Having trouble with "elitism"

I am new here and new to the world of diagnosed sleep apnea. I have had a sleep study, had the run around from DME & insurance companies. I am a no BS kind if guy, sometimes to a fault, so I decided to just purchase my own equipment and be done with it. I purchased an Airstart 10 CPAP machine because it was well reviewed on various websites and I could actually afford it. The machine will arrive this Wednesday so I've been doing a lot more reading to try to prep myself for success.

I am completely baffled by the amount of "CPAP elitism" I've seen on this board. I understand the indignation regarding DMEs supplying substandard equipment for top of the line prices, that's BS and not what I'm talking about.

This is an example of what I'm talking about.
viewtopic/t113511/New-model--ResMed-Air ... -only.html

After dealing with all the medical industry BS I was ready to give up on starting therapy. Fortunately my dad has been using a CPAP for 20+ years so when I called him to vent he steered me in the right direction of buying my own equipment. I was relieved to find a machine that I could afford and felt liberated by not having to jump through hoops to get it. Then I come here and see people trashing budget friendly machines because they don't have every bell and whistle that allow CPAP nerds to tinker with (not a negative term, I nerd out on plenty of things).

Long story short, it's good to see the benefits of the premium flagship machines but trashing the affordable every level equipment because it makes you feel superior is only going to cause newbies like myself to delay or forego treatment entirely.

Otherwise I have gained a bunch of knowledge by reading through posts here.

Welcome to the forum.

There is a time and place for those low budget...no bells and whistles...type of machines.
If you read more on this forum you would see that we don't always trash them.

The problem is those bells and whistles might just be the difference between successful therapy and non successful therapy for some people. If a person is going to be able to get just one machine...we recommend the one that has the best chance of them being successful. It's not so easy to trade up for a more comprehensive machine should it be discovered that there is a problem with the therapy and something needed to help figure out a problem is missing and available on a more comprehensive machine.
We try to cover the bases as much as possible ahead of time instead of after the fact.

If all you can afford is the base model...then that's all you can afford and so be it especially since you already elected to go that route.
Hopefully your treatment/therapy will be uneventful and you won't have any problems that having some bells and whistles might make it easier to eliminate.

Good luck to you and we wish you well. Should you have a problem...we will still try to help you and offer ideas based on what you have available to work with. We do realize that not everyone ends up with a machine that has more tricks up its sleeve to help people out.
We will do the best we can though in terms of ideas though.

I hear what your saying about a budget machine but you can buy a used low hour machine for what you just paid with all the bells and whistles if you need them.when your machine comes we can help you set it up to get the best treatment you can.

Yes, there are always a few on every forum board that will turn off a certain number of newbies if you let them. It's the internet,....don't take anything personally, and partake of the vast amounts of knowledge that can be found here.

I bought myself a brand new AirStart10 Cpap last year from our sponsor to use as a back up. It was a great deal at 187 bucks during a special sale. Works perfectly, and at my prescribed settings is identical to my Airsense10 in how it works. I was prescribed a constant 8cm with EPR of 3, and have changed to 7/15 APAP with EPR of 2 on my own from various recommendations here.

I started out with a DME when diagnosed, but quickly tired of the games and the hoops you have to jump through. I am very happy I decided to go it on my own with the help of some of the members here.

Each person is different of course. Myself,....I like having the ability to look at my SH charts from time to time, and see if everything is remaining status quo. I do this maybe once or twice a month,....certainly not obsessive about it. That gives me the ability to be comfortable with using a so called 'brick' if needed, due to the fact I know how I respond to a certain fixed pressure.

The main reason the 'attitude' you are complaining about exists, is because this is pretty much a do it yourself based site. Without data, it can be hard to self treat,....that's just common sense. I agree that some of the members come off too harshly, but I revert back to what I said earlier, it's the internet,....no reason to get worked up over a strangers comments.

As long as your titration study showed success in treating you at a fixed pressure, and nothing changes, you will be good to go with the new AirStart10, and I wish you good luck.

"Then I come here and see people trashing budget friendly machines because they don't have every bell and whistle that allow CPAP nerds to tinker with (not a negative term, I nerd out on plenty of things)."

Characterizing some of the features provided by more expensive devices as simply "bells and whistle that allow CPAP nerds to tinker" is disingenuous.

I have followed a few threads here where the "Bells and whistles" along with the advice from the experts have transformed ineffective, uncomfortable and poor therapy into successful and effective therapy.

Low end machines with no auto-adjusting and data have no equivalent and limited options to improve the experience.

This can make the difference between success and abandoning CPAP. It is not elitism.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 10:43 am

The machine will arrive this Wednesday

What's the return policy on unopened packages?

I bet some of the members can help you find a machine appropriate for managing your therapy in good shape/low hours for what you paid or less.

I buy used machines for my own use and have been very satisfied with quality/price.

Interesting first post!

After a few months see if what you wrote still rings as true as it does now.

What you learn from Pugsy's post, and a few others with deep knowledge, about changing parameters on a machine to improve treatment success might steer you toward realizing the elitism posts are based from experience. Of not knowing how to help those with the base model machines. There is simply NO way to know what is going on with them. No way to share the collective knowledge of how they might improve someones sleep and treatment.

I hope you are lucky and your machine takes good care of you the way it is set up now.

I didn't realize there was a market for used equipment, seems common sense but I didn't consider it. If my machine doesn't work I will persue that avenue.

I understand the benefits of the data tracking ability, I also know that my dad has never needed anything beyond a basic machine and I'm hoping the same is true for me.

The stuff that I'm mainly referring to is comments like this, "Hey......ResMed......If you're reading......you're greedy, pathetic and disgusting for producing products like these."

As a newbie, I read stuff like that and think that I may have made a huge mistake with my purchase. Not trying to call anyone out or stir the pot, just trying to provide some perspective from a newbie.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 12:33 pm

The stuff that I'm mainly referring to is comments like this, "Hey......ResMed......If you're reading......you're greedy, pathetic and disgusting for producing products like these."

I'm not fond of that rhetoric either. On the other hand, you could say it's just hyperbole.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 12:33 pm

huge mistake with my purchase

I wouldn't say "huge". Just a common newbie mistake.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 10:43 am

Long story short, it's good to see the benefits of the premium flagship machines but trashing the affordable every level equipment because it makes you feel superior is only going to cause newbies like myself to delay or forego treatment entirely.

It's an interesting perspective, but this is a forum where people come when there therapy *isn't working*. So the people who come here are a skewed portion of CPAP users. And when people who come here have a basic machine without data collection and without an auto mode as an alternate mode of therapy, there isn't much people here can do to help. Much of the time people with basic machines were **ripped off** by their DMEs because the insurance code for CPAPs and APAPs is the same, so the DMEs can make more money by giving people the crappiest machine and keeping the profit. Telling people about the flasgship models isn't elitism it's putting the patient first, ahead of corporate profits, it's consumer protection.

As you may have read, sleep apnea can change from day to day, and even within a night of sleep as you change positions, so for many people the best therapy comes from a machine that can change pressures to keep up with a person's changing needs throughout the night. A fixed pressure CPAP can't do that.

And far from being elite, people on this forum have helped get people used, discounted and sometimes even free equipment. And while I know I sometimes annoy Pugsy, she, for example, deserves recognition for her unwavering generosity. She has been extremely generous with her time and helping people get gear they need, as have others.

I think you'd be better off with a used flagship machine than the new basic model for the same price. That's not elitism. That's putting patients first. But, many people do get by with basic models, and they don't tend to need to post here. My best wishes that you will be one of the people who has trouble-free therapy.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 10:43 am

I am new here and new to the world of diagnosed sleep apnea. I have had a sleep study, had the run around from DME & insurance companies. I am a no BS kind if guy, sometimes to a fault, so I decided to just purchase my own equipment and be done with it. I purchased an Airstart 10 CPAP machine because it was well reviewed on various websites and I could actually afford it. The machine will arrive this Wednesday so I've been doing a lot more reading to try to prep myself for success.

I am completely baffled by the amount of "CPAP elitism" I've seen on this board. I understand the indignation regarding DMEs supplying substandard equipment for top of the line prices, that's BS and not what I'm talking about.

This is an example of what I'm talking about.
viewtopic/t113511/New-model--ResMed-Air ... -only.html

After dealing with all the medical industry BS I was ready to give up on starting therapy. Fortunately my dad has been using a CPAP for 20+ years so when I called him to vent he steered me in the right direction of buying my own equipment. I was relieved to find a machine that I could afford and felt liberated by not having to jump through hoops to get it. Then I come here and see people trashing budget friendly machines because they don't have every bell and whistle that allow CPAP nerds to tinker with (not a negative term, I nerd out on plenty of things).

Long story short, it's good to see the benefits of the premium flagship machines but trashing the affordable every level equipment because it makes you feel superior is only going to cause newbies like myself to delay or forego treatment entirely.

Otherwise I have gained a bunch of knowledge by reading through posts here.

You're overlooking some aspects of this whole scenario.
First of all, this situation has been going on for many years. The manufacturers make "bricks" (data-less machines) and then the unscrupulous DMEs pull a "switcheroo" on the new users. They know that the insurance providers pay based on billing codes and for CPAP machines, it's exactly the same amount for the lowest level machine as it is for the top-end full data machines. The billing code for CPAP machines is "E0601". So, the DMEs will optimize their profits rather than giving the users machines with which to monitor their therapy.
Our "beef" has been with the manufacturers. It is more than likely more costly to make multiple lines of similar machines than to just make one line of fully-data-capable machines. In many cases, the internal components of these machines are identical and the main difference is the programming which turns on or off the capabilities.

In reality, the costs of the data-less machines isn't that much less than full-data machines. It's also very easy to find new to lightly used machines that are much less expensive than the full-price versions. Many of us on the forum have purchased those types of machines and know what we're talking about.

If you compare these machines to automobiles, the question one could ask is would you buy a car that didn't have a speedometer or other gauges?
Would you try to use a ruler or yardstick that didn't have any measurement marks on them?
Same logic applies here.
If you don't have any way to measure your CPAP therapy progress, you're "in the dark".
It's definitely NOT "elitism" to recommend that users get machines with which to be able to measure their therapy progress.

I would strongly suggest trying to exchange your "brick" with something that will provide you with some information about your therapy. Or, keep the brick and get an additional machine that is data-capable. It's a good idea to have spare/backup machines with this therapy. "Murphy's Laws" apply to these machines, too. If they DO fail, they will do so at the worst possible time.


Den

.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 12:33 pm

I didn't realize there was a market for used equipment, seems common sense but I didn't consider it. If my machine doesn't work I will persue that avenue.

I understand the benefits of the data tracking ability, I also know that my dad has never needed anything beyond a basic machine and I'm hoping the same is true for me.

The stuff that I'm mainly referring to is comments like this, "Hey......ResMed......If you're reading......you're greedy, pathetic and disgusting for producing products like these."

As a newbie, I read stuff like that and think that I may have made a huge mistake with my purchase. Not trying to call anyone out or stir the pot, just trying to provide some perspective from a newbie.

You DON'T REALLY KNOW that for sure.......if there's no way to monitor his data.

And, what else would you call it if the manufacturers and DMEs are screwing the users out of THEIR money? (insurance or out-of-pocket expenses) Like I said in my previous post, the production costs are probably more to make multiple versions than to make a single one (that is fully data-capable).
I've been watching and participating in this forum for nearly 14 years and the scenario keeps staying about the same. And, it pisses me off how they take advantage of new/uninformed users.


Den

.

The way i read this is you bought a low budget machine because that's all you could afford. three options:
1. use it and do the best you can.
2. return it unopened the day you get it and buy a good one from somebody on this forum for less than your refund will probably be.
3. keep it as a backup and get a good one from a dme and let insurance pay for it.
Good Luck.

Bighungry69 wrote: ↑

Sat Nov 24, 2018 12:33 pm

I didn't realize there was a market for used equipment, seems common sense but I didn't consider it. If my machine doesn't work I will persue that avenue.

I understand the benefits of the data tracking ability, I also know that my dad has never needed anything beyond a basic machine and I'm hoping the same is true for me.

The problem is that, without the "data tracking ability", you won't know whether the machine is taking care of your apnea. It's like painting the windows of your car black and trying to drive to work.

The challenge with apnea is finding a treatment that is effective. If a patient is not compliant, no treatment will be effective. I think compliance best comes from: a) a solid understanding of the risks of untreated apnea; b) patient feeling subjectively better when treated; and c) solving the issues that make treatment uncomfortable or ineffective. The issues can be varied -- and if I had to pick the top one it would be mask type and/or fit. That said, the device is also important.

Let me take a brief stab at three features and why I personally find them valuable.

a) Data recording beyond basic compliance. I determine quality treatment by both objective (frequency and type of sleep disruptions, mask leaks, O2 sats, etc.) and subjective measures (do I feel less tired). While both measures typically move in tandem, there are exceptions. If your treatment starts to degrade (assuming you are even aware of that fact), your only real solution is to go back in for a titration study or make adjustments using only subjective measures.

Lets say your Dad is diabetic and he worked with medical professionals to establish a diet that was good for glucose control. It does great although he does no in-home testing and only gets his fasting glucose checked once every few years. How certain are you the glucose is being effectively managed six months later, or when he has a cold, or....?

b) Auto adjusting. If your figures are rock solid during the night and don't bounce around as you change positions, go in and out of REM, and don't change over time with congestion, etc, great. Otherwise, you compensate by setting higher pressures than otherwise needed. That is not bad per se, but higher pressures are often perceived as less comfortable and tend to make mask leaks worse.

c) Heated hose. This all depends on your situation but if you like high humidity and a cooler room, this is mighty nice. Granted, you can insulate the hose (and that will help some) or take other actions (lower the humidity, increase the room temp).

There are other features that I personally find of little value...the mask fit test mode (whatever that is called) and things like smart ramp or the build in modem. In my case, BiPAP is important but it is not in all cases. Likewise, if you are having central apneas you need a machine that effectively treats those (and neither your nor my machine does).

There are actually plenty of options around used machines...some pop up for sale here. I have also had great luck with me DME -- I was replacing an S9 with a Dreamstation. DId not like it so I was able to swap for the Aircurve...provided I did so within the trial period.

Not a medical provider -- I am just a consumer.