Letter to Resmed.

[purple]

Hi,
Date: November 15, 2012 11:28:28 AM CST
To: ideas@resmed.com

1. I wanted to suggest an idea for a mask. Nearly all of we xPAPerS have at one time, and will again, have had a cold or nasal congestion that prohibits breathing through the nose. Nearly all Full Face Masks that I have used, prevent the mouth from opening.

I feel we need a mask to breathe through the mouth. Perhaps exclusively through the mouth.

My sister needs CPAP, but she has sinus infections that have become so frequent and severe that she can not use CPAP. She needs a mask which can be used mouth only.

I realize that kind of mouth only breathing comes with problems, and acclimatization issues, but then, this is a mask which nearly all PAPer'S will choose to have for a emergency.

2. Six months ago I had my appendix removed. At the last moments before I went into surgery, I asked the surgeon if I was going to wake up with my hands tired and a vent tube down my throat. He said, "No, they used a lighter anesthesia. After the several hours I woke up, as the Surgeon described, with me already in my bed in an assigned room. I was mostly sitting up and with my FitLife Total Face mask on, blowing, with the O2 cannula under it. If I knew the truth about how my EKG changed during that surgery, I would feel the need to Sue someone. So I am pretty sure no doctor is going to tell me. I had before the surgery one funny looking T Wave. On a resting EKG my doc said I had a right branch bundle blockage, which meant to him, that the right side of heart did not beat in proper rhythm. The right side being better for this problem than the left side.

My sister had a surgery on, her nose, that was before she knew she needed CPAP, but she had a long history of feeling tired much of the time, and not having good sleep. The Surgery was, like mine, laying down on her back. While the Surgery was in progress, she had a heart attack. Later Stress Tests and Nuclear medicine study said there were no blockages in her heart.

Seems like we need a Standard for Surgery, when those who already use CPAP, or who might need CPAP to use a Vent, or something better than blind luck.

I suggest Resmed get behind the concept of using a proper vent for surgery, and push.

3. It is obvious as well, that my machine does not normally come with the attachment for O2. That machine was then a Respironics' M Series Auto CPAP with A-Flex. Still, seems to me that it would be easily possible for a company to manufacture a short piece of hose to go between either the mask and the long portion of the hose going to the mask, or between the mask and the hose. Then stock this as a sterilized, but not smelling like plastic part, in every hospital. Shame there is no way to make sure that the humidifier is not turned on after surgery. The staff is smart enough not to want moist air in the lungs of a post surgical patient to prevent infection. Still that was a miserable four days with my dry nose and airways tasting like burned plastic.

4. I took the Series M machine to the hospital, but left at home the machine I purchased a year ago. My DME was furious when I bought a PR System One REMstar Auto CPAP Machine with A-Flex online instead of through them. My Sleep doc was willing to let me get a Resmed, but lobbied me to get a similar PR. Let me say, I had to take out a Lien on my car, and it has been really difficult paying that off. The reason that send me to the ER the night when my appendix was taken out in the early dark of morning, was that I had a huge painful abdomen. None of that swelling from the Appendix, but from Aerophagia. After discovering that I could not tolerate a Nasal mask. I came to the conclusion I needed a Bi-Level machine. My sleep doc is willing to write the script, Medicare probably will not pay for their part. I do not see how I can pay my 20 percent at best. Someone gave me a low hour S7 Malibu, which has helped a lot in my treatment. Which led me to a new series of issues. My DME, not surprisingly will not touch either my PR System One Auto or S7 Malibu to set them, as I did not get the machine though them. My Sleep Doctors office has an absolute policy not to plug any thing into the USB ports of their computers, I am sure it is an from a directive on-high to prevent malware getting onto their machines. The sleep doc’s office told me it was the DME’s responsibility to read the data, and send it to them. Altho, the Sleep Doc’s office will read an SD card. I got around that by learning how to Plug the S7 into a serial to USB adaptor cable, download the data onto my computer. Cost me a lot to buy new printer cartridges to print that stuff. Resmed Software is awful. I see why my Sleep Doc lobbied for me to get a PR machine. I doubt if the complaints about the Resmed software to read these things is a surprise to you. No reason for me to repeat all the things about how your software is not in a class with PR, you already know.

What I did want to say. I have been told that the difference between the Bi machine I now need, and the lower level Auto CPAP machine is some plastic pieces, and firmware. I fully agree that a company which spends a lot of money developing and testing software should be compensated for it. Still, seems to me that Resmed could make as much profit if they dropped the guise of producing a lower machine, and only produce as their lowest level machine which is selectable up to auto bi-level machine. And then raise the price for that one by only a few dollars. Then I would not have to have this nightmare of trying to get Medicare to pay for the machine which I need. We now have book keepers making medical decisions based only saving dollars, and not really based upon need.

Let’s see did I cover it all? My sister needs a mouth only mask, and so do a lot of others. There is real risk for CPAPers’ in having surgery, because some doctors do not consider the risk. Your company can sell some type of standard O2 adaptor that can be universally stocked in hospitals, and DME’s for those who might have a need for an O2 addition. That is hose to hose adaptor on each end.
Resmed needs to upgrade their software to compete with PR, or even the open source SleepyHead. I feel it is nearly impossible to meet the standards to get insurance to allow for me to have a Bi machine for Aerophagia. Altho, Resmed might not give up any profit they now get by making their minimum machine an auto Bi machine with options software selectable. In fact by reducing the number of products in their line, might have some cost savings.

I am aware that companies do not pay outsiders for ideas, and I write this with the knowledge that Resmed is not responsible to pay for any use or partial use of the ideas in this letter, or the loss of the information contained in this letter.

Uh, I also feel I should say, I would really like a modern, new Bi machine, but can not afford to pay for it. Like anyone on Social Security, I am desperately poor, and need money for better food, and so on.

[zoocrewphoto]

I'm confused. A full face mask is so that we can breathe through the mouth. I have been using one for 7 1/2 months now, and I sleep with my mouth open. I actually closed my mouth and tried for a few breaths to breathe through my nose to see what it felt like.

I can understand the need for more variety in masks as everybody is different. And I would love to try a mouth only mask (without something inside the mouth). But I am confused as to why you believe a full face mask can only be used with a closed mouth. That would defeat the purpose.

[jencat824]

Maybe this might help your sister, a mouth only mask:

https://www.cpap.com/productpage/fisher ... -mask.html

Good luck to her,
Jen

[zoocrewphoto]

The oracle looks good, but it is not a mask that will work for many people. It has a piece that goes inside the mouth, very similar to a pacifier. I can't imagine trying to sleep with something in my mouth. I would prefer a bubble around my mouth, like the hybrid mask, but without the nasal pillows.

I have the Mirage Liberty, and it is very comfortable. I don't use it very often though as the nasal pillows bother me, and I don't breathe through them anyway.

[chunkyfrog]

If I could not breathe through my nose at all, I would want to use a Liberty hybrid mask;
with the pillow holes plugged up. Luckily, this is not the case, as Resmed's full face size paradigm
assumes a lot more chin than I was given.

[Slinky]

I also do not understand a problem w/breathing thru the mouth w/a full face mask. I've used the Resmed Mirage Quattro, the ProBasic Zzzz Mask and can mouth breathe thru either. I'm currently using the Resmed Quattro FX which I very much like and can breathe thru mouth or nose as w/the Mirage Quattro and the Zzzz Mask. Perhaps her full face mask is too small not allowing her to open her mouth w/o her lower lip falling below the mask cushion???

I am on Medicare. I was started w/the Resmed S8 Elite in October of 2006, paid for by Medicare. In early 2008 it was determined that I needed a bi-level PAP. Medicare paid for my Resmed S8 VPAP Auto as well, Your doctor just has to stipulate your need and most likely a bi-level titration study will be needed.

I sure do NOT understand your complaint regarding Resmed's ResScan software!!!! I have used both ResScan and PR's EncorePro software and I find ResScan MUCH superior. I would take a strong guess that your problem w/the ResScan software is not ResScan itself but rather the limitations of the S7 data capabilities. The S7 is a very outdated CPAP. Its probably equal to Respironics Legacy series and your S7 model is most likely the lower end of the S7 series and equal to a lower end Respironics Legacy series. Resmed has long been superior in the access to and the amount of data available from the fully data capable CPAPs.

There IS a simple adapter for supplementing CPAP w/oxygen. It is a simple "tube" maybe 3 inches long. One end fits on the humidifier where the mask hose would usually fit, in the middle of its length there is a "nipple" for the 02 tubing to fit on and the mask hose fits on the other end of the adapter. I use one. It would be attached at the mask hose opening of the PAP if no humidifier is being used and then the mask hose attached to the other end.

My local DME supplier has serviced both my Medicare purchased provided by them Resmed S8 VPAP Auto "AND" my self purchased out of pocket PR SystemOne BPAP Auto as well as my original Resmed S8 Elite which was provided by a different local DME that I fired as soon as the Elite was paid for "AND" my Resmed S8 AutoSet Vantage that I had purchased out of picket as a slightly used APAP. You just have an unwilling local DME provider. I'm sure it helps that I also get my oxygen and all my oxygen supplies from them making it economically wise to keep me happy since they are very much aware I fired and walked away from my first local DME provider which I switched to my current provider.

[purple]

It is good that others have chimed in on this with their experience and knowledge.

One: I have used several FFM's and none of them allowed for a person to breathe through their mouth. Like the Fischer & Paykill 431 and Forma masks have a chin cup, which keeps the mouth closed, and greatly reduces leaks as the chin cup helps to keep the mask in place. I was seeking to focus the skill Resmed has displayed in designing masks into creating a mask for anyone who had sinus problems, and for colds/flu. Might be that the the mouth only mask someone pointed out would work quite well. You are correct I have never seen it before. There is also the idea of blocking the sinus part of a hybrid mask. I am pretty sure altering any mask will not sell well to the public in that many more sleep apnea patients do not alter their equipment.

Two: Not sure if perhaps Resmed has already improved their software. I am certain that my sleep doctor showed me the pages he received from Respironics Software from my Respironics Series M Auto, and specifically said that the information shown then by an S9 Resmed Software was not as clear to him and fewer pages. Please notice I did not make blank statements, but tried to explain my knowledge level. Once again, the advice of others with other experiences is a good thing.

Three: Taking my APAP machine to the hospital and then undergoing surgery. It is obvious to me that the hospital personell were not anxious to fool with my machine. Too many different machines, too many different potential settings while they only having my word as to what settings should be. The hospital could have simply used a vent during surgery, and avoided any potential O2 loss to my brain, heart, kidneys during surgery. They did not. Resmed is in a good position to press hospitals to raise the bar for how to provide respiration to those in general surgery, and help keep their customers, potential customers alive.

I was sure that there exists an way to easily add O2 to an XPAP machine. Having a universal adapter, sterilized, in a sealed bag waiting at every hospital is an advocacy. I do not feel that the hospital personell calling a DME on the phone were someone will eventually find the right part, get it to the hospital, where an overworked nurse/RT will wash it and then call someone to come around (probably the next day) to insert it. Notice also that some of those actions require a doctor to write an order.

This is an advocacy for Resmed to help place in hospitals the devices which will keep xPAP patients at the best possible functioning, not simply about the existence of devices. Devices which BTW, I have never seen in the front room of a DME, meaning even a DME employee would have to look around to find one, unless the DME was out.

By advocating that no general surgery be conducted for any patient without a Vent covers all those out there who need xPAP and all those categories, did not bring machine, do not know they need xPAP, will not use xPAP, and staff who do not, for whatever reason, keep the mask from leaking while it is being used. Resmed is in a position to help push for the studies that will help to drive the regulation of properly taking care of patients in hospitals. I am sure my docs do not even remember that I said anything about this issue. These kind of issues being something they expect RT's and nurses to take care of without the doc having to do anything.

Notice I do not say that Resmed should lose any money on this.

If I were an Resmed exec, I think, despite my lack of knowledge in some of this, I potentially could get a bonus, and insure my "golden parachute." by a memo like this. Instead I am, like many others out there, desperately poor. Some of that poverty being the result of a lifetime of needing xPAP treatment that was unavailable to me (I am 62), which would have allowed me more energy during the day, to excel at work, which would have brought me more money. As by what happened when I sent this letter, Resmed, only had a bot to acknowledge the letter and say someone would/might get back to me.

Slinky: I am glad you wrote, you allow me to illuminate what I said with more specifics. Sorry you have issues, glad you can get the proper treatment as it is available at this time, and hope that you get everything you need/ feel you need. I only needed O2 when I had surgery and for 48 hours afterward, so my adapting my xPAP to use O2 is not something I was prepared to do. Nor as it turns out, was the local hospital.
Perhaps the problem I have getting a bi level machine is much later than to when you got one. My doctors word is not sufficient for Medicare to provide a Bi Level machine. The DME was sure, looking at the data from my sleep study, that I would not qualify. The DME would provide the bi machine, after I signed a statement saying that I would be responsible for paying the entire cost of the machine if Medicare did not agree to it. By the statements of the DME RT, who has a lot of experience in seeing the acquisition of Bi Level machines, the DME did not believe my case was sufficient to warrant a bi level machine. Aerophagia is not one of the reasons for which a bi level machine is available by Medicare rules. Assuming that Medicare had allowed me to receive the machine, the twenty percent of the cost would have been, to me, staggering. I do not receive enough money now to eat a quality diet. Now those of us on Medicare, with the usual Social Security payments which are below poverty, are being asked to decide to delay, forego health care on their own decision so the government can not be accused of denying health care. Welcome to the new Medicare. We are the surplus population.

In truth, I also buy things which some would advocate I do not need, like internet connection.

I say that while the situation with different classes of machines, bricks, CPAP with data, APAP, Bi Level grew up as the technology improved, there is no reason for companies not to produce a very limited number of machine models which have all the capabilities that would be in any one of these machines, which could be sold for a bit more than an APAP today, and the manufacturers would have the same profit level. We, the patients would not have all this nonsense of different machines, bricks, while having the treatment we need available to us. While giving up insurance rules that are made up by book keepers rather than based upon good practice of treatment, medical facts.

Sleep Apnea machine manufacturers do not need to be making crippled machines to get a good profit for themselves.

BTW: If I have the attention of those on the board who are more knowledgeable who can correct information I get. I had someone who told me that the order of the body organs which need O2 on the highest level are the Kidneys, Eyes, brain, heart. Which raises the question, what are the statistics of kidney damage to apnea patients. Perhaps nature has provided such (as NASA says, back up capacity) that the kidneys survive a lot of abuse from lack of O2. ???? Comments anyone??

[Madalot]

A quick perusal of this thread and I saw the F&P 431 mentioned.

I've been using that mask for over three years now and I CAN and DO open my mouth with it. I breathe through my nose starting out, but always end up with my mouth open when I'm sleeping.

[sickwithapnea17]

the problem with resmed asvs is they are too sensitive and have no ramp- they are really almost impossible for me to use!

[purple]

the problem with resmed asvs is they are too sensitive and have no ramp- they are really almost impossible for me to use!

Excellent point: As I tried to say, but did not say so clearly, a model that can be adjusted to emulate everything out there now.

Madalot: I am glad to hear you chime in. To be clear to those who are reading this, we are talking about the Fischer and Paykill Forma mask. https://www.cpap.com/productpage/fisher ... -mask.html

Maybe it is the size to the point of my jaw to the size of chin up of the mask when I say my mouth is closed when I used this mask. Still, consider that a person who does not want to breath through their nose, for whatever reason, that is more close to my goal. The thought of AND/OR breathing through ones mouth while still being able to breathe through ones nose is quite good for many situations.

We need a mask/model which does for taking in air what the nose does when we breathe.. Part is to clean large particles out of the air with nose hair. Another is make the air moist. We add to this problem the fact that we might have bacteria/virus in our mouth which we do not want being impacted into our lungs all night. I can guess something more like a variation of a mouthpiece of the tube which is used to help start someone breathing again? I specifically did not add a lot to my letter because I was sure that Resmed experts should start with a blank slate, not just rejecting my description which puts them in the wrong frame of mind.

[Slinky]

Purple, most of the problems you are discussing re: your surgery and hospital stay are the direct result of hospital staff ignorance.

I remember a hospital stay, I'd brought my CPAP, Respiratory came down to administer a nebulizer treatment. Somehow, at that point, Respiratory wasn't even aware that I needed CPAP. The RRT was intrigued and impressed w/my Resmed S8 and glad I had brought it as she said the hospital's CPAP they would have provided was so much bigger and heavier. And even she wasn't aware of the 02 adapter between my Resmed and my mask and was impressed w/that. My DME supplier provided that adapter along w/my 02 and PAP equipment. Prior to that I had no knowledge of how 02 was supplemented w/PAP therapy.

When I visited the sleep lab at Mayo Clinic, Rochester, they took my S8 to download the data and brought it back saying they couldn't access the data. They hadn't looked any further than the back of my S8, found no card "slot" and gave up. At that time I was using the S8 ResLink oximetry recorder which fits on the data card "slot" but is taller than the S8 PAP so cannot be left on the S8 when packed in its case. The ResLink was right there IN the case but the Mayo staff evidently was totally unaware of what the ResLink was or how to attach and download the data from the PAP w/the ResLink. And then that night in the sleep lab I had my laptop open to ResScan and was downloading the data whilst waiting for the RPSGT to come in to set me up for the night. She was impressed that I had the software and what data I could obtain from it and said she wished all her patients could have that access.

Its the hospitals and staff that need to become more aware of OSA, OSA needs and equipment. And more are becoming aware and educated. How long ago was your surgery?

As for the bi-level issue. Most insurances and Medicare require that you "fail" CPAP therapy before they will pay for a bi-level. There's been discussion here in the past as to just what constitutes "failure" w/CPAP.

And by the way, most full face masks do NOT have a cup or other manner of keeping the mouth closed. The Resmed Mirage Ultra and the Resmed Quattro FX are two such full face masks w/o cups or other type of chin holder/mouth closer.

[Slinky]

I would mention again that the Resmed S7 Malibu is an OLD model Resmed and it is NOT as fully data capable as the NEWER Respironics M Series and Resmed S8s. It is NOT the Resmed software, it is the age of the S7 and its limited capabilities. Full data capability is relatively new in the history of CPAP therapy. ResScan software can not provide data that the PAP is not capable of collecting and recording. You are not even comparing apples and oranges, you are trying to compare grapes and grapefruits. Or maybe I should say raisins and grapes or prunes and plums?

[purple]

Slinky said, "Purple, most of the problems you are discussing re: your surgery and hospital stay are the direct result of hospital staff ignorance."

Slinky: Great statement. I suggest they are both somewhat ignorant of xPAP things, but it also becomes on the back of their mind. I can guess that during my surgery the guy is using an O2 Cannula to keep my Blood O2 up. When he says to the surgeon, the O2 level is falling, the guy monitoring that cranks up the O2 going to Cannula. Anyone here want to guess how much that helps?

I think a lot of folks here have problems keeping their mask seal during the night. So now, in my case, after putting on the O2 Cannula, the guy is supposed to put my mask over that, and keep it mostly sealed. What are the odds? We all know how difficult it is to keep the mask sealed when it wakes us up for losing seal, and we are experienced with our mask, our way of adjusting it. The surgeon is saying, I have him open, I have to finish. O2 of 85 percent is not good, but I should just finish as fast as I can. Crank up the O2 some more. The one comment the RT guy who watched me during surgery, after I woke up in the room, mask on, sitting up in bed, was that my Remstar Auto Series M (which was four years old) looked brand new. I may have dirty dishes in my sink 98 percent of the time, but I take care of my APAP.

Was I harmed by the surgery? I do not believe in suing doctors, so I have avoided asking for better detail. Something is not right with my cardiovascular system. I know it takes awhile to heal up after surgery. As an old RN once told me, "Any surgery is an insult to the body, and it takes a year to get to feeling OK again." I know I have improved my xPAP treatment. I have lost weight. I hope to spare anyone else the kind of things I now must go through.

I am pushing an advocacy for the much larger group of people out there, who might have surgery, or something laying on their back, who probably should be in xPAP treatment, and for whatever reason are not.

Someone said: "As for the bi-level issue. Most insurances and Medicare require that you "fail" CPAP therapy before they will pay for a bi-level. There's been discussion here in the past as to just what constitutes "failure" w/CPAP."

I was part of one of those discussions: I only know what I know. First of all, no one should expect that Medicare 2012 operates as it did during previous years. I am sure a Sleep doc would say, Aerophagia should first be treated with these kinds of ways, send the patient to an Gastroenterologist, who will try to do this that and the other. Also tell the patient to slope their bed. Essentially, my particular situation, while it might be helped by all that other expenditure of money I do not have, has more complications.

Those complications are a bit interesting from a Sleep Apnea Standpoint. When I first started treatment several years ago, the doc chose a pressure of straight 11, do not use Auto, do not use Flex. I think he was very sharp even though I do not know the reasons for his choice of pressure. I am guessing those who work at the sleep clinic are also have to be sharp, or he would not keep them around. So I am guessing that during the night of my titration, they did a lot of tests that allowed them to come up with straight 11.

I felt from the very beginning, I could, while awake, inhale air faster than the machine could supply it. Which we all know can not be. I think my airway is so constricted that when I pull air, that restriction will limit how much air I get into my lungs, before my body said to exhale. This is why I did not feel rested on a straight 11, and set me onto using Auto. On Auto, as it got up to 15, I got more air on inhale before my lungs said it was time to exhale. I have to wonder if whatever allows my body to sense O2 really works right was part of my issue.

After surgery, the sleep doctor agreed to do another titration. He said that in his experience, that after awhile on treatment, many of his patients could happily get along with less pressure. They felt rested, and the lower pressure was more comfortable. He wrote a titration order to start at 7, if it got to 12, then I should be titrated as a bi level. The first few hours of that was really unpleasant. I felt like I was suffocating, my heart was so stressed that I had to get up to go the bathroom every 20 minutes, and then had to fall asleep again before the monitoring started. At like two AM I had to get up and walk outside to burp out the excess air. That is when the RT, who has been in this business for many years, said she had never seen such a bad case of Aerophagia. When I left in the morning, the RT said I had never slept while laying on my back, that I might have to come back to do another titration night. OH, and how would I describe how I felt. I could groggily only think of how much better the last two hours were than the first five, "pretty good."

The scoring came back and said I should use straight 11, which I have a lot of personal experience as not being enough. I did not know all the Medicare rules as to Bi Level machines. Technically I had failed cpap in a sleep study, because I had not slept on my back. It was really bad for my own verbal statement on awakening was that I felt "pretty good" was a reason for me not to get a bi level machine. Given that currently Medicare is pushing not to spend money, I should not expect that they will agree that I should have a bi level machine.

I do not have any more money to spend on health care. Right now I only have borrowed money and a nearly maxed out credit card to buy food. The twenty percent I would be required to spend on a Bi Level machine, if I did qualify is not something I can afford. My DME expects to be paid. I already owe them money, but so far I have managed to keep that under 100 dollars, so they still ship to me. In fact, I am pretty sure that those in the DME who send me supplies, do not even know I owe money. It is not on their computer how much money I owe, or whether I have insurance or pay it all in straight cash (straight cash would be the maximum payment amount.)

Okay, I have paid very little of what I owe on health care this year. Whatever credit I might have had is being ruined as those bills go to collection. I surely do not have the money to see a Gastro guy, or another sleep study, or pay someone to slope my bed, or pay any percentage of a Bi Level machine.

Insofar as reading the S7, it does not use a card. It has a serial port cable, which I had to buy a serial port cable and an adapter cable to plug into my USB port. My current sleep docs office refuses to read directly from the machine. Their computer security rules say nothing is to plug into the USB ports of hospital/clinic computers.
Docs office says, "Never bring a sleep apnea machine into their office, bring the card. Otherwise it was the job of the DME to read the information and send the information to the sleep docs office."

My DME was furious when I bought my previous APAP from cpap.com instead of through them, and refuses to touch it. I would not bother asking them to read the S7, which they also did not sell me, nor do they have the cables to do that. Besides, I would have to drive like 90 miles to go to their office and back home for them to read the machine. I did end up paying 7 dollars to drive to Wal Mart and another forty something to buy fresh inkjet cartridges to print the S7 reports. Then I had to pay like 14 dollars of gas to go to the sleep doc, and thirty something as a co pay.

Slinky: I just saw your statement about S7 not offering the same data. I am guessing that you have more experience with a Malibu than I, and surely much more experience than myself with other programs. I do know that Malibu-Resmed software offers the kind of detail I want for one day, the last day. All the rest of the days are smashed together so the individual parts of the data is not readable. I like the Sleepy Head software better, but as you point out, that is for a later model Respironics machine. I could hook the S7 every day and get the data, but it does not print it all off so very well. Are you replying to the frustration that Respironics as a company has a corporate philosophy of keep the patients in the dark, don't let them know anything. I agree with that frustration. Sleep treatment is far too important to go six months without know how well one is doing. Still, it is the statement of my multiple previous sleep doctors that Respironics software gives them more detail that they like. I would bet Resmed has heard of that statement, perhaps they have changed their software.

Now the government is agreeing on exactly how to fix Social Security and Medicare, which is code for arranging to keep benefits low, and arranging for my part of health care payments to be higher.

[sickwithapnea17]

people have said that resmed is better than phillips but without a ramp they are really uncomfortable

[zoocrewphoto]

One: I have used several FFM's and none of them allowed for a person to breathe through their mouth.

I am still very confused about your posts. The whole purpose of a full face mask is to use it with your mouth open. Why else include the mouth in the mask? Perhaps you need to loist every mask you have tried and what problems you had with each mask. I have tried two full face masks, and I sleep with my mouth open every night, all night. No problem. I actually had to intentionally close my mouth to see what it felt like to breathe through my nose while using the mask. And that was after using it for over 7 months. I do NOT breathe through my nose while wearing my full face mask. So, I really can't understand why you can't breathe through your mouth with a full face mask. Perhaps your DME is not fitting you properly.

You are asking Resmed for something that already exists, many times over.

Two: Not sure if perhaps Resmed has already improved their software. I am certain that my sleep doctor showed me the pages he received from Respironics Software from my Respironics Series M Auto, and specifically said that the information shown then by an S9 Resmed Software was not as clear to him and fewer pages. Please notice I did not make blank statements, but tried to explain my knowledge level. Once again, the advice of others with other experiences is a good thing.

I suspect that you had an older machine or an older version of the software. I have the S9 autoset with a slightly older version of the software, and it is great!

I was sure that there exists an way to easily add O2 to an XPAP machine. Having a universal adapter, sterilized, in a sealed bag waiting at every hospital is an advocacy. I do not feel that the hospital personell calling a DME on the phone were someone will eventually find the right part, get it to the hospital, where an overworked nurse/RT will wash it and then call someone to come around (probably the next day) to insert it. Notice also that some of those actions require a doctor to write an order.

I have the Quattro FX. There is a piece that can be removed that allows the oxygen hose to go in without disturbing the seal of the mask. I can see how hospital employees may not be aware of these things, but that is certainly not Resmed's fault. They made the capability built-in, so there is no problem.