Nervous

An Audiologist did that to my mother. We left and never looked back. I found an office with a professional attitude. The original firm was sold and started sending out information and advertising. I called and let the new owner know what had transpired telling her to not send any further advertising. She wrote a nice letter thanking me for letting her know what the former audiologist had done and said that my input was helpful.

msla wrote: telling her to not send any further advertising.

That's excellent, punish the nice new doctor for what her predecessor did.

Techs are not allowed to tell you anything at all about the results of your first nights study. When a nurse or RT tells the patient about their results they do so only as instructed by the doctor.

Secondly, those in a sleep clinic who choose to work at night, rather than the day, usually do so because they are not people persons. Thank goodness for that kind of personality, because a people person would go crazy watching computers all night.

While you might not want to talk to the guy again, realize he was probably exhausted, and going home to face goodness knows what, including the cost of gasoline.

The good news, Sleep Apnea Treatment can help you to sleep better, and you are not as likely to lose weight without sleep apnea treatment as with it. Plus, I feel so much better. Sleep apnea treatment is both frustrating, and it is like coming back to life again.

The bad news, you need sleep apnea treatment, and it can be frustrating to accomplish. Not sure what the exact percentage is, but nearly fifty percent of those who get a machine, quit treatment. Some of those admitting that the treatment was very helpful.

What you need to focus on when going for the titration, where you might again see those who lack a bunch of interpersonal skills, is not about them, but about finding the right mask for you. A lot of times an RT, or someone with expertise in the sleep apnea field, can take on look at your face, hear your concerns, and can suggest the type of mask with uncanny accuracy. They have seen hundreds, if not thousands of patients who have tried different masks, while most of us have only experience with our own face. I think more folks here prefer nasal masks or pillows than a Full Face Mask. You have to decide for yourself how much you can tolerate. Well, sometimes when the tech is first helping you adjust a new mask to your face, it is not pleasant, once the machine is turned on and air gets blowing, it will not feel like you are suffocating, but rather that you are trying to breathe into a hurricane. It is likely that the first several hours of the titration study that you will not be getting enough air to sleep very well. Sleep studies are places where very little sleep actually seems to happen. Take heart, they do know what they are doing. Even if they are a bit brusque, they can lead you past the land of Nod to dreams to (I hope) more energy during the day, and for some of us, a re awakening brain.

Most sleep docs office have a list of DME's (the guys who will arrange for your new machine, supply masks, hopefully help you with acclimating to your new way of sleeping.) A list of DME's arranged in order of how well their patients feel about the helpfulness of the DME's.

Personally I have only had great sleep docs and great DME's. A lot of folks here have not seen a good one of either. Newcomers are advised to read. http://maskarrayed.wordpress.com/what-y ... me-part-i/

Please realize that when you first start talking to the DME, they will likely only seem to be concerned with their paperwork. It is the nature of the beast. The local DME's I have had could never tell me about prices or money, the office DME did not do that. My dollar costs are more connected with whatever insurance I have, so I will not know the co payment part until after I get the machine, and the DME billing service, (usually in a different state) has applied to my insurance, and gotten a reply from insurance company. Usually at least a month. On the other hand, everyone at the local DME office only wants to help me out, and are not much concerned with their company make money. Find out what your insurance, and the DME do about trying new masks for a new patient. That is, when I started, I could try as many different masks as I wanted for the first thirty days.

Despite what some here tell you about being prepared to be confrontational to get a machine with full data, and auto, my DME's only brought me top of the line equipment with all the better options available without being asked or my being confrontational. I am glad I tried to start off being nice to the DME, as part of my real personality is like the guys who stay up all night.

Best wishes, and let us know how it goes.

All the rest on the forum here, pls tell the OP where I am wrong. I get a lot wrong.

Julie wrote:
Weight loss alone is highly unlikely to do the full job

Do you have empirical evidence to back up this claim?

I wouldn't contend that weight loss is the cause of all sleep apnea (far too many people in this forum that are not over weight, but still have OSA), nor would I say that all people who are obese and have OSA could be cured since in a number of cases, OSA was a major CAUSE of their obesity. The statement that it's "highly unlikely" simply can't be supported by any studies that I've found.

I agree with many (virtually all) of the weight-OSA statements that I see in these threads, telling someone that "Weight loss alone is highly unlikely to do the full job" seems to be as wrong as Dr's assuming that an overweight patient's obesity caused their OSA.

purple wrote:Please realize that when you first start talking to the DME, they will likely only seem to be concerned with their paperwork. It is the nature of the beast. The local DME's I have had could never tell me about prices or money, the office DME did not do that. My dollar costs are more connected with whatever insurance I have, so I will not know the co payment part until after I get the machine, and the DME billing service, (usually in a different state) has applied to my insurance, and gotten a reply from insurance company. Usually at least a month. On the other hand, everyone at the local DME office only wants to help me out, and are not much concerned with their company make money. Find out what your insurance, and the DME do about trying new masks for a new patient. That is, when I started, I could try as many different masks as I wanted for the first thirty days.

Despite what some here tell you about being prepared to be confrontational to get a machine with full data, and auto, my DME's only brought me top of the line equipment with all the better options available without being asked or my being confrontational. I am glad I tried to start off being nice to the DME, as part of my real personality is like the guys who stay up all night.

I called a local DME suggested by the sleep clinic and the guy was very helpful. I had read info about being careful not to get a brick and was pleased that did not look like it was going to happen. However, on the DME page they have this : "Technology...our remote monitoring program uses cellular signals to track your progress. If any problems arise, we work with you and your doctor to quickly address them and get you on track to a better nights sleep!"

Is that weird? That a salesman would be the patient/doctor go-between? He said that if I didn't like that that I could just bring him the SD card....which is not different just more trouble.

He told me that with my insurance I own the machine outright....but that they might (unlikely, but could happen) want him to provide them with proof of my compliance (a word that makes chills run down my spine).

I have a perfect driving record (knock on wood) and still will not allow the insurance company to install one of those black boxes to lower my financial cost at the cost of my privacy and freedom. It just seems like a line that shouldn't be crossed.

I am not sure how similar the two things are but I don't like the idea of a bunch of salesmen having access to my medical info...am I wrong or missing something?

DMEs are (or should be) more than must salesmen. They are "supposed" to help you with any problems you might have with any of the equipment they provide be it mask or machine. Sometimes they do and sometimes they don't. That's why there's good ones and not so good ones.

reevesfarm wrote:That a salesman would be the patient/doctor go-between?

Actually it's fairly common. Depends on the doctor and if the doctor has the equipment and software to read the SD cards and if they even bother.

reevesfarm wrote:that they might (unlikely, but could happen) want him to provide them with proof of my compliance (a word that makes chills run down my spine).

Don't let it scare you. You need to call your insurance company yourself and find out what their policy is. If they need compliance it really isn't that big of a deal. Most of the time all it is is 70% of a 30 day period that you use the machine at least 4 hours a night.
Most go by Medicare's compliance requirements in terms of use and that's what makes Medicare happy. Medicare also has a requirement for a face to face meeting with your doctor sometime between the 31st and 90th day of therapy. Now your insurance may not require that meeting.
Always best to get the insurance information directly from the insurance company as the DMEs have to deal with hundreds of insurance plans and may not get all the facts pertaining to your particular plan.

Do find out exactly which model machine the DME is going to supply though.
If they say the work with your doctor to find optimal therapy needs...they had better be supplying more than a brick because the brick doesn't offer any useful data about how optimal your therapy is.

Did you read Janknitz's blog yet? If not, read it now.
http://maskarrayed.wordpress.com/what-y ... me-part-i/
http://maskarrayed.wordpress.com/
the machine information hasn't been updated just yet for the newly released ResMed AirSense machines..

I believe he said the S9 Elite

The ResMed S9 Elite is a full data straight CPAP machine. Software is easily available and free.
I have information about the software options in my signature line. SleepyHead works great and is easier to manage than the ResScan software. Don't mention the software to the DME...we aren't supposed to know about it much less use it.

The only drawback to the Elite is that it doesn't have APAP mode (auto adjusting pressure mode) which the S9 Autoset has (it has both cpap mode and apap mode).

APAP mode is where the machine can auto adjust the pressure if it senses the need. Comes in handy if your pressure needs might change during the night due to sleeping position or sleep stages. Not everyone needs apap mode though and not everyone even likes apap mode. So not having it may or may not be that big of a deal for you. I have always felt it is better to have something and not need it than need it and not have it so I always prefer the machines that also offer auto adjusting capabilities just in case it might be needed.

Insurance companies pay by HCPCS billing code and the code is E0601 for any of the cpap/apap machines....so DMEs get paid the same amount no matter which model they dispense. The APAP capable machines cost a little more so DMEs like to make a little more money by supplying the not quite so costly Elite. They will say that they can't dispense an APAP because your RX doesn't call for it but they could if they just would because all they would need to do would be dispense the AutoSet with the settings set to cpap mode at the desired pressure.

At least they are supplying a full efficacy data Elite and not the brick Escape.

OhHelpMe wrote:

msla wrote: telling her to not send any further advertising.

That's excellent, punish the nice new doctor for what her predecessor did.

The jerk was still there and I wasn't going to find out if he had been reformed.