Don't throw stones, I'm just a tech :)

[jnk]

Southern Girl,

Welcome aboard. From your tone, you sound like someone who will be very, very, valuable to this forum.

The tech at my PSGs was awesome! The only people I've had trouble with were emplyees of the DME I deal with. And they weren't evil; just not very bright. (At least I will assume that was the reason for their lies and bad service.) But hey, I've had not-so-bright bad service from people in many other professions. And I don't think all airlines employees are evil, either.

Personally, I expect everyone to do what they do for the money. Gotta have it to live! It just seems that the system, which supposedly evolved to protect the patient from himself, mostly benefits the people who are supposedly the only ones allowed to be officially trusted with the information on how to make adjustments to xpap machines. I don't blame the techs for the system. I just don't like the system. That is only my personal opinion. And I'm no activist. I just want a good night's sleep. And my PSG-tech gave me enough off-the-record pointers that I feel I was able to navigate through the system better than if I hadn't gotten those hints. I am forever grateful for that.

I just wish I had asked my PSG tech to recommend a DME instead of letting my insurance people pick. Or I wish I had had enough knowledge when I started out to just get my own machine and get reimbursed. But I seem to be locked in with my DME now. Oh well. At least I'm pretty sure they hate me more than I hate them!

But I apologize in behalf of anyone who sounded like he/she was against all techs, if you found that to be offensive. I haven't posted what I do, since my job is much less popular than yours. I think that sleep techs are the backbone of it all and the ones who seem to do the most good for the most people on a daily basis, at least it seems so to me.

Some here seem to talk in short-hand and with their tongue planted firmly in their cheek. So please make allowances. It gives the place a sense of community when we tell our "ain't it awful" stories to each other.

And admit it--techs love to get together and tell their own horror stories on their worst patients. Oh, yes they do!

Thanks for your comments so far.

jnk

[Babette]

I've NEVER bashed the Techs. RT's are the ONLY ones who know a bloody thing! It's the brainless DME's who DON'T EMPLOY ACTUAL RT's that get my goat.

I've actually had GREAT experiences with my MD's too. Others have not been so lucky. But my Techs have all been the ones that taught me the most - more than the docs.

I LOVE TECHS!!!!!!!

Cheers and keep on tech-ing!!!!
Babette

[Insomniyak]

Nicely said JNK. Now I really wanna know what you do.

[DreamStalker]

Fist of all, welcome Southern_Girl!

I think each member creates their own reputation regarding name calling and whether they know much of anything. We have a few techs that come here and provide great info from their perspective. We also have a couple that come here under the cover of a Guest and try to discourage new patients/members who are struggling with their treatment to avoid the advice given here and go back to their doctor or DME (like thedean).

If they were getting great service from their health professionals then they probably would not feel the need to look on the internet for further help. Most of us have come here for a reason ... we were given the cheapest equipment and told to come back when we needed new supplies or we were told to just make sure we slept at least 4 hours per night with the mask on (we were set up for failure).

The primary reason why this treatment is so difficult for most is that there is no educational support. Many DME provide machines that give no feedback on the efficacy of the treatment. Why? My only guess is so that if the patient's treatment fails and the patient does not give up, they can be given another sleep study (ie. to maximize profits) ... why can they just not provide an APAP to begin with?

Then there is the old “it's against the law to change your own pressure”. In fact my RT specifically told me that it was also against the law for me to even look at the efficacy data from my machine. Why do they say that if it is not true?

It is those types of techs/DMEs that we give a hard time too. As Snoredog stated, as long as you come here with the understanding that patients have the right to manage their own treatment, you should not fear having stones or names thrown at you.

Again welcome and I hope the learning is a two-way street for you and us.

[Guest]

Hello Southern_Girl. I am sure that there are a lot of competent and caring people in the field of sleep medicine. You sound like one, and there are a number of others here that provide invaluable assistance every day.

I think one of the reasons for the sometimes less-than-friendly tone towards Dr's and DME's come from the group that hangs out here. You have to understand that we are self-selected.

If someone goes to a good sleep Dr and works with a competent DME, the chances he will be found here trying to get answers is pretty small. Therapy works well for him and if it doesn't he's got someone to call.

I diagnosed myself from this board (and my wife's reports). I went into my HMO and gave the Dr my apnea symptoms, chapter and verse.

He sent me to the sleep lab where I got a home apnea monitoring unit and short class on how to hook it up. I turned the monitor back in and about a week later I picked up a recording APAP for a one-night titration. The information was relayed to my primary care physician and a prescription was issued.

I never saw a sleep Dr, never talked to anyone who knew anything about CPAP therapy.

My insurance doesn't cover the equipment, so the prescription was the end of the line for me. Even though proper therapy is vital and compliance is a dismal 50%, they have never checked up on me, not once.

The message to me is clear. I am on my own.

And with the help of the people here, I'm OK with that. I have learned terms like "flow restriction" and "hypopnea." I know what "AHI" stands for. I know about leak rates and pressure settings. I know enough about reading an EncorePro report to ask intelligent questions. I'm no professional and I wouldn't presume to prescribe for others, but I need to take of myself.

So forgive us if we seem a tad hostile sometimes. And welcome to the board. We need you.

[Insomniyak]

Then there is the old “it's against the law to change your own pressure”. In fact my RT specifically told me that it was also against the law for me to even look at the efficacy data from my machine. Why do they say that if it is not true?

I think the only thing that is against the law, I beleive is telling people people to change their pressures without a license to practice medicine. A machine with a 'prescribed' pressure IS a 'prescription'.

[DreamStalker]

Then there is the old “it's against the law to change your own pressure”. In fact my RT specifically told me that it was also against the law for me to even look at the efficacy data from my machine. Why do they say that if it is not true?

I think the only thing that is against the law, I beleive is telling people people to change their pressures without a license to practice medicine. A machine with a 'prescribed' pressure IS a 'prescription'.

Please show me the statute ... there are many on this forum who want to see it.

BTW- Tomjax the pharmasist will argue the second point as being false.

[wlenz]

A very big welcome S_G
I am an engineer and have studied electronics all my life. Frequently a person that uses equipment I know like the back of my hand will recommend a solution that is stupid, ridiculous, and will make the problem worse. Being educated makes for good choices. OK, so now you know that you have my respect as a sleep professional.
Here is problem that has brought most if not all of us to this group. SOME of the professionals have not given us the help we need. I for one, have allergies and possibly other breathing problems. One night I can breathe ok, another night I am gasping for air. Swollen sinuses, humidity/temperature changes, plus other variables that I am not aware of are probably causing my problems. What I am getting at is this...one pressure setting for eternity will not work. My doc prescribed 13/9 cm/h2o and that helps. But, some nights it is not. I complained to my docs office assistant...yes, she passed the info on, but I never got the ear of the doc. Three weeks later my DME calls and said they have a new prescription for me. The doc raised the 13 to 15. Wow, so now the DME wants to come to my house and change the settings. The next time I have a problem, I should call the office assistant, hope she talks to the doc, and perhaps 3 weeks later the DME will call and schedule another visit. THIS DOES NOT WORK. I believe I should have been prescribed and A-Pap rather than a Bi-Pap. I should have a machine that records data while I am sleeping so that adjustments can be made with hard data, not guesses. This machine is supplying oxygen to me, and not getting enough is an instant problem, not something that can wait a month to be resolved.
The office assistant wants another sleep study, but my condition changes with the weather, or whatever. A sleep study is just a sampling for one night, not my best night, not my worst night. That is why I am a member of this group and I visit here often. Fellow members of this group have helped me solve many of my problems. They are great and deserve my respect. I hope you will visit here often and offer your expertise.
In a perfect situation, I would have had all my problems taken care of my the professionals that evaluated me. But, we do not live in a perfect world.

[Insomniyak]

Dreamstalker, that's why I said I Beleive...

In most states it is generally a felony to prescribe without a medical license, and you do need a prescription to get a CPAP because it is AT a prescribed pressure. When a medical preofessional changes the pressure, they are prescribing a different pressure. I am saying that what you do on your own is your choice, but with this in mind, telling someone to change pressures, as we often see here, that is the same as prescribing without a medical license.

If this were not true, why would we need to get a prescription from a licensed MD to get a CPAP, we could just buy one set at 4 and change it on our own without a script.

[Wulfman]

Dreamstalker, that's why I said I Beleive...

In most states it is generally a felony to prescribe without a medical license, and you do need a prescription to get a CPAP because it is AT a prescribed pressure. When a medical preofessional changes the pressure, they are prescribing a different pressure. I am saying that what you do on your own is your choice, but with this in mind, telling someone to change pressures, as we often see here, that is the same as prescribing without a medical license.

If this were not true, why would we need to get a prescription from a licensed MD to get a CPAP, we could just buy one set at 4 and change it on our own without a script.

I have to strongly disagree with your premise(s).
What we do here on the forum is "suggest"......we don't ACTUALLY go to the user's homes and change their machines' pressures.......which is what the DMEs do when they get the "order" from the doctor to do so.

We generally say "If it were me...." or "I would suggest....." or "You might try.......". In any case, there's that statement at the very bottom of each and every page on this forum. We don't force the users to make the changes.....and we don't usually make any suggestions unless or until we've seen some of their reports.

And, you don't actually HAVE to have a prescription to purchase any of this equipment......there are numerous places to find them without the prescriptions.

And, for the BIGGEST problem......you don't need a medical license to tell someone that they're leaking their therapy air out their mouth and need to stop it in some manner.

P.S. - There is absolutely NO law that makes it illegal for a user to change their OWN pressure. If there was, people with diabetes would be in deep do-do.......and it's overwhelmingly recognized that THOSE individuals DO adjust their OWN medications (particularly insulin).

P.S. #2 - I'd like to know how many people would rather suffer through this therapy with a wrongly-prescribed pressure from a doctor as opposed to the "correct" pressure.....determined through their own therapy evaluations and tweaking.


Den

[DreamStalker]

Dreamstalker, that's why I said I Beleive...

In most states it is generally a felony to prescribe without a medical license, and you do need a prescription to get a CPAP because it is AT a prescribed pressure. When a medical preofessional changes the pressure, they are prescribing a different pressure. I am saying that what you do on your own is your choice, but with this in mind, telling someone to change pressures, as we often see here, that is the same as prescribing without a medical license.

If this were not true, why would we need to get a prescription from a licensed MD to get a CPAP, we could just buy one set at 4 and change it on our own without a script.

Believe what you want .... but faith based statutes are not enforcable.

[danmc]

Dreamstalker, that's why I said I Beleive...

In most states it is generally a felony to prescribe without a medical license, and you do need a prescription to get a CPAP because it is AT a prescribed pressure. When a medical preofessional changes the pressure, they are prescribing a different pressure. I am saying that what you do on your own is your choice, but with this in mind, telling someone to change pressures, as we often see here, that is the same as prescribing without a medical license.

If this were not true, why would we need to get a prescription from a licensed MD to get a CPAP, we could just buy one set at 4 and change it on our own without a script.

Believe what you want .... but faith based statutes are not enforcable.

LOL. Actually, we have a secret script agreement in OZ apparently. I was told that in OZ, there is no legal requirement for a script - it's voluntary on the part of the players in the industry. In other words - any old Joe can sell me one but the cpap manufacturer may not cooperate with that Joe and supply him.

[superjetttt]

should probably cross check the IP addresses of the Southern_Girl character and the troll techs who started the recent flame war thread.

-superjet

[roster]

......This site IS a wonderful tool for both new and veteran CPAP users to help, discuss, and teach other less informed users.

...........I DO believe that this site DOES help greatly with CPAP compliance, and for that, I am thrilled.

........At times we (the techs) may come across as being somewhat harsh when being approached by a patient who takes advice (i.e. mouth taping and pressure changes without a Dr order).

.........Let me say, this thread is NOT about me trying to lecture ANY of you in the least bit. Understand that coming from a medical viewpoint, we cannot condone any of these actions guys.

.........I came into this field because I wanted to help people.

......... We all work together for one goal, to help.

A hearty welcome Southern Girl. As far as I am concerned the more southern girls the better (or east, west and north).

I like most of what you say.

Do be aware that some of us can be stubborn and argumentative. Don't take it personal if you get shot at. Us patients here often fight among ourselves so if you never get slammed here Southern Girl, then it means you ain't contributing much.

Hope you stay around,

Rooster

[Southern_Girl]

should probably cross check the IP addresses of the Southern_Girl character and the troll techs who started the recent flame war thread.

-superjet

I'm not quite sure what you're implying. The war thread? The link that was posted on page 2? Check IP addys all day. I had nothing to do with that. That was done by someone who lacked any sort of tact. I believe I made it through 3 or so pages before I could read no more. There is a way to speak with people, an amount of RESPECT we ALL deserve, and the tech (if even a tech) who started that thread lacked all of the above. Besides Dustin, you should know me a little better than that my BFF