Dr. Barbara Phillips and whether CPAP should require a prescription

[jnk...]

A doc may figure out a pressure, or range of pressures, for a patient to try. DMEs sometimes actually program the machine correctly according to that doc's wishes. But pressure needs change over time. So many of us here choose to learn to get into the clinician menu ourselves to customize our pressures according to what machine data says is best for us over time. The best-informed docs, and even a few DME RRTs, are fully on board with that process and even appreciate the interest of the patient in getting involved, since that indicates a high likelihood of success.

[ChicagoGranny]

the user cannot do anything to increase pressur

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[Janknitz]

Most pressures set in straight CPAP are "too high" for some portions of the night and often "too low" for other portions of the night. Thus the beauty of the advent of APAP.

That makes sense. And it's connected to question I just asked in another thread, which you might be able to answer.

When a CPAP machine is purchased through a traditional prescription and DME supplier, the pressure is set in such a way that the new owner can't change it. The machine might physically be able to run at any pressure, but the software has been instructed to never deviate from 9cm (or whatever).

Are AutoPAP machines given any programming that the owner can't override? For example, if the prescription says "Needs variable pressure between 6cm and 15cm," would the DME supplier set 15cm as the max pressure -- so even though the machine is physically capable of going to higher pressures, the user cannot do anything to increase pressure over 15cm? Would they set a minimum pressure as well?

CPAP machines at max pressure are NOT dangerous to 99.9% of people, unless you drop it on your head. Some people have a very rare and delicate lung condition and could be harmed by too much pressure, but this is very rare. In fact, most APAP's are set "wide open" 4- 20 cm at first anyway. If that was dangerous, they wouldn't do it.

There is a "secret handshake" for CPAP machines that allows the clinician to get into the clinical menu and change any setting. Most of us know what that "secret handshake" is--typically it's holding down the two main buttons for about 20 seconds. But if that doesn't work, the clinical manuals are available to help you find the "secret handshake" for your machine. Yes, DME's set the machines according to a doctor's prescription. But we know how to get in and change settings, and if they were sold OTC that would be in the instruction manual for the patient buyer.

Nowadays most machines have modems and can be set remotely by a doctor or DME too. But you can still override that. I have my machine set in "airplane mode" so the only one looking at my data or changing it is ME. When a person is in an insurance compliance period, you may want to let the modem transmit so the DME or doctor can collect the compliance data, and if you have a good doctor who is working with you on refining the settings you would want them to have access (very few doctors actually work this way!). But mostly, there's no reason to leave your machine so that others can change settings without your permission or knowledge.

[palerider]

This is a good point. For some people, these machines can be dangerous if mis-used,

This is not a correct statement.

Thanks for the correction. I'm a newbie and still learning.

Here's why I said that. I was under the impression that if the pressure is set too high, a CPAP machine can have adverse affects. Is that incorrect?

"adverse" is not "dangerous".

Any any "adverse" affects are *very* mild.

You're dealing with pressure that can't even inflate a balloon.

Please don't offer advice until you've got some miles under your belt, it just confuses the issue.

[palerider]

Most pressures set in straight CPAP are "too high" for some portions of the night and often "too low" for other portions of the night. Thus the beauty of the advent of APAP.

That makes sense. And it's connected to question I just asked in another thread, which you might be able to answer.

When a CPAP machine is purchased through a traditional prescription and DME supplier, the pressure is set in such a way that the new owner can't change it.

This, too, is not correct.

The machine might physically be able to run at any pressure, but the software has been instructed to never deviate from 9cm (or whatever).

Again, not correct.

Might be you should take everything you think you know that you learned at the doctors or DMEs, and toss it in the wastebasket.

To my knowledge, there hasn't been a machine made (yet) that the user can't change the settings on.

[JerryL]

Again, not correct.

Might be you should take everything you think you know that you learned at the doctors or DMEs, and toss it in the wastebasket.

To my knowledge, there hasn't been a machine made (yet) that the user can't change the settings on.

My apologies. I was stating things that I thought were correct, and it's good to learn I was wrong.

[chunkyfrog]

Anybody at all can be wrong.
Or so I have been informed.
Numerous times.

[palerider]

Again, not correct.

Might be you should take everything you think you know that you learned at the doctors or DMEs, and toss it in the wastebasket.

To my knowledge, there hasn't been a machine made (yet) that the user can't change the settings on.

My apologies. I was stating things that I thought were correct, and it's good to learn I was wrong.

Try to only state things you *know* are correct, not just things you've been told by the DME, RT, or Doctor...

And yeah, finding out you're wrong, you learn things!

[Grace~~~]

Everyone is so adult, mentally stable / healthy around here lately.

All without the banning or words, or the "nanny state" worrying (and worse enforcing!) if anyone is "offended" by eliminating free speech and bringing the level down to the lowest denominator.


Johnny, Cpaptalk and Pugsy should be running the country!

The whole idea of "UTTERLY" free speech really works!
Worry about sticks and stones ... you can heal from a word that might have hurt you ~~~

[Pugsy]

Pugsy should be running the country!

No, no and hell no.
I guarantee you that you would NOT be wanting me in charge of the country.

[esel]

Hey Grace~~~~^~~ is back ... how nice.

How come that I can understand what you wrote I used to try, did read you again and again thinking my brain must have gone out to lunch.

Why in the hell did I go an open that can of worms?

Are you eating them ?

And what on earth is this "nose ring and in the process the bed fell off of the truck exposing a can of worms... god bless me I messed out a lot lately.

But here some adds for CPAP.

download.jpg

Unknown-1_21.jpeg

[Pugsy]

And what on earth is this "nose ring and in the process the bed fell off of the truck exposing a can of worms... god bless me I messed out a lot lately.

You snooze you lose.

Private joke best left private.

[JayDee]

Unless you've got a super-sweet, ultra-fabulous insurance plan, most will only cover what is deemed "medically necessary" (for the most part). They won't take my word for it that something is "medically necessary" for some silly reason... So I have to go get a Doc's Rx to prove it to them. A prescription in that context is reasonable & necessary and has "value" to me, *IF* I want insurance to subsidize the cost *and* I've already met my $2600 individual deductible.

HOWEVER, doctors/clinics/hospitals combined with insurance also tends to (not always, but *tends* to) cause the price of everything to rise. A tylenol in the Dr's office (or hospital) costs a bloody fortune compared to a tylenol I buy at Walmart.

So there's a balance to be struck. Had I found this forum *before* I engaged a sleep-doc, I would have likely bought my APAP, mask & stuff used (secondwindcpap .com or ebay or whatever) and saved *over* $800 -- most likely well over $800 based on the reduced cost of a used machine -- because I was nowhere near reaching my deductible at the time.

On the other hand, I can't get a "street-priced" cholecystectomy on ebay or craigslist (slight correction - I would not *want* to get it off ebay or craigslist), so in that case, I'll pay whatever it works out to with insurance.

Can we have it both ways? I know insurance plans differ, but the ideal situation (at least to me) would be that the machines, masks & supplies do not require an RX, but a Doc could still write a "medically necessary" Rx when needed.

Better yet, kick the FDA to the curb after the healthcare industry formed & supported an independent organization akin to a "Healthcare Underwriter's Lab" that vetted/certified treatments, drugs & equipment. If there was some treatment/drug that did not have the "UL Approved" tag, then it would be up to you and your Doc (and/or your ins co) if you needed it and wanted to risk it.

Well, that's my idiotic opinion. Bleh... This topic could too easily get bogged down in the finer details.
-JD

[Grace~~~]

No, no and hell no.
I guarantee you that you would NOT be wanting me in charge of the country.

~~~I'm a bit of an anarchist at heart ... but if someone does have to be in charge now and again, my dream would be for them to be a LOT like you.

[Grace~~~]

Hey Grace~~~~^~~ is back ... how nice.

How come that I can understand what you wrote I used to try, did read you again and again thinking my brain must have gone out to lunch."







< waves hello at the VERY funny esel >

Sweetheart, when you begin to understand me ... *THAT'S* when you need to worry that your brain may have gone out to lunch!