Frequency of Follow-up Visits

[GumbyCT]

One month, three months and six months seems to be the SOP around here for sleep doctor visits after starting CPAP.

Now why didn't you say that before?

[xenablue]

I saw my neurologist after my sleep study, then one month after starting CPAP. She wants to see me again in 6-months, but said if I had any concerns or questions to call her before that. She was very happy with my first month of therapy - fortunately I was able to show her the stats, thanks to this forum.
I believe she's genuinely concerned, but I've only seen her twice, so I will re-evaluate her concern at the next appointment.

Cheers,
xena

[Slinky]

Because Shaky said he/she was doing good and was reluctant to make the appointment when there didn't seem to be any need for it. He/she had a 6 month follow up and this was to be a six month follow up to the six month follow up.

I've gotten to the point where that is how I handle my specialist "well visits". If I'm doing good and having no problems WHY would I waste my time and money w/a "well visit" appointment when they are so busy w/the dang "well visits" they don't have time to schedule me in a timely manner when I'm having trouble and need them??

It helps to discourage making "well visits" that most of them are in the NE corner of the county in the "high rent district" and I'm in the SW rural area of the county.

[BusyLyn]

In my case, I saw my sleep doctor before the initial sleep study, both sleep studies were scheduled on that day (the second would have been canceled if not necessary), he read both studies within 24 hours of their occurrence, my Rx quickly went to the DME, and my follow-up was 8 weeks later. At titration my AHI was 2.1, my 30 day AHI at the follow-up was 1.3 (now 1.1), I felt much better than before cpap, and my mask issues are minor. My next follow-up will be 12 months after this last one.

His advice was to not obsess about getting the absolute lowest number for everything (I'm an engineer and I like numbers, and sometimes I have to tell myself that good enough is good enough ), but to make an appointment to come in if I have a problem. In other words, I'm a big girl and I know when to ask for his help. Also, I have enough other doctors to go visit!

[rested gal]

I received a new CPAP (Auto-set s8) a year ago and have had great results. I did a follow-up visit at six months and all the data was great. I'm still sleeping great and have no problems

1) S8 AutoSet has not the latest technology in it. It lacks some of the output of the S9 AutoSet. So you might want to visit your Doc and ask for an Rx for the newer machine.

Shaky's S8 Autoset gives all the data output most people need to check how their therapy is going. It's most unlikely insurance would pay for a "newer" same-kind-of-machine just a year later.

I don't see any particular reason for Shaky to try to get an S9 Autoset when the S8 Autoset is doing a fine job for him/her.

2) You have been on CPAP just for a year.

That's a pretty long time in "cpap years", imho. Seriously, given the high drop out rate for cpap users, a year of cpap use really is a nice long time. Good for you, Shaky!!

seeing the Doc after 6 mo is more than practiced in my area which is 3 mo, especially if you have a medical "problem".

I suppose it depends on what the medical problem is. Sounds like Shaky's SDB (sleep disordered breathing) medical problem is being taken care of fine by CPAP therapy. And there's already been a 6 month follow up showing that CPAP is taking care of it -- both from the data download and from Shaky's own words to the doctor. I see no need for more follow up appointments unless Shaky starts to have problems.

Let me ask: how can you say that your sleep is going well if you don't know how to check the data?

Ummm...well, I think it's a pretty safe assumption that Shaky's sleep is going well because of how Shaky feels, coupled with the fact that a download done just a few months ago showed that the treatment was effective.

I do agree, avi, that it's nice to be able to check one's own data.

Fortunately, if Shaky digs into posts on this forum about how to find and understand the "efficacy" results the S8 Autoset can display right there on the machine itself, Shaky will be able to learn how to check the data at home.

[rested gal]

I'm not very sophisticated about this whole process and don't know how to check my own data.

Perhaps this will help, Shaky...

Brenda's post:
viewtopic.php?t=22776

My post:
viewtopic.php?p=226375#226375

_______________________________

To see overnight data results on a ResMed S8 without going into clinical setup menu:


Hold right and left arrow buttons down together for about 5 seconds.

When screen changes and you see the word "Review", press the left arrow button under the word "Enter."

When you see the word "Settings", press left arrow button under the word "Enter."

"Results" -- Press left arrow button under the word "Enter."

"Efficacy Data" -- "Enter."

The 95% pressure will appear in the LCD window.

Use down arrow button to bring up Leak data. (0.0 is perfect. 0.40 or more is unacceptably high.)

Use down arrow buttons again to bring up the AHI (apnea/hypopnea index) number - under 5.0 is good.

Use down arrow button again to see just the AI (apnea index) number - 0.0 is ideal.

Use down arrow button again to see just the HI (hypopnea index) number

Note: With an S8 machine, I'd mentally cut the "HI" index number in half, then add that "half" to the Apnea Index to get a new AHI figure. I'd consider that new total to be my AHI. (No need to "halve" the HI if using the newer S9 machines.)
__________________________________

If you try to look at the "efficacy" results in the machine's little window, you need to do that before noon, as that's when the machine resets data results to zero, to make ready for the next sleep session.

And... whomever set up the machine in the first place had to have enabled ("turned on" via the clinical setup menu) allowing those things to be shown in the patient menu. If they didn't enable that, you can...if you want to get into the clinical setup menu yourself. Brenda's post above and my post will teach you how to do that.

Check your Private Messages, Shaky. I've sent you one.

[Shaky]

I received a new CPAP (Auto-set s8) a year ago and have had great results. I did a follow-up visit at six months and all the data was great. I'm still sleeping great and have no problems, but my doctor is basically demanding that I come in for another follow-up visit (a "card" visit, as they put it) just six months after my last visit. Is this the usual protocol? I looked for a protocol for follow-up visit frequency online, but couldn't find anything.

Comments:

1) S8 AutoSet has not the latest technology in it. It lacks some of the output of the S9 AutoSet. So you might want to visit your Doc and ask for an Rx for the newer machine.

2) You have been on CPAP just for a year. So seeing the Doc after 6 mo is more than practiced in my area which is 3 mo, especially if you have a medical "problem". My dentist expects to see me every 6 mo even for cleaning.

3) You posted this:

I'm not very sophisticated about this whole process and don't know how to check my own data. I got the machine from the doctor (insurance paid some, I paid some), so there is no third party to go to. If there is an easy way to do this, that would be great. Otherwise, I plan to find another doctor, have my charts transferred over and do another appointment at the end of this year or early next year (roughly 12-18 months after my previous check-up), which seems like a more appropriate interval for someone whose sleep is going well.

Let me ask: how can you say that your sleep is going well if you don't know how to check the data?

Just to clarify my earlier post. I've used this CPAP for a year, but overall I've been on CPAP for 16 years.

I did get a 6-month check up after seitching to this new machine, so I know that everything was going well at that time. I don't have data since then, but feel rested. Six months seems to be a little soon to see a doctor again, but I was even more bothered by actions I felt were coercive. I think it's just best to make a clean break.

Thanks for the feedback.

[JimIllinois]

It's nice to be able to get replacement masks and other supplies through insurance, but for that you need a prescription. And that means at least once per year doctor visits.

Otherwise, I've seen no pressure to come back. If there was a problem, I'd be quick to set up an appointment.

[LSAT]

It's nice to be able to get replacement masks and other supplies through insurance, but for that you need a prescription. And that means at least once per year doctor visits.

Otherwise, I've seen no pressure to come back. If there was a problem, I'd be quick to set up an appointment.

My DME has not asked me to update my prescription...it is 2 years old.