (the sick) for many years now, to the tune of lets say a billion or more dollars. Plus, there was the "co incidence" of my reading the article the same day as the purchase (true, pure superstition), and my intuition that the fellow was putting one over one me (which I am vulnerable to, since my sleep apnea alters my level of alertness). Intuition has a scientific basis, and should be listened to, or bad things will happen.
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