Update on Dad

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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BleepingBeauty
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Re: Update on Dad

Post by BleepingBeauty » Fri Mar 20, 2015 5:22 pm

bwexler wrote:I could never have your patience. I would call and insist on holding until a manager could come to the phone. When they disconnect instead of placing me on hold I would call back immediately. I find 3 or 4 consecutive calls will get someone out of the "meeting" to talk to me. I always escalate my request from the worker Bee to the senior bee to the manager, general manager, owner/president.
If the phone fails, just walk into their facility Monday morning with your specific RX in one hand and a pillow and blanket in the other hand. Let them know you will not leave til you have what you came for in hand.
I agree with you (in concept, anyway), except for the patience part. I've never been patient, and I'm sure not starting now.

Unfortunately, this is not a brick-n-mortar DME, so there's no physical place to walk into; I only have a toll-free number for them. The office that I'm dealing with is just that - an office. It isn't a place you can walk into and obtain equipment of any kind. It's located south of Miami, and my folks live nearer to West Palm Beach (for those unfamiliar with the area, it's about a 90-minute drive from here with no traffic).

I did call again this afternoon (four times since 4:00 p.m.), and the poor receptionist got an earful of my experience with them thus far. She tells me during the first call that the RTs are waiting for a specific prescription from Dad's PC about the settings (the study report advises an Auto with settings of 5-20), so I asked her why they keep telling me they're coming to set him up (first on Tuesday, then again on Thursday) if they have to get a prescription first? Of course, she has no idea. I insisted on speaking with an RT, and she tells me that all the RTs are in a conference at the moment, that they should be "done soon," and she'll have someone call me. At 4:55 with no return call, it's time for me to call them again.

Call again, tell the receptionist what's going on, that nobody has returned my call after this "conference," and I tell her I want to speak with either Abel (the RT manager) or Juan (an RT). (I got their names a few days ago when I was told one of them would call me back to schedule a visit and set-up for Dad.) Needless to say, I've never spoken to either one. So LSS, she says she's transferring me to Juan. Juan answers after a few minutes, I go through the rigmarole one more time, and he tells me he'll leave a message for one of the RTs to call me back. I said, "But *you're* Juan, aren't you?" He says, "My name is Juan, but I'm in the Call Center. I'm not the RT named Juan." Jeezus, seriously??? How incompetent is this fucking company?

He puts me on hold and, while I'm waiting (now 22 minutes into the call), he disconnects me. Awesome. So I call back, wait on hold for someone to answer, and finally get a girl on the phone, begin speaking with her, and she's suddenly laughing and telling someone that the call froze and "I lost him." (I'm often mistaken for a man on the phone, so no surprise that she referred to me as a "him.") But once again, I'm disconnected and get nowhere on the phone call. Peachy. I call back yet again and get a young man on the phone. I apologized to him straight away, because now I'm really pissed off, and my annoyance is quite obvious. I explain one mo' time why I'm calling, and he puts me on hold (after me telling him to be sure he doesn't disconnect me in the process) to try to reach the RT department. It's now about 5:45, and lo and behold, none of the RTs is answering their phone... (Sure, it's Friday night, and it's time for Happy Hour! ) So the kid in reception apologizes profusely for what I've been through with them thus far, and he then assures me that he's sending the RT Department email outlining the situation with a screenshot of Dad's sleep study/order attached. Again he assures me that someone in the RT Department will call me back, and I reiterate that they've yanked my chain with that line of bullshit all week.

Surprisingly, they're open tomorrow, so I'll be on the phone at 9:00 in the morning to start this crap all over again... GRRRRRRR!!!

My Dad wants me to stop calling them and insists that I not aggravate myself anymore. But I told him I'm stubborn as hell, and this place WILL do what they're supposed to do (even if it kills me). (I rail against this kind of bullshit; can't help myself, as it's just the way I'm built.) I plan to call the folks' insurance plan on Monday, too, and bitch about this experience.

I hate not having any option when it comes to choosing a DME and getting Dad set up with equipment. Believe me, if I had the money, I'd buy from cpap.com and relieve myself of all this hassle... But the situation is what it is, and I'll deal with it.
Veni, vidi, Velcro. I came, I saw, I stuck around.

Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

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Re: Update on Dad

Post by HoseCrusher » Fri Mar 20, 2015 9:57 pm

In a morbid sick way, I am laughing my head off. I can't believe what you are going through.

I am taking notes. This would make a good book or short play. Customer non-service, at its best.

I can't wait for you to get through this, and then see how you fill out the "how did we do" survey...

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Re: Update on Dad

Post by poppi2 » Sat Mar 21, 2015 12:04 am

BB,
I'm waiting for you to tell us exactly how you feel about these guys.
You are so like my older daughter.
I would have trouble sleeping if I had experienced your weeks of frustration.
Give them hell, they deserve it. Earl

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archangle
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Re: Update on Dad

Post by archangle » Sat Mar 21, 2015 4:19 am

Be sure and make a formal complaint to your insurance company. They probably won't care, but nothing will happen if you don't complain. If it's through your employer, formally complain there. Complain to Medicare and Congress if applicable.

When discussing S9, A10, and PRS1, my standard response is that there's no clear winner between the three.

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BleepingBeauty
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Re: Update on Dad

Post by BleepingBeauty » Sat Mar 21, 2015 6:18 am

HoseCrusher wrote:In a morbid sick way, I am laughing my head off. I can't believe what you are going through.

I am taking notes. This would make a good book or short play. Customer non-service, at its best.

I can't wait for you to get through this, and then see how you fill out the "how did we do" survey...
I'm glad you're enjoying the saga. I trust I'll be able to laugh about it when Dad's got his equipment and is getting decent sleep. Then I'll be able to relax and look back on this experience with some amusement (and satisfaction that it was worth all the hassle).
poppi2 wrote:BB,
I'm waiting for you to tell us exactly how you feel about these guys.
You are so like my older daughter.
I would have trouble sleeping if I had experienced your weeks of frustration.
Give them hell, they deserve it. Earl
Let me know when you're ready.
archangle wrote:Be sure and make a formal complaint to your insurance company. They probably won't care, but nothing will happen if you don't complain. If it's through your employer, formally complain there. Complain to Medicare and Congress if applicable.

When discussing S9, A10, and PRS1, my standard response is that there's no clear winner between the three.
Oh, not to worry. Humana will know exactly how I feel about this awful DME when I get done with them. And no, they probably won't give a shit, but I'll have had my say, and it'll be on the record. No employer, as the folks are both retired. I'll likely also contact the state's AG...

Thanks for the opinion on the different machines. As I said earlier, I'd prefer the Respironics for my own reasons, but even if it's a Resmed, I'll insist on the A10.

I've not yet spoken with anyone of significance at this awful DME (it's only been the poor souls in their Call Center, so far); wait til I wrap my vocal chords around the neck of one of these RTs... <rubbing hands and laughing maniacally>

Veni, vidi, Velcro. I came, I saw, I stuck around.

Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

PR S1 ASV 950, DreamWear mask, F&P 150 humidifier, O2 @ 2L.

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Re: Update on Dad

Post by Madalot » Sat Mar 21, 2015 6:37 am

You might want to consider going ahead and calling Humana. Since this is the only DME in their network, you should let them know the issues you are having with them. Might not gain you anything, but then again, you never know.

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Re: Update on Dad

Post by robysue » Sat Mar 21, 2015 9:17 am

BB,

I am truly sorry to hear about the saga you've been through and are continuing to be trapped in with this DME.

I agree with Madalot: There's no need to wait to complain to Humana. Your complaints about the DME should be registered with Humana NOW and not after the fact.

Robysue

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Re: Update on Dad

Post by BleepingBeauty » Sat Mar 21, 2015 12:34 pm

Madalot wrote:You might want to consider going ahead and calling Humana. Since this is the only DME in their network, you should let them know the issues you are having with them. Might not gain you anything, but then again, you never know.
robysue wrote:BB,

I am truly sorry to hear about the saga you've been through and are continuing to be trapped in with this DME.

I agree with Madalot: There's no need to wait to complain to Humana. Your complaints about the DME should be registered with Humana NOW and not after the fact.

Robysue
I appreciate that POV from both of you. As of right now, I'm not going to call Humana until Dad has a machine, because I *did* finally speak to an RT this afternoon and get *some* satisfaction from that conversation.

After a few more phone calls today, I was finally able to speak to the right Juan (the RT) and get the lowdown from him. He says they need a signed prescription from Dad's PC (I'll make sure it's specific enough so that Dad gets what he needs and there's no more delay), that the sleep study report and a note from the doctor about giving Dad an Auto set from 5-20 isn't enough, that they need specific pressure(s). Whatever. I'm going to have the script written from 5-20, same as the sleep study report, since there's no titration to go by, anyway; I'll change the settings once I have the machine. Juan tells me he updated the notes in Dad's file with this info several days ago and apologized that I kept being told that either he or Abel (the RT manager) would be coming out (first on Tuesday, then again on Thursday) to set Dad up. So I'll call his PC first thing Monday and make sure that the script is written and faxed to the DME that day. Maybe Dad will have a machine by mid-week...

From my experience with his doc's office thus far, I'll have to go into bulldog mode again when I call there (i.e., become a huge PITA which, as you guys now know, is not a problem for me ) in order to get this done. (Dad's still waiting on a prescription he was supposed to have filled several days ago, and from what Mom tells me, the pharmacy isn't fond of this doc's office, either; they're apparently very slow. That's been my experience with them, too, thus far. Oy...)

This DME really does leave a lot to be desired, and I feel bad for anyone who has to deal with them. I asked Juan about other things (i.e., fitting Dad with a proper mask, the resupply schedule and how that works, what their exchange policy is on the initial mask, etc.). LSS, he did know some of what he was talking about (he uses xPAP, himself), but some of the crap he was slinging was the usual bullshit we all hear from sleep professionals all the time (like someone who needs a higher pressure can't use nasal pillows). He also told me that he started his therapy with a FFM that "broke his nose." He said it actually broke his nose. I've never heard of that happening to anyone and commented that he must have had that thing strapped down like he was expecting a hurricane or something. Jeezus...

Their return policy on the initial mask is one exchange in the first 30 days. Supplies are on the usual schedule (mask and filters every three months, hose and humidifier chamber every six months) but he said they would need a new prescription every time for those supplies. WTF? Has anyone ever had to jump through these kind of hoops? Seriously, I would like to know, because this seems really crazy to me. My mother is NOT of a mind to be involved in Dad's therapy in any way, so I'll be taking care of it for as long as I'm here; after that, I may have to manage this long-distance.

As to machines, they carry (and offer) ResMed, Respironics and F&P. They do only carry the S9 and not the A10; why? Because their company hasn't been able to work a deal with ResMed, price-wise. Big surprise. So we can choose between an S9 Auto and a DS560.

He kept insisting that a titration was necessary, and I kept telling him that Dad is almost 86, not well, and is NOT going to a lab for an overnight titration, end of story. I also told him how inaccurate they can be, and it doesn't matter as long as we have an Auto and can titrate at home. He then suggested that Dad might want a regular CPAP and not an Auto because of the potential for centrals; I pointed out that he had exactly one central all night during the diagnostic study (a copy of which Juan has in front of him - hello?), so centrals aren't an issue; and since an Auto can also function as a CPAP, we'll take the more versatile Auto, TYVM.

I've found a local pulmonologist/sleep doc and will get a referral to her on Monday, as well. I don't have a lot of faith in sleep docs at this point, but I'd like to meet with her and see how she operates and what she knows, with hopes that Dad could have a good sleep doc on his side to monitor how his therapy is going and help with scripts for resupplies. Not much faith, but fingers crossed...

Opinions, please, on how to word the script re: the mask. Dad's claustrophobic, at times a mouthbreather, and his nostrils are extra-long (so long that the P10's pillows leak). Juan said the only pillows mask that makes an extra-large pillow is the Breeze, but I don't think that's a good choice (not only because of the mouthbreathing, but because of the headgear). I'm thinking maybe I'll have the script written as "FitLife Total Face Mask or mask of patient's choice" to leave us some wiggle room. Juan said he can get any mask by the three manufacturers in a couple of days if he doesn't already have it in stock.

So my first call on Monday will be to the PC's office (for both the script Dad's been waiting on and the one that needs to be faxed for this), and then I'll text Juan to let him know to expect the script. I guess I'll remain in bulldog mode with the DME until the set-up is actually done and Dad has the equipment he needs.

Whew. Deep breath. Okay, now, where's the nearest chocolate?
Veni, vidi, Velcro. I came, I saw, I stuck around.

Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

PR S1 ASV 950, DreamWear mask, F&P 150 humidifier, O2 @ 2L.

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Re: Update on Dad

Post by Madalot » Sat Mar 21, 2015 3:14 pm

BleepingBeauty wrote:
Madalot wrote:You might want to consider going ahead and calling Humana. Since this is the only DME in their network, you should let them know the issues you are having with them. Might not gain you anything, but then again, you never know.
robysue wrote:BB,

I am truly sorry to hear about the saga you've been through and are continuing to be trapped in with this DME.

I agree with Madalot: There's no need to wait to complain to Humana. Your complaints about the DME should be registered with Humana NOW and not after the fact.

Robysue
I appreciate that POV from both of you. As of right now, I'm not going to call Humana until Dad has a machine, because I *did* finally speak to an RT this afternoon and get *some* satisfaction from that conversation.
Makes sense. After reading your last post, I agree with you. Sounds like you *might* be moving in the right direction, finally. You keep pushing (I know you will) and don't like these buttheads get you down, k?

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Re: Update on Dad

Post by On the virge » Sat Mar 21, 2015 4:07 pm

BleepingBeauty wrote: He says they need a signed prescription from Dad's PC (I'll make sure it's specific enough so that Dad gets what he needs and there's no more delay), that the sleep study report and a note from the doctor about giving Dad an Auto set from 5-20 isn't enough, that they need specific pressure(s).
Good luck. My wife's sleep doctor gave us the sleep study, the office notes, and his prescription which was "e-signed". That seemed good enough to me but the DME said they needed a real signature to meet (at least their interpretation of) Medicare requirements. Whether they are correct or not doesn't matter; that's their policy. The DME was helpful in getting what they needed and there was no BS in their manner; that's just their way.
My point is make sure your doctor sends a SIGNED prescription.

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Re: Update on Dad

Post by BleepingBeauty » Sat Mar 21, 2015 4:34 pm

Madalot wrote:Makes sense. After reading your last post, I agree with you. Sounds like you *might* be moving in the right direction, finally. You keep pushing (I know you will) and don't like these buttheads get you down, k?
Thanks again. You know I won't stop until Dad's taken care of. He has enough to deal with right now, and since he's finally on-board with getting therapy, I'm not willing to let it slide.
On the virge wrote:
BleepingBeauty wrote: He says they need a signed prescription from Dad's PC (I'll make sure it's specific enough so that Dad gets what he needs and there's no more delay), that the sleep study report and a note from the doctor about giving Dad an Auto set from 5-20 isn't enough, that they need specific pressure(s).
Good luck. My wife's sleep doctor gave us the sleep study, the office notes, and his prescription which was "e-signed". That seemed good enough to me but the DME said they needed a real signature to meet (at least their interpretation of) Medicare requirements. Whether they are correct or not doesn't matter; that's their policy. The DME was helpful in getting what they needed and there was no BS in their manner; that's just their way.
My point is make sure your doctor sends a SIGNED prescription.
Thanks for relaying your experience. Yep, the RT stressed that the script has to be signed by the doc, but apparently it doesn't have to be an original (he wants it faxed to him). Dad's doc's office isn't far away, and I'll be more than willing to physically go there and get in someone's face on Monday (if need be) to make sure this gets taken care of.

If they know what's good for 'em, they'll get it done after the phone call.
Veni, vidi, Velcro. I came, I saw, I stuck around.

Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

PR S1 ASV 950, DreamWear mask, F&P 150 humidifier, O2 @ 2L.

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Re: Update on Dad

Post by BleepingBeauty » Tue Mar 24, 2015 1:40 pm

Annnnndddd... the bullshit continues. Jeezus, I'm about to lose my mind.

I did go over to the PC's office yesterday morning and got in the face of the Medical Assistant who's supposed to be the person who handles my dad's care (he's the contact between the patient and the doctor). There were three issues that I wrote down and gave to him:

1. Get Dad's new prescription done TODAY (a doctor at the office said he was writing the script 10 days ago, when Dad was last there). The pharmacy still didn't have it (and told my mother they hate this doctor's office for just this reason). Hello?

2. I asked for a referral to a local pulmonologist/sleep doc in Dad's Humana provider book (which is about 2" thick).

3. I wrote out the specific script I wanted the doc to send to the DME (specific machine w/heated humidifier, mask of patient's choice, hose, filters, resupplies as needed every three months) and told the Assistant that I wanted it faxed to the DME TODAY so that Dad could get outfitted ASAP. Enough delays already.

When I spoke with the RT at the DME on Saturday, he told me that he could get any mask by Resmed, Respironics or F&P (and would order a specific mask from any one of those manufacturers if he didn't already have it in stock). I texted him yesterday after the doc's office told me the script had been faxed, just so he'd know it was at his office. He texted me back last night, telling me that the mask I want Dad to try (the FitLife total face mask) cannot be had without a specific prescription. WTF? After what he told me on Saturday? He said the FitLife costs more and has its own mask code, and it has to be specified on a script in order to get it. (JFC, I'm gonna kill this guy.) I tell him that the script was supposed to say "mask of patient's choice," so the FitLife shouldn't be a problem, and he tells me again that because the FitLife costs more, it needs its own script; he also sends me a picture of the script he got, and I then wanted to kill someone at Dad's doc's office, because all the script says is, "Auto-titration Pap device with pressure range 5-20cm H20." That's it. WTFF???

I called the Assistant at the doc's office about an hour ago and left a message for him to call me back. I'm going over there again...

I also called Humana yesterday because I wanted to give them negative feedback about the nonsense design of their Provider Booklet (which is apparently useless for other reasons, as well). The pulmonologist's office I wanted the referral to told me that she doesn't take Dad's insurance. WTF is she in his booklet for (an up-to-date 2015 issue) if she doesn't take the insurance? So I call Humana again to request another sleep doc that IS covered, and one of the names she gives me is this same pulmonologist. Again WTFF?

Just got a call from another RT at the DME, wanting to make an appointment to come here tomorrow with Dad's equipment. I question what kind of equipment he's planning on bringing, and he tells me the machine and a FFM. I ask again, "What is it with you people not understanding that someone who's claustrophobic is not likely to tolerate a FFM, and yet your company keeps insisting on fitting him with one." He says, "Well, we can try a FFM and exchange it later if we have to." This is the mentality I'm dealing with. Dad's allowed exactly one exchange within 30 days, and they want him to try a mask he won't tolerate to start with? Help me, Rhonda...

I swear, I'm gonna go postal on somebody soon... What little patience I like to think I possess is waning quickly with this bullshit. I can't imagine how anyone without an advocate gets anything done here, ever.

I'm about to go back to the doctor's office and raise some hell. Stay tuned... ARGH!!!!
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Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

PR S1 ASV 950, DreamWear mask, F&P 150 humidifier, O2 @ 2L.

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Re: Update on Dad

Post by chunkyfrog » Tue Mar 24, 2015 1:59 pm

(((Web cam needed))); OMG, I'm so sorry you are going through this nonsense!

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Re: Update on Dad

Post by Madalot » Tue Mar 24, 2015 2:34 pm

Sadly, I have been down a similar road in my "adventures" advocating for myself. I feel your pain and know exactly what you're going through and how you feel. Sometimes the stupidity and incompetence of our fellow human beings is enough to make me ashamed to be one of them.

Stay strong, BB. Don't let the idiots get you down.

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Re: Update on Dad

Post by BleepingBeauty » Tue Mar 24, 2015 3:53 pm

chunkyfrog wrote:(((Web cam needed))); OMG, I'm so sorry you are going through this nonsense!
Thanks, CF.
Madalot wrote:Sadly, I have been down a similar road in my "adventures" advocating for myself. I feel your pain and know exactly what you're going through and how you feel. Sometimes the stupidity and incompetence of our fellow human beings is enough to make me ashamed to be one of them.

Stay strong, BB. Don't let the idiots get you down.
Thanks again, Maddie. It's unfortunate that so many of us here can relate to this crap.

~~~~~~~~~~~~~~~~~~~~~~

The receptionist at Dad's doc's office took one look at me and said, "Uh-oh. That looks like frustration." She couldn't have been more right. When I saw the Assistant, I told him, "It's not my mission in life to make you miserable, but I'll be happy to oblige." He said he hadn't called me back because he was with a patient when I called; yeah, okay. I think I know better. But he put me together with the girl in the office who does referrals and scripts, and I told her what I wanted the script to say. I stood there at her desk while she typed it up and then faxed it, and then I got a copy of it for myself. She said she understands how these things go, because her mom (in Houston) also uses a machine.

So the DME finally has the script as I wanted it to be written. Now we'll see how long they take to bring the equipment and get Dad going.

It's bad enough I'm having to make such an effort between getting the proper prescription and dealing with this DME; I also have to push back against my folks when they say I shouldn't worry about it, that it's not important, what's the use, etc. I firmly believe that Dad *can* get better (physically, if not also mentally), but it won't happen until he's getting good enough sleep to let his body repair at night. With a sleep efficiency of just over 50%, it's no surprise that he feels like shit. I hate that he sleeps so much during the day and feels so useless even when he's up and around. His mind is deteriorating fast enough without apnea helping it along...

And so it goes. And goes. And goes.

Thanks, all, for the support and encouragement. It *does* make it easier for me to keep going.
Veni, vidi, Velcro. I came, I saw, I stuck around.

Dx 11/07: AHI 107, central apnea, Cheyne Stokes respiration, moderate-severe O2 desats. (Simple OSA would be too easy. ;))

PR S1 ASV 950, DreamWear mask, F&P 150 humidifier, O2 @ 2L.