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+--- Thread: Frustrated with recommendations by doctor (/Thread-Frustrated-with-recommendations-by-doctor)
RE: Frustrated with recommendations by doctor - Sleeprider - 08-21-2018
If your doctor has an irrefutable prejudice against ASV you must change doctors. That position makes no medical sense and ensures a certain portion of his patients will be improperly or inadequately treated...that specifically includes you. I don't think I would do anything but get a copy of my records and transfer your care to a more open minded physician. I would not even ask for a referral as he is unlikely to appreciate the work of a physician that disagrees with his position on ASV.
RE: Frustrated with recommendations by doctor - allanri - 08-21-2018
I wouldn't ask the sleep doctor for a referral, but rather my GP. In Ontario, I can't see a sleep specialist without a referral.
RE: Frustrated with recommendations by doctor - sheepless - 08-21-2018
rejecting asv because he doesn't like it is absurd. unconscionable. I can't speak for sleeprider but can tell you he helped me titrate my asv and I've read threads in which he helped others with same.
RE: Frustrated with recommendations by doctor - jaswilliams - 08-21-2018
(08-21-2018, 09:59 AM)allanri Wrote: Well, he’s already said he doesn’t like ASV machines, and wouldn’t recommend one. I will certainly try again. I’m also going to ask to be referred to someone else for a 2nd opinion.
The only thing I need a doctor for is to get a prescription for a new machine. Insurance is already maxed out for this kind of equipment. And if I can get a machine (eg used) without a prescription, then I don’t have to deal with the doctor at all. Except for the settings... or do you think this is something that I can figure out with input from experienced apnea board member and trial and error?
The other possibility if your doc won’t recommend an ASV is a BiLevel with backup rate such as a Resmed Aircurve Vpap ST but they are not as comfortable as an ASV to use nor as effective
RE: Frustrated with recommendations by doctor - Sleeprider - 08-21-2018
Answering your question via PM in the thread...
RE: Frustrated with recommendations by doctor - Cpapian - 08-22-2018
(08-21-2018, 10:49 AM)allanri Wrote: I wouldn't ask the sleep doctor for a referral, but rather my GP. In Ontario, I can't see a sleep specialist without a referral.Hi allanri,
I am from Toronto. A couple of things you have said puzzle me.
I am always about the money. So first, the Ontario Government ADP program should have paid 75% of your CPAP. That should have included everything to get you up and going, ie mask, hose, etc. The prices are regulated by the Program. A provider must be registered with the program and they should only charge you the 25%. So it worries me that you say your insurance has maxed out.
Second, your sleep doctor is no good. Treated is considered an AHI of 5 and under here in Ontario also. Your results are not acceptable. (My untreated AHI was 39 - my treated AHI is 0 - 2 usually). If you are going to get another sleep doctor, there are some really good places to go. Sunnybrook has a sleep lab. A while back, I found a place that seemed quite comprehensive in their approach and where they stated they weren't happy until you were. I'll try to refind their name if you want. I'd imagine a sleep lab could work with the existing studies unless they felt there were shortcomings in the original ones.
I would definitely encourage you to get another sleep specialist and if you paid 100% of the cost of your machine, you should probably follow up on that also.
RE: Frustrated with recommendations by doctor - allanri - 08-22-2018
(08-22-2018, 02:29 PM)Cpapian Wrote: I am always about the money. So first, the Ontario Government ADP program should have paid 75% of your CPAP. That should have included everything to get you up and going, ie mask, hose, etc. The prices are regulated by the Program. A provider must be registered with the program and they should only charge you the 25%. So it worries me that you say your insurance has maxed out.
Hi Cpapian - I wasn't clear, sorry. I did get the ADP coverage (though my mask and tubing wasn't included in what they submitted to the Ministry of Health ... I will ask about that). The reason my insurance is maxed out (or close to) is because in my, er, enthusiasm to embrace CPAP, I also bought an AirMini travel machine, because I do travel a lot. My coverage through my extended health plan is only about $2000/year for respiratory equipment, and there are also limits on the # of CPAP devices you can buy in a five year period.
So, when I say I'm not worried about the money, of course, I don't want to spend any more than I have to. But I'm prepared to spend what I need to if it will solve my issues.
And thanks for the input re: what qualities as reasonable reductions in AHI in Ontario. I am going to try to find another doctor; I will check out Sunnybrook. If you do come across the name of someone there, by all means PM me .. I'm anxious to move forward on this.
RE: Frustrated with recommendations by doctor - allanri - 08-22-2018
I looked in to the ADP details (http://www.health.gov.on.ca/en/pro/programs/adp/policies_procedures_manuals/docs/respiratory_equipment_manual.pdf) ... ADP covers only a "basic" mask and tubing; I was given heated tubing, and I guess the mask I got (Respironics Dreamwear Nasal) was considered an upgrade, and therefore not eligible for coverage.
RE: Frustrated with recommendations by doctor - allanri - 08-22-2018
(08-21-2018, 05:45 PM)Sleeprider Wrote: Answering your question via PM in the thread...
Thx!
RE: Frustrated with recommendations by doctor - Cpapian - 08-22-2018
(08-22-2018, 03:45 PM)allanri Wrote: I looked in to the ADP details (http://www.health.gov.on.ca/en/pro/programs/adp/policies_procedures_manuals/docs/respiratory_equipment_manual.pdf) ... ADP covers only a "basic" mask and tubing; I was given heated tubing, and I guess the mask I got (Respironics Dreamwear Nasal) was considered an upgrade, and therefore not eligible for coverage.
Ya but ....... they should have given you the regular hose and regular mask.
I don't know anyone at Sunnybrook, but the clinic I was thinking of is Toronto Sleep Clinic. It is run by a UoT professor. They are at 790 Bay Street. Their website had a lot of information, they have a number of different testing techniques over and above the polysomnography. An interesting website if nothing else.