Deemed untreatable

[Gfm]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tired during day, I know I stop breathing at night, but I sleep! When I try to use resumed Quattro- air mask I am exstreamly tired during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D.o.t. to take away my comm. lic. I am very scared! P.S. I also stop breathing with mask............ Thank you for all the input, very helpful. I see the cpap technician tomorrow May 2 2014 I will get more information about my machine and what's it doing, and post that info. A lot of the tech response I don't understand from here! but I will learn them as I go along. My attitude has changed since joining this site 3 days ago. Thank you

[Bill44133]

What kind of machine are you using?

[The Latinist]

I'm guessing the term your doctor used was not "untreatable" but "noncompliant" -- as in "you are not complying with the treatment I prescribed." Here's the thing: once she has diagnosed you with sleep apnea, she has a responsibility to see that you treat it. Whether you think you're tired during the day or not, your sleep apnea could cause you to be less-than-fully alert, creating danger to yourself and others. It's a huge liability that both you and your doctor have to be concerned with.

The answer for you is to find out why your treatment is not working satisfactorily, not simply to stop using it. Perhaps your mask doesn't fit properly; perhaps your pressures are not set right. Perhaps you need a different machine or mask. The first step is to let us know what your machine and pressure settings are so that we can make informed suggestions.

[chunkyfrog]

If your inability to tolerate the mask and machine is due to service-related reasons, you may qualify for disability.
If you would prefer not to go that route, there are dozens of other masks which might work for you.
Nasal pillows are very minimal, and many of us find we open our mouths much less once we are comfortable with therapy.
Thank you for your service; and now let's fix this problem!

[Pugsy]

The DOT requirements for being "compliant" are really rather generous in the grand scheme of things.
What are you scared of? Having your medical card and thus your CDL license pulled or what might happen to your body with the sleep apnea going untreated?

To maintain your DOT CDL you are going to have to prove compliance now and at any time they want to check it in the future...they are really getting serious about cracking down on medical issues to keep the medical card.

[jencat824]

The DOT requirements for being "compliant" are really rather generous in the grand scheme of things.
What are you scared of? Having your medical card and thus your CDL license pulled or what might happen to your body with the sleep apnea going untreated?

To maintain your DOT CDL you are going to have to prove compliance now and at any time they want to check it in the future...they are really getting serious about cracking down on medical issues to keep the medical card.

Pugsy is 100% correct. If you want your job, once you have diagnosed with OSA you MUST be compliant, meaning you must use your machine for x number hours per night. If you value a job driving using your CDL, you will have to comply. Search 'CDL' & you will read some of the difficulties CDL holders are dealing with. My hubby has recently had his medical card pulled, he had to comply with no longer taking sleeping pills. He was CPAP compliant, but suffers from familial insomnia. Too bad, if he wants to work at his decent paying job, he will have to do without his meds. He choose to keep his job & his CPAP therapy is keeping this from being even worse. You may not think you need therapy, but according to the DOT you must comply. The choice is yours to decide if that CDL is worth it. With CPAP your overall health will be better. Without CPAP you can look forward to heart disease, stroke, diabetes, to name a few things that CPAP us can prevent. Your choice.

[Todzo]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tierd during day, I know I stop breathing at night, but I sleep! When I try to use resmed Quattro- air mask I am exstreamly tierd during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D.o.t. to take away my comm. lic. I am very scared! P.S. I also stop beathing with mask

There are indeed nonanatomic causes of Sleep Apnea which CPAP exacerbates rather than helps. That is why, I do believe, so many find themselves unable to benafit from CPAP use.

But that also means that truck driving is not for you.

[Wulfman...]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tierd during day, I know I stop breathing at night, but I sleep! When I try to use resmed Quattro- air mask I am exstreamly tierd during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D o t to take away my comm lic I am very scared! P S I also stop beathing with mask

How long have you been on CPAP therapy?
How have you tried to address the issues you've had with your therapy?
How much time (if any) do you have to try to correct your predicament?
Did you tell the VA doctor you are having problems and need help adjusting to your therapy?

Whatcha gonna do???


Den

.

[avi123]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tierd during day, I know I stop breathing at night, but I sleep! When I try to use resmed Quattro- air mask I am exstreamly tierd during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D.o.t. to take away my comm. lic. I am very scared! P.S. I also stop beathing with mask

Comment,

May be DOT would be doing an important service by NOT letting those with OSA drive trucks on the roads. Why is OK for DOT to control licensing persons with Alzheimer's, Parkinson's, etc., and not for those with OSA's? Do you know that DMVs expect family members of those with Dementias to report it to them so that the DMVs could test them and decide if to revoke their licenses? There are other options that the DMVs could impose instead of revoking licenses such as not driving at nights and/or not driving above certain speeds. Notice that Docs are out of the picture b/c they would not contact the DMVs as being afraid of getting sued.

See this:

http://www.ncdot.gov/dmv/driver/medical/

[Todzo]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tierd during day, I know I stop breathing at night, but I sleep! When I try to use resmed Quattro- air mask I am exstreamly tierd during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D.o.t. to take away my comm. lic. I am very scared! P.S. I also stop beathing with mask

Comment,

May be DOT would be doing an important service by NOT letting those with OSA drive trucks on the roads.

yup

Why is OK for DOT to control licensing persons with Alzheimer's, Parkinson's, etc., and not for those with OSA's? Do you know that DMVs expect family members of those with Dementias to report it to them so that the DMVs could test them and decide if to revoke their licenses?

I really wish we used the vigilance monitoring technologies to help with this process.

There are other options that the DMVs could impose instead of revoking licenses such as not driving at nights and/or not driving above certain speeds.

If they cannot maintain vigilance day or night at any speed is not safe!!!

Notice that Docs are out of the picture b/c they would not contact the DMVs as being afraid of getting sued.

Which would you rather be sued by? An angry person whose loss of job you can well justify. Or the injured, those that suffered property loss, and the families of the dead.

[space45]

Problem! I am a commercial driver, diagnosed with severe sleep apnea, I am not tierd during day, I know I stop breathing at night, but I sleep! When I try to use resmed Quattro- air mask I am exstreamly tierd during day! So I don't use it. Now my Veteran's Adm Doctor said I am untreatable and she is going to contact D.o.t. to take away my comm. lic. I am very scared! P.S. I also stop beathing with mask

like what has been said, some are lucky and get a good treatment system going right away and others have to struggle to find something that works.
if your are serious about wanting to stay driving then you need to do several things, one get a laptop so you have a computer with you in the truck if your a long hauler, if your home every night when just make sure you have access to a computer, next a o2 meter, I use the contec sleep apnea screening meter model RS01, use that to monitor your o2 levels through out the night, also get a VPAP or equivalent and download the software for it and use it. your insurance may not cover such a high end unit, but it will make changes through out the night and report to you what it is doing, then you adjust the setting in response to what it is telling you. next make sure your mask is sealing and doing its job, you may get away with a nose mask and a chin strap to keep your mouth closed, you need to make sure air is not going out your mouth, the first guys to lend me a machine did not tell me that and yes nights were worst with machine when with out, if you need a full face mask like me for what ever reason then get one, and keep getting and trying masks till you find one that fits and works. that can take some time and be costly so read up on the forum on masks and fitting and adjusting them and getting them to work right, that is a art in and of its self. when you get it all working you will get a good nights sleep. also have you done a proper sleep study at a real sleep lab? if not I would ask for that, demand it if need be.

you need to do whats right for you, and the VA has a real bad record for doing the right thing. they are appalling to say the least. I thank the men and women that serve their country in that way and hate the way they are treated when they come home. it is a real shame on the countries part for not being more on top of all this and looking after their veterans better. they above all others deserve better.

hope this helps and it all works out for you
Stan

[sleepy1235]

The obvious issue hasn't been raised.

If your doctor contacted anyone saying you were non-compliant or non-treatable I would think that would be a serious violation of patient-doctor confidentiality.

Also, I think it might be a matter for the local medical review board. This is a serious breach of ethics.

Also, what is she going to say to the Dept. of Transportation, I am so-and-so's doctor and he isn't compliant?

Did the doctor have evidence of this, and if evidence was produced it would be your private medical records.

Get a new doctor.

[Julie]

Sleepy, I understand your indignation, but you may not be aware that doctors are mandated to report dangerous drivers (as they might believe them to be). It's been around quite a while and pertains to e.g. patients with epilepsy that haven't been shown to be treated effectively (may not be anything the patient or doctors are doing wrong, just a fact of life for certain hard to treat patients), or certain seniors with dementia, etc. etc. The doctor could lose their license if they didn't speak up.

[sleepy1235]

I didn't know that.

It would seem that this might discourage commerical drivers from seeking help.

I still think strong arming someone isn't the way to convince them.

Also, there might actually be some problem with the machine or the set up.

[Todzo]

I didn't know that.

It would seem that this might discourage commerical drivers from seeking help.

I still think strong arming someone isn't the way to convince them.

Also, there might actually be some problem with the machine or the set up.

Probably we should just go to vigilence monotoring and let the monitors make the determination of fittness.

Frankly about half of the time the treatments we have are unusable or otherwise do not help. And doctors tend to loose contact with those treated. That leaves a lot of people out there that are under treated and still a danger.