my doctor's reply to an e-mail I sent him

[ephraimh]

my email:
"Do you know that these settings can be adjusted by tenths, i.e., 13.4, 13.5, not just by increments of one?"

his reply:
"I'm not sure it does 0.5 increments but I also wouldn't think that degree of fine tuning is necessary or even helpful. We'll see how you do on 9 with the new mask."

-------
He's my HMO doctor. He will not be interpreting my next sleep study a week from now at another hospital. I do not understand for the life of me how some people are able to get medical degrees. Is there anyone left on this planet who knows how to think? Anyone?

I'm sending a few complaints, Dept of Health, my HMO, http://www.absm.org , ....

[Goofproof]

There are three levels of matter, Matter, Anti-Matter & Don't Matter, Your E-mail comes onder the third, I'm supprised he answered your email. Seldom do I side with a Dr, but obcessing over 0.1 cm settings is crazy, most machines only have 0.5 cm settings available, and even worrying about that is a waste of time, XPAP isn't Rocket Science, it's Air.

The fact that he replied at all is a sign he's a good Dr. Jim

[LSAT]

There are three levels of matter, Matter, Anti-Matter & Don't Matter, Your E-mail comes onder the third, I'm supprised he answered your email. Seldom do I side with a Dr, but obcessing over 0.1 cm settings is crazy, most machines only have 0.5 cm settings available, and even worrying about that is a waste of time, XPAP isn't Rocket Science, it's Air.

The fact that he replied at all is a sign he's a good Dr. Jim

I agree...+1

[Guest]

He's my HMO doctor. He will not be interpreting my next sleep study a week from now at another hospital.

Just cuz he is a Dr. doesn't mean he knows anything about sleep much less how a cpap works, that is where RT's or this forum come in.

I think everyone is good at something. And for me I go to a sleep doc. I had a primary who in conversation with me admitted he doesn't believe in sleep apnea saying that more than 95% of people tested would test positive. To me that doesn't mean that OSA doesn't exist.

btw - I thought he was an excellent primary doc and I did like him very much and believe me I am fussy. He moved on to in patient (hospital) care so I hope I never see him again.

If I don't like a doc I won't be making any more boat payments for them.

[palerider]

my email:
"Do you know that these settings can be adjusted by tenths, i.e., 13.4, 13.5, not just by increments of one?"

I believe that resmeds adjust by 1/5th cm steps, (at least, the s9 series did) so you can't set it to 13.5.
the respironics adjust by 1/2 cm steps, so can't do 13.4.

I don't know about other manufacturers.

[Julie]

I agree that his answer was reasonable... your attitude isn't.

[SleepyEyes21]

I agree that his answer was reasonable... your attitude isn't.

Hi Julie, I respectfully disagree with your answer to the OP.

To the OP: I agree with what Guest said in that oftentimes, primary doctors do not understand the cpap/ bi-pap machines and how they operate. When I was first diagnosed, I asked my primary doctor at the time if he could write the prescription for an auto-adjust machine. He didn't know what that was, so I had to explain it to him (which I found very ironic, since CPAP was new to me!) After my explanation, he said " No- I don't want you to have that." And he wouldn't discuss it further.

Sometimes in the beginning of CPAP (or any new diagnosis) when we are still learning and trying to figure it all out about what's important to pay attention to and what's okay to be just 'average,' it is very easy to become overwhelmed and angry at medical professionals who don't seem to have the correct answers that we expect them to (I've been there, done that too.) The reality is that not every medical professional is trained in every specialty, so there is no way a primary doctor can 'know it all.'

ephraimh- keep doing your research and stay compliant with your treatment. That's the BEST thing you can do for yourself right now. And, imo, reconsider writing this complaint letter before you waste your precious time and energy, because if this is NOT the doctor that will read your results/ adjust the machine, you'll get what you need from the sleep doc.

I do think it's great that you are trying to stay educated and fine-tuned to your treatment as much as possible As you learn more, I hope you will find that treatment becomes much easier for you and one less thing to worry about

[chunkyfrog]

When I shared my settings with my sleep doc, he added a tenth.
I just let him have the last word. It does not really matter.
I can set mine to whatever numbers work best for me.
I let my doctor work for the patients who can't figure this stuff out for themselves.

[cands]

my email:
"Do you know that these settings can be adjusted by tenths, i.e., 13.4, 13.5, not just by increments of one?"

I believe that resmeds adjust by 1/5th cm steps, (at least, the s9 series did) so you can't set it to 13.5.
the respironics adjust by 1/2 cm steps, so can't do 13.4.

I have an ResMed Airsense 10 Autoset. It adjust by .2 cm (1/5). I find it convenient and helpful to make adjustments .2 at a time, but it probably doesn't matter that much. Have the ResMed machines always been adjustable by .2, or is this a recent change by them introduced with the S9?

[Goofproof]

If you only had any idea how little 0.1 cm of air pressure is and what a difference it could make, better get a barometer, and altimeter, and a Oui-ja board to set you XPAP. then you need a injection of drugs to paralyze you in bed so you don't move when you sleep as position can cause the need for more pressure.

Meanwhile you set your APAP at 4 to 20 C.M., and think your treatment is good. You need to find something worthwhile to obsess over. Jim

[BlackSpinner]

I agree that his answer was reasonable... your attitude isn't.

No increases should be based on comfort. Increasing a cm or more can cause major discomfort in the chest muscles and if the discomfort is bad enough people end up in ER thinking they are having a heart attack.

What they should do is simple take control of their therapy, do their own increases at a rate that is comfortable for them. A diabetic doesn't go to see a doctor to adjust their insulin.

[palerider]

I have an ResMed Airsense 10 Autoset. It adjust by .2 cm (1/5). I find it convenient and helpful to make adjustments .2 at a time, but it probably doesn't matter that much. Have the ResMed machines always been adjustable by .2, or is this a recent change by them introduced with the S9?

Thanks for the info on the air10 machines. I don't have experience with the pre-s9 resmeds and setting granularity, sorry... I can't see where a tenth would make *any* effective difference at all... a fifth, mayyyyybe. as far as I can see, all .1 changes would do is double the amount of knob twiddling you have to do to get to a pressure...

[chunkyfrog]

Weren't we warned not to twiddle several years ago?
Something about going blind?

[Goofproof]

Weren't we warned not to twiddle several years ago?
Something about going blind?

You may have a point, I thought it was diabetes, turns out I was just Twiddling in my sleep. Jim

[palerider]

Weren't we warned not to twiddle several years ago?
Something about going blind?

probably, but like a lot of what we were told long ago, turns out that it's actually a good idea... keeps the pipes clean.