Well! Not the best Dr appt....`

[Lachesis]

I was so looking forward to my appt today. I was sure I could talk to him about different machines and such.
HMPH not sure why but he is picking my machine... w/o any input from me. Kinda ticks me off. He wouldn't give me a prescription even after I told him I wanted to shop online. He is having "someone come out". I got no input at all.

He said I do not need a apap (at first he had no clue as to what I was talking about ) because I needed a "5" {thats the only # he gave me and I have no clue what it means. He did say I had moderate to severe sleep apnea-- 18-20x an hour of substancial loss of breathing. Not sure what the means. Those numbers seem low compared to a lot of other folks.} and no more nor did he feel my level changed.
I told him of course not, I couldn't roll over even on to my back muchless my other side because of all of the wires. Boy didn't I feel like a dingbat.

I go back in 6 weeks and give him input. I think I am renting until then. He did say if one mask did not work to make sure and let the company know.

So as of now, I have no clue what kind of machine is being "prescribed" AND on top of it, my husband's insurance kicked in, so we're double covered for medical stuff. And I am probably going to get some crummy machine.

Any thoughts or words of encouragement?

[Snoredog]

Rule #1: Always GET a copy of your PSG.
Rule #2: Always GET and KEEP the original prescription.
Rule #3: If doctor won't listen to your needs, dump the doctor and suggested DME they are usually in cohoots anyway.

Take the CPAP script and use it as written to puchase a apap on-line. Just place the order and fax over a copy. Or if you have a scanner, scan it to a jpg image and email it to cpap@cpap.com (they will email you if they don't get the script, you can reply with it back).

[kteague]

After that fiasco masquerading as a doctor's visit, no wonder you are discouraged. My "conflict of interest" radar is flashing. Someone else may know if it's your legal right to have that prescription or if it just should be. There is no comfortable way to tell a doctor that you disagree with what they are saying. I wanted to shrink up and slink away when this happened with my doc, but my indignation flamed at his disregard of me. He wasn't shy about his first concern being for the insurance company and the DME's profits before me, his patient. I was just angry enough to not be intimidated.

I'm guessing you really did sleep enough for a valid pressure determination? And does your report substantiate that you did not sleep any on your back while on cpap? If so, armed with that report you could tell him that you have no confidence in the reliability of the titration study since sleep apnea is known to be worse when supine, and you were not evaluated in that position. I would then refuse a repeat study, and say they needed to rectify their error to assure a therapeutic pressure in all positions - at no further cost or inconvenience to you, (5 is low), and you want that rectified thru an autopap that you can extract the data. Period. Now, if he's decided to play hardball, it's up to you how far you are willing to take it. Get what you want from him, then be done with him. If you're not up to all this, maybe another doctor would give you the prescription. Have you checked with billmyinsurance.com to see if your insurances will allow a purchase at cpap.com? That might make a difference in which way you want to rock that boat. Best wishes. Hopefully you'll soon be a happy cpaper and daily feeling better.
Kathy

[snoregirl]

Is this your regular doc or some special sleep doc? If it is a sleep doc go straight to your regular doc and ask him/her to write the prescription, or get the regular doc to have your records transfered to them so he can read them and then write. You can get APAP from CPAP.com with the CPAP script so no need to push that issue if you are paying cash.

If it is your regular doc, it is time for a new one. Find a new one and get your records transfered.

I believe that you are legally entitled to copies of all YOUR medical records. I am not an attorney but I have seen this many times. In addition my sister, who is a nurse, gave me the same talk when I wanted MY xrays from the hospital. They caved quickly after telling me I couldn't have them.

Another way to go about this is call the DME who your doc is "working with" and go there and demand a copy of your prescription and sleep study. They have it too. You don't really need the original, prescription, a copy to fax to CPAP.com will be fine. Once you have that script you can order and find a new doc (and have the records transferred at your lesiure).

I know any of this is a hassle, but do you really want to work with a doc who treats you like this ever again? I wouldn't. I fired my GYN years ago for telling me a surgical procedure (biopsy of the cervix) without pain relief didn't hurt "It was all in my head". Not someone I ever wanted to see again and didn't. This was 20 years ago and obviously I am still angry like it was yesterday!

Also for what it is worth, many of us can't breath at a level of 5.

I personally need 7.5 to feel like I am not suffocating. My guess is if you rent a CPAP at 5 you are setting yourself up for failure.

[snoregirl]

One more thing. If you are double covered on insurance, see if bill my insurance .com (on the main page of the CPAP.com web site) will work with either of your coverages. You should be able to find this out by emailing them without having a prescription in hand (I did). I couldn't make it work, but you might. Then you can get whatever machine you want when you manage to get that prescription.

[labmanok]

Lachesis - My Dr.'s visit was the same as yours. Only I had my sleep study first , and my Dr.'s consultation weeks later. They wanted me to pick up my machine before I met with my Doctor. When I said I wanted to discuss my options with him it has sent u red flags. They said I had 111 incidences in an hr. My O2 dropped to 73% in REM. When I asked about the internet or apap machines, he said the amount of air I would be hit with at once by an apap machine would be disengenuous to my treatment. The DME offices in the Sleep Center where he works. The DME carries two cpap machines, that is it.

[oldgearhead]

he said the amount of air I would be hit with at once by an apap machine would be disengenuous to my treatment

What? Did a Doctor say that? The amount of air you are 'hit with' is determined by the 'Minimum' and Maximum' settings on the machine.


Why not just buy this or a newer, new one from cpap dot com, and skip all
the 'red tape'?

http://auctions.yahoo.com/i::112821025

[whatrdreamsmadeof]

Same stuff with dr. and dme here...my neuro is a whack my primary care will write scripts if I tell her what to write it for...clueless but helpful..Keep on truckin with advice from here.......which my dme said was a load...well it's the greatest thing since my study...these guys are great...good luck Ellen

[caty]

I have "moderately severe" apnea and was titrated at 6 cm. Only slept 3 hours during the titration portion of the sleep test. Was given a straight cpap from the dme - no choice, didn't see my prescription. I discovered this website after this happened and did a lot of reading. I decided to purchase at my own cost the S8 Vantage apap since I already had the humidifier. I wanted to monitor my thereapy. Requested my prescription from the doctor. First I used my new machine as a CPAP. Then started nodding off again at my desk at work. Read about how titration might not be accurate based on only one night of data. Decided to use the APAP. Set it for 6cm - 9 cm. Next day 95% pressure was 9 cm! Changed the top setting to 10 cm. Next day 95% pressure was 10. Set it to 12. Since then, my pressures have ranged from 9.8 to 10.4. So I absolutely believe that a straight cpap machine is a waste of time. With the apap, I found my titration was wrong. I can use either the cpap or apap with my machine. It just makes so much more sense to issue apaps. Don't know why this isn't standard.

[Arizona-Willie]

I first mentioned falling asleep all the time to my foot doctor who told me that Tri-City Cardiology ( where my cardiologist happens to practice ) had set up their own sleep centers because they were disgusted with the poor quality of sleep centers in the Phoenix area.

So when I saw my cardio dude I mentioned the falling asleep to him and he promptly sent me to their center ( REM Medical ).

My doctor there is a diplomate in sleep medicine with an abbreviation salad behind his name.

He seemed very very good.

He had no problem giving me copies of my test and prescription. He wrote a prescription for the ResMed S8 Elite with the heated humidifier. I had seen in my pre-test research that many people almost had to wrestle their doctor to get a humidifier.

He said he never writes without prescribing the humidifier.

They have 2 sleep centers. One in Mesa and one in Scottsdale I believe.

I saw you were in Arizona so I thought I would mention this lab in case you are in the Phoenix area. If not, might want to take a drive this way

I was very happy with the testing and the follow up doctor visit(s). They had me come back and read the machine after the first month.

Then I bought the software and card reader for it so I can track things myself too.

[NyNurse33]

I had my titration study late July, got my equipment 1st week in August and am just going to see the sleep MD at the end of September. After I joined here and learned some things, I went to my DMEs who probably fed me alot of BS!.. The RT told me that APAP machine is "lazy therapy". Anyone ever heard of it being referred to as this? I have to admit it did make sense to me, but afterall I am still a newbie to all of this. Also, my sleep MD is in the same building as the sleep lab. The DMEs told me that this machine is all that the sleep lab RT ever orders. I was told by the sleep lab, who I called a few weeks ago and asked that their RT call me back about my machine and she never did, that the RT writes the RX for the machines. How can that be?!? Shouldn't the MD have something to say about that, even though she will agree with the lab, who works with the DMEs, so they are all connected. I like lots of people on here, did not sleep well during the titration study and the mask leaked when I turned to the side, so like a scared child, I lay still on my back all night. When I talked about feeling water on my face the next morning, the overnight RT told me I was just dreaming. This of course was all before I heard about rain out. I just need to hear some arguements comparing the pros and cons of cpap vs apap.

[oldgearhead]

I think the real question is: 'Is there any reason to make any machine
other than an APAP?' Of course the answer has little to do with treatment.
The answer is $336.00 (Auto 'M' - DS100).

Why don't the doctors, DMEs, and Insurance companies simply tell us the
truth up front, and offer everone the 'Auto' option for a higher copay?