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Just diagnosed - jb1176 - 04-23-2014

Hello everyone,
I just was called by the sleep clinic telling me the results of test. Confirmed apnea with average of 35.8 episodes per hour over two hours. With full face mask and pressure range 5-7 episodes eliminated. I am male age 71 and this is my first sleep study. Have not met yet for machine and mask selection. Medicare eligible. Side sleeper. Felt claustrophobic with the full face mask and was difficult to use as a side sleeper. I need some help knowing what is ahead for me when I meet to select machinery.

1. With Medicare will I have a choice of full face or nose mask?
2. We travel out of the country frequently. Will they allow me a travel machine?
3. Continuous flow, bi level flow, or automatic? What should I get?
4. Heated, humidity ?
5. Remember I'm a side sleeper. What mask should I look for? Will Medicare allow an upgrade for machine, mask, etc?

Thanks for advice. This is going to be an adventure and hope I can go with the flow. Many of my friends gave up.


RE: Just diagnosed - Rycharde - 04-23-2014

(04-23-2014, 01:06 PM)jb1176 Wrote: Hello everyone,
I just was called by the sleep clinic telling me the results of test. Confirmed apnea with average of 35.8 episodes per hour over two hours. With full face mask and pressure range 5-7 episodes eliminated. I am male age 71 and this is my first sleep study. Have not met yet for machine and mask selection. Medicare eligible. Side sleeper. Felt claustrophobic with the full face mask and was difficult to use as a side sleeper. I need some help knowing what is ahead for me when I meet to select machinery.

1. With Medicare will I have a choice of full face or nose mask?
2. We travel out of the country frequently. Will they allow me a travel machine?
3. Continuous flow, bi level flow, or automatic? What should I get?
4. Heated, humidity ?
.

Hi jb 1178,
I am also 71, but have been on cpap for 4.5 years now. I can tell you what I have done. I was titrated with a nasal mask, a resmed, and have not varied from it in all the years. I was given a "brick", a common term used for a cpap machine that gives only compliance data, but no useful data, but learned quickly about the cosding and got the DME to exchange it for a data capable one. If you can pick up one of these gently used bricks, it would make an ideal travel machine because you realy haven't lost anythying if it's stolen or lost.
Medicare will not "give" you a machine, but your primary referring doctor will write whatever prescription the sleep doctor recommends, such as a cpap, apap. The common no-data brick, data capable continuous pressure cpap and the Apap all fall under on code number for insurance, so you need to get the best you can have your doctor sign for. The DME, equipment supplier, will try to give you the cheapest machine they can since it means morte profit for them, even though Medicare will pay the DME the same for all three.
I am now using a resmed autoset which is miles beyond a straight cpap machine. Look around the forum and you can find lots of material about many different btands of machines, and there are many, many masks out there that one will be sure to be comfortable on you.
Enjoy your time here, and keep in mind that most of the members are not doctors, just people that are willing to lead you through the do's and dont's of what they have learned. My opinion is that the Resmed S9 Autoset with H5i humidifier and easy clean bowl is the best I have used. But keep in mind that I have used a S8 Elite for 4,5 years and it was also very good, and I use it for a travel/spare machine.
Glad you found this forum, and others that are more knowledgable will give their "opinions" as well.
Rycharde


RE: Just diagnosed - jb1176 - 04-23-2014

Rycharde,
Wow, thanks for quick reply and valuable information. Called the doctors office and told them not to order any equipment until I talk with them. I'm sure they would have ordered the cheapest "brick" as you call it for me without even consulting me. We will see what they have to say when they call me back.

Your rapid response may have saved me a huge headache! Thank You.


RE: Just diagnosed - trish6hundred - 04-23-2014

Hi jb1176,
WELCOME! to the forum.!
You might check out the link below. It has some great information on machine choices.
http://www.apneaboard.com/wiki/index.php?title=Archangle:Machine_Choices
Hang in there for more responses to your post and best of luck to you with your CPAP therapy.


RE: Just diagnosed - jb1176 - 04-23-2014

Thanks Trish6hundred,
I stumbled on these recommendations a couple of minutes before your kind post.

Thanks,
jb1176


RE: Just diagnosed - jb1176 - 04-23-2014

Does anyone know how Medicare works in obtaining a breathing machine? I found the DME section on the Medicare site and plugged in my zip code to get the list of machines and supplies that authorized suppliers will provide. However there are no brand names and only one code for a continuous machine and three codes for bi level machines. My understanding is that Medicare rents the machines and after 13 months the equipment belongs to the patient. However, how do I fight for the top recommended machines from the list that Apnea Board choices recommends? Perhaps aps I can't get those good machines through Medicare?


RE: Just diagnosed - Marnid2014 - 04-23-2014

(04-23-2014, 03:08 PM)jb1176 Wrote: Does anyone know how Medicare works in obtaining a breathing machine? I found the DME section on the Medicare site and plugged in my zip code to get the list of machines and supplies that authorized suppliers will provide. However there are no brand names and only one code for a continuous machine and three codes for bi level machines. My understanding is that Medicare rents the machines and after 13 months the equipment belongs to the patient. However, how do I fight for the top recommended machines from the list that Apnea Board choices recommends? Perhaps aps I can't get those good machines through Medicare?

I am also on Medicare, and I just told the DME the machine I wanted and they gave it to me. Make SURE you are compliant, or they will take your machine away from you. Medicare requires 90 day's of data showing at least 5 hours (I think it is) of use each night in order for you to keep your machine. They will take the card out of the machine and look at it and then you must see your doctor for follow up. If you do all this, the machine is yours after 13 months. My suggestion is go get the ResMed S9 machine. Download the software and make sure you check your data all the time so you know that your apnea is being REALLY treated. You will be shown your leak rate and other things that make a huge difference in your thearapy. People here will guide you to make sure you are comfortable. I had no clue that my leaks were above what is considered safe and had to work with pressures and masks until I was on my way. Good luck and welcome to the forum, THIS IS THE BEST PLACE!!!!!!!!
As far as a mask, if you are a side sleeper the nasal pillows are good and they are comfortable, at least for me. I have the p10 by ResMed, it's very low profile, I struggle with it a bit though, it's too loose on me so I am modifying it.




RE: Just diagnosed - Gabby - 04-23-2014

Welcome jb1176!
I can see you are already receiving excellent information.
You have come to the right place.
Stick around and good luck with your CPAP journey.


RE: Just diagnosed - jb1176 - 04-23-2014

Wow! You all are great and so swift in your help. I needed it quickly before they ordered equipment I didn't want. Told them to wait until they heard from me. The pulmonary doctor's assistants order the machines. Does the pulmonary doctor have to write an Rx for a specific machine? I think I just talk to his staff and never have contact with the DME people. Trying to figure out how to get the ResMed S9 auto set with the p10 ResMed nose pillows and not some cheap generic product.


RE: Just diagnosed - retired_guy - 04-23-2014

(04-23-2014, 09:47 PM)jb1176 Wrote: Wow! You all are great and so swift in your help. I needed it quickly before they ordered equipment I didn't want. Told them to wait until they heard from me. The pulmonary doctor's assistants order the machines. Does the pulmonary doctor have to write an Rx for a specific machine? I think I just talk to his staff and never have contact with the DME people. Trying to figure out how to get the ResMed S9 auto set with the p10 ResMed nose pillows and not some cheap generic product.

You ask the docs people to please specify a "ResMed S9 auto set with the p10 pillows mask" on the prescription. That'll do it.

They should be willing to do this, as it's really no skin off of their noses.