Swift LT vs Swift FX

[tigeragent]

Hi ----

I am a newcomer to the CPAP world and wanted to know people's experiences with the Swift FX vs the Swift LT mask. Is the mask really better?

I did my titration at the lab with the Swift FX mask, and I found it really comfortable and I slept well with it without too much discomfort. My Dr. specifically prescribed that mask.

When I went to my DME provider (Lincare), they told me that although they have the FX mask, due to the insurance company reimbursements that they get, they could only give me the LT. I wore it for one night and noted that I frequently got leaks when I changed positions, but when I tighten the mask, my nose started to feel uncomfortable. I slept horribly (worse than in the titration study).

Here are my questions:

1. I spoke with my insurance company (United Healthcare) and they said that they authorize masks by "procedure code," not by specific mask model, they said if my Dr. wants one specific type of mask, he would have to write a letter of medical necessity to get it covered. Should I call other DME's in my insurance company's network to see if they would provide me with the FX (Lincare said I had 30 days to return the mask)? (BTW, I am using the Resmed S9 with humidifier) or should I try to do the "medical necessity process"?

2. Should I give the LT a longer trial period to see if I can adapt to it?

3. On a separate issue, I understand from reading this forum that adjusting to a mask is sometimes a long process. Does prescription sleep medication (ie Ambien) make this adjustment process any easier? Although I took one during my titration study, I try not to take it regularly so it doesn't become habit forming.

Thanks for the help.

[The Texan]

I have used both and YES, IMHO there is a huge difference between the 2. I have 2 LTs that I will not use due to problems with the pillows and fitting, while the FX was a good fit from the first night. Yes, call around and see if you can find a DME that puts its customer ahead of the almighty dollar. The difference in cost between the 2 is negligible.
Bob

[dtsm]

No flame intended but the LT vs Fx is an old one - there are multiple threads and different folks have different experiences. What works for one doesn't work for another. I've posted elsewhere re my own experiences so won't repeat here. A search will suffice

On the insurance issue and your DME, this is the more important question. You are your best advocate. DME are generally out to make money; fortunately some are more reputable than others. It appears Lincare falls in the former group. Call you sleep center, get them to talk with your insurance company and get the mask that best fits you.....

And yes, some folks take time and experimentation to find the best/suitable mask for them. I'm not one in the Ambian camp....it took me 5 wks to get used to therapy and I just tried to be patient.

Good luck and keep us posted.

[sleeplessinaz]

Hi There---yes, there is a big difference in fit between the two masks--I use the LT but I also have the FX. I am still trying out the FX and cannot seem to find a good fit with the size of nasal pillow so I am still trial and error with that one. Seems the price of the 2 masks should be almost the same ---I don't see why they would say you can only have the LT--wierd. I think perhaps that your DME may have had the LT on hand and did not want to order the FX for you. My DME told me that my FX was a "a special order" item ------

Keep checking and fighting for the mask you want. I have about 6 or 7 masks in the "dead mask" closet at my house that I tried and hated!!! LOL! A good mask is essential to your therapy. HANG IN THERE!!!

Carrie

[chunkyfrog]

There are two little froggies in our queen-size bed--we both wear FX's

[Janknitz]

When I went to my DME provider (Lincare), they told me that although they have the FX mask, due to the insurance company reimbursements that they get, they could only give me the LT.

Excuse my French, but Lincare is whistling out its behind! There is a SIX dollar retail difference between these two masks, meaning that the wholesale difference is $1 or $2. I think the real story is that somehow you scored a ResMed S9 Auto which really bites into their profit margin and they are unhappy about that. Or they didn't really have them in stock and didn't want to go through the trouble of giving you a mask to use while they ordered more.

Your insurance will cover ANY mask with the same HCPC's billing code. You should get any mask you want and that makes you comfortable. This IS important--the mask is the single most important factor in CPAP success--if the mask isn't comfortable, you won't use the machine.

I suggest Monday morning you march into Lincare and insist on the mask you asked for in the first place. Make sure they know you spoke to your insurer and it is covered. If they refuse, return the LT and proceed to another DME covered by your insurance to get one. Make sure the insurance company knows you returned the mask and that they should NOT pay Lincare for it.

And make sure from now on you get your masks and supplies elsewhere.

[Flower51]

I like both the FX and LT. Having said that, from the first night I had the FX on I've not used the LT again except for a brief one night "comparison" as the FX is so much lighter its as though there's nothing on my face or head. What I like about the FX: It comes w/soft fabric that I use both on the side cheek parts, which it was made to cover, and also use the second set to cushion the strip that is at the top of my head too. I have roseacea on my cheeks so its best not to have the plastic resting on my cheeks making marks at night...I had made little cheek pads out of soft fleece and velcro for my LT which works too but the LT feels heavier on my face and more intrusive than the FX...that's diff from the first time I tried it out when I didn't have the pillows on properly.

The thing about getting a good fit for the pillows: Size is important. I had to get a large pillow size which the FX doesn't come w/but my dme switched out.....also....and this is KEY: put your mask on, holding the pillows a little away from your nostrils. Turn on the machine. as the pillows fill w/air and they'll "puff out" a bit...just set them gently in place. If you look at the swift video online (cpap talk) you will see there is an angle they should be at which I didn't know before watching the video....its made a world of diff in my ahi's and lack of leaks. Kind of angled "up"
towards the top tip of your nose....best to see the video! Not what I'd done intially, where I tried for a snugger "fit" in the entire nostril...that's not how its designed to work best. Hope this helps!

btw....I found the FX tricky at first to disassemble for cleaning but someone on this site made some suggestions that helped me get the hang of things...no big deal anymore....Terry

[jlk]

If you got an S-9 Escape, return that also and find a dme that speaks without a forked tongue. The S-9 you want is an Auto or Elite, NOT Escape, that is the entry level unit and is not fully data capable. You have a deceitful dme and you will always have to question who they are wanting to help, your health or their bank account. Good luck with your therapy and good luck dealing with them. Please keep asking questions here and you will find cpap therapy help from many longtime users. john

[robysue]

As an FX user who found the LT extremely uncomfortable when I merely tried it on at the DME, I have to say I can understand why some folks might strongly prefer the LT to the FX.

The LT has these L-shaped parts of the frame that are supposed to lie flat against your cheeks and stabilize the pillows on your nose. I am convinced that when those L-shaped parts of the frame correctly lie on your cheeks, the mask is likely a really nice one and is probably far more stable than the FX in actual use. The LT also has a way of easily adjusting the angle of the nasal pillows without adjusting the whole headgear if I recall correctly. And the FX does not. For some folks, that ability to adjust the pillows angle is a major plus for the LT.

But for me, the structure of my face---high, prominent cheekbones and somewhat hollow cheeks---makes those L-shaped parts of the LT dig most uncomfortably into my cheeks. There's no way I'd be able to use this mask at night; it's simply too uncomfortable. But I stress again: The problem is not the LT. The problem is that the LT's design just doesn't work for my face's structure.

[jmb521]

Hi everyone!

I'm new to this board and new to Cpap as I have only been using it for a week.

I'm getting a little frustrated though, as I'm still waking up with headaches and I wake up periodically during the night (way more than I remember before cpap) feeling as if the pressure is off. I have tried the xs, s, and m size pillows and I can't tell which one will work properly. I tried looking for the video mentioned above and couldn't find it. Could someone post the link? With the small and xs size pillows it seems as if air only comes out one side. When I put the medium on I ended up taking the mask off in the middle of the night and I don't remember why...I just remember doing it. I'm still waking up with headaches and while I know it maybe premature to expect a change...I still don't feel any better. I thought I would have noticed a slight improvement by now.

[robysue]

jmb521,

I've been using CPAP/APAP for just over a month now. I'm still not really feeling any better than I did before starting CPAP, but at least I'm not feeling 100 times worse, like I felt during the first 2 1/2 weeks of use. So give it time: For most people, CPAP is not an instant I feel great solution.

I'm still waking up with headaches

Are there other possible causes for your morning headaches? Yes, sleep apnea can cause morning headaches, but so can a whole bunch of other things. Allergies? Coming down with a virus? Stress? [Stress of adjusting to CPAP?] Awkward sleeping position? They can all cause problems with morning headaches.

Also---how tight are the two straps of your FX? The FX in particular can and should be adjusted really loose. On mine, there's easily enough room to get several fingers between the top silicon strap and the top of my head. If that strap is too tight, you could get a headache. That strap being to tight can also cause problems with the pillows not sitting right against your nose, and that irritation could also contribute to a headache. Likewise, if the back (cloth) strap is too tight, it can easily cause a tension headache. For me, I can tell if that strap is too tight because it being too tight guarantees a tension headache in the morning that is located right above the nape of my neck and runs from the back of one ear to the back of the other. On the other hand, if that back cloth strap is too loose, it slides down over my ears and can also cause a nasty tension headache in exactly the same place. I have to figure out whether the strap is too loose or too tight by the location of the strap in the morning. Down on my ears = too loose. Up near the top of my head = too tight.

With the small and xs size pillows it seems as if air only comes out one side. When I put the medium on I ended up taking the mask off in the middle of the night and I don't remember why...I just remember doing it.

Make sure the inner pillows are in the correct place. Visually inspect the pillows before you put them on. Check the owner's manual; it's got some pictures that show how the inner pillows are supposed to stand up inside the outer ones. If one of the inner pillows is twisted or pushed the wrong way, that might explain the feeling of no air on that side. If the xs or s pillows cause the bottom part of the cone to go into your nostril, then they are too SMALL. Only the tip of the cone is supposed to go into your nostril. You might try trying the mask on during the day and looking in a mirror to see what's happening with the pillows.

As for taking the mask off in the middle of the night. Try not to be too harsh on yourself. It's a very common problem for folks just starting out: Sleeping with a hose attached to your face is not normal and it does take some time to get used to. I'm still getting used to it and I've been working at it a full month. Getting better at it though, and it's not feeling like quite as much work to get ready to go to bed and go to sleep as it was at the start.

As for what to do to try to train yourself not to take the mask off at night: Only solution I can offer is that if you wake up (at night) and the mask is off, calmly put the mask back on before you go back to sleep and don't worry about it the next morning.

Others may give you more advice on how to train yourself to not take the mask off if you post a new thread asking that question.

Good luck

[The Texan]

Hi everyone!

I'm new to this board and new to Cpap as I have only been using it for a week.

I tried looking for the video mentioned above and couldn't find it. Could someone post the link?

Your profile says you are using a Swift LT, not an FX, which the video is designed for. You may want to try the FX to cure some if not all your problems.

[tigeragent]

I suggest Monday morning you march into Lincare and insist on the mask you asked for in the first place. Make sure they know you spoke to your insurer and it is covered. If they refuse, return the LT and proceed to another DME covered by your insurance to get one. Make sure the insurance company knows you returned the mask and that they should NOT pay Lincare for it.

And make sure from now on you get your masks and supplies elsewhere.

Thanks for the advice. I did like you said and Lincare told me that the insurance company provides them a fixed amount for the mask, and at the price they pay, this is all they would give me. They said if I return the mask, I have to return the S9 as well. I told them that I would be happy to keep renting the machine from them, but they insisted that I had to return it. It does not make sense to me, especially since my insurance company said they would pay for any type of mask. They told me I would keep the H5i humidifier, since that item is not rented, it was purchased.

Anyway, I found another local DME provider who said they would give me the S9. They said they primarily deal with Respironics equipment, but could get a S9 though for me. As soon as they get the equipment, I am planning to return the S9 and mask to Lincare. What a hassle!

I informed my insurance company of this problem with Lincare, because I am sure I am going to have billing problems with trying to deal with this.

[Janknitz]

Good for you! Ask for an S9 ELITE or Auto, don't accept another Escape.