Finally I get my equipment....maybe?

[spitracer]

Wow, it has been a real experience getting to this point!... I appreciate all the kind words from my first post. After I had my sleep study I was a little annoyed that I wouldn't get a chance to speak to my Doctor until a month after getting my eqiupment and based on my reading and the articles you all suggested I found out that I had some choices and that I didn't really need to have this (sorry for the pun) shoved down my throat. So I called the sleep clinic requested an appointment, found out my stats (not very good) read a little more to see that my stats weren't that terrible...bad enough! asked for the DME supplier be my choice and asked that he put equipment to be selected by patient which he did. I also interviewed DME's and selected the one I thought would provide me the best care and had no problem with my selection of equipment.

This DME has been a little bit of a disappointment as the first time I called, the lady that was the technician said she would order the equipment immediately and send my paperwork into my insurance so that when she got back from a weeks vacation everything would be set. so I waited till the day before she said she would be back and called their office to make sure that my insurance was good to go and that apon her return we could have a fitting. The lady that answer's the phone from the DME supplier says let me check and tthen the technician picks up (OK- maybe she got back a day early??? I got it wrong a day....hmmm) the tech now tells me that she failed to put my primary care doctor on the form and the insurance was denied...hmmmmm. So I give her the Doctors name and ask her how long this will be for the issue to be corrected, she's not sure. So the next day I call my insurance and have a talk with them, they tell me that the previous day was the first that they had heard from my DME....hmmmm. They also said that I wouln't have been denied for that info..hmmmmm. I asked them how long before they could get an approval out and they say a couple of days before they can have a review look at my claim. I let her know that I was pretty bummed as I have now been waiting 4 weeks since my first study and my equipment is just waiting for me at the DME providers office. She looks at my stats puts me on hold for about 1 min. and comes back with an approval that she will fax to my DME.....now thats service. So I wait a couple of hours and call me DME about an appointment, tech is busy and will need to call me back. Several hours and no call back after a second attempt. So since I'm close I decide to stop down to talk in person, the tech finally comes out and says that everything is good to go and that she has gotten it taken care of......hmmmmm. She even drops the name of the agent I talked to to let me know she is working with my insurance, I informed her that I took care of it several hours earlier and that the agent called her at my request.....blank look.....hmmmmm. So here's the best part, "So you have my equipment", yep, she replys. "great, so can I still get an appointment today", nope.....I'M NOT TRAINED ON THE RESMED 9 AUTOSET!!!! WTH!!!! "So who is?" My partner, she responds. "OK, is he available", nope he won't be back until next Tuesday as he injured his back and has been out for awhile.....WTH x2!!!!

So now nearly 5 weeks and counting I might (fingers crossed) and I repeat might get fitted tomorrow at 4 pm.

I really wanted to come unglued with her as I chose her company over the Hospitals DME, I did let her know that I thought some of my case handling was a little loose, but maybe with her partner off she was overwhelmed. I just would have thought that sometime in the past 3 weeks she would have let me know that she wouldn't have been able to fit me with the resmed and we would need to wait until her partner returned.

Oh well, thats hope her partner has it going on...or I will come unglued!

Hey before I go the Doctor did say one thing that troubled me, he said that they had some difficulty getting my pressure stabilized as my brain wanted to stop breathing!!!! He said in 2/3 of the cases the brain gets over this and works with the equipment. I didn't get what this was called....sounded scary as hell! I asked what happens with the other 1/3 and he said a differen't piece of equipment and I shouldn't be concerned as I didn't look like I would fit in that catagory.

Cheers ALL.

[nanwilson]

You don't need to be trained by a tech to use your machine. You can get lots of help right here! They are messing with you BIG TIME, and I'll bet they don't have the right machine ready for you.

[Pugsy]

Sigh.
NanWilson is probably right. Make sure you get the machine you expect.
Also..brain forgetting to breathe...centrals. Make double sure your equipment will actually score centrals (clear airway) and not an older model that doesn't.

Sounds like your doctor thinks that you have complex sleep apnea. Might want to read up on it.

[Janknitz]

Well, you've already seen that your chosen DME isn't very truthful. A saying around here is that if a DME tells you the sky is blue, you better go outside and check for yourself.

You might want to look around for yet another DME who will provide the equipment you want, because I'm guessing this DME is going to stall you some more (probably because they aren't too happy about providing an autoset and are trying to come up with an excuse). If that happens, you can tell them thank you very much and that you will be taking your insurance approval and prescription to a DME that won't keep you waiting with a dangerous apnea for weeks on end. It's amazing the type of service you will get when a DME realizes you aren't playing along with their games.

If you stick with them, check your equipment carefully to make sure it's exactly what you want. And don't give them any time for more games if not (Expect to hear "Oh, the autosets are out of stock, but the Escape Auto works exactly the same"). Having another DME in your back pocket will give you the freedom to walk out if they continue playing games.

A FULLY EFFICACY data capable and auto adjusting machine is all the more important for you given the difficulty titrating you in your sleep study. Do not back down!!!!

[zoocrewphoto]

Have you mentioned your sleep apnea to anybody in your area, such as friends, family, co-workers? I have found that tons of people have sleep apnea, and they would be great people in your local area to ask about where to go. I picked my DME because my mom already used them. I joined this group after getting home with my new machine.

Thankfully, my DME was really good. I contacted them a week before my doctor appointment and they told me to have the doctor fax over the prescription and insurance info after the appointment. The morning after my appointment, they called to let me know that had received the information and would now verify my insurance which normally takes 24-48 hours. They called again a couple hours later to let me know it had been verified and they could schedule my appointment. That was a Friday. They scheduled me for Monday. When I arrived, they had my Resmed S9 auto, already programmed for me and ready to demonstrate. When he mentioned masks, I told him I was hoping they had the same kind I used in my sleep study. I brought a printout of the Quattro FX which looked the same as what I used. He went and got one, and fitted it for me. I never had any hesitations or runarounds. About a week and a half ago, I emailed them to ask when I would qualify for a second mask as I wanted to try a new mask, but not exchange the first one. At the time, I thought I wanted to try the Oracle. She emailed back a few days to let me know that my insurance would go ahead and pay for another one now, and the Oracle was in stock. Just call for appointment. I had decided over the last couple days that I would try a hybrid instead, so I emailed back with that, and called the next day to make the appointment. Got the appointment for the very next day, and the DME knew I wanted to try a hybrid. No problem.

When I told my neighbor that I have sleep apnea, he asked where I was going for DME. He started with Apria, but changed to the same place that I am now going to. He highly recommended them. So, had I been looking for suggestions, I would have gotten a good one.

[DoriC]

Well, you've already seen that your chosen DME isn't very truthful. A saying around here is that if a DME tells you the sky is blue, you better go outside and check for yourself.

Another saying around here is that if a DME's lips are moving they're lying. Unfortunately your story is an old one that we hear many times. Sorry you're going through this but it looks like you've got your wits about you. Keep us posted and good luck.

[wolewyck]

Hey before I go the Doctor did say one thing that troubled me, he said that they had some difficulty getting my pressure stabilized as my brain wanted to stop breathing!!!! He said in 2/3 of the cases the brain gets over this and works with the equipment. I didn't get what this was called....sounded scary as hell! I asked what happens with the other 1/3 and he said a differen't piece of equipment and I shouldn't be concerned as I didn't look like I would fit in that catagory.

What I think your doctor is talking about here, is the potential for you to have "complex apnea". As you will learn, there are several types of apnea-- obstructive (the most common), which means that there is a physical obstruction of breathing during sleep. Others have "central" apnea, in which the airway is not obstructed, but the brain (central nervous system, hence the name "central" apena) fails to tell the body to breathe! Still others have "complex" apnea. This can show itself as follows-- first, in a patient's initial sleep study (without xPAP), the patient seems to have significant numbers of obstructive apnea, but when put onto a CPAP machine, the patient starts to show central apneas instead (or in addition) to the obstructive events. If a patient has complex apnea, the technician may have a hard time finding a good pressure during the titration... too low a pressure, and the obstructive events persist, but too high, and the patient starts having lots of central events instead. It sounds as though your titration study didn't go as well as the doctor might have hoped, and he suspects you may have complex apnea.

If you do have complex apena, regular CPAP therapy may not effectively treat your condition. Instead, you may need a different kind of machine, called an ASV. These machines cost a lot more but can be very effective to treat both obstructive and central-type events. The important thing is, once you have a machine, to make sure it is recording data on the therapy's effectiveness--e.g., can it show you your AHI every night? And how many of your apnea events each night are obstructive vs. central in nature? If a CPAP or APAP machine isn't able to control your apnea events well enough, you should go back to your doctor and remind him of the difficult titration you had, and see if an ASV might be better.

[mnfe]

I would be looking at switching. If this is how they are now, how will it be later? How will they be when you want to exchange your mask? Ask around and find somewhere else!