Post
by allinknots » Fri Sep 12, 2008 11:25 am
********MY PHONE CALL TO MY PHYSICIAN IS SUMMARIZED BELOW!!!****
I phoned the sleep clinic twice, and left messages that the Attending sleep physician that I saw return my call. I bypassed calling the Fellow physician since I think I had better rapport with the Attending physician, and the Fellow didn't seem quite as knowledgeable about the subject. In addition, his accent was a bit difficult to understand. (A little language barrier.)
I received a call back today--NOT from the Attending, easy-to-understand dr., but rather from the Fellow.
First of all, I'm a little disappointed. I feel that the Attending passed this call off to his Fellow. If I am a paying patient, shouldn't I be able to discuss something with a dr. of my choosing? The Attending DID tell me that I could call either him or his Fellow with questions. I called HIM, but the other dr. returned the call. Oh well. I kind of feel like a bait-and-switch was done, and I don't think that's very professional. (I think it would have been more professional if the Attending had called, and then perhaps suggested that I discuss my concerns with the Fellow as well, etc., but that didn't happen.)
The conversation was difficult. I politely mentioned that the DME called me and said that a straight CPAP had been rx'd, but that I've done a little research on them. (I "conveniently" left out that I did any research on a forum, since they hate to hear that, . But you all know you are the unsung heroes!) I mentioned that I looked at different machines on cpap.com, and that I found a couple that I was interested in, and that they are data capable apap machines.
He told me:
1. You don't need an APAP machine. Research shows efficacy of the CPAP machines, but not the APAP machines.
2. You don't need a data capable machine, because they will show whether or not you're compliant with the machine, but will not show pressure, etc.
3. Thousands of machines are out there, each manufacturer will claim they have the best, but they're mainly the same.
4. The sleep lab will only determine a pressure setting for a CPAP machine, not an APAP machine.
5.. Insurance will only cover a CPAP machine to begin with, he thinks.
I politely told him that I would try out the CPAP setting on an APAP machine, and then not even bother with an apap setting if I get relief with the continuous pressure. But that it would be nice to have the option to go to automatic if *he* thought it would be helpful. And that it would save me from needing to drive and get different machines. That way I could print out the data, HE could review it, HE could decide anything needed to be changed, etc.
If I may be so bold as to say so, I remained pleasant, diplomatic, ego-sparing, polite, yet firm. I tried to let him know that I needed to defer to his advice and wisdom on settings, etc. I politely mentioned that the machines I was looking at would even be able to show more data than just the compliance data--could show pressure, "events," etc., and that my insurance would cover that machine because I checked. (Allowed him to save face--I didn't accuse him of not realizing that some machines are capable of determining more than compliance data alone.)
He ended up saying that he could rewrite the prescription.
I had the "Prescriptions for CPAP Machines" info printed out from cpap-supply.com. (I got the link from the "Our Wisdom" I think.) I suggested that insurance would like it written like that if possible. I also asked that he add a card reader, smart card and software to the prescription. (I know that many insurances won't cover that, but what the heck, thought I could try.)
So far so good.
Emboldened by this, I think I then pushed him over the edge. I <gulp> requested a recording pulse oximeter to be added to the script. Uh oh, that was probably a mistake. Looks like I went totally overboard with that one. All kinds of red flags--think sirens--went off in his head. He didn't know why I would need that for a home xpap machine, etc., that the pulse recording only needs to be done in a sleep study, that he would need to review this with the desk to make sure that he can include this on a script, etc. I just hope I didn't tick him off, and get sent back to square one---cpap only--again. (Think Monopoly game: "Go back home. Do not pass 'GO' do not collect $200.")
I asked him to fax me the script (instead of sending it to the DME associated with the clinic, methinks conflict-of-interest issues perhaps?) because I'd like to take it to a DME that is closer to where I live. He agreed to that part.
I politely thanked him for spending time explaining this to me, wished him a nice week-end, and all-in-all ended the conversation on a positive, upbeat note. Birds were singing, butterflies flapping their wings, a wonderful Disney moment. All is copacetic.
OK, now I just have to wait and see this fax when it comes in. Please keep your fingers crossed for me! (We need a "smilie" symbol for that--crossing fingers!!! OK you grahic artists out there...)
PLEASE KEEP THE ADVICE COMING!!!
Do you know how much you've helped me? Probably not! I've read and re-read the posts to me, printed them out, read posts to others, printed some of those out. Read "Our Wisdom," printed it out, printed out the pm's that were sent to me. I studied them, highlighted important facts, took notes, dripped coffee onto them. These notes have been on my computer desk, in the kitchen, even up to the bathroom (too much info, sorry!) Due to your suggestions, I went to cpap.com, studied there a bit, printed out machine comparisons, etc. It felt *SO GOOD* to feel like I knew something when I called the dr. back. Due to you, I felt reasonably prepared to "plead my case" with the dr., and I think ( ) I succeeded, at least for the most part.
You can all go to sleep tonight, with your Xpaps quietly whispering, and know that you did a good deed and truly helped someone today. Me!
Hugs,
All in Knots
Last edited by
allinknots on Fri Sep 12, 2008 12:21 pm, edited 1 time in total.
