New version of Free Money, Come and Get It!!

OK: quick edit here. Gonna make it easy for you. Just read post #4 on this thread and then answer the questions below. If you're not startled, disgusted, outraged, flabbergasted, disappointed, or something, I will channel it for you.

Hard to figure how something so EXPENSIVE and harmful could miss getting on this list. With all the things on the list, being excluded from it is just unfathomable.

I guess we rank down there with "Screen for allergies to Hen's Teeth and Flying Pigs." Or unicorns, even.

OK, here's the original unedited posting:

You know, I have been thinking about how to incent others to action. Gotta keep banging the drum if you believe in the issue.

So, putting my money where my mouth is, I hereby pledge a $10.00 gift certificate, redeemable at CPAP.com to anyone who participates successfully in this very simple scavenger hunt.

Rules are simple:

1) Go to a very recent thread whose title contains the word "lies".

2) Read the postings all the way through.

3) Reply to THIS thread (no fair PM'ing answers) with your answers to these questions:


a) What is missing from the list on the posting about Family Practice physicians?

b) What are you going to do about it?

Fine print: my budget will have to limit me to a maximum of $500.00. So, that leaves about fifty gift certificates to be awarded.
Any "joke" answers will be disregarded at the sole discretion of . . . me.

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com

A) What's missing? I got what 's missing from list, but have to admit, the greater benefit was in gaining the info the thread contains. (Didn't state it specifically cause then no one else will have to read.)
B) What to do about it? Had already written letters to doctors I am involved with, but will follow up with the specific suggestion that they extend their personal list beyond those screenings recommended.

I want to compose (or use something someone else composes) to fire off an awareness email to everyone on my contact list. Wouldn't it be interesting to see if a slew of us did that, how long it would take us one of us to receive that email as a forward but not through our sending it out. Then we would know it is being widely circulated. My one stipulation would be that it contain no big guilt trip at the end. I hate those so much that I have a personal commitment to NEVER forward those messages where the writer is so presumtuous as to think they know best what I should do with an unsolicited email. (Can you tell that's my pet peeve?) Hey, if we make it to snopes.com we'll know we've "arrived".

Kathy

kteague wrote:A) What's missing? I got what 's missing from list, but have to admit, the greater benefit was in gaining the info the thread contains. (Didn't state it specifically cause then no one else will have to read.)
B) What to do about it? Had already written letters to doctors I am involved with, but will follow up with the specific suggestion that they extend their personal list beyond those screenings recommended.

I want to compose (or use something someone else composes) to fire off an awareness email to everyone on my contact list. Wouldn't it be interesting to see if a slew of us did that, how long it would take us one of us to receive that email as a forward but not through our sending it out. Then we would know it is being widely circulated. My one stipulation would be that it contain no big guilt trip at the end. I hate those so much that I have a personal commitment to NEVER forward those messages where the writer is so presumtuous as to think they know best what I should do with an unsolicited email. (Can you tell that's my pet peeve?) Hey, if we make it to snopes.com we'll know we've "arrived".

Kathy

Most excellent, Kathy. You just won yourself $10.00 at CPAP.com. I'll probably wait a week on this post and then tally up to find a way to get the gift certificates to you and others most expeditiously.

Thank you for your thoughtful post.

drB

From the offical website for the Family Practice Physicians website, in it’s entirety.

Clinical Preventive Services, Including Screening and/or Counseling or Immunization:

1. Screening specified populations for abdominal aortic aneurysm
2. Counseling parents and patients more than 2 years old regarding accidental injury prevention
3. Screening and counseling specified populations regarding alcohol misuse
4. Screening specified population for asymptomatic bacteriuria
5. Screening for bacterial vaginosis in pregnant women (Note: Considered but not recommended)
6. Screening for bladder cancer in adults (Note: Considered but not recommended)
7. Counseling and screening women 40 years and older for breast cancer with mammography
8. Teaching or performing routine breast self-examination (Note: Considered but not recommended)
9. Referring specified female population for genetic counseling and evaluation for BRCA testing
10. Counseling parents of infants regarding breastfeeding
11. Screening adults and children for cardiac disease with electrocardiogram (ECG) (Note: Considered but not recommended)
12. Screening women for cervical cancer with Pap smear (Note: Guideline developers considered but did not recommend primary screening with human papillomavirus testing and new technologies)
13. Screening specified populations for chlamydia
14. Screening specified populations for colorectal cancer
15. Screening in women of childbearing potential for congenital rubella syndrome by history, serology, or vaccination
16. Counseling adults at risk for coronary heart disease regarding aspirin prophylaxis
17. Screening for coronary heart disease with electrocardiograph, exercise treadmill test, or electron-beam computerized tomography (Note: Considered but not recommended)
18. Providing fluoride supplementation to prevent dental caries in specified populations – (editor’s note: Geez, hello? What rhymes with Apria?)
19. Screening for depression in specified population
20. Screening specified populations for type 2 diabetes
21. Immunizing children and adults for diphtheria
22. Screening infants for dysplasia of the hip (Note: Considered but not recommended)
23. Screening for family violence and intimate partner violence (Note: Considered but not recommended)
24. Screening for genital herpes simplex virus infection (culture, serology) (Note: Considered but not recommended)
25. Screening for glaucoma (Note: Considered but not recommended)
26. Ordering ocular prophylaxis for gonococcal infection in neonates
27. Screening for gonorrhea in specified populations
28. Immunizing specified population for Haemophilus influenza type b disease
29. Behavioral dietary counseling for specified populations
30. Screening and counseling specified population regarding hearing difficulties
31. Screening newborns for hearing loss sensorineural (SNHL) (Note: Considered but not recommended)
32. Screening neonates for hemoglobinopathies, phenylketonuria (PKU), and thyroid function abnormalities
33. Immunizing specified populations for hepatitis A
34. Immunizing specified populations for hepatitis B
35. Screening specified populations for hepatitis B virus
36. Screening for hepatitis C virus (Note: Considered but not recommended)
37. Screening specified populations for human immunodeficiency virus (HIV) infection
38. Hormone replacement therapy in postmenopausal women (Note: Considered but not recommended)
39. Screening specified populations for hypertension
40. Immunizing identified populations for influenza
41. Screening for insulin dependent diabetes mellitus using immune marker screening (Note: Considered but not recommended)
42. Screening specified populations for iron deficiency anemia
43. Screening specified populations for lead poisoning
44. Screening specified populations for lipid disorders with fasting lipid profile or nonfasting total cholesterol and high-density lipoprotein (HDL) cholesterol screening
45. Screening for lung cancer with x-ray and/or sputum cytology (Note: Considered but not recommended)
46. Immunizing children for measles
47. Immunizing specified populations for measles, mumps, rubella
48. Immunizing children for mumps
49. Immunizing specific populations for meningococcal disease
50. Folic acid supplementation in specified female population to prevent neural tube defects
51. Screening and counseling for obesity (Hello, anybody home?)
52. Screening for oral cancer (Note: Considered but not recommended)
53. Screening specified populations for osteoporosis
54. Counseling specified populations regarding calcium intake as prevention
55. Screening for ovarian cancer (Note: Considered but not recommended)
56. Screening for pancreatic cancer using abdominal palpation, ultrasound, or serological markers (Note: Considered but not recommended)
57. Screening for peripheral arterial disease (PAD) (Note: Considered but not recommended)
58. Immunizing children for pertussis
59. Screening neonates for phenylketonuria
60. Counseling children, adolescents, and adults regarding importance of physical activity
61. Immunizing specified populations for pneumococcal disease
62. Immunizing children for poliomyelitis
63. Screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination (DRE) (Note: Considered but not recommended)
64. Rh (D) blood typing and antibody testing for pregnant women
65. Immunizing children for rubella
66. Screening for idiopathic scoliosis in adolescents (Note: Considered but not recommended)
67. Counseling parents with children in the house regarding second hand smoke
68. Counseling adolescents and adults regarding prevention of sexually transmitted diseases
69. Screening for skin cancer (Note: Considered but not recommended)
70. Screening for speech and language delay in preschool children (Note: Considered but not recommended)
71. Screening specified populations for syphilis
72. Screening for testicular cancer (Note: Considered but not recommended)
73. Immunizing for tetanus
74. Screening for thyroid cancer using ultrasound (Note: Considered but not recommended)
75. Screening for thyroid disease (Note: Considered but not recommended)
76. Screening neonates for thyroid function abnormalities
77. Screening specified populations for tobacco use and providing smoking cessation counseling
78. Screening specified individuals for tuberculosis using the Mantoux test
79. Screening specified populations for vaginal cancer (Note: Considered but not recommended)
80. Immunizing specified populations for varicella
81. Screening specified populations for visual difficulties
82. Vitamin supplementation (A, C, E, beta-carotene; multivitamins with folic acid; or antioxidant combinations) for prevention of cancer or cardiovascular disease (Note: Considered but not recommended)
83. (Editor’s note: Not recommended, and apparently not even considered: insert relevant statistics here.)

What needs doing is a concerted effort at getting the medical schools to include OSA as a serious condition like any other, and giving it the same attention to detail as those. What about getting together a big group of OSA pts in one place (i.e. a hotel conf. room) with a few keynote speakers, and invite the media - just word the invites in such a way as to be sure they show up and cover the story. Don't just say it's about OSA, but do say it's about a condition only recently brought to light (or some such blather) that's having a huge impact on people (and throw in a few 'sexy' draws like BP, car crashes, cardiac stuff, etc. Make LOTS of noise publicly in places that count - but coordinated the way the big health charities do it - and get as many warm bodies to attend and speak as possible. Do it in NY, LA, Chicago, etc. simultaneously if possible, or at least as a traveling roadshow in major centers, with concurrent mailings to Johns Hopkins, Mayo, etc. etc. with the list of 'screening for' conditions attached - blatantly NOT showing OSA. Get famous people like Rosie (but also some with possibly more credibility and less stridency) to show up, speak up and be heard. Dr. B., are you doing anything for the next ??? 6 mos? Are you good at organizing? Anyone else out there?

drbandage wrote:a) What is missing from the list on the posting about Family Practice physicians?

Aside from the obvious exclusion of sleep apnea screening, as I look through the list I notice that many/most items on the list have simple, inexpensive screenings available. Current practices for sleep apnea screening are horribly expensive by comparison.

drbandage wrote:b) What are you going to do about it?

First, I'll point out that screening and testing for apnea need not be expensive. To wit, the following link:
http://Apnea Sufferer's Bill of Rights

Second, I'll offer assistance to anyone wanting to set up a non-profit corporation for the purposes you've outlined, drbandage. (I recently set up a non-profit corporation myself, so the information is still fresh.)

Regards,
Bill

I am amazed at how much information is available online, if one only takes the time to read. Well done!

As for the what's missing, I've PM'd you, drbandage.

As to what I plan to do about it - I'm taking my nice little machine with me to my next doc visit(s), (Respironics M series Bipap Auto), with all its bells and whistles, plus a newly filled out Epworth sleepiness scale, AND my copy of my sleep study summary. I'll be showing the docs (both my primary and my pulmy) how well I'm doing (hopefully - as soon as my smart card reader comes), the actual changes from pre-bipap to bipap with the wrong pressure settings, to bipap finally titrated to the correct pressure settings.

Great challenge, Drbandage!

girlsaylor

Hello Doc!

Well, we know what's missing...lol. Heck, I knew what it would be before I even read the entire list. However, what to do about it is another story.
It amazes me how so many people I know just shrug it off when questioned about their sleep. Including my sister who has been on CPAP for 4 years now and my mother who just started 3 weeks ago. I have talked to both of them and two friends on CPAP about this site and the wealth of information available to them. Their response: "Who cares? My machine works fine." or "Why are you so obsessed with this? Get a life" . Gee, I thought that's what I was trying to do! Even talking with my sleep doctor felt like hitting a brick wall.

I actually found the person most active regarding OSA and screening was my regular internist. In a recent discussion, he said he always asks patients how they sleep, how they feel during the day, etc. during regular physicals and during sick visits depending on what they come in for. His words were basically "It's so simple to ask a few extra questions, why wouldn't I? He said every patient he has referred for a sleep study has been diagnosed with OSA. I say, good for him!

So what will I do? I will continue to badger my sister, my mother, my friends, my father who has it but is in denial and feels he is too old (75) to do anything about it! GRRRR...so that's what I will do. And hopefully, it will sink in someday and they too will talk to their families and friends and doctors about OSA and maybe someday it will become part of the regular screening process.

Whew, ok,so much talking, I feel the need to strap my mask back on! lol

Have a great day everyone!

Mary

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

Please take my $10.00 and do one of the following.

1) Give it to an OSA education fund.
2) Use it for copies of articles for Docs.
3) Donate it to People who have OSA and do not know it fund...

OK, so it is obvious what is missing. I did kinda shock me, cause my family physician has spoken to me for years about OSA and I always dismissed it as being under control as long as I slept on my stomach. It wasn't until my life/health went absolutely nuts, that he insisted on a sleep study. I was finally ready to accept anything whatsoever to help. As I spoke of in an earlier thread, he always sends his students in to see me and we usually have a long talk about OSA. Doc jokes with me that I probably know more about it them him. But I guess my Doc seems to be the exception.

What am I doing about it... Well, I think I have become the advocate at my doctor's office for OSA. I must admit I have not asked him if he is doing regular screening for OSA, but knowing him as long as have, I am sure he considers that when the symptoms are there, or when somebody is in at risk group. He actually asked me about OSA many years ago because of the "architecture" of my throat. I didn't think I had symptoms, but looking back I probably did.

However, at this same time that my health kinda went haywire, I was sent to see an edocronologist because my Calcium was high. Numerous tests, by two different docs, and I was scheduled to see a surgeon for parathyroid surgery. Then my endo's boss came back from vacation. He insisted upon two weeks of more tests, at which time he concluded there was not a calcium problem. He said it was all lab mistakes up to that point. It wasn't till recently that I put 2 and 2 together and realized I was on cpap for about 2 months when this conclusion was reached. So this morning I fired off an email to him and his associate suggesting that my OSA was maybe "contributing" to my body not functioning properly. I am sure he won't even read my email (he was a pompous...), but his associate was always willing to exchange email and provide information, so I am optimistic that she will at least respond.

I truly hope we can get some kind of national momentum behind this issue, but in the meantime I firmly believe that we can do quite a bit just by being open and not ashamed of our condition. My wife was hesitant when I placed in our Christmas letter a paragraph about my OSA, throat surgery, etc. But it has caused a lot of good conversation at many family gatherings. And as I also spoke about in an earlier post, I have made my condition well known inside my work organization. It has lead to many good discussions and several others coming forward who have been on cpap longer than I but were embarrassed to talk about it. A lot can be done if there are thousands of voices singing the praise of XPAP, but I agree it would be more effective if you could put those thousands of voices into one choir. So good for you Dr. B. I hope can we can keep this moving forward.

Tired_in_NC wrote:Please take my $10.00 and do one of the following.

1) Give it to an OSA education fund.
2) Use it for copies of articles for Docs.
3) Donate it to People who have OSA and do not know it fund...

Thanks, TINC. It will go to something that promotes the cause, I promise you that.

BTW, here's the way to "make a comment" if you so choose:


If you have comments or suggestions, please send us a message at fp@aafp.org

I think personal messages about how OSA and the challenge for diagnosis and treatment are the most important, along with the obvious question: why is this enormous and devestating problem not even a blip on their radar screen? Then a request for action: include it!

There are lots of links there about their advocacy for the patients. Well, here their chance to step up to the plate in a very meaningful way. Demand it.

I'm not sure which thread to post this one to, but since you posted the e-mail address to the AAFP site in this one, I thought this one was about as good as the other.
I went to the Family Practice Physicians website

http://www.aafp.org/online/en/home.html

and did a search on "apnea" and got lots of results. A few of them are listed below.

http://familydoctor.org/791.xml

http://www.aafp.org/afp/20051001/1319ph.html

http://www.aafp.org/afp/20040201/561.html

http://www.aafp.org/afp/20020115/229.html

http://www.aafp.org/afp/20000315/tips/5.html

http://www.aafp.org/afp/20020115/snorph.html

It's not like they're not AWARE of OSA......so I don't know why they wouldn't have included it in the screening list you posted.

It seems to me that a number of the items listed in the screening list would be a clue to also screen for OSA (and it's "relatives", like CSA).

I also did searches on "APAP" and "Auto-titrating" and came up with ZERO results.

Best wishes,

Den

[quote="Wulfman"]
I also did searches on "APAP" and "Auto-titrating" and came up with ZERO results.

Best wishes,

Den