Respironics/Remstar System Question

Miko,

You've gotten me curious so I did a little searching and found the following at sleepnet.com http://www.sleepnet.com/apnea110/messages/658.html
This post claims his gerd was eliminated by CPAP.

Also... http://www.sleepnet.com/apnea110/messages/578.html This is an extensive discussion on the subject.

Hope you find some answers.

Hi wading thru the muck!

I had to discontinue CPAP completely. I could not tolerate the CPAP due to belching, abdominal pain and cramping in the middle of the night. I frequently had to have to rush to the bathroom because of this. I was trying to get accustomed to the CPAP when these other issues developed.

I recently changed GP's and now I am being referred to a Gastro Specialist as opposed to a surgeon. My previous GP did sent me to a surgeon. The surgeon did not know of any link between GERD and apnea when I suggested this to him. So, I ditched him and my GP.

I don't know how well the Nexium is working but I do know that unless I am very very careful, I can develop abdominal discomfort gas, and or pain soon after eating. My previous GP said I have refux, but I also have ulcerative colitis or some other form of Irritable Bowel Syndrome. No physician is willing to link directly or indirectly any other these problems, except GERD with the sleep apnea. My appointment with the specialist is not until the New Year. In the interim, I am taking meds to help with the colitis. Earlier, I felt confident I could try CPAP again, but I don't think so now as I feel my condition is once again worsening. At best, I can get ne good week and one bad week with my gastric issues.

As far as surgery goes, I don't know if this will remedy anything as we really don't know the "official" physiological reason why the esophaegeal (sp?) sphincter is so sensitive to the pressure of the CPAP machine. My doctor's view of surgeons is that "if you give them a scalpel, they will use it". However, the GI surgeon did tell me that this is a very invasive procedure when I asked him about it and I shouldn't go there right now. But, he did want to take a part of my colon out and send it to the lab for examination.

Thanks for the link on how GERD was cured with the CPAP. This is my intent, to control the GERD so I can once again start CPAP therapy. However, it's like I am chasing my tail. If I can't use CPAP, I can't treat the GERD or my hypopneas.

Miko, check out this site: http://www.amisleep.com

I've been reading some posters on another message board who have been having remarkable success using the TAP II (Thornton Adjustable Positioner) dental device instead of cpap. One had full PSG studies both before and after getting a TAP. Another had overnight recording pulse oximetry that proved from the nice high sats that the TAP was doing the job for her. She had been trying cpap and autopap for almost a year with not a dent in her sleep problem...in fact, I bought the almost new autopap and the 7 or 8 masks she had tried from her after she switched to the TAP and felt great from her first night on. Might not be the answer for you, but would be worth looking into. The biggest problem might be finding an experienced dentist who could evaluate you realistically (and not just with $ signs in his eyes) to give you a truly objective appraisal of whether the TAP could be expected to possibly help you breathe better at night.

Thanks rested gal for the link. I will be pursuing the dental appliance. I am in Western Canada and we have a dentist that has something similar and he also patented his dental appliance. After a one hour consul, he admitted that he is the only dentist that has official trials supporting the benefits or success of his "Klearway Dental Appliance" http://www.klearway.com/. I asked him what he interprets as success. His response was anything less than 10 AHI per hour. Unfortunately, I need as close to 0 AHI as possible. Even at an AHI of 5 or 4, I was not receiving much benefit. My regular AHI is 16. That being said, this may be the best I can do until I (hopefully) can tolerate CPAP one day.

I chose not to get the Klearway dental appliance because of the cost and "poor success percentage". The cost is approximately $2100 CDN. I will check out another dentist who also has a dental appliance and call one in Washington in the link that you gave me. I am sure the cost must be cheaper than $2100.

What really is awful is my insurance company will only pay for either an appliance or a CPAP machine, not both. The good thing is that stores like CPAP.com sell CPAP far more cheaper that what we can get in Canada. The average CPAP costs around $2000 CDN from a DME. Money is of course and issue, but not the only one. I want something that works. There is a strong liklihood that our Candadian dollar will plunge within the next few days after Bush win's tonights US election and the cost of the CPAP machine will rise.

Hi Miko,

Interesting that both the dental appliance and CPAP are $2000 +/- each

To bad there isn't a dentalappliance.com to save you 66% like cpap.com

I have an AHI of 12 and had severe daytime sleepiness so a residual AHI of 10 with the dental appliance doesn't seem worth $2100.

What is the current CND to USD conversion?

Glad to hear you are predicting a Bush win. If things are as in 2000 we may have some time before we know who won.

Why do you think the CND will plunge if Bush keeps the presidency?

Again hoping you find a solution to your delema.

Hi again,

Yes, an AHI of 10 is not good. But, my sleep doc says I won't know for sure unless I try the sleep appliance. I guess for them, a couple of thousand is small change. Anyhow, I hope to find someone that sells the dental appliance for less than $1500 CDN. The CPAP will cost less with the software at today's exchange rate if I get it online from CPAP.COM. The local DME's charge about $2000 and my insurance company caps at $2000 for either the CPAP or dental appliance. I can only buy one CPAP every 10 years and they wont cover any rentals or maintenance for 10 years.

Currently the bank exchange rate is 1.24 USD to $1 CDN. It hasnt been this high in over 10 years.

The loonie will likely drop because over the last little your green back has been weak and plagued with politically uncertainty. With the win, either Bush or Kerry, there will be politically certainty and this will increase the USD and therefore decrease our loonie. In the long-term though, oil prices will have more of an influence our loonie than the USD. Our fuel prices, except diesel fuel have dropped significantly largely due to the weak USD.

It will be interesting to see what happens. I probably should be about $1500 USD in the next few days so I will be able to get a CPAP machine, if I can in the new year. I am renting the PB Goodknight 420E this weekend and I hope I will be able to tolerate it and eventually get off the 40mg/day Nexium pills. Oh, PB has announced that in February they will have their own humidifier for the 420's that should dramatically reduce rain-out.

Thanks again for your well wishes. I dont think science can help me out, just faith.

Here's the skinny on the coming Puritan Bennett Humidifier...

https://www.cpap.com/DisplayNewsletter/17

cpap.com will be sending out a Medtrade Edition of our newsletter with more information about this unit in the next few days.

Nice humidifier. It looks a lot like the Remstar one. I wonder what the hold-up is with the FDA. Too bad the CPAP machine will not be able to power the unit.

Hi Miko,

Jump on that exchange rate. You can buy that 420E for 125 less CND than I paid USD!

Hope you like the PB. I was all set to buy the Remstar Auto because of that slick integrated humidifier but then I saw the cpap.com Oct newsletter with the story on the new PB heater so I went ahead with the 420E.

The PB+software is cheaper so I was able to but an interim humidifier that I will keep as a back-up or sell on ebay/yahoo.

Good luck on your trial run - Keep the Faith! I'll be praying all goes well

Miko,

Good news for both of us Bush wins and the Canadian dollar hits a 12 year high

That CPAP machine is getting cheaper for you every day!

Thanks, wading thru the muck!!

Yes, surprise surprise on the dollar. I was also amazed how close Bush's win was.

I just bought some US currency today @ $1.235 to cover the cost of the PB. I hope everything goes well this weekend with the trial with the PB.

Curious, how did thje 420E drop in price?

Again, thanks for your support.

Hi Miko,

Those of us here in the US that support Bush are happy the margin of victory was so large. Any closer in tight state and we'd be without a winner until it was decided in the courts (not good!)

Enough politics before we get moderated. It's a nice diversion though!

Tell me if I'm wrong but if the value of the CND (relative to the USD) goes up the more USD you can buy with it. Thus the 420E costs you less CND.

Do you have to pay a premium to buy USD? The rate I found in a google search earlier today was 1.2053. You said you paid 1.235.

Apparently the USD dropped due to inflation fears.

Again, good luck with your CPAP trial

Yes, you are correct. The CDN loonie hasnt been this high for over 10 years. If I were to buy a CPAP 6 months ago, If I had purchased the same machine the same time you did, I would have to spend a lot more Canadian money. That's why I was confused when you wrote that the 420E is cheaper now than it was you bought it. I recall when I was young how the CDN and US dollar was at par. A while ago, I had the option of purchasing a Respironics CFLEX Machine for $2100 CDN and at CPAP.com it was cheaper, but now it is even less expensive. CPAP.com is great with their prices.

The online rates really vary and aren't necessarily accurate. The rate I quoted you is the cash rate that banks sell USD to us. There is no direct surcharge. The only time there is if you use your credit card to purchase goods in US dollars, say from CPAP.com. The banks buy US currency from the Bank of Canada and then they sell it to us, the individual. http://www.bankofcanada.ca/fx/daily_close.htm

One of the biggest banks in the country, the Royal Bank has a very good website on the buy/selling prices of CASH currencies to the consumer.
http://www.rbcroyalbank.com/rates/cashrates.html

In any case, your USD still goes very far. Perhaps you can make it up our way to enjoy our wonderful and mild temperatured city. Maybe even take a cruise to Alaska. Here is a very nice live webpage of our city. It's best to view it during daylight hours. Some sunset shots are fantastic.

http://www.katkam.ca/

Again, thanks with your well-wishes,
Cheers,
Miko

Miko,

Thanks for all the great links.

I'm not that far on the US side of the border so I know that lovely sunbathing weather.

I just bought my machine 10 days ago so the drop in price I was refering to was since this most recent drop I paid $639 USD for the 420E with software. That should be approx $789 CND right? I think I may have done the conversion backwards in an earlier post , but it's still much cheaper than your $2100 option.

Hope all is going well with your CPAP trial run.

Just a follow-up. I was only able to use the PB for one night. That was it. It is just too noisy. My DME said that he does get that complaint regularly. He thinks it could be worsened by the inner tube vibrating against the tube.

My DME just returned from a week's course at Standford University. All the big boys were there, the father (creator) of CPAP and the best sleep specialists in the world. He brought up my case and he was told the same thing, this disease (Sleep Apnea) is in it's infancy and there is not much one can do with the air swallowing (aerophagia). One can try different sleep positions but that doesn't necessarily work for most people. My problem with noise wasn't mentioned, I'll bring it up the next time I see him (when I try a different machine). But that won't be until Xmas when I will have some time off work.