Should I fire my sleep doc?

[NotLazyJustTired]

That's a rhetorical question. He's fired.
I had my 2 month follow up. Here's how it went.
First, I met with the nurse. Took weight, blood pressure, any new meds?, blah, blah, blah. She informed me I would not be seeing the doc, but the nurse practitioner. So, I ask, "Will anyone be interested in looking at my SD card?" I got the deer in the head lights look, like, what's an SD card? So I explain that it contains my data from my CPAP and shows how my treatment is going on. So she informs me that the DME will be taking that report and sending it to the doctor. Well, I haven't had one word of conversation with the DME since I picked the machine up in March. Now I am thinking, "What the hell am I even doing here?"

So she hurries out the door and a few minutes later in comes the NP. Nice gal, but also clueless. Asks "How are you feeling?" My answer, "I feel great! No more need for afternoon naps and I feel like I am 10 years younger!" Type, type, type. "And what are your settings?" Really? Aren't you guys supposed to know that? So I tell her that I increased my minimum pressure and gave a short dissertation on why I did that. Type, type, type. "Any nose bleeds?" "Nope." And that was pretty much it. She heads out the door and says, "I will see if the doctor wants to see you."

A couple minutes later in comes the doc. "How are you feeling?" "I feel great" repeating everything I just told the NP. "That's great!" Then he goes on a 5 minute monologue basically patting himself on the back for writing me the script. NP asks, "So when do you want to see him again?" Doc looks to me and asks, "Are there any changes you think we need to make?" I say, "As a matter of fact I think I could benefit a little more from a minimum pressure increase." He spins around to the NP and says, "Let's see him again in 6 to 8 months." Explains to me, "I have a feeling you will lose a few pounds over the summer, so we will see where you are in another 6 months or so." And that was that.

Here's the thing. I could lose a few pounds, sure, but I am not overweight. Furthur, I do not have many obstructions. My sleep study only scored two OAs the entire night. I have upper airway resistance syndrome! Why the hell would weight loss play a factor?

What really irks me about this whole thing is that this process started in October when I complained to my internalist about extreme fatigue. It was a lot of waiting and appointments and fighting just to get the CPAP machine and now he is telling me to come back in November before we even start to talk about optimizing my therapy? That is over a year from my first visit on this issue!

No thank you. I am taking over from here. I let them make the appointment in November but I have no intention of keeping it. If I have any further issues I will take it up with a competent professional.

I ask myself these questions: "Why bother with a full efficacy machine (which he prescribed) if you aren't even going to look at the reports?" And as my wife so aptly pointed out, "What would he have done if you told him you felt like crap? "

Thanks for letting me rant. I am feeling better, but I do not believe my settings are optimal. I had hopes that this guy would collaborate with me on this journey, but he only seems interested in collecting fees for appointments. I have already bumped up my minimum pressure to 8cm. We'll see how that goes. Thanks for being here. I would still be a miserable mess if it weren't for caring people on this forum!

[SleepyonMagnoliaSt]

Wow... even if he hadn't mentioned anything about weight I would have been hunting for a new doctor. The way they were all 'I'll see if the doctor wants to see you!' Is completely foreign and a turnoff to me.

[chunkyfrog]

A word of caution: if you have no intention of keeping the October appointment,
then you will probably want to cancel it, rather than simply not show up.
They tend to charge for broken appointments, and insurance can be stinky about paying.

[NotLazyJustTired]

A word of caution: if you have no intention of keeping the October appointment,
then you will probably want to cancel it, rather than simply not show up.
They tend to charge for broken appointments, and insurance can be stinky about paying.

Yeah, I got 24 hours beforehand to cancel. I figured it was easier to cancel over the phone then argue in person. I am such a wimp.

[NotLazyJustTired]

Wow... even if he hadn't mentioned anything about weight I would have been hunting for a new doctor. The way they were all 'I'll see if the doctor wants to see you!' Is completely foreign and a turnoff to me.

You know what also gets me, he didn't even score me on the Epworth questionnaire. Sheesh!

[avi123]

I don't think that you'll find another Sleep Doc in Gastonia, NC. And even if you do, those Sleep Docs are friendly with each other and you'll become an outcast in the area.

p.s. Epworth is a subjective method and good for the birds.

[caffeinatedcfo]

Good for you! What a joke most of these guys are. I suspect my 90-day follow up this June will be similar, but he already knows I am taking control of my therapy and is just there for me if needed for consultation.

[StuUnderPressure]

Yeah, I got 24 hours beforehand to cancel. I figured it was easier to cancel over the phone then argue in person. I am such a wimp.

It is amazing how many times I have had to go out of town on the appointment day with my Sleep Doctor. Yes, I need to cancel, but will call you back to reschedule when I know I will be in town. I never call back.

I don't fire my Sleep Doctor because I need one for a new machine prescription, etc. But, I see them about 10 times less than how often they want to see me.

When I got my last prescription for a new machine in December, 2011 they said: Have you really not been here in over 4 years?

[NotLazyJustTired]

I don't think that you'll find another Sleep Doc in Gastonia, NC. And even if you do, those Sleep Docs are friendly with each other and you'll become an outcast in the area.

p.s. Epworth is a subjective method and good for the birds.

Yes Epworth is admittedly subjective, but it is more scientific than just, "How do you feel?"!

[NotLazyJustTired]

Yeah, I got 24 hours beforehand to cancel. I figured it was easier to cancel over the phone then argue in person. I am such a wimp.

It is amazing how many times I have had to go out of town on the appointment day with my Sleep Doctor. Yes, I need to cancel, but will call you back to reschedule when I know I will be in town. I never call back.

I don't fire my Sleep Doctor because I need one for a new machine prescription, etc. But, I see them about 10 times less than how often they want to see me.

When I got my last prescription for a new machine in December, 2011 they said: Have you really not been here in over 4 years?

That's a good idea. I like that. Thanks.

[racprops]

WOW do I feel at home here.

Rather than repeat my rants please if interested read:

viewtopic.php?f=1&t=89026&st=0&sk=t&sd=a

Specially pages 4 and 5.

Rich

[kteague]

I ask myself these questions: ... And as my wife so aptly pointed out, "What would he have done if you told him you felt like crap? "

A. Randomly increased the pressure.
B. Scheduled you for another sleep study.
C. Told you it takes time to adjust so come back in 6 months.

Pick one.

Unmet expectations are so common in medical visits of all sorts, not just in the sleep field. I'm still learning how to be more explicit. Sometimes it changes the course of things, but more often it simply leaves them without excuse and I don't have to wonder about our future (or lack thereof). Unfortunately I too often think of what I wish I would have said after I've left the office. Hopefully you'll continue to see great results from your treatment and minimize your need for regular medical intervention for your UARS. But it sure would be nice to feel some confidence in those you turn to for their supposed expertise, wouldn't it?