After Covid time to look for a new doctor/sleep doctor

[Homerec130]

Kellysfriend,

I use a full face as I am a mouth breather and have a deviated septum. I started out with nasal pillows, but got nowhere with them. My first DME went belly up so I had a new study done and got a new machine. At the study the tech recommended a FFM (full face mask) and I have been using one ever since (almost 10 years).

My wife and I both use the ResMed F20 with the comfort foam on the cushion. I have a tendency to wear my mask a little tight, but then I flew with an oxygen mask for a good many years and we had to wear them to ensure a good seal. My prior mask was the Quatro FX and I still have one buried in the supply box. Both of the masks go from below the chin to over the bridge of the nose. Neither one of us has any issue with leaks around the eyes. My wife also suffers from dry eye so how the mask fits around the eyes/nose is critical for her.

I also run a 10 foot hose which comes over the top of the headboard. That way, if I toss and turn at night, I don't have to worry about pulling the machine off the stand. We both use hose covers, not to help with rain-out, but to keep little kitty teeth out of the hose.

[Kellysfriend]

The ResMed F20 looks fairly comfortable. I might give it a try. I am not adapting to the nasal pillows very well. I would like to though. 

If you are a mouth breather and you wear a full face mask do you breath through your mouth? I know that sounds like a dumb question, except I thought the point of the CPAP is to keep the nasal passages open so the throat does not close up. I am assuming your mouth is not open all the time, otherwise you would sleep with a hose in your mouth and exhale through your nose? 

I do not know why I am opening my mouth now and I didn't all these 20-years before or maybe I was and didn't know it. I know now because my mouth is all gummy and dry in the morning. The machine says I have leaks. It does not say I have leaks everyday.

I get it about pulling the machine off the stand. I have mine sitting in a cart I got from IKEA, It sits down about 3" in the top bin and it is on rollers, I pull it up to the bed so there is plenty of room with the 6" hose. I havee pulled one off a bedstand. I never heard of a hose cover. Just looked them up and will order one. I have a 3-month-old kitten who sinks here teeth into everything. I looked at my new hose and thought I would be in a world of hurt if she bites into it. 

[Big Guy]

I've been a mouth-breather for as long as I can recall. I simply cannot get enough air flow via my nasal passages. 

I currently use an AirFit F30 mask. With it, I can breathe thru my nose, but habit doesn't allow it for very long. So yes, even with a FFM, I still mouth breath.

Oh yeah.....if you're not using a hose hanger / holder, try one. It will greatly improve your experience.

[Homerec130]

Like Big Guy said, you can still breathe through your mouth. I have a deviated septum and nasal pillow never worked for me. I have also always been a mouth breather. I do try to breathe through my nose, but it always ends up switching.

Hose hangers are great. You can either by one that fits between the mattress and box spring or make one of your own. Some folks have put a heavy duty hook in the wall over the bed (make sure you hit a stud) and use a heavy elastic band.bungee cord to hold it in place. Stops you from getting tangled in the house and subsequently pulling the machine off the nightstand.

[BB63]

I suspect part of the original issue stated is that the OT (old timer) practitioner hasn't kept her education current and just doesn't know things that she should know about more recent advances in medicine. This is not a slam against ALL older doctors as many of them do not have a contemporary reeducation issue(s).

I studied this issue in depth about 3 years ago as I transitioned from traditional medicine to functional medicine. What I learned was shocking. It seems that (on the average), it takes 20 years for an Ivy League medical school to teach students regarding more modern findings and practices and medical research findings. A new doctor is 20 years behind the times when they graduate!

Part of this issue is due to the Ivy League medical schools practice of hiring professors based on prestige of the doctor turned professor as a selling point to perspective (newbee) students. The older and well established doctors make massive amounts of money already, but they leave their practice for a more cushy job when an Ivy League medical school makes them an offer they can't refuse. They tend NOT to keep up with recent developments in medical technology-again, there are many exceptions.

Part 3 is the power Insurance Company's have to dictate what they pay for and what they do not pay for. Your doctor MUST conform to their demands, otherwise they don't have a viable medical practice. They also offer kick backs to doctors who don't submit claims for treatment often-this practice indirectly denies the patient adequate and proper medical treatment. Note that the financial agreement between the doctor and the insurance company IS NOT reviewable by the patient, so the patient is left wondering WHY the doctor is unresponsive and acts inappropriately!

And, finally we have Medicare and their dictatorial practices-don't get me started. Legislators in Congress and the House of Representatives???? They have their own agendas regarding reform and refuse to take proper action, again, don't get me started.

I believe our medical system is failing, not due to the professionals themselves.....but due to interference from outside interests. Those who interfere with the doctor's professional purpose do not consider what's best for the patient's health, they only consider what's best for their own pocket books.

AB

[sawinglogz]

What do you consider an "Ivy League medical school"? Your observations may be accurate for many (or possibly most) medical schools, but I have not seen what you describe at top medical schools. Most of the instructors are actively researching, publishing, and practicing.

[BB63]

For the purposes of my assessment above, an Ivy League medical school might be anything from a College that teaches medicine OR a Prestigious Hospital where doctors to be learn while doing under the direction of other more senior medical professionals.

It might have been better for me NOT to use 'Ivy League' in my post at all.

AB

[sawinglogz]

Got it, it doesn't sound like those are serious medical schools at all then.

I don't know how widespread your observations are, but I can well imagine that there are lots of lower-tier schools for kids with low MCAT scores. It sounds like that's what you've encountered.

[Kellysfriend]

I wrote down the type of mask you use to check it out. A hose hanger / holder, never heard of that, I will look it up. Sounds reasonable. The hose is all over the place. Thanks.

[Kellysfriend]

Thanks for the info on breathing through your mouth and the hose hanger. The one you put under the mattress won't work for me. I would need the wall hanging one. Noted on the stud. I looked on Amazon. Dang, I could buy a 6 ft. hose for ten bucks and a 10 ft for twenty. Now that I feel OK about breathing through my mouth I will get out the full face mask I was not wild about and will start with the DME company tomorrow to get the fullface. I know it is going to be a fight. There is a 30-day period if a mask does not work and I am within that 30-days, but it happened once before and they gave me a lot of BS.