Lack of Communication, Doctor & DME

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 3:21 pm

I had a bad night on the machine, my AHI was higher, looked at my information for the night and my pressure was 13.5 all night. I was under the impression my APAP Machine was going to be set between 10 to 16 and the Doctor would prescribe pressure changes as needed. I looked at the settings and I did not see my 10- to 16 range and the A-Trial was not there like before. I called my DME and they told me the A-Trial is for the machine to learn what pressure I need, basically it self-titrates me and then it decides what pressure. So my machine as stated was at 13.5 all night like straight CPAP, no ups or downs on the graphs - just a solid line at 13.5, my DME says the machine will still make adjustments up and down.

Please chime in if this is correct or not? This really pisses me off thinking I was getting used to my machine and thats how life is going to be and then to see it doing this

Pugsy · Post by **Pugsy** » Mon Mar 12, 2012 3:35 pm

Is your machine the Auto IQ? What you are describing is the Auto IQ which only does the auto (APAP) mode for a short time then switches over to straight cpap mode.

Check the bottom of your machine for a model number.
Auto IQ is DS 450 because it is a PR S1 Pro with limited 30 days of APAP ability.
The regular PR S1 Auto CPAP with A Flex is model DS 550 and has full time forever APAP ability and won't ever change on its own.

BlackSpinner · Post by **BlackSpinner** » Mon Mar 12, 2012 3:35 pm

They changed it. Get online and find the clinical manual.

However there is a machine out there that locks into place so check your machine name carefully. I believe that version has the term "IQ" in its name.

Pugsy · Post by **Pugsy** » Mon Mar 12, 2012 3:43 pm

This is the Auto IQ
https://www.cpap.com/productpage/respir ... utoiq.html

This is the full time APAP https://www.cpap.com/cpap-machine/respi ... -flex.html

If you have the model DS550 (full time APAP) the only way to change the settings is either the modem...SD card changing RX...or manually going into the clinical menu.

Sounds like you have the Auto IQ. Once the 30 days of APAP is used up my understanding is that it is no longer available. Waste of money...price difference between the Auto IQ and the full time APAP is tiny.
What happens in 6 months or next year and something changes and someone might want or need APAP mode again?

Mary Z · Post by **Mary Z** » Mon Mar 12, 2012 3:43 pm

If you just started therapy when you joined the forum rest assured it does get better with the help and support you get here. If you got the AUTO IQ, in theory is sounds like a great idea. You can give us a progress and product report as time goes by. I know about being pissed. I recently had some machine problems that made me want to chuck it all. It's one symptom of sleep apnea- this getting pissed over things that can be worked out. You should have gotten a better explanation of how your machine works. Memorize that owners manual and get the clinicians manual from apneaboard if they have it now. Hang in there, keep posting, help another newcomer. Like AA, but one night at a time.

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 3:46 pm

Pugsy wrote:Is your machine the Auto IQ? What you are describing is the Auto IQ which only does the auto (APAP) mode for a short time then switches over to straight cpap mode.

Check the bottom of your machine for a model number.
Auto IQ is DS 450 because it is a PR S1 Pro with limited 30 days of APAP ability.
The regular PR S1 Auto CPAP with A Flex is model DS 550 and has full time forever APAP ability and won't ever change on its own.

Just looked it says 450 P and AutoIQ in the top of the machine, my DME says it is limited to 30 Days total and then it is done - no more Trial left unless you guys know a way to reset the machine?

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 3:49 pm

Mary Z wrote:If you just started therapy when you joined the forum rest assured it does get better with the help and support you get here. If you got the AUTO IQ, in theory is sounds like a great idea. You can give us a progress and product report as time goes by. I know about being pissed. I recently had some machine problems that made me want to chuck it all. It's one symptom of sleep apnea- this getting pissed over things that can be worked out. You should have gotten a better explanation of how your machine works. Memorize that owners manual and get the clinicians manual from apneaboard if they have it now. Hang in there, keep posting, help another newcomer. Like AA, but one night at a time.

Thanks Mary Z, I have been on therapy 3 weeks now, it is the AutoIQ. I will hang in there, have no other choice, and I will be glad to help newcomers down the road.

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 3:52 pm

Pugsy wrote:This is the Auto IQ
https://www.cpap.com/productpage/respir ... utoiq.html

This is the full time APAP https://www.cpap.com/cpap-machine/respi ... -flex.html

If you have the model DS550 (full time APAP) the only way to change the settings is either the modem...SD card changing RX...or manually going into the clinical menu.

Sounds like you have the Auto IQ. Once the 30 days of APAP is used up my understanding is that it is no longer available. Waste of money...price difference between the Auto IQ and the full time APAP is tiny.
What happens in 6 months or next year and something changes and someone might want or need APAP mode again?

I have my RX that states Auto CPAP and Patients Choice of Full Face Mask, I made a copy before I gave it to the DME and have it scanned to a PDF. So I should be able to buy another machine at anytime correct? If so I will probably just buy the DS550 to end the frustration right now, I should be able to still use my existing humidifier with it correct?

chunkyfrog · Post by **chunkyfrog** » Mon Mar 12, 2012 4:08 pm

If anyone gets any info on whether or not the auto can be reset;
--to be sure it will be found here--if it is at all possible.
I would suspect if a DME sold one and had to take it back (due to non-compliance),
there would HAVE to be a way--or $end it back to the factory.

BlackSpinner · Post by **BlackSpinner** » Mon Mar 12, 2012 4:22 pm

azpilgrims wrote:
I have my RX that states Auto CPAP and Patients Choice of Full Face Mask, I made a copy before I gave it to the DME and have it scanned to a PDF. So I should be able to buy another machine at anytime correct? If so I will probably just buy the DS550 to end the frustration right now, I should be able to still use my existing humidifier with it correct?

They didn't give you that. They gave you a cpap. They didn't fill the prescription. Your doctor wants you on an auto cpap. Bring it back and tell them it is the wrong machine.

Pugsy · Post by **Pugsy** » Mon Mar 12, 2012 4:23 pm

azpilgrims wrote:I have my RX that states Auto CPAP and Patients Choice of Full Face Mask, I made a copy before I gave it to the DME and have it scanned to a PDF. So I should be able to buy another machine at anytime correct? If so I will probably just buy the DS550 to end the frustration right now, I should be able to still use my existing humidifier with it correct?

Yep. You can sure buy another with that script and yes..buy the DS550 model and it will work with your existing humdifier.

Technically the DME didn't give you what the RX stated. There is a big difference between full time APAP (if that is what your doctor ordered) and 30 days of APAP.
If you are up to a fight and have your doctor to back you up you could probably challenge them on this. If your doctor ordered a range of pressures one would assume that he meant that to be "forever" and not 30 days.

It is still a good machine but not what you thought you were getting. Up to you if you want to fight with them over this. For some people the less hassle of purchasing out of pocket is worth it. The DS450 still makes a great backup machine.

If you bought another machine to use now instead of later do you have any insurance requirements left on the DS450 that need to be met? Some people have so many months at a rent to own thing...some people have insurance that just buys the machine out right and no need for compliance requirements to be met.

I know what I would do but then I am known to be a bitch....

Do what you feel is best for you under the circumstances. You can get the DS550 from cpap.com for $519 https://www.cpap.com/cpap-machine/respi ... -flex.html this will indeed work with your existing humidifier.

There is a brand new APAP model https://www.cpap.com/productpage/pr-sys ... -tube.html $649...that includes humidifier and accessories.
Please note that this new machine is not backwards compatible to your existing machine or humidifier. Just wanted to make you aware of this new machine...just in case...so you have all available information.

BlackSpinner · Post by **BlackSpinner** » Mon Mar 12, 2012 5:54 pm

I know what I would do but then I am known to be a bitch...

Yes me too. I would be in there breathing fire! They did NOT fill the prescription! They really have no option but to replace it with what the doctor ordered.

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 6:36 pm

I spoke with the Respiratory Therapist, she is checking with the owner of the DME to see what they can do - she briefly spoke with the owner on the phone and he thought there would be like a $ 350.00 up-charge but will check and call me back tomorrow. Yes, my insurance is covering 70% as a purchase as I did not want the DME milking my insurance for 13 months. I told them "WHAT" about an up-charge, I said to look at cpap.com and that I could buy the whole machine for $ 500.00 roughly and the difference between a 450 and 550 models was less than a hundred bucks.

So we will see what they have to say tomorrow, I can be a dick if I want to when folks are not doing things the honest and ethical way.

azpilgrims · Post by **azpilgrims** » Mon Mar 12, 2012 6:39 pm

BlackSpinner wrote:
I know what I would do but then I am known to be a bitch...
Yes me too. I would be in there breathing fire! They did NOT fill the prescription! They really have no option but to replace it with what the doctor ordered.

That's what I told them, this is not an Auto Machine - this is Auto for 30 days and then turns into a single pressure machine. She said this is what she always fills for my Doctors Patients, I feel bad for these people who get stuck with this crap, they are probably miserable when they figure out their machine is different.

Thanks for all your help, this place and you folks rock!!!

Lizistired · Post by **Lizistired** » Mon Mar 12, 2012 6:49 pm

BlackSpinner wrote:
I know what I would do but then I am known to be a bitch...
Yes me too. I would be in there breathing fire! They did NOT fill the prescription! They really have no option but to replace it with what the doctor ordered.

Me Three!
"What they can do", is fill the prescription as written!

I don't get why PR even created that beast. Well, probably at the request of the DMEs. I wonder if we will see a firmware update for it in the future. They will probably sell it only to DMEs. See where Encore Pro got them.

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