Smargie’s Therapy Thread...in Need of ASV Advice

So...I did another sleep study and I don't remember what my AHI was but it was in the "serious" range. Mostly centrals but also some hypopneas (no obstructives). My oxygen was 96% and the doc said she'd just been chatting with a colleague about whether situations like mine actually need to be treated. And apparently I'm a slow and shallow breather too, which I thought was the case. She said it was unlikely that I still needed an ASV.

She ordered a split study next. I wasn't able to sleep at all once they put the mask on because the pressure and the speed of the air was too much. The tech let me leave after about an hour. I think he knew I needed an ASV but said they aren't allowed to test with those without prior authorization. The doc said I needed an ASV after all and ordered yet another study to work out the settings.

At this next study I told the tech that I had previously used very low pressure and he said "That never helps anyone", but if you all remember I was using a particularly low setting to avoid aerophagia and did very well for a long time. He started me out on what felt very high and fast. I became claustrophobic and nauseous pretty quickly and began to panic and pull the mask off. I was too rattled and upset to continue with the study and I left.

To my surprise the DME called to have me come in for my new machine. I used a Resmed before and would have requested one again had I known that the doc was going to give me a machine without the study. They brought out a Respironics. Of course the pressure was too high and fast. I asked why it didn't adjust to my breathing rhythm and she looked very puzzled and said I had to adjust to it, not the other way around. I asked for a Resmed and she brought the big boss in to tell me that wasn't possible. He said my doc specifically wanted a Respironics for my treatment and that it was unlikely that the doc's office had the software to work with a Resmed anyway. The RT said maybe the doc would "take pity" on me and lower the settings. I left without the machine and said I'd call my doctor because there was no way I'd be able to use that machine.

Do I remember correctly that I have the right to choose the machine I want? I wanted to ask you all this before calling the doc. I know it's BS about the software issue, and the DME folks clearly don't want to give me the Resmed (which adjusts to MY rhythm)...they said they'd ordered that machine specifically for me, that ASVs are high tech and expensive and they don't just keep them laying around. They were pretty shocked that I stood my ground.

I'm not sure I need treatment anyway so I'm not going to do it unless I can have a machine that I can tolerate.

Smargie wrote: ↑

Wed Apr 14, 2021 11:19 am

I left without the machine and said I'd call my doctor because there was no way I'd be able to use that machine.

Do I remember correctly that I have the right to choose the machine I want? I wanted to ask you all this before calling the doc. I know it's BS about the software issue, and the DME folks clearly don't want to give me the Resmed (which adjusts to MY rhythm)...they said they'd ordered that machine specifically for me, that ASVs are high tech and expensive and they don't just keep them laying around. They were pretty shocked that I stood my ground.

I'm not sure I need treatment anyway so I'm not going to do it unless I can have a machine that I can tolerate.

you go, girl!

if that doctor won't write a prescription for what you want, find another doctor who will. it does NOT have to be a sleep doctor; any doctor can write it. a dentist or whomever.

now i'm too lazy to go back to see what insurance you are depending upon. if none, full steam ahead. if you DO need it, get in touch with your insurance and see what your next step is.

of OURSE they have the software for resmed. that's just a bs excuse.

good luck!

The machine adjusts to your breathing, NOT the other way around and you need a doctor who understands at least that very basic issue!

Plus just "Resmed" is meaningless without a model #, of which there are many, so just asking for Resmed is not much good. You have the right to choose your machine, but if the info. you base that on is no good to begin with, there's not much point.

And it's not always a matter of 'tolerating' one machine or another, but of understanding again that various factors contribute to how well any machine works - for you - depending on how it's adjusted - many think they can't tolerate a machine when it's just a matter of having tweaked certain things to work for them.

I suggest you download Oscar and post results in this thread so we can see what's what for a couple of nights and then, if necessary, advise re adjusting certain things or depending on results whether you might need a different machine or even any machine at all, vs possible treatment for another condition entirely.

Thanks Julie...I had a Resmed Aircurve 10 ASV which I rented from the same DME I'm using now. That info used to be in my signature but it seems to have disappeared. At least I'll know what to request. This wonderful forum interpreted my charts and got me to a setting I could live with. Eventually those setting stopped working and unfortunately I was having technical problems and couldn't post charts at the time. The DME took the machine back because unbeknownst to me my insurance wasn't paying their portion. But if and when I do get another machine I'm sure I'll be back here posting OSCAR charts.


Zonker, thanks for the encouragement! Apparently there actually was a problem with my last insurance, though they let me keep the machine (but unfortunately none of the rent I paid went toward owning it). I changed insurance in January and hopefully this new plan will be better. I now have Wellcare Medicare.

No one's equipment's showing up now - glitch - so don't worry.

Smargie wrote: ↑

Wed Apr 14, 2021 2:30 pm

unfortunately none of the rent I paid went toward owning it). I changed insurance in January and hopefully this new plan will be better. I now have Wellcare Medicare.

Was your old insurance a different Medicare Advantage plan from this Wellcare plan?
A lot of the Medicare Advantage plans are going to perpetual rental so you never actually own the machine.
You need to find out if the Wellcare plan is going to do the same thing. So no ugly surprises.

Smargie wrote: ↑

Wed Apr 14, 2021 2:30 pm

Zonker, thanks for the encouragement! Apparently there actually was a problem with my last insurance, though they let me keep the machine (but unfortunately none of the rent I paid went toward owning it). I changed insurance in January and hopefully this new plan will be better. I now have Wellcare Medicare.

i leave you in the capable hands of others as i don't use medicare for my cpap.

good luck!