DO DMEs PUSH FULL FACE MASKS?

[chunkyfrog]

Lovely!--How far away are you from me? (edit--umm, that's a ways)
I honestly believe that in many cases, OSA is treated as a "one shot" thing,
assuming many patients will bail--no matter what is done--
and repeat business happens only randomly with little or no effort on the part of "providers".
I'd really like to see more altruism in the business; and know of a few individuals,
but have not have an encounter with a company with such values. (our hosts excepted)

[Stormynights]

Mine showed me a wall of 20 or so mask and said "lets try them all and see what you like." When I had it down to a couple of mask she said I could take on try it a couple of nights and then try the other one.
Same thing when the Wisp and another new mask came out.

That is the way they all should be. Who is your DME?

[hyperlexis]

In my case the DME said on our first meeting--"With your pressures, you can use any of the three types of mask" and then proceeded to offer me a choice between two types of FF mask. I experienced four nights of hell and in the meantime discovered this website and a couple others, insisted that I be allowed to try the nasal pillows, fell in love with them and have settled into what I think is a healthy and sustainable relationship with my CPAP therapy. When I asked for the pillows, the DME exclaimed "Of course! That is our most popular!" So why did he not start me there?

I seem to read of many cases in which FX Swift or other nasal pillow types of mask have to by "found" or "discovered" by patients struggling with FF. Why might this be so? Is there some financial benefit to the DME to starting a patient with FF?

Just because you would prefer a pill to a shot doesn't mean the pill is better....

No, I'd assume it's not a conspiracy. You really have to look at things from a holistic perspective. It's the DME recommending what they think would work best for you, clinically, not necessarily what you would presume works better.

When I started CPAP I asked the DME for a mask (and a machine) different than what he was originally going to give me -- I vaguely recall wanting nasal pillows because, frankly, they looked less gruesome than the alternatives. I was told no, absolutely not, at least not at the start of therapy. Because, with my history of allergies and sinus problems and mouth breathing, chances are I would be opening up my mouth at night out of habit and that would cause leaks and mess up the therapy. So I was told to start with the FF mask and then in 3 to 6 months try out a nasal pillow mask and see how that works.

And, honestly, the DME was right. With a good, comfortable FF mask, CPAP therapy can work well with few to no leaks and mouth breathing is almost nil. I have since bought a Swift FX and the Activa nasal mask and have been able to control my mouth breathing for the most part. So I can change masks every once and a while for some variety.... (Pillows are so much easier for travel).

Because you need high pressures, a good FF mask or nasal mask may legitimately work better for you to start. Some have reported that pillows can leak later during sleep under high pressures due to buildup of moisture/oils/mucus.... ugh in the nose causing the pillows to break the seal. But everyone is different.

Otherwise if you are happy and your numbers look good throughout the night, then stay with what you like. Although it would always be prudent to find a good FF and keep it in reserve for nights you can't use a nasal/pillows mask. Have you seen the new Quattro Air? It looks like a great one to consider -- very light, simple to clean and minimalistic for a FF mask. Otherwise with super high pressures, then one of the older 'gel' cushion FF masks may be best.

Good luck!

[BobF4]

When I got my first mask, my DME (Apria) gave me the exact same mask I had during my titration (I think it was the Ultra Mirage II). No choice, or anything. But, I got my machine in early 2003, so that could explain it right there.

I am on mask 3 now, which was recommended by Apria, as well. I currently use the Mirage FX. I had been using the Mirage Activa LT, but wanted to switch.

[Janknitz]

I think DME's tend to give FF masks for a few reasons:
1. It seems to "cover all the bases" if you turn out to be a mouth breather.
2. They THINK they are easier to fit and use (I think they're the hardest masks to fit and use because there's a lot of surface area to leak, a lot of face contour to fit, and a very tender nose bridge to accommodate--versus itty bitty little nasal pillows). A DME's cursory upright fitting is usually inadequate, but if the newbie has trouble they are told that they just need to try harder and longer and few newbies know enough about how to use the 30 day trial period wisely.

Because of reasons 1 and 2, they think there will be less likelihood of a return within the first 30 day and the paperwork that entails. A win for the DME, loss for the CPAP user.

3. FF mask cushions tend to last longer. I don't think the DME's make much profit on replacing your nasal pillows up to twice monthly (which is why some DME's refuse to do it), whereas a mask cushion can last a few month most cases. By the time you really need a new cushion, they can usually also sell you a new mask and pocket two payments from Medicare for supplying basically one item.

[John from Brookston]

Mine started me out with a nasal mask, even though my script specified a Quattro. I didn't get along too well with the nasal mask, so I went in to go "mask shopping" with a list of several models and styles of masks. The RT dismissed nasal pillow masks out of hand, going so far as to call the Liberty hybrid a "Piece of Crap". I left w/a Quattro in the wrong size (he didn't measure me, just sized me up and said "Yup. You're a Large"), fortunately, a friend had a Quattro in Medium that he wasn't using so he gave it to me.
Now I'm using an FX and loving it.