I got my hand popped

[tvmangum]

I was talking with my doctors office regarding my last APAP titration at home. I confessed to resetting the pressures on the machine and the results that I been getting. My "prescribed" pressure is 14cm and my AI was still in 10+ range. I changed my pressure to 16cm and the highest my AI has been is 1.9 and I actually have more energy. Now I just need to get my HI under control. Since my HI are still in 7-10 range I get to have yet another titration study in May.

Well, the office popped my hand for being able to get into my machine and setting the pressure myself. I've read on the board here about other users taking their treatment into their own hands and have success so I tried it myself. If the doctor keeps popping my hand what should I tell them?

[deerslayer]

Oops ! caught by the CPAP POLICE....you must be prepared when confronting the hand poppers of the medical community . prepared to ask them a few ?'s like don't you want me to be an informed patient & learn all i can to better improve my health & make your job easier. don't you want me to be a partner with you in bettering my health ? ...etc. ....there are many more reasons to dazzle them & perhaps educate them a little. after all we can all learn from each other.. tim

[carbonman]

If the doctor keeps popping my hand what should I tell them?

....don't tell them.

[jnk]

If the doctor keeps popping my hand what should I tell them?

....don't tell them.

Is the revolution over? Nobody told me!

( viewtopic/t40740/viewtopic.php?f=1&t=39 ... 78#p351078 )

[Slinky]

Diplomacy is NOT my forte. I would simply state that "I" am the one to endure the benefits - or consequences - of any therapy I agree to, NOT the doctors or medical professionals. Therefore, I expect to be informed and kept informed, to take an active part in my healthcare and a doctor who accepts me as a member of my healthcare "team". I would also remind him by showing him the data that I had improved upon the titration study's suggested pressure setting. If he can't accept me as a member of my own health care team and work WITH me then it will be necessary for me to find a sleep doctor who will.

If you feel as I do on this subject then HOPEFULLY you are capable of presenting it to your doctor much more diplomatically and tactfully than I am capable of.

[SharkBait]

If the doctor keeps popping my hand what should I tell them?

I'll have to PM my response 'cause I can have a bit of a potty mouth. (Hint: F-Bomb...)

[rested gal]

Well, the office popped my hand for being able to get into my machine and setting the pressure myself. I've read on the board here about other users taking their treatment into their own hands and have success so I tried it myself. If the doctor keeps popping my hand what should I tell them?

Depends on how much abuse you want to take.

Regarding this --

Now I just need to get my HI under control. Since my HI are still in 7-10 range I get to have yet another titration study in May.

Well, it's always good to get as much full PSG info (sleep study diagnostic and sleep study titration) as you can. I'd go for it, but then I really like seeing PSG data about my sleep.

But if another titration were going to cost money I didn't want to spend, or I just didn't want go, I'd think about some "if's" --

Get ready for a bunch of "if's"...nonmedical opinion of a cpap user...me!

IF I were using a ResMed machine, and IF I were striving for an AHI under 5.0, and IF I were feeling good... I'd mentally cut the HI in half and add THAT new HI number to my AI number (to get the overall AHI total) and consider THAT to be my AHI.

I'd figure the machine (with the settings I chose to use) was doing its part of the job just fine.

Here's why:

Get ready for a bunch of links...again, just my nonmedical opinion. You'll get tired of reading my saying essentially the same thing over and over. Of course, my saying it repeatedly doesn't mean I'm right at all, or that what works for me would apply to someone else.

If you start skipping, do skip down to the bottom link for Velbor's cool chart showing the definitions the three major manufacturers use for calling an event an apnea or an hypopnea.

High HI affecting AHI rating. Should I be worried? - topic started by ChrisC:
viewtopic.php?p=355205#p355205

Hubby's AHI sucks... - topic started by Debjax:
viewtopic.php?p=339278#p339278

Just got my new machine! - topic started by Mr. Smiley:
viewtopic.php?p=343123#p3431234

ResMed Efficacy Results - topic started by ehreesejr:
viewtopic/t35569/ResMed-Efficacy-Results.html

Understanding AI, HI and AHI results - topic started by mdbarthe:
viewtopic/p337504/Understanding-AI-HI-a ... sults.html

Alternative ways to decrease the AHI - topic started by christo:
viewtopic/p324562/Alternative-ways-to-d ... e-AHI.html

Question About HI Scoring - topic started by Weezer:
viewtopic.php?p=214731#p214731

Why can't machine be 100% - topic started by Fireguy24:
viewtopic.php?p=322835#p322835

New and need advice - topic started by Billyboy:
viewtopic.php?p=238008#p238008

numbers not great but not tired anymore - topic started by sleepyhead63:
viewtopic.php?p=216599#p216599

Playin w'the big dogs! - topic started by abysmillard:
viewtopic.php?p=193917#p193917

How to reduce Hypopnea - topic started by zorro13:
viewtopic.php?p=262830#p262830

is Resmed any good - topic started by Barnaby:
viewtopic.php?p=57735#p57735

-------------------------------------------------------------------------------

CPAP: By the Numbers - topic started by ThomasMcKean:
This thread contains Velbor's chart of 3 brands' definitions of apnea and hypopnea:
viewtopic.php?p=356255#p356255

[Pineapple]

I admit that my answer is slightly tarnished because I'm not real happy with my sleep doctor. Last time I saw him in October (early) he said my followup would be in 3 months. So here we are in April with no followup appointment yet, not even a phone call from the nurse to see if the changes they made in October helped. Of course, he gave me a funny look when he told the nurse to make an appointment with the DME for me and I told him not to bother, just give me the changes, I could do that (and not take half a day off to see the DME) 5 minute appointment and he charged my insurance company an arm and a leg

My answer would be "It worked didn't it? And where have you been - You can @#$% ^& *$$!!!" So maybe I should learn some dipomacy from Slinky

At my own tiration, they stoped raising the pressure when I started having blow out, so it was entirely off. If the insurance company will pay for the sleep study, I'd be willing to do it, but if I had to pay out of pocket (or had a large deductable) I wouldn't.

[Wulfman]

Well, the office popped my hand for being able to get into my machine and setting the pressure myself. I've read on the board here about other users taking their treatment into their own hands and have success so I tried it myself. If the doctor keeps popping my hand what should I tell them?

Ask:
Whose therapy is this?
Whose machine is it?
Who sleeps with it every night?
Who's insurance and money is paying your fees?
Is this what you would tell patients with diabetes? (they can't monitor with a meter or adjust meds?)

Den

[alnhwrd]

You really have four options.

1. Knuckle under. The result will be that your Doc will be happy, your therapy will less effective and you will have less money because you will be spending it on PSG's and repeat dr visits.

2. Appear to knuckle under but keep doing what you have been doing. This will allow you to continue to be in charge, which IMHO has been working, and will keep you from getting popped.

3. Thank your doc and his staff for their help and concern but tell them politely and firmly that since it is your body and your health and your well being that you will continue to make adjustments that bring improvement in your condition, and that you are happy to listen to their input as long as they realize that you will make the final decision. This could result in your doc firing you as his patient so be prepared. It could also set the appropriate boundaries for your continued Dr/patient relationship and make life easier for you and other patients who find themselves in the same boat.

4. Find another sleep doc.

Craven cowardly dog that I am, I would likely pick #2. But #3 is probably the best and most straightforward way.

[jda1000]

Well, I'm in the process of changing doctors....

Saw a sleep doctor for the first time yesterday - told his tech my titration was 7, that I'd raised it to 8, and it worked better. She looked shocked and asked how I did THAT - I said I Googled it - didn't want to out you guys!

She remained mildly aghast... and went away.

The doctor came in, and we discussed all things OSA and CPAP - I was pretty happy with him, compared with past experiences. He said "you did the right thing in changing your pressure" and then recommended I raise it to 9. I am still pulling the mask off in my sleep for reasons unknown.

So the tech came and got my machine and changed it to 9, and gave it back and said "now, Doctor doesn't want you changing that again!"

So I just smiled. Overall, I think the doctor gets it, but have my doubts about his tech.

Am doing a mask-fit in a couple weeks, and trying to address chronic congestion in the meantime.

**
I agree with alnhwrd's options - am starting with #4, because my past doc was unable to have the conversation that would've got us to #3.

[carbonman]

Is the revolution over? Nobody told me!

Choose your battles. This is not worth it.

Never give information....only receive information.

Patronize them till they wet themselves over how good they are....
walk out smiling......adjust machine as needed.

I am not a professional.

[jnk]

Is the revolution over? Nobody told me!

Choose your battles. . . . Never give information....only receive information. . . . Patronize them . . . walk out smiling......adjust machine as needed.

I am not a professional.

Not a professional?! That sounds like standard black-ops instructions for a professional, uh, "problem-solver" to me!

[robertmarilyn]

If the doctor keeps popping my hand what should I tell them?

....don't tell them.

How do you not tell them you are changing your settings if they are going to read your card? Won't reading the card show that you've changed the settings?

mar

[Slinky]

Snort. There are a lotta sleep doctors out there that won't even notice!!! They just glance over any data printout, ask how yu are doing and send you on out the door. Then there a those who do notice - but most likely just figure they forgot they ordered a change in pressure. The odds are probably on our side.