Introduction

bdivine · Post by **bdivine** » Mon Mar 02, 2009 7:41 am

I have been lurking for a couple weeks. I had a PSG and titration about a month ago. I have an appt with my doc tomorrow to get the script for a xPAP. The information I found here has been invaluable to arm me with information. I requested the results from the sleep lab, and know what to ask for in the prescription (will try for an APAP, but at least a CPAP fully data capable, and heated humidifier). I dont trust the titration the sleep lab did especially after looking at the results. I was using a full face mask because I simply can not breath well through my nose (too many nasal surgeries, abnormally narrow passages). The recomendation was for nasal cpap (reading the charts is probably not allowed ). The RT wasn't a real fan of full face masks and insisted on putting it on so tight the cushions collapsed and the plastic dug into my cheekbones. When I finally got him to loosen it, I ended up with about 2 hours sleep. THe results showed 0 ahi's at 7, 8, 9 and 10 cm/h20, but they put 10 for the titration. I suspect a few nights on an APAP will give better numbers.

I dont anticpate much problem from my doctor. He's generally all about the patient being involved and in control. Hes quite good at education rather than just dictating.

Anyway, I wanted to thank everyone for all the information. I'll post the specifics one I find out the exact model (I'm leaning toward the resmed s8 auto) and the mask that seems to fit best.

Brian

Gerryk · Post by **Gerryk** » Mon Mar 02, 2009 7:57 am

Welcome aboard. I would suggest you make a list of things to take to your doc. Questions you have and possible machines you want. If your doc is as open as you say he is he will be glad you are asking questions, even more impressed you have done some homework and are ready to become involved in your own treatment.

Take some paper with to write on and a pen. Write down what he says and his answers. He will appreciate that because he won't have to answer those questions again as you have them written down.

Good luck with your treatment.

Gerry

elader · Post by **elader** » Mon Mar 02, 2009 12:27 pm

bdivine wrote: I requested the results from the sleep lab, and know what to ask for in the prescription (will try for an APAP, but at least a CPAP fully data capable, and heated humidifier). The recomendation was for nasal cpap (reading the charts is probably not allowed ).

Brian

Hey it's your life. You are entitled to see the charts by law. BTW, if you are chronically stuffy, why wouldn't they be a fan of full face masks?? The full face mask has made my stuffy-nosed life so much easier.

Gerald · Post by **Gerald** » Mon Mar 02, 2009 1:09 pm

Brian....

If I were you, I'd push hard for an "auto"....because the difference in cost is really minor.

A Respironics "M" series Auto with AFLEX will give you (5) different modes of operation......a "swiss army knife" so to speak......and your chances of comfortable success go up dramatically the more choices you have.

Welcome to the group.....

Gerald

RipVW · Post by **RipVW** » Mon Mar 02, 2009 1:14 pm

Hello & Welcome, bdivine! Glad you found this forum—SO much useful info and everyone here is so willing to help!

Ditto to elader’s comment re FFM!

And, in my opinion, the M Series Auto w/A-FLEX is THE DREAM MACHINE!

"You are getting sleepy . . ."

roster · Post by **roster** » Mon Mar 02, 2009 1:26 pm

bdivine wrote:.......
I dont anticpate much problem from my doctor. He's generally all about the patient being involved and in control. Hes quite good at education rather than just dictating.

.......
Brian

Welcome aboard Brian. You are lucky to have a doctor like that. He probably enjoys dealing with you because you are proactive and educate yourself.

The Respironics A-Flex with heated humidifier ( https://www.cpap.com/productSearch.php?q=1&query=a-flex ) would be a good machine to start with. Get a card reader and Encore Viewer software and you can redo the titration for an optimal therapy. The labs don't commonly get the pressure right from just one night in that strange environment.

Good luck,

rested gal · Post by **rested gal** » Mon Mar 02, 2009 4:42 pm

Welcome to the message board, bdivine!

bdivine wrote:will try for an APAP, but at least a CPAP fully data capable, and heated humidifier

You've definitely been doing your homework! Very good job, the way you've been getting yourself up to speed on equipment.

One thing you might want to think about.... if you end up being given a CPAP rather than an APAP, is how to make sure the DME understands what kind of CPAP you'll accept. "Fully data capable" is simply a phrase we often use here on the message board. I don't think that's a term used by the manufacturers in their descriptions of machine specs or features. Nor is it a phrase that would mean much to most DMEs. The DME might think any machine that can have data downloaded from it is "fully data capable" or records "full data."

We (on the message board) know that what we mean by "fully data capable" or "records full data" is that the machine can record AHI and leak data, among other things. But some (perhaps most?) DMEs are accustomed to thinking of data downloaded from the machines as being the hours-of-use compliance data some insurance companies require.

"Hours of use" is the only kind of information from a machine download that insurance or Medicare is interested in, so it's understandable that most DMEs would think of data (even "full data") from the machines as being just that -- "compliance" data showing hours of use/pattern of use -- using the machine at least 4 hours a night/five nights a week.

Many (perhaps most?) DMEs might assume that if a machine has a Smart Card stuck in it or can use a cable for a download, the machine can record "full data." Not so. For example, the M series "Plus" machine can have a Smart Card in it and is recording onto the Smart Card every time you use the machine, but all that the Plus model records is "hours of use"...not "full data" the way we use that phrase here on the message board.

To get an idea of the confusion (perhaps genuine, perhaps feigned) that a DME had, check out LinkC's post on page 2 of this thread:

viewtopic.php?p=342111#p342111

So, if you can't get the doctor to prescribe an Autopap (some doctors just won't), and if you want to be sure the DME understands what kind of data a CPAP machine must be "capable of", you might want the doctor to add these words to the Rx: "Machine must record AHI and Leak in addition to compliance data."

bdivine · Post by **bdivine** » Mon Mar 02, 2009 10:11 pm

Thanks everyone for all the suggestions. I'll keep you posted tomorrow after the visit with the doc. The next will be the DME. I've searched the forum and see a few that people have had luck with in the DFW area so will try them first (two are not far from the house).

Brian

Introduction

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Mask	Humidifier