My doctor is scolding me. What should I do?

I started with IPAP of 8 and EPAP of 5 for my sleep problems. I slept like that for 5 days, went back and complained and asked for a Bipap. I had changed the pressure settings too during that time to experiment. He was not happy. He changed my pressure to 6 IPAP and 4 EPAP, to see if the lower EPAP would make me more comfortable on the exhale. It was slightly better than the previous settings, but not clearly better than having no CPAP. My original titration study said 8 was the optimal IPAP. Anway, I slept liek that for a month, then went back, and asked for Bipap again. He agreed and wrote me an Rx for 9 IPAP and 4 EPAP.

Now while I am waiting for my Bipap, I changed the settings on my machine to 7 IPAP and 4 EPAP. I figured it would be no big deal since it is heading in the direction of the prescribed BPAP settings. But after a couple nights I got scared that what if he remotely sees I changed the settings. So I changed it back to 6 IPAP. Then I called him and asked if I could change it to 7, while waiting for the Bipap. He scolded me and told me that as a young man I need to learn, and that it's not respectful, and that I am going to be shooting myself in the foot my whole life. I told him I don't agree, and that I am literally alive because I chose not to do what my doctors told me (it's true...I have a chronic infectious disease that only the "quacks" have been able to diagnose and help me with). He said, "Well, maybe that's why you're like this".

Then he hung up all of a sudden. Then he called me back in 3 minutes and told me my pressure is already set to 7. So he can see remotely (gulp...). I had set the pressure back to 6, but I guess the change had not showed up on his system. I played dumb and said, "Is that so?" So I told him to nevermind, since my machine was apparently already on the setting I asked for. After hanging up, I changed the pressure back to 7. Do you guys think he only sees the current pressure setting, and hopefully not a history of pressure settings? He does probably have a copy of his prescription on file, so here is to hoping this never comes back to haunt me...

I guess I just need some support. Were my actions out of line? I don't think so.

Typo: should read "but NOT clearly better than no cpap"

We actually can go back and edit our posts.
There is also a preview button that we can use while proof reading.
At some point, you will notice many errors left in place by others,
because as long as it's understood, this is not English class.
You will only be graded at the end of the semester.

Are you using Sleepyhead software to monitor your therapy?
If not, you should, as it would definitely be of help to be able to document your therapy changes if they provide better therapy.
That way, if your changes provide better therapy, you've got documented evidence to show your doctor.

Besides, in the end, the doctor works for YOU. You and your insurance are paying him like a contracted employee.
Your machine only produces "air" to splint your airway open and it's not like a dangerous drug.
If he keeps giving you more guff, tell him you want to be involved with your therapy. At some point, the doctors stop seeing the patients and then they're on their own to fend for themselves. You need to be a better informed patient when that happens. Most users find out that their therapy improves when they take full control of it.


Den

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They make more untrained Doctors every year. Find one you can live with. Jim

metallikat36 wrote:Were my actions out of line? I don't think so.

Your doctor was way out of line. Find a better one.

I've always been of the opinion that "C"s get degrees. Don't buy into his little power trip. Your doctor should be glad you are taking an interest in your health. It should be a team effort. Time to find another doctor.

My doctor is totally sincere in this, and I think he really cares and wants whats best for me. Definitely not a power trip. So I can't criticize his motivation. But I do think he is wrong, and you guys have given me some confirmation on that. But on the other hand, someone might argue there is a selection bias on a forum like this . The more rebellious are probably the types that come to the forum.

I am not using sleephead yet, but I will in the future.

My thoughts swing both ways on this. Yes, you want a doctor who respects your input, or at least respects your right to have input. Just try to be sure that input is backed by reason as much as possible. Were you making changes based on data or what? A patient who makes changes willy-nilly would be every doctor's nightmare. The doctor has no way of predicting outcomes if there's variables out of their knowledge or control, yet they will be blamed if the outcomes aren't good. A lack of compliance with prescribed treatment is a vote of no confidence in your doctor. It doesn't make for a good doctor-patient relationship either direction.

Personally, I'd recommend any future changes be decided based on data as much as possible. Also, frequent changes do not allow for things to settle in to see what is a trend. This is a treatment of trends. Exception would be if there is obvious and immediate need for a change. I'm guessing your doctor can see your history. At this point you have to decide if you want to show him you're trying to work with him, or if you are going to strike out on your own. If your machine is a rental or if insurance is covering supplies, you don't want him to say you aren't complying as it may affect your insurance approval. I personally don't see your relationship with the doctor as unsalvageable yet. After a period of time taking his advice, then see if he's open to suggestions (maybe even framed as questions) that are based on data you are seeing that is not optimal. Consider all the aspects of your situation if his response if not acceptable. Good luck going forward.

Until you have enough knowledge and data to make sound decisions regarding your treatment, I would follow his instruction. It sounds to me that he is truly trying to help you.

metallikat36 wrote:My doctor is totally sincere in this, and I think he really cares and wants whats best for me. Definitely not a power trip. So I can't criticize his motivation. But I do think he is wrong, and you guys have given me some confirmation on that. But on the other hand, someone might argue there is a selection bias on a forum like this . The more rebellious are probably the types that come to the forum.

I am not using sleephead yet, but I will in the future.

Not to belabor the point, but "as a young man I need to learn, " and hanging up on you does not sound like sincere caring to me. I do agree moving forward with more information about how you're doing is to your advantage. I would just do it with someone who isn't treating you like a little child. Best wishes in your journey. I hope it works out for you.