How do you communicate with your doctor?

[wolewyck]

I feel as though I'm not getting enough attention from my sleep doc. Things are not as much under control as I'd like of late (AHI in the past month has been above 5 pretty often -- all centrals, pressure setting is . I have emailed her about this, and about another health-related event (potential CO poisoning(!)), and basically haven't gotten satisfactory answers. She suggested increasing my pressure to deal with the AHI--which I had actually tried last fall, and it didn't work then, no surprise, as they are CENTRALS-- and while emailing me back to express shock at my CO (mis)adventure, said she'd get back to me after researching whether this might be a contributing issue-- and then failed to follow through.

What's reasonable here? Am I only supposed to get substantive feedback on how to adjust my therapy during actual appointments, spaced months apart? I know she doesn't get paid for email responses, but it seems to me that this is a condition that can benefit from a bit more hand-on monitoring, especially when things aren't perfect. How do you all interact with your doctors-- only through appointments, or do they actually call you, or respond by email, if you have a concern?

[radaddict]

If you're not getting the response you need via phone/e-mail, make an appointment to see her face to face. If you still don't get what you need, find another doc.

Regarding your centrals: I was able to reduce the number of CA events I was experiencing by changing the pressure relief settings (turning it off works best for me).

[Slartybartfast]

You've gotta be proactive here. Don't rely on e-mails for this important stuff. A physician's life these days is very busy. I read a while back that the average GP has something like 4,000 patients under their care. Don't wait for a call back. Make the call. Politely remind whoever answers the phone that you were told she'd get back to you. No reason to be other than very polite, because the front office is very busy. However, if what you describe becomes a consistent pattern, find another doc who perhaps runs a more efficient office.

And I second the "centrals" issue. If you're on fixed pressure and experiencing what Resmed calls centrals, it's likely that your pressure is too high. Your doc' should have picked up on that. Either reduce the pressure a cm or so, or dial in EPR to 3" and see what happens. In my case, when I turned EPR OFF, I encountered "centrals." When I turned it back on, they vanished.

[M.D.Hosehead]

Making an appointment would get you a few minutes of undivided attention, probably more than you get with an email.
But your experience is distressingly common on this board. That's why the help we get here is irreplaceable.
Can you post some reports and let others take a look?

[DavidCarolina]

Quite frankly, my sleep doctors both have horrific bedside manners, want me out of their office quickly,
and only ask questions when directly asked. I rate them 2 out of 10. I would describe them as
aprupt and even rude at times. They know they have a pretty good monopoly going right now. There is absolutely
no empathy or warmth whatsoever from either one. I know that sounds harsh, but its true.

To add insult to injury, when I requested a prescription of Klonopin for "agitation" they told me I looked
"anxious" in the office. Well, im still having apneas and extreme agitation at times in my central nervous system
after having undiagnosed apnea for 4 years. So you'd think they might understand that might make any normal
person a little anxious right?

When I requested that my pressure be simply changed from 9 to 10 because I didnt feel i was getting quite enough
air and pressure, I was virtually insulted with "WHY? The numbers show youre doing fine". No attention was paid whatsoever to my comfort level. They only reluctantly agreed to change it one number because I politely insisted.

Im planning on making the switch to a charlotte doc as soon as I can. Its ninety minutes away, but well worth it.

Nevertheless, its good having the sleep studies that show empirical data. My AHI numbers have been improving,
so thats the main thing right now.

Im also on the learning curve, as a newbie, so im gathering information as I go, and then when i make the jump I'll never be back there.

This general outlook goes for all my doctors. Ive learned that most of them are greedy and violate their hypocratic oath every day. Money is more important to them than their patients well being and many of them are beholden to pharmaceutical companies.

Again, this sounds harsh, but it is my studied opinion of 1.5 years now.

[DavidCarolina]

Sorry for another post, but I strongly and humbly advise the OP to get another doctor.

A doctor should be concerned, knowledgeable, helpful, responsive, and thorough.

It sounds like yours is none of the above.

[BlackSpinner]

How do I communicate? The first time we spoke English and the second time we spoke French as my ability to think had increased with the increase in O2 at night. Those are the only 2 times we communicate in 2 years.

[STL Mark]

She suggested increasing my pressure to deal with the AHI--which I had actually tried last fall, and it didn't work then, no surprise, as they are CENTRALS--

This may be somewhat off topic of your subject, but too high of a pressure will cause centrals. It does sound like you could benefit from a one-on-one discussion with your doctor.