Treatment at the VA

howdidthemovieend? · Post by **howdidthemovieend?** » Wed Nov 08, 2006 7:07 am

Has anyone had experience getting OSA treatment at the VA?
I will be getting my CPAP soon for a 7 day titration. I'm wondering if they have a choice of equipment or if there is any advice you would share regarding preferences for DME. Thank-you.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 7:36 am

There was one poster on this (VA issue) just yesterday or the day before. Do a search.

He said that they only authorized a Resprionics plus machine. Hard to believe, but it is our government so he could be correct. But lots of folks come here saying their DME only gives x brand, or can't give them a machine that records data, when in reality a little well applied pressure or a failure with the machine issued can do the trick. I don't know how the VA works in that area. Might be similar or might be they truly only authorize plus machines. Maybe more VA people will post here.

He had an interesting issue (pressure of 15) and issues with getting the mask to seal.

In my non-medical opinion, 15 is getting close to justifying an APAP or BiPAP.

Auto would allow much of the night to run lower and only go up to the max titrated pressure as required, thereby making breathing easier and making it easier to keep the mask on. BiPAP I believe also has its benefits for high pressure users though I have not used one and have to defer to others with experience.

I am really curious what your experience will be after what the other person went through.

I hope he responds to your post.

I think that the best thing you can do is get informed and be ready to ask questions. And be ready to go back if what they give you doesn't work for you.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 7:39 am

Other thread was Remstar Cflex settings started on Nov 6th. Read all the pages before you get to the VA stuff.

Handgunner45 · Post by **Handgunner45** » Wed Nov 08, 2006 8:49 am

My OSA is being treated by the VA. They did a split night sleep study, and the next morning I went home with the equipment I have. All at no cost to me other than my drive to and from the VA Hospital. I have had no follow up with them at all and haven't heard that they want to see me about it. If you have private insurance, the VA will bill them for the sleep study and the equipment, but in my case they accepted what my ins would pay and it was done. Just as a FYI, I do have a service connected disability so it might be different for you.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 12:01 pm

And you got a Pro2 not a Plus -- very interesting.

christinequilts · Post by **christinequilts** » Wed Nov 08, 2006 2:22 pm

There have been several posters over the 3 years I've been reading various apnea boards who were treated through the VA. Some are more successful then others at getting more then standard issue xPAP & mask; some had no options at all for machines & only a couple options for masks. It sounds like it depends a lot on where you are treated at- and if you are good at advocating for yourself & patient enough to wait for them to try something else.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 3:01 pm

Sounds pretty much like the rest of the world.

Sleepy-eyes · Post by **Sleepy-eyes** » Wed Nov 08, 2006 3:37 pm

howdidthemovieend?

I'm the one referred to concerning the VA's sleep disorder care.

I had two sleep studies performed. Then a couple of months later, the results indicated I needed a CPAP machine. The only one they authorize is the Resperonics REMstar/Pro 2 with C-Flex. They have been more than willing to work with me to help find a proper mask. So far I haven't had much luck with the entire process. I've had the machine since back in August and have just now logged 122 hours of use. Lots of issues concerning comfort. I've not figured out what purpose the machine is serving if I can't sleep while wearing it! But other's have managed, and I guess I will.......eventually. Good luck with your VA.

howdidthemovieend? · Post by **howdidthemovieend?** » Wed Nov 08, 2006 3:55 pm

Thanks to all who answered my question.

Handgunner45 · Post by **Handgunner45** » Wed Nov 08, 2006 4:10 pm

snoregirl wrote:And you got a Pro2 not a Plus -- very interesting.

Kind of surprised me at the time. Course at the time I didn't know the difference between the two. I only knew that I deal with Respironics at the hospital where I work and feel that they make good equipment.
Was really surprised that the VA did not deliver bottom level equipment. Especially as they told me that they didn't have any idea what the card in the machine was for. I will one day have a chance to try the Remstar Auto. We are getting some for use at the hospital and I have already got an OK to take one home for a trial.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 4:52 pm

Sorry handgunner. I mixed sleepyeyes up with someone else who got a plus. My fault.

So it looks like both of you from the VA got Pro2.

There seems to be a big group of new cpappers in the past few days got a little confusing.

Now I remember sleepyeye's issue -- trying to deal with keeping the mask on at a constant pressure of 15. I had wondered why the VA wouldn't consider an Auto for someone with that high a pressure. Seems like he would be a good case for needing it.

Sleepy-eyes · Post by **Sleepy-eyes** » Wed Nov 08, 2006 5:18 pm

Snoregirl,

I still haven't heard back from my Primary Care Physician at the VA concerning my questions............................but we'll see. I highly doubt they will offer a different machine. They are very strict about what medicines, and prothetics they offer. They claim to only offer only the best to veterans. I don't have any idea where the REMstar Pro 2 stands in the line of equipment quality, but I know the Veteran's Patient Review Board wouldn't allow poor quality equipment to be distributed. It's just that there's so much red tape connected with the whole process that it sometimes takes forever to get anything done or responded to.

Handgunner45 · Post by **Handgunner45** » Thu Nov 09, 2006 7:29 am

Sleepy-eyes,

Contact the RT dept at the VA center where you had your sleep study. Ask him/her about the possibility of a Bipap machine. I know that I was told by them to contact them direct with any issues. They told me that if the CPAP was a problem they would be happy to let me try a Bipap. The night that I had my study, there were 2 of us, and the other patient was sent home with a Bipap with settings of IPAP 8/ EPAP 4. They were concerned with his ability to adjust to CPAP. I had tolerated the CPAP at 8 quite well so they felt comfortable with a CPAP for me but indicated that switching to a Bipap would not be a problem. The issue of an APAP was not even a consideration as they only had 2 at the hospital for use in the occasional home titration.

Wulfman · Post by **Wulfman** » Thu Nov 09, 2006 12:13 pm

Sleepy-eyes wrote:Snoregirl,

I still haven't heard back from my Primary Care Physician at the VA concerning my questions............................but we'll see. I highly doubt they will offer a different machine. They are very strict about what medicines, and prothetics they offer. They claim to only offer only the best to veterans. I don't have any idea where the REMstar Pro 2 stands in the line of equipment quality, but I know the Veteran's Patient Review Board wouldn't allow poor quality equipment to be distributed. It's just that there's so much red tape connected with the whole process that it sometimes takes forever to get anything done or responded to.

Sleepy-eyes and howdidthemovieend?,

If they give/gave you a Pro 2, that's a very good CPAP machine. For one reason, it will record nightly statistics so you can monitor your own therapy. If you'll notice, I have one and have used it almost exclusively for a year and a half.

Best wishes,

Den