A funny thing happened on the way to the DME......

elazarus · Post by **elazarus** » Sun Aug 19, 2007 2:03 pm

Well, thanks to this forum I have learned just enough over the past 2 months to be able to, at least, know what is in my best interest and what is not.

After receiving a Plain Jane CPAP exchange on Wednesday and calling the Doctor....I went in on Friday to the DME where they gave me back the Remstar M Auto and ordered the A-Flex for me to come in on Monday.

I brought in the insurance code for the RT and she said she knew what the code was and said that it was "Pretty Crafty" of me to know that the RemStar Basic and A-Flex would use the same code for insurance purposes. By not saying anything else she know that I knew that the decision was based upon profit margin and nothing else.

Now I do have a question. My number originally was 8. A month of logs (pun intended) said my number was 10...and I notice the last 2 nights the machine was at 12...the top end of where I have it set.....it is set on 9-12.

Do I need to adjust the top end number?

Funny aside....The RT asked me if I wanted it straight CPAP at 10 or 7-12 where we had it set. I said let's do 9-12 and she said , no I can't do that without it on the prescription. I told her to set it anywhere...and re-set it when I got home.

What a game.....

Regards

Elliot

Organplayer · Post by **Organplayer** » Sun Aug 19, 2007 2:10 pm

Thats one for the patients. Its nice to see a victory .

Kevin

Slinky · Post by **Slinky** » Sun Aug 19, 2007 2:54 pm

You might have been better off setting it at 7-12 as the DME's RT suggested.

RunningBare gives an excellent explanation of how an autoPAP works at the American Sleep Apnea Association's Sleep Apnea Support Forum in the CPAP Mask/CPAP Machine Questions folder's threat titled "Any Ideas/Suggestions".

Goofproof · Post by **Goofproof** » Sun Aug 19, 2007 7:53 pm

Now get the software and reader, and life will be complete. Jim

goose · Post by **goose** » Sun Aug 19, 2007 8:15 pm

What's your AHI??? If 9-12 or 7-12 keeps your AHI under 5 you probably don't need to mess with it.
My APAP was set between 7-15, but it was causing NR problems as it increased the pressure, so I have it set to CPAP mode at 10. Pulled my data tonight and my AHI is 2.1 -- could be better, but very acceptable.....

Finding the software will be problematic as it's no longer available to the user.

good luck!!
cheers
goose

elazarus · Post by **elazarus** » Sun Aug 19, 2007 8:16 pm

Thanks for the input. Yes the card reader.....I forgot.

Slinky, we did set up the auto on 7-12 before the DME ripped it out from under me....when the Dr. change the prescription from 8 to 10....I thought that going from 7-12 to 9-12 would bring up the bottom.

I did read the post that you mentioned and he does make a case for a lower number....I still find it confusing to choose a high and a low and let the machine do what it needs to.

Why 7-12 if it has been at 12 the past couple of nights??

Thank you

Elliot

elazarus · Post by **elazarus** » Sun Aug 19, 2007 8:32 pm

The AHI is 4.9....In 2 months it seems to have come down from 7.5 +/-.

Thank you

Elliot

goose · Post by **goose** » Mon Aug 20, 2007 4:47 pm

4.9 is in the "normal" range, so that's a good thing. I note that mine has come down very slowly!!!
That said, I'm a tweaker and at that AHI, if the machine was at 12 MOST of the time, I'd up the pressure by .5 or maybe 1cm and leave it for a few weeks and see what happened to the AHI number.

When I had my first sleep test, about 1/2 way through they strapped a hose to my nose and set the pressure at 6.....my AHI at that level was 9, so they set it to 8 which brought the AHI number to 7....unfortunately my test was over before they could get it below 5.
Now. Based on that test, I guessed at that time my pressure would fall between 10 and 12.
Then I had a titration test and I actually titrated at 5.....Don't ask, I don't have a clue!!! So my initial setup was at 5....That was barely enough to breathe. I looked at my reports and consulted with the doc and got an APAP that she wanted set from 7-15. The change in pressure that the machine did wasn't working with me -- it was causing "Non Responsive" apnea events when it was changing pressure up.....So I set the APAP to CPAP mode and set the pressure at 10 (the bottom end of my initial guess based on the first test). Having done that about 3 weeks ago, my AHI has gradually lowered to 2.1 (yesterday's report based on 27 days).

SO, the drop in AHI is probably going to be gradual (as near as I can tell). You'd have to look at the reports (if you can) to see where the machine is spending most of its time. If it's low, great!! If it's high, a slight tweak may be in order, but I would consult the doc and see where it goes.....

Sorry for the long post (I left out a lot of details, but.....) -- hope some of the explanation helps.

Good luck,
cheers
goose

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