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Change Therapist?
#1
Change Therapist?
When my uncle passed away, my aunt told me that if I got tested and needed a machine, she would give me my uncles. It was only used for 8 months. I got tested, needed it, and proceeded with the machine.

When I had my appointment to set up the machine, the therapist didn't know how to do it (have the Philips Resironics A20 BiPAP) and I had to come back that afternoon after she learned how to set it up on her lunch break. She was pushing for me to get a new machine, new face mask, new hoses, etc., and she told me that it's the way they get their money to cover their costs. I'm in Canada and medicare doesn't cover this. She stopped about the new equipment once she realized that the machine is practically new with 2 years left on it's warranty. Her area manager said to waive the $80 set-up fee and to waive the $45 new hose fee as I had a new hose still sealed in it's bag, but that I had to buy the mask at a cost of $345. I inquired about just the face cup, because I have my uncles harness for a ResMed F20, but she told me that the manufacturer only sells full kits, and that there is no way to get just a face cup. (I have since bought a face cup for $38) After all this, she did set it up, and I went home to use it for about a week before my next appointment.

My prescription (according to the doctor I seen) was 19, but he told me he wanted me to start out at 14 and work my way up to 19. According to the therapist, my prescription was for 14, and if needed I could go as high as 19. I had asked to just be bumped up to 19 as I was having no breathing problems at 14 and adjusted to that pressure easily. I was told that she could not change the pressure without first analyzing the data from my machine. She then takes the card out to her area manager who was in her office that day to get the data. After a few minutes, she says that there is no data on the card, and that maybe the card was bad. So she tries to download onto a new card, and she claims the same result. Then they called technical support at Philips, who said that my machine was bad since it wasn't writing on the card, and that they would send a new machine under warranty. I'm to switch mine for the new one when it arrives this week. Now, they must have called Philips because they found out which company my machine was under when my uncle got it when they ran the serial number. Since then I've been using their loan-out machine so that she can get the data for my next appointment. 

Out of pure curiosity, I downloaded the EncorePro software onto my laptop, set myself up as a client and popped in the card. It downloaded the info and I can get the data and charts. Now I'm livid mad at these guys because how does a technician and their supervisor not be able to get data, when I can just download a program and get it myself at home. I'm thinking that they want me to get a machine under their name so that maybe I'm somehow tied to them for ongoing treatment monitoring. After this, I really don't trust them. I'm worried that they will send my unit off, and then I'll be stuck with a new unit that cannot be returned since it's been used, and then I'm on the hook for the cost of that unit if Philips rejects the warranty claim. Of course, my insurance would cover the cost of a machine, but not the cost of THAT machine. Here they charge about $2000 for a regular CPAP, but the one I have from my uncle is $6000, so I'd be on the hook for the $4000 difference. Of course, it would be their mistake, but then I'm sitting with their machine now and don't have my own, so they would have all the leverage. Maybe my mind is taking it a bit far, but I'm planning on going to my appointment on Tuesday and just handing her a printout of my machine's data, and asking her how I am able to get my data when they cannot. 

Should I just be telling them off and get a copy of my prescription and go to another therapist? I'm thinking about the one my uncle had.

EDIT: Just tried Encore Basic and it will download my info, although it just hangs when trying to do a report. I attached the summary report from EncorePro, so it this the info I should be getting? I know the detail is a 16 page report, and the trend is a 6-page report, but both are above the attachment limit. Thanks
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#2
RE: Change Therapist?
Get a copy of your sleep study and prescription. That's top priority. Get your machine back and then dump these people!

Also the print out you have is what you should get on a summary.
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#3
RE: Change Therapist?
Hi DBTaylor,
First, get a copy of your sleep study and a copy of your prescription.  You have a right to those documents.  

I personally wouldn’t put up with the therapist you are currently using.  It doesn’t hurt to look elsewhere.

The machine you have inherited is a Bipap and I doubt it is set up correctly.  It looks like it is set up in Cpap mode.  Hang in there as I’m sure that someone with Bipap experience will be along to help.

Your AHI is a little on the high side, and we can help you with a properly set up machine.

You can order the Clinicians manual for your machine here:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual
OpalRose
Apnea Board Administrator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Change Therapist?
I wanted to point out you can get the provider manual for the Respironics PR System One BiPAP A40 from the CPAP Setup Manuals page http://www.apneaboard.com/adjust-cpap-pr...tup-manual This is a very advanced hospital grade machine capable of CPAP, BiPAP S, S/T, PC, T, and AVAPS-AE. CPAP is most likely the mode you need, however, don't ignore the potential of BiPAP S mode to allow you a lower pressure (EPAP) that resolves obstructive apnea, then use pressure support (IPAP) to deal with any residual hypopnea, flow limitation and snores. For example, you may find an EPAP of 14 works great with IPAP of 18 to resolve everything better than a fixed pressure of 19. Let's leave that judgement for later. The sleep study will provide the snapshot results of various CPAP pressures, and a recommendation, that is a fine starting point, but eventually it would be interesting to make use of the next level of therapy available.

As far as using this supplier as a therapy consultant and paying them fees for that service, I'd suggest you can get better suggestions between this forum and your own use of software and personal judgement. I would ensure you have copies of your prescriptions, and find the best price online for replacement supplies.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Change Therapist?
Thanks for the quick replies. The way it works here is that in order to see these people you first need a recommendation from your doctor, and since they are located in a town 20 minutes away, that's where I was sent to. I have been in contact with the other company, which is in a city an hour away, and I just need to bring them a copy of my prescription for them to work with me.

I think I'll just finish with the ones I'm with now, and get the mask I'm using from them since I already said I would. It's a Simplus and has less leakage than the ResMed one I recently bought online. Then I'll go to the other providers.

Thank you for all the help.
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#6
RE: Change Therapist?
Be sure to keep copies of your first post here in case you need to reconstruct details later for some kind of claim. A screenshot that also captures the time/date clock of the post might be a good idea.
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#7
RE: Change Therapist?
DB Taylor, you still have a fairly high apena index between 6 and 16 events per hour. I'd like to see you increase pressure by 1-cm and see if it results in an improvement. Not too difficult to make that change. We want to verify the apnea respond appropriately to pressure increases to eliminate the possibility that there may be centrals involved. Simple OA will respond to increased pressure. If AHI increases, then the situation gets more complicated. It would help a lot to know if event are apnea or hypopnea. If most of those events are hypopnea, then pressure support (BiPAP) is indicated.

Other statistics in your report are excellent. If on the graphs, you observe clustering of OA, then a soft cervical collar may help. Turn off the Mask Resistance Setting. You are using 3 with a Fischer-Paykel mask, and should not use the mask settings with other brands. I have no idea if this will help, but can't hurt.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Change Therapist?
I find it funny that you received the same bulls*** comment about the manufacturer not selling replacement face cups as I did. Sounds like that is the corporate lie/policy for selling entire new masks.

I'm in Canada too, does the vendors name begin with V for victimize?
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