Saw my sleep doc today...changes

[ramblingasian]

TyroneShoes that was a very interesting read and you brought up a lot of good points. I think my sleep doc is one of those docs resisting change. Change is more difficult for most people as we age and my sleep doc looks to be about 70. I am sure he like many other docs will stick with what they know and as you pointed out it's their bread and butter. Someone that age also does not understand technology, is not interested in learning it, nor put any stock into it.

I think I may end up buying myself either an open box or slightly used Auto CPAP machine at some point in the coming months depending on how my therapy progresses.

I like how you blame your doctor even though he has absolutely no control over what machine he can prescribe you. I hate to say this, but you do know that even if you had a young sleep doctor you wouldn't get prescribed an APAP anyways. It has nothing to do with your doctor. If you really want change, you will need to go to your MPP and get them to change the rules set by the government.

As I've mentioned before, you can purchase your own APAP machine if you want. It just seems ridiculous that you're blaming someone for something that is beyond their control.

[cate1898]

I like how you blame your doctor even though he has absolutely no control over what machine he can prescribe you. I hate to say this, but you do know that even if you had a young sleep doctor you wouldn't get prescribed an APAP anyways. It has nothing to do with your doctor. If you really want change, you will need to go to your MPP and get them to change the rules set by the government.

As I've mentioned before, you can purchase your own APAP machine if you want. It just seems ridiculous that you're blaming someone for something that is beyond their control.

Hey I'm not trying to blame him for the sake of shifting blame. I honestly had no idea that the docs had no leeway in deciding to prescribe auto CPAP's. I was trying to get him to talk about it cause I really like what I have heard about the A10 FOR HER in particular. Supposed to be more suited to the way a female has OSA compared to a man.

Knowing what you are telling me, I realize there is no sense in trying to bring the subject up again! Thanks for enlightening me!!

[zonk]

I like how you blame your doctor even though he has absolutely no control over what machine he can prescribe you.

In the first instance, he prescribe "CPAP" model, when cate1898 ask few questions, he have no answer as "CPAP" model does not report any useful data to figure what is going on. So, he wrote a new script for the "Elite" model, the Elite is top notch fixed pressure machine. Its not about money, there is not a lot price difference between the models, so has to be about something else than money
My guess, they like to be in control, dispensing "AutoSet", hand the control back to the engaged patient (where should be)

[ramblingasian]

I like how you blame your doctor even though he has absolutely no control over what machine he can prescribe you.

In the first instance, he prescribe "CPAP" model, when cate1898 ask few questions, he have no answer as "CPAP" model does not report any useful data to figure what is going on. So, he wrote a new script for the "Elite" model, the Elite is top notch fixed pressure machine. Its not about money, there is not a lot price difference between the models, so has to be about something else than money
My guess, they like to be in control, dispensing "AutoSet", give the control back to the engaged patient (where should be)

Sorry, but the OP chose a DME that wouldn't provide her the CPAP model she wanted. She did not need the doctor to prescribe her that specific CPAP model. The DME could have provided her the machine but chose not to do so. That's not the doctor's fault.

As well, since you're not from Canada and you seem to have no actual knowledge of the actual process to get a machine with government money, let me make it clear to you: unless she fits tight criteria, she will not be prescribed an APAP machine under the public insurance program. It's not the doctor's call. It's the government's.

And you are wrong about the patient not being in control. She can have all the control she wants. The OP is free to purchase whatever machine she wants, but if she wants a massive government discount on the machine, she must purchase the machine that her diagnosis dictates.

It's as simple as that. We can talk semantics about everything from A to Z. But unless the OP decides to petition the government, the doctor has his hands tied. So don't blame the doctor in not prescribing her an APAP.

[zonk]

As well, since you're not from Canada and you seem to have no actual knowledge of the actual process to get a machine with government money, let me make it clear to you: unless she fits tight criteria, she will not be prescribed an APAP machine under the public insurance program. It's not the doctor's call. It's the government's.

From http://www.health.gov.on.ca/en/public/pr.../cpap.aspx
If you meet the ADP medical eligibility criteria and your sleep physician confirms that you have obstructive sleep apnea syndrome, an Application Respiratory Equipment and Supplies form will be completed. Your sleep physician and sleep clinic staff will decide what type of equipment you require.

[ramblingasian]

As well, since you're not from Canada and you seem to have no actual knowledge of the actual process to get a machine with government money, let me make it clear to you: unless she fits tight criteria, she will not be prescribed an APAP machine under the public insurance program. It's not the doctor's call. It's the government's.

From http://www.health.gov.on.ca/en/public/pr.../cpap.aspx
If you meet the ADP medical eligibility criteria and your sleep physician confirms that you have obstructive sleep apnea syndrome, an Application Respiratory Equipment and Supplies form will be completed. Your sleep physician and sleep clinic staff will decide what type of equipment you require.

Yes, the sleep physician and the sleep clinic staff will decide what type of equipment you require. However, you conveniently neglected to include the actual section where the rules for the ADP program are.

From The ADP rulebook for CPAP/APAP and BiPAP

335.01. The individual must have polysomnographically documented OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more; and the change must occur between REM vs. NREM sleep or supine vs. sleeping on their side.

Now that I've given you the actual rule that the doctor must follow in prescribing an APAP machine, can you tell me where in the rule above does it say that the doctor can prescribe any machine the OP wants if she wants to follow the ADP rules, as you claim?

[ramblingasian]

I know everyone on this forum has their utmost well meaning in mind when they immediately tell new CPAP users that an APAP is the best machine possible. And for most places, including most parts of Canada and the US, I agree it's the right call.

However, I've found quite a few instances both on this forum and on others where for users in Ontario, they immediately are told that an APAP is the best machine possible, and that is the only machine that you should ever be prescribed by a doctor.

I'm worried that by not knowing the proper rules and by giving people incorrect information like in the above posts, new users will be immediately disappointed when they do not qualify for an APAP through the ADP program that forums like this "promise" them they would get. This disappointment could inevitably lead one to quit using a CPAP machine that can still provide proper treatment to a user because they have been told that the machine is "inferior".

[zonk]

Rules are not set in stone, at times, they throw the book at you and at other times, they let you scot-free

Thanks of setting matter straight

[cate1898]

I know everyone on this forum has their utmost well meaning in mind when they immediately tell new CPAP users that an APAP is the best machine possible. And for most places, including most parts of Canada and the US, I agree it's the right call.

However, I've found quite a few instances both on this forum and on others where for users in Ontario, they immediately are told that an APAP is the best machine possible, and that is the only machine that you should ever be prescribed by a doctor.

I'm worried that by not knowing the proper rules and by giving people incorrect information like in the above posts, new users will be immediately disappointed when they do not qualify for an APAP through the ADP program that forums like this "promise" them they would get. This disappointment could inevitably lead one to quit using a CPAP machine that can still provide proper treatment to a user because they have been told that the machine is "inferior".

ramblingasian; this is true. I have definitely felt disappointed and also wonder if I am getting inferior therapy. Perhaps this is not so.

You are right BTW. When I was at the DME the first time, the RT said that they did not have a data capable machine to loan me and that the Escape was my only option. It was only since the doc requested a data capable machine that they had to provide me with one. They ended up giving me what was their demo model of the A10 Elite, which oddly enough they tell me they've never sold one. I guess I'll be their first when I buy!

Thanks for the link. I have saved it.

[zonk]

I'm kind of hopeful that I'll have more improvements in the coming weeks. I had an appointment with my sleep doc today and I complained about the following:

-still having morning headaches - although I confessed they are not as severe
-still just as tired
-still waking 2-4 times per night
-air pressure seems ok at bedtime, but wake up feeling like it's not enough


Pros:
-snoring has stopped (at least I've been told by family)
-full compliance since beginning CPAP
-sleeping about an hour longer on average in the a.m.


Upon hearing about the above, the sleep doc decided to increase my pressure from 6 to 7.5. And he wants to look at the data next time I come in, so he ordered the DME to provide me with a data capable machine (YAY!!)

Let us hope, the pressure increase does the job
Out of interest, is snoring and headache got better with the new machine and new settings, also what is AHI and leak so far?
You'll need to check "Essentials" set to "Plus" in the clinical menu so more info displayed on the screen sleep report and period set to 1 day (for last night data) default set to 1 month. Whenever the machine unplugged period revert back to 1 month

A10 setup and how to get the clinical manual for your CPAP machine
http://www.apneaboard.com/resmed-airsens...setup-info