Family Practice Doctor disses xpap therapy

[KeziasPurr]

This morning I visited my family doctor b/c of some acid reflux I've been having. I also told her that I started Bipap therapy b/c of sleep studies that were recommended by my psychiatrist.

Basically, she went into this lecture about how all individuals (especially those who are over weight, like me) would test positive for some sort of sleep apnea and that the entire sleep study/therapy routine is a hoax. A big money making scheme.

I was quite insulted by her comments b/c I take my OSA very seriously and don't want to put extra strain on my body by not getting treatment. She almost made me feel stupid for believing the "hype" about OSA.

I don't really know why I'm writing this. I guess I just wanted to see if anyone else has had negative feedback from their doctor about OSA. Should I see another doctor? Problem is, she's the best family doctor I've ever had; super thorough, concerned and on top of my ailments and overall health. I don't know if I should switch or not. Or possibly just see another doctor for my OSA only. Anyone have a good doctor in the Houston/Sugar Land area?

THanks,
Lisa

[ejdischer]

I have found that there is a certain segment of the population that thinks CPAP and OSA is blown way out of proportion. My father's doctor didn't go as far as saying it, but when my dad asked if he should go for a sleep study he said, "You don't need that, you're fine." Problem is, he isn't. Look, the guy may have a medical degree and a license, but he has never observed my dad sleep. When I lived at home, there were many times that during the night my dad would stop breathing. He also snored as bad if not worse than I did. So after I started my therapy I encouraged him to go and pushed it, but he asked his doctor and got the response that convinced him he didn't need it. Heart disease runs in my family and I know OSA can lead to heart issues.

Losing weight is not going to get rid of OSA either. At my study, I had an average of 82 events/hr. When I went back to my ENT I was all prepared to tell him that if I lost the weight I'd be fine, as I do need to lose about 60lbs. Anyway, he was quite frank in telling me that even if I lost the weight the OSA wouldn't go away. It might get slightly to moderately better, but it wouldn't go away.

Oh, and finally, if your doctor doesn't take your condition seriously, it's time for a new doctor who does. OSA and CPAP can be tough enough, you don't need someone trying to convince you it's a hoax and there's an easy way out.

EJD

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[Slinky]

GOOD family doctors are hard to find. The kind you have some rapport with and who are genuinely concerned for your welfare. Its too bad if they have a weak area of knowledge about OSA and xPAP but if you are that happy w/your current family doctor I would stay w/her. I just wouldn't discuss sleep apnea w/her. I'd continue xPAP therapy thru the sleep doctor at your sleep lab and have any necessary reports sent to your family doctor. By the time you see her for your next office visit that report will have put in your file and she will most likely have forgotten about it since she dismisses such therapy.

If she does bring the issue up just inform her that whilst you are very happy w/her care you do happen to believe in xPAP therapy and intend to continue it. Most likely it won't even get brought up.

[oldgearhead]

and that the entire sleep study/therapy routine is a hoax. A big money making scheme.

I know this is after the fact, but you might write her a letter asking for
the medical studies to support her claim. I'm betting there are more studies
disproving her position, and maybe if she 'looks up' and reads a few medical studies, she will change her mind...example most, even medicare,
and VA insurance providers approve payments for OSA treatment.

[allend]

I'd get the hell out of there as fast as I could. There is something wrong with this woman, if after all this striking "smack you in the face evidence," that she has the need to deny it. She stands alone with a bunch of other a__hole doctors who don't believe in mitigating the problems of Apnea. She probably doesn't believe in Global Warming either.

She may blame everything on your weight or emotional problems directly related to not being awake enough to function optimally.

Houston is a big place. Go to a big university hospital and get someone who is a leader in the field of Sleep Medicine and ask that Dr. to recommend another family doctor, preferably an internist. It may take awhile but you need to remove the problem of Apnea first, then do some exercise and get yourself totally healthy. Staying with your current Dr. and her recommendations will get you no place good.

I differ with the posting above mine, your doctor is not a good family doctor.

[allend]

I know this is after the fact, but you might write her a letter asking for the medical studies to support her claim. I'm betting there are more studies disproving her position, and maybe if she 'looks up' and reads a few medical studies, she will change her mind... example most, even medicare, and VA insurance providers approve payments for OSA treatment.

I wouldn't waste my time, as I think for a Dr. to have those narrow-minded feelings today, there is something wrong with her. I wonder what medical school she went to. What she said is unconscionable today.

I say, send her a picture of Tom Cruise, with a big "Goodbye and you are as crazy as he" is written across it!

[snork1]

I vote for change to a different doctor, NOW!

I would not trust MY health with any doc that is this far out of touch on something so obvious. What if you had something OBSCURE that actually required the doc to know SOMETHING current?

Losing weight to a safe level is good for all sorts of things, but should be treated as a separate issue from Apnea.

[KeziasPurr]

Thanks to everyone who has posted replies to my thread. I am going to seek out a new doctor. One who's not complacent regarding serious health issues/risks. I was thinking of calling my DME to get a list of local "sleep" doctors. Or should I not?

Thanks a bunch!
Lisa

[bookwrm63]

Lisa,

I would try your insurance company first. They would have a good list of who is "in" your network and maybe from that list your local DME can help weed out uninformed choices. Isn't Houclay near you? Maybe he has some good ideas as well!

Good luck..I know it's hard to leave someone you've trusted for a long time but maybe it has happened for a reason.

Mary

[Mile High Sleeper]

Discussion thread on sources of finding a sleep doctor:
viewtopic/t14872/What-is-a-sleep-doctor ... 2356138016

Finding a sleep doctor through the American Board of Sleep Medicine:
http://www.absm.org/diplomates/listing.htm

Even easier, use the Locator on cpap.com.

[allend]

You never know what someone will do if they are grateful, like the lab grateful for a Dr. sending all his patients. How about the Texas Woman's Hospital or the Texas Medical Center? Are they well respected hopitals. Do some research.

Keep in mind, you don't have to settle for the next one.

[kteague]

Lisa,
My gut says "run and run fast" but you may want to print out the informative document "Sleeping With the Enemy" and get it to your doctor. Either by note or in person, tell her how you have appreciated her attentiveness to your health up to this point, but that you are disappointed in her response to your sleep apnea for all the reasons cited in the literature. Her reaction will either confirm your need to move on or maybe even salvage the relationship (if you're still interested). One thing we've been taking about on this board is making a difference in our own sphere of influence to enlighten the uninformed. It may be too late for you and her, but it may make her think twice on the next patient, and maybe save a life.
Kathy

[Julie]

Yes I agree, if you feel good about her otherwise, who's to say what your next MD might be like (whether or not they're up to scratch on OSA)? Educate her, in a nice way, but don't throw out the baby with the bath water. She may just never have been exposed to decent information yet at the particular school or conferences she's attended, and to just leave without at least sitting down and discussing it, showing her up to date stuff from major medical centers that she can't 'diss', is worth a try.

[dsm]

Lisa,

Good luck with this - it is a tricky situation...

At first glance it does seem your doctor is ill informed but without discussing it directly with her we can assume she doesn't understand, or can assume she knows more than has come out here in our analysis.

For example, if she has seen a lot of cases where it is simply a matter of people losing weight & OSA goes away, then she may have some justification for believing that there is a hype element that prefers to sell cpaps vs telling the patient to lose weight.

On the other hand, as suggested by a couple of posters, losing weight doesn't always get rid of OSA for all people. I believe it is accepted in medicine that people with particular throat structures are inherently prone to OSA especially with gaining age and also gaining weight.

My original GP doctor (retired in Dec) used to say to me that she valued any feedback I could give her on cpap as she got so little info & few patients had much to say after she referred them to respiratory specialists.

In my own case I have been losing weight & am scheduled for a new split night sleep study at end feb. My weight is now 20 lbs less than when I did my 1st sleep study 2 years ago (it fluctuated markedly during the 1st 20 months - went higher & lower in 3 cycles. By the time I do this study I expect to be around 183 lbs (am at approx 189 now).

If they say I have no symptoms of OSA at that sleep study, then in my case losing weight categorically made a difference, if they say I still have a significant AHI, then losing weight will have probably aleviated the symptoms but not removed them so that comes back to some other reason that OSA persists for me should the AHI be over say 5.

I went to a new doctor last night as since losing weight (this weight loss has largely been easy to achieve once I finally got my cpap settings right - took me over 18 months to reach this point). The vist to the doc was to a) get a new doctor & b) to ask him why I am now getting constant nasal congestion & muck in my nose/throat - he said he could see my turbinates were swollen & throat red & has aked me to stop using Otravin as a nasal spray & to switch to Flosnase - he wants to see if this will reduce the turbinates & allow more air to get through the nose.

Summary is, that you doctor may have good reasons we are not aware of as to why she feels the way she does & it is interesting that you like her on all other matters plus her general approach.

Again good luck

DSM

[tomjax]

Sometimes I remark that doctors and DMEs and everyting else are like a box of chocolates----------------

This is why I, as a pharmacist, always cringed wen a patient prefaced a statemt, "well, my Doctor said" ..........as if everything that followed was the absolute final and authoritative word on the subject.

We all have seen examples of advice covering the entire range.
Your doc's advice is very frightening and makes one wonder about the rest of the advice he gives and if you should trust your health to a person with such a closed mind.

I would write him a letter stating that you are very concerned with his attitude and apparent and obvious lack of knowledge on a very serious health issue.

I would print out the letter from sleeping with the enemy(?)and send it to him/her along with your letter. Maybe the writer of the other letter can help you with this.

It may just help save SOMEONE ELSE"S life who is his/her patient.
You owe his other patients this. tomjax