[Treatment] What should be typical during a review/check-up from your doctor?

[KGsleep]

Hello,

I’m looking for feedback on what would be standard practice during a sleep apnoea review with a consultant or similarly qualified health care professional regarding the treatment of sleep apnoea.

I’ve been using CPAP for 11yrs now. I was originally diagnosed whilst on a work assignment in the US in 2012. I had some reviews in the US in 2012 & 2013 before returning back home to Ireland in ‘13. Until recently, my last review was in Ireland in 2014.

I had a review recently with a Consultant in Respiratory Medicine who specialised COPD, Sleep Apnoea, Respiratory Sleep Disorders. This was not the same doctor I seen in 2014.

I felt the recent review was not very thorough and some basic things that should have been done were not. Also, these are things that were done in all recent reviews in both the US and Ireland.

Firstly there was not a review done on the data from my CPAP machine(Philips system one 60 series). I had brought my machine with me it as I assumed this would be something that the doctor would be doing. The doctor advised me that he had no capability of performing this task and directed me to use Sleepyhead.

Something else that was not done was an inspection of the mask I was using and how it fitted and functioned whilst I was wearing. Again this was something that was done on the previous reviews that I had. In fact, when I asked the doctor if he wanted to see the machine and setup I was using, he had no interest and said something along the lines of “there was no need to take a look at it, its just a machine”

I came away from my recent consultation feeling that a proper review had not been performed. Also this was based on previous past experience were I felt a more thorough review had been done.

However all above said one can’t help but second guess themselves. This is the reason I’m posting this here to look for feedback on what would typically be standard during a review of sleep apnoea treatment with your doctor.

Thanks in advance for taking the time to provide your feedback.

[Sleeprider]

After 11 years of therapy, you might know more than the doctor, or should as it pertains to your own therapy. In the U.S. we tend to have brief annual follow-ups that consist of a questions like, How is your therapy going? Any questions? There is nothing really stipulated as standard practice unless a sleep study is being conducted or a specific problem addressed. I think when you have an appointment like this, you should come prepared with an agenda, data, equipment.

At least your doctor was aware of Sleepyhead / Oscar. If you have concerns about your therapy, I suspect you will get more return on posting a chart and asking your questions here. I think your experience is more typical of any medical consultation without an identified issue or problem.

[mesenteria]

The past is prologue. 

One's immediate and recent history is a very good predictor of what is likely to be the case for the next while.  So, if we can be charitable and assume that those meeting you took the time to peruse your recent treatment results, that person would have mentioned any weaknesses or troubling issues...wouldn't they?  If your results show that your treatment is within a narrowly defined range of 'acceptable', much like an AHI below 5.0 is deemed to be 'acceptable', then he/she needn't belabour those matters with you.  If your AHI results are good, then your mask fit and the delivery of air must be suitable.  That would be my conclusion.  Any other matters of concern to you would be your responsibility to raise....in my view.

[Gideon]

I really wish I could say your experience was not typical. Sleeprider nailed it. Lacking a problem to dive into typical seems to be a simple keep doing what you are doing and see me in a year.

Post your charts here. I'm sure you will either find you have no issues or you will learn a lot. And please be very critical on how you feel. That is so very important for your therapy.

[KGsleep]

Thanks for the responses.

Using OSCAR I have sent a 6mth report to the doctor and he said he will review.

For posting charts here, is it just screenshots that one posts?

[Sleeprider]

Our preferred screenshot is shown in the tutorial for Organizing your Oscar Charts. If there are issues that need a different view we will ask for more information or zoomed images on things like mask pressure, tidal or minute vent, resp rate and some other things. We can see a lot from the full-night view, but sometimes the 3-minute zoomed view tells us important information about the respiratory wave form that is only available when you can see the individual respiratory wave-form and can learn about flow restriction, tissue obstruction, and even cardiogenic oscillations and insufficient inspiratory effort. Normally, not needed.

[Homerec130]

I bring a copy of my OSCAR report to my sleep doc and we go over it. He usually asks if I am having any problems (which I don't), asks about my supplies, updates the script, and sends it off to my DME. I see him every 6 months.

Last week we went to my wife's sleep doc. She has her bring in the machine (mine doesn't) and we spent the whole appointment with the tech as her numbers were what we were trying to accomplish. We are trying to get her compliance reestablished with Medicare.