Help, I'm overwelmed

[echap]

Hello,

I have been trying to read thru the site to not ask newbie questions the last couple of weeks since I had my sleep study when I had free time, but I am almost more confused now than I was when I started. If I hadn't found this site, I would have taken whatever machine they wanted to give me and been fat, dumb and happy.

Well it's too late for that and now, and my DME has called and wants me to come in tomorrow ight after work. I can't quickly find info on the two options that they have for me, I have commitments away from the computer until late tonight, and then work tomorrow, so I thought I would ask for group help and approval on which machine to get.

Here are the options I have:

Respironics M series #550

Or

Res Med S9 Elite

I guess they both costs the same, so I hope to lean on your experiences and judgment to guide me in this selection.

Thanks in advance this is a very helpful site.

Eric

[Janknitz]

Respironics M Series is an OLDER and DISCONTINUED model, but the 550 is an APAP. It has full data capability, but the data card is proprietary and it's difficult and expensive to get the card readers nowadays. Do NOT accept that machine.

IF you accept any Respironics machine make sure it's a System 1, which is the current model for that manufacturer and it uses a standard data card you can read in any inexpensive reader. Avoid the "System One CPAP Plus"--no data, but just to confuse the heck out of you the "System One CPAP with C-flex Plus" is fully data capable. Or ask for the System One auto.

The Resmed S9 Elite is a very good, fully data capable CPAP but not an APAP. If you want an APAP you should ask for a ResMed S9 AutoSet, do NOT accept any ResMed with "Escape" in the name, even a ResMed Escape Auto.

Read my blog below for the link on "What you need to know BEFORE you meet your DME." If you want a good auto, the DME will try to tell you you can't have that (although they seem very willing to give you a discontinued one ), and it will take some finagling to get what you want.

Be sure to call your insurer BEFORE you go to the DME so you know exactly what is covered and how it is paid for as explained in my blog. That way the DME can't play you for a sucker--the choice of machines they have offered you already indicates to me that is exactly what they intend to do.

Keep in mind that unless you have an HMO plan that limits your choice of DME's to that particular one, you can shop around--you don't have to do business with them if they won't work well with you.

[echap]

Thanks for that info. I already read your blog part 1. How to get to other parts? My insurance deductible is high, $3000, so I will be basically paying for this out of pocket, unless the sleep study costs more that that.


Is it worth it to just buy one on-line and not mess around with the insurance making me buy something that I don't want?

[mayondair]

If you will be paying out of pocket( crunch some numbers, sleep studies are $$$) you will probably be better off buying the machine on line, you can still use the local DME for masks. Not only will you save money, you will get exactly the machine you want. I'd go for the Resmed S9 Autoset, PR SYS 1 auto or Devilbiss intellipap auto .don't be rushed into this take your time and do your homework.

[Janknitz]

Is it worth it to just buy one on-line and not mess around with the insurance making me buy something that I don't want?

Most likely it is very worth it to buy online and get exactly what you want for less out of pocket cost and definitely less hassle, especially since it's almost the end of the calendar year and your insurance deductible will probably reset in January. But you need to do the numbers to be sure. Find exactly the machine you want and price it online from a few sources, including our hosts at CPAP.com. Don't overlook used sites like Secondwind.com and CPAPauction.com (run by our hosts as well). You will need a prescription for all of these online sites, although some people score very good machines on Craigslist, but it's buyer beware. The online CPAP suppliers will even contact your doctor for you to get the prescription.

Be sure to price out what you want BEFORE you walk into the DME. In most cases, if it's going toward your deductible and the DME has a contract with your insurer, they must offer you the insurance company's negotiated price--but not always. A brick and mortar DME might charge as much as THREE TIMES what an online supplier will charge, and it may be that you can submit your receipts for the online purchase to your insurer and it will still count toward your deductible. Do your homework and you will probably save yourself a bundle of money.

[Janknitz]

I might add that there is some power in walking into the DME and telling them exactly what you want, knowing that if they can't supply it to you and at a reasonable price without a bunch of negotiating, you can simply walk out and buy online. It definitely takes the sucker sign off your head. Who knows, you might get a DME who will work with you.

P.S. Don't buy their baloney arguments that you NEED a DME to help you set up and understand the machine. Most DME's do the opposite--they make it difficult or impossible for you to check your own data and manage your own treatment. Don't expect them to think it's a good idea that you will access your data, or (the Horrors!) change your settings yourself--they will even tell you it's illegal and could cause serious harm--neither is the case. Don't waste your breath arguing with them either. Just ignore them.

[kempo]

If you go with the Resmed s9 tell them you want the AUTOSET. It can be used as a cpap and a apap. If they try to talk you out of it just go to another DME. It's your money!

[archangle]

I don't think there is a Respironics M series 550.

There's a M series 500 and 510. Unless he's offering you a really REALLY cheap price, walk away and find an honest DME if he's really trying to sell you one of these. He's selling you obsolete merchandise at full price.

The Philips Respironics System One (PRS1) REMstar Auto DS550 is an excellent machine. If that's what he's offering, grab it.

The PRS1 Auto (Model DS550) is better than the S9 Elite.

Be sure to get an integrated heated humidifier either way.

The PRS1 machines are the only ones that say "Philips." They're black and white. They're good machines as long as it's the PRO or Auto. Do not accept the PRS1 PLUS or AutoIQ models. The name of the machine is above or below the display. Be sure and look at the name.

PRS1 looks like this:



M series looks like this:

[Gaga58]

Echap...my deductible was waaay lower than yours and had been met and it was still cheaper for me to pay out of pocket and purchase my machine online...as they tell you on here, don't rush! Just because they say you are to get the machine on Fri. doesn't mean you HAVE to get it then. I was a few weeks later in getting mine after the titration just because I had come here first and was trying to understand it all BEFORE I sunk the cash! The DME I tried to use wanted to sell me an M series also..thank goodness I had read enough before to know that wasn't right AND they argued with me when I said it wasn't what I wanted, so be prepared! Yes, they appear to know what they are talking about, and yes, they are good at fielding your questions in the wrong direction...again, if it hadn't of been for reading on here I would have been stuck...so don't rush! If you don't get that machine til next week or the week after you're fine...just make sure you get what you want...it's your money, not theirs!!!

[echap]

Thanks for all of the great info. I'm going to go there this afternoon and see what they got, but won't be signing any contracts. Thank you all for your help.

[echap]

I just got a call from my doctor and found out my numbers. AHI = 104 and oxygen went to 72%. They starting me at 13cm.

Any thoughts on these numbers, seems pretty bad to me.

[Marky]

I was overwhelmed too......




...............Didnt take me long to be underwhelmed by the standard of my treatment.

My Consultant told me yesterday that although I may be mouth breathing with the Nasal pillows......BUT! its ok if its only a couple of hours per night. My resmed Escape doesnt say...so how would anyone know?


Anyway welcome echap! And dont worry........ The "treatment and advice" you get on here will raise the bar.

[Pugsy]

I just got a call from my doctor and found out my numbers. AHI = 104 and oxygen went to 72%. They starting me at 13cm.

Any thoughts on these numbers, seems pretty bad to me.

Well the AHI gets you the "severe" rating.
Obviously the O2 level is quite low but common (I had 73%) and others have gone much lower.
Pressure of 13 just means you need that much pressure to keep the airway open. It is not an indicator of severity.
It is a physical thing. You need 13..someone else might have AHI of 20 and need 18 cm and another might only need 8 cm.

[Pugsy]

My Consultant told me yesterday that although I may be mouth breathing with the Nasal pillows......BUT! its ok if its only a couple of hours per night. My resmed Escape doesnt say...so how would anyone know?

Couple of hours of less than optimal therapy wouldn't be okay with me. Like you say...how would you know for sure?
All depends on how much for how long. 15 minutes? That I would take if it was occasional.

[Marky]

My Consultant told me yesterday that although I may be mouth breathing with the Nasal pillows......BUT! its ok if its only a couple of hours per night. My resmed Escape doesnt say...so how would anyone know?

Couple of hours of less than optimal therapy wouldn't be okay with me. Like you say...how would you know for sure?
All depends on how much for how long. 15 minutes? That I would take if it was occasional.

I asked him how he knew it was only a couple of hours in say 8.

He said I would be tired.......I told him I was shattered!

He then went on to say he'd heard some horror stories about people taping their mouths shut. I said he obviously hadnt had the air forced out of his mouth!
I have another appointment in 3 months, and I have no idea if this therapy is working or not. All it tells is how long I lie on a night trying to keep my mouth shut, re-positioning it and unwrapping the tube from my throat. Or being elbowed by the other half because of the draught on her.

Sleep Apnea...... the gift that keeps on giving.....Aggravation!