Here's my plan to get a better machine - advice welcome!

Slinky · Post by **Slinky** » Fri Mar 30, 2007 9:51 am

Both the fully data capable Resmeds and Respironics machines utilize data cards for downloading the data to software installed on your PC.

I was given a Resmed before I knew a whole lot about all this so I'm a bit partial, I'm sure, due to familiarity. Resmed's AutoScan 5.7 software is EASY to install and EASY to use and easy for me to understand the data. AutoScan is the ONLY software I've ever been able to install and use on first try. Every other software for ANY purpose that I've tried to install and get working has been a challenge and a battle. I''m just not "computer friendly"!!

I had a RemStar Auto w/C-Flex (classic) loaner for 3 weeks. I had a devil of a time installing EncorePro and finally gave up and had to have my 'puter guru play w/it to get it up and running. Even for him it was a bit tricky! Not real difficult for him as he is a professional but he didn't get it working first try either! I just had him take it all home w/him and get it running on his 'puter before he came back to install it on mine. When I returned the loaner Auto I did NOT remove the EncorePro and its driver - just in case. One thing we did find was that "they" were NOT kidding when they said to use the "port" on the 'puter rather than an extension. My Resmed reader uses the extension w/o batting an eye or hesitating in the least. Sure beats having to grope around the back of the puter to plug in the reader cable!!!!

Snoredog · Post by **Snoredog** » Fri Mar 30, 2007 10:31 am

if you are wanting insurance to pay for it, that may be an uphill climb. There has to be a medical reason before they will ever pay for it. That means you cannot use cpap due to aerophagia or other reason.

if you are going to pay for this out of your own pocket, you can use your existing cpap prescriptions, no special script needed. OSA is a life long disorder, your script never expires until you do.

the 420e has the best reports in my opinion, the machine is so small you can take the machine to the computer much easier than messing with any SmartCard.

Buy the machine outright, sell your existing insurance supplied machine on yahoo or craigslist and recover part of your cost.

tangents · Post by **tangents** » Fri Mar 30, 2007 10:44 am

[quote="Snoredog"]the machine is so small you can take the machine to the computer much easier than messing with any SmartCard.

Snoredog · Post by **Snoredog** » Fri Mar 30, 2007 10:59 am

[quote="tangents"][quote="Snoredog"]the machine is so small you can take the machine to the computer much easier than messing with any SmartCard.

mlim650 · Post by **mlim650** » Fri Mar 30, 2007 11:18 am

Just to let you know that Silverlining stores 96 hours of detail data and I believe up to 200 sessions of "summarized" data. So you don't need to download the data everyday.

tangents · Post by **tangents** » Fri Mar 30, 2007 11:19 am

you ONLY download your data daily when you are a newbie. After that excitement wears off you may only do it once every couple weeks.

High tech method? It is a modular telephone cord for the serial cable with a db9 RS-232 on the other end attached to the computer, you could also plug that into a modem, that is what doctors do when they know how to turn on a computer.

if you want high-tech, buy your self a laptop and get rid of that dust collecting dinosaur in the other room that doesn't move around

If I could just ditch those money-sucking kids of mine, I could have all the high-tech toys I wanted! And, oh yeah, I forgot, if only my stupid (duck season here yet? I hear some quacking...) doctor had gotten me a decent machine in the first place, I could use THAT money on a laptop! Too funny, Snoredog. Thanks again for the help. Good to know I won't have to add the sneaker-net to my daily list of morning chores once I'm an "oldie" like you...

Wulfman · Post by **Wulfman** » Fri Mar 30, 2007 11:55 am

Snoredog wrote:you ONLY download your data daily when you are a newbie. After that excitement wears off you may only do it once every couple weeks.

After two years, I must still be a "newbie"......

For me it's always been something to do while the coffee is brewing (and satisfy my curiosity). If I didn't, it would throw off my whole morning routine and screw up my day.

Den

Gerald · Post by **Gerald** » Fri Mar 30, 2007 12:50 pm

Cathy.....

If you purchase an auto CPAP out of your own pocket....and you aren't able to return the "Quack Unit", you might consider keeping it around as a spare.

After a few months, your auto CPAP will teach you where your "sweet spot" is and your "Quack Unit" could be set to approximate that "best pressure" for you. This way, it really wouldn't be a total loss. It might be a good travel unit too.

As for "being a newbie" and checking your software report every morning, I'm like the Wulfman....I'm so danged curious that I can't sit at the breakfast table without seeing how I did last night.

Checking our software report every day helps us tweak and tune. I suspect you'll have to know too!

Gerald

tangents · Post by **tangents** » Sat Mar 31, 2007 8:01 am

Thanks everybody. I hope my last reply didn't get taken seriously - nobody loves their kids more than I do! (As much, maybe, but not more.)

I saw my GP yesterday and we had a really long talk. He is convinced that the CPAP is helping, as he said I looked better and spoke more coherently than I have in years. His suggestion was to explain to the sleep doctor that I need to determine whether my apneas/hypopneas were being treated (ie, I need a data logging machine), and ask him to write the letter of medical necessity to the insurance company. The GREAT news is that my GP promised that if the sleep doctor wouldn't do it, he would! Whoo Hoo!

Funny thing about last night, too. I decided to give my new Twighlight NP a second chance, and wrapped the whole shabang in material to prevent rainout. I forgot to leave the vent holes uncovered! Yet I feel better this morning than I have in many days.... was I going through CO2 withdrawal or something? Don't worry, I won't do that again tonight, but I sure find it interesting. I can't thank you enough for your help, it really helped me "hold it together" at the doctor's office.
Cathy

Slinky · Post by **Slinky** » Sat Mar 31, 2007 12:25 pm

Meanwhile, check w/your INSURANCE COMPANY what DME suppliers they are contracted with. If possible get out from under having to work w/this DME supplier who is so closely tied to your sleep doctor. Get the Letter of Medical Necessity from the sleep doctor, get the script from your sleep doctor. Or your family doctor if necessary. Then shop the DME suppliers who are contracted w/your insurance company for your equipment.

Gerald · Post by **Gerald** » Sat Mar 31, 2007 12:49 pm

Cathy......

Some years ago when I was researching my great-great grandfather (he was a Texas Ranger who commanded a group of mounted riflemen), I came across a quotation that has stuck with me.

"It's almost impossible to stop a man.....who knows he's right.....and who just keeps on a'comin."

You are demonstrating the resolve expressed in that quotation by an old Texan. Your GP recognized it.

You've got things "going your way" now......

Don't waver....don't stop.

Gerald

Guest · Post by **Guest** » Sun Apr 01, 2007 11:57 am

I saw my doctor on Friday. I don't have a sleep doc, just my regular GP. We talked over how things are going and he agreed to write the new prescription for a remstar auto m series with cflex and data card. I dropped it off at the local office of the DME right after the appointment.

I had talked with my insurance company on Thursday about returning a machine, and since they are renting it, they said it's no problem. Just get the new prescription and bring it to the DME. If that DME doesn't have the machine, just give them their machine back and go to another DME. I just hope it really is that simple.

The DME is charging $111 per month rent, so that should more than cover any machine I want given that for the 9 months left to the year, it would pay for any machine.

I'm going for the remstar because I like the sound of it and I already have the humidifier, which insurance purchased.

Hope I hear from the DME tomorrow about delivery.

Stacey

Slinky · Post by **Slinky** » Sun Apr 01, 2007 12:02 pm

Good luck!!!!

snoregirl · Post by **snoregirl** » Sun Apr 01, 2007 12:16 pm

Good luck Stacy.

Be prepared for a couple things though.

DME tells you if they don't have it see another DME. That to me between the lines means, if we don't make as much money as we want on the machine you are going to request, good luck and good bye and see if another DME will be any easier to get it from. It may be difficult to find a DME that will fill the order. Very possibly tell you you don't need it, your insurance doesn't cover it etc.

Your current DME should be able to order the machine you want whether or not they have it in stock. The "we don't carry it" is their out to not give it to you for the same copay.

Did you give your original prescription to the DME? Hopefully not. If so go get it and let them keep a copy, not the original. Also get a copy of your sleep studies.

I really hope that I am wrong and you easily get the machine you want but just in case I thought I would bring up some common issues so you can be prepared.

queenwizard · Post by **queenwizard** » Sun Apr 01, 2007 9:19 pm

WRITTEN WITH CAPTURED ADVICE WORDING FROM OTHER POSTERS ON THE SUBJECT

Killing Me Softly . . .

For 10 years I have been in complete compliance in using a CPAP machine recommended as a result of a sleep study diagnosis of severe sleep apnea.

Although the CPAP therapy seemed to be working these past 10 years (I felt better and was less tired), not one person (medical or medical equipment company staff) asked me if my sleep apnea was under control or even if I was in compliance with the therapy.

I was not alarmed that my primary physician did not inquire regarding my sleep apnea as I have been under the care of several different primary physicians the past 10 years, albeit the same physician group. And, the same medical center where I receive my care and where I was also employed, went through a disruptive merger, then “demerger.” I believe my sleep records with the sleep study lab were lost when medical records went to the “other side.” The doctor who reviewed my sleep study remains in same office at the original medical center where my sleep study was conducted.

And even though my insurance carrier allowed for a new mask/headgear/hose every six months, no one told me. After approximately 5 years when my nose mask, etc., was showing signs of wear, I called the DME (Wasserotts) who had provided the CPAP machine, etc. to ask what the procedure was to replace the nose mask and head gear and was told to come in to the facility (warehouse) where I picked up a replacement.

Several years later when it was time for another replacement, I called Wasserotts to discover that Wasserotts had merged with Apria. I can only guess that no notices were sent to their client list. But then, maybe a notice was sent to those on record, as by this time my records were among the missing at Apria. At Apria, I was given a new mask and headgear – no choice – just “here it is.” A short time later, an adjustable plastic part on that nose mask snapped so I “superglued” it. Of course it was no longer adjustable, but it did work.

Within the past year I began to notice some daytime tiredness. That, with occasionally falling asleep in the morning while in a sitting position with coffee cup in hand and my husband’s keen notice of returning snoring (and a variety of other mouth/nose noises). I blamed the mask. So, just under 6 months ago, I returned to Apria for a replacement nose mask. Again, I was given no choice – just handed a mask.

The snoring and other breathing noises continued with the new mask. I tightened the straps so tight that they left grooves on my face. The snoring did not stop. Then, weeks ago, my CPAP machine of 10 years began to make noises on its own! It actually started to whine at me! And then it began to rattle. I believed it to be dying. Oh no – what should I do now? Go online to see if there is a new and improved CPAP machine after ten years? Yes! There is – a REMstar Auto C-flex! Hooray! I dutifully called Customer Service at Capital Blue Cross to find out if I could have this new machine as a replacement for my dying ten-year-old dinosaur. “Yes” I was told. I needed only to take a prescription from my doctor to a DME on their approved list of medical supply dealers.

My doctor wrote a prescription for a REMstar Auto C-flex with heated humidifier, Encore Pro Software and Card Reader and a Mirage Activa Mask with head gear. The information on the new prescription went to Apria. There the music died. Apria said my ten-year-old, outdated CPAP machine might be repairable. I had to take the old machine in to Apria for repair.

Maybe the machine can be repaired, BUT IT SURE CAN’T BE UPDATED.

I called my “friendly” Customer Service representative at Capital Blue Cross to protest. This time I was told that my doctor just had to call the insurance company with a preauthorization and all would be fine. The preauthorization was called in to Capital Blue Cross and to Apria.

RESULT: Apria maintains that Capital Blue Cross insists that the machine be repaired not replaced.

So, in that case, can Capital Blue Cross have my XX plus ten-year-old body repaired and rejuvenated as well as my ten-year-old machine? CPAP machines have been improved; I can’t say the same for my body. I would love to have ten years erased. Does someone really think that nothing changed internally in ten years that could affect sleep apnea? Who at Capital Blue Cross can claim that tissue doesn’t become softer and less resistant to a predetermined pressure? Even changes in weight affect the pressure required to treat apneas. My weight has fluctuated. Sometimes I sleep on my right side, sometimes my back and sometimes my left side—usually a little of each during the night. An auto-adjust machine can compensate for these moves--and weight changes--and mask leaks. An auto-adjust machine ADJUSTS to change. The ten-year-old CPAP machine does not.

Respironics makes the REMstar Auto C-flex as well as the newer REMstar M Series Auto C-flex that records data including pressure profiles, number of minutes at a specific pressure level as well as the occurrence of flow-limitation.

I have a lifetime condition. I need to use this machine every night for the rest of my life. There is no way of knowing if the old machine is adequately treating my apnea. The old machine does not log any data except hours of usage; it is NOT capable of providing any data other than compliance. I have already proven my compliance with ten years of determined and faithful use. But what happens if my treatment does not go well? When I gain or lose weight? Start a new medicine? Change masks and need to know the actual leak rate? If I am no longer sleeping well? If I have headaches in the morning or develop other health problems? How can my doctor or I know for sure that I am not having apneas, or if my pressure needs to be adjusted? My doctor cannot adequately monitor my therapy if I do not have a machine with full data capability.

April 2007

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap machine, respironics, humidifier, mirage, activa, C-FLEX, Encore Pro, CPAP, DME, Prescription, auto

Here's my plan to get a better machine - advice welcome!

Adding my story to machine upgrade quest - LONG