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Diagnosis and followup - DeepBreathing - 10-12-2013
I've been reading with interest the various tales of how people got diagnosed and their follow-up treatment. Also the cost involved. So here's my story, and maybe others would like to share theirs.
I've been having trouble with heart arrhythmia and angina. My GP referred me to a cardiologist, who works for a big cardio vascular company here in Perth. She referred me for a stress test, Holter monitor and echocardiogram at the same company. That showed that >10% of my heartbeats are ventricular ectopics. A (small) proportion of each of these consultations and tests was covered by Medicare and/or Medibank Private.
She then referred my for a sleep test at another branch of the same company. This was an overnight in-hospital test - I counted 17 different electrodes attached to various parts of my body. The outcome was very severe apnoea with an AHI of 62. Apnoeas were roughly 50% OSA and 50% CSA. The full cost of this test was covered by Medibank Private. The same company fitted me up with a Resmed S9 Autoset for four weeks and four consultations. This cost $360, of which about half was covered by Medibank Private.
I'm now on week six of my four week trial (no extra charge so far), on my fourth mask and second machine (Philips Vpap). The results have been disappointing to date. My AHI has varied from 5.1 to 19.8 and I have had many occasions of removing the mask in my sleep. I feel worse now than when I started. However, last night (my first with the new machine) I got 7 hours of therapy. My OSA and CSA were down to zero but my AHI was 7.8 due to a large number of hypopneas. (Is the Philips more sensitive t these than the Resmed?)
I've had six consultations with the sleep therapist. She has been fantastic - explains everything clearly, listens to my concerns and works with me to overcome the problems as they come up.
She Who Must be Obeyed is delighted that she can now get a good night's sleep without my snoring. On the other hand, I'm not feeling any improvement so far. I am sure that I'm not too far off cracking this particular nut. But if it had not been for the help provided by my therapist I probably would have given up by now.
RE: Diagnosis and followup - PaulaO2 - 10-12-2013
Has she explained why you are not on an ASV? or is that what the P-R VPAP is?
RE: Diagnosis and followup - Peter_C - 10-12-2013
It sounds like your numbers have gone down quite a bit though. Remember, this has most likely been going on for some time, so it can take some time to feel improvements.
RE: Diagnosis and followup - DeepBreathing - 10-12-2013
(10-12-2013, 11:21 AM)PaulaO2 Wrote: Has she explained why you are not on an ASV? or is that what the P-R VPAP is?
Probably my incorrect terminology - it is a ASV machine. Philips Respironics BiPAP autoSV Advanced—System One.
RE: Diagnosis and followup - DeepBreathing - 10-12-2013
(10-12-2013, 02:23 PM)Peter_C Wrote: It sounds like your numbers have gone down quite a bit though. Remember, this has most likely been going on for some time, so it can take some time to feel improvements.
Agreed, Peter. From 60+ down to 7 - 8 on average is a huge improvement. And while it's very early days with the new machine I actually woke this morning feeling refreshed for the first time in a very long time.
RE: Diagnosis and followup - PaulaO2 - 10-12-2013
Ah, good. It can all get confusing with all the alphabet soup flying about!
Treating complex apnea or central apnea is a different beastie than just obstructive. The AHI is harder to keep under 5, at least from what I have gathered from other users here.