Going Back to Doc

[Magnum]

Well,

Too make a long story short I have not gone to my sleep doc for a while. Saw my general doc and she was shocked at the treatment I got from them and was not happy when I told her that the doc had said to come back in a year, even though I was complaining of still being tired.

Soooooo..

My question is I will be seeing my family doc next week for a followup. My questions are can a general doc write a perscription for a CPAP machine?

Just curious if it is worth having my gen doc work with me or find another sleep doc in the area and try and get them to work with me. I have no doubt my family doc would. I have the moeny and can probably purchase a better machine if needed even if insurance does not reimburse, I just know I have to have a script to buy one, and whoever writes the script I want to make sure it has the probper wording on it.

And yes, it has been a long time since nothing has been done, partially due to frustration.

[Snoredog]

[quote="Magnum"]Well,

Too make a long story short I have not gone to my sleep doc for a while. Saw my general doc and she was shocked at the treatment I got from them and was not happy when I told her that the doc had said to come back in a year, even though I was complaining of still being tired.

Soooooo..

My question is I will be seeing my family doc next week for a followup. My questions are can a general doc write a perscription for a CPAP machine?

Just curious if it is worth having my gen doc work with me or find another sleep doc in the area and try and get them to work with me. I have no doubt my family doc would. I have the moeny and can probably purchase a better machine if needed even if insurance does not reimburse, I just know I have to have a script to buy one, and whoever writes the script I want to make sure it has the probper wording on it.

And yes, it has been a long time since nothing has been done, partially due to frustration.

[Sleeprider]

My primary physician finally wrote a presciption for an auto-titration auto PAP machine with humidifier and supplies. That pretty much opened the door for some of the best machines available. I was getting bounced around between an Ear Nose Throat specialist with no discernible knowledge of apnea, and the sleep clinic. I was diagnosed with severe obstructive apnea for over a month,a nd still and didn't have a titration study. My GP solved the whole problem by specifying an Auto PAP.

Best thing she could have done. I got the Remstar Auto with Cflex from the DME (another 2-week delay) and have been pretty successful at this since the end of May. I wish you the best of luck. Don't be afraid to be your own advocate, cause almost no one else will.

[RipVW]

Hello Magnum,

If you have the script for your first machine, you don't need a new script to purchase an auto (assuming you plan to purchase the machine yourself rather than through insurance). cpap.com (and others) will accept your CPAP script, and you may purchase an auto titrating machine with that script. Based on my personal experience, I highly recommend that you get an auto titrating machine. If I hadn't found this forum, learned about data from my machine (I started with an S8 Elite, fully data capable, but didn't know how to retrieve it—my RT told me that ONLY DME's and clinics could purchase the software!!). After more than a year (July 2006 – October 2007), even though I'd used my machine every night, I still felt tired, still felt that I wasn't getting recuperative sleep. My doc never scheduled a follow-up appointment . . . Then, I found cpaptalk.com. First thing I did was purchase the card reader and software. The machine showed my AHI for the previous 6 months, averaging 9. My pressure was prescribed at 6, and I had no idea how to change it (RT held that information as TOP SECRET). I decided that I wanted an auto machine that would enable me self-titrate, got the M Series Auto A-FLEX in October. Well, turns out that my required pressure "sweet spot" is 12. After experimenting with masks, humidifiers, getting my leaks under control, my AHI now averages 0.4 Most importantly, I just feel GREAT!! Consistently sleeping well, 8 hours of restful sleep. I feel rejuvenated, energized. So, I humbly submit that ALL CPAP users should take control of their therapy, should change their own settings. Had I not done this, I'd be continuing the useless therapy I began with. Well, that's my story! Three cheers for cpaptalk.com and all of you wise old-timers who saved my life (or a least lengthened it!).

Good luck!

[Twilightcat]

Hello RipVW and Others,

I would like to say thank you for taking the time to share personal stories of struggles leading to eventual successes. I have learned so many important concepts through the year by reading these types of stories.

Best wishes to you , Magnum. I hope it goes well with you.

Take care,
Twilightcat

[Slinky]

The Resmed Compact CPAP you have is, as SnoreDog said, just an entry level device capable only of providing compliance data which is of absolutely no benefit to you or your doctor but only to the local DME supplier's profits via proof of use for insurance reimbursement. It DOES provide excellent therapy - once you know what your pressure needs are so I would keep it as a back up and travel device.

Fortunately, it is an S8 and so uses the Humidaire 3i integrated humidifier. Assuming you also have the Humidaire 3i you would be wise to stick w/a Resmed brand autoPAP and save the expense of buying another. Besides, Resmeds have the easiest access to data via the LCD screen. That being said, I would recommend the Resmed S8 II AutoSet. Its a newer model than the Resmed S8 AutoSet Vantage but they are BOTH excellent autoPAPs and both use the Humidaire 3i integrated humidifier.

I have the S8 AutoSet Vantage I self-purchased and was very happy w/it, prior to that I had the Resmed S8 Elite w/EPR (also fully data capable) purchased by my insurance. I was just recently brought in for bi-level titration and switched to a bi-level. I was so happy w/my Resmeds I INSISTED on the new Resmed S8 II VPAP Auto and I've VERY happy w/it!

But back to square one. Send a written request to that sleep lab doctor for a copy of his dictated results from both your sleep evaluation and your titration (1-2 pages each) AND a copy of the full scored data w/condensed graphs from both your sleep evaluation and your titration (5+ pages each) as well as a copy of your equipment order (script). They are a part of your medical records and if you are in the USA you have a legal right to copies of them. The written request ensures that there is a paper trail and if he fails to comply you have him by the short hairs, altho if he is a real jerk you may have to send a second written request via Certified Mail, Return Receipt Requested. (If it comes to that be sure to save a copy of your request, your proof of certification and the Return Receipt when you receive it). And if that second request becomes necessary I would be sure to cc it to the state licensing board and local medical society and that he sees that it has been cc'd to them.

As others have said, your original script is sufficient to self-purchase an autoPAP via an online DME supplier. If you opt to go that route keep in mind that both Resmed and Respironics have instituted MAP (minimum advertised pricing) policies for online DME suppliers so don't pay any attention to the advertised prices but rather call the online DME supplier and ask if they have an "unadvertised price" or an "unadvertised sale" on the items you are interested in.

If you are going to want the software and cable reader for the fully data capable CPAP you purchase, the Resmed software you want is ResScan 3.4 (ResScan 3.3 does not support the S8 II devices) or if you have Vista on your computer, ResScan 3.5. I'm not up on the latest Respironics software other than the patient version, EncoreViewer.

With the scored data report from your titration you will have a good idea of the pressure range to set your new autoPAP. There are plenty of experienced autoPAP users here to advise you on suggested pressure ranges once you have your report and your autoPAP on hand.

[DreamStalker]

Uhhh ... there is nothing "fortunate" about having an S8 or Humidaire 3i integrated humidifier (not the best avaialble) or wise about staying with ResMed brand.

The only wise or fortunate thing that could or should happen is that they get a data capable machine regardless of brand or humidifier. The next best thing is that it be an APAP with the most options avaialble.

There is more to this treatment than ResMed machines Slinky. ResMed is neither the best nor the worst ... it is just an option, and if it is not data capable, it is a bad option regardless of brand.

[Guest]

Thanks for all of the info and replies. I think one post asked if I was still tired and the amount of sleep I get the answer is yes and I get anywhere from 4-6 hours of sleep a night due to insomnia. Recently I took a trip to Ohio and took my CPAP and they would not refil my Ambien for one day, the day after I was leaving for vacation.. So I took some Sonota I had. Turned out that was the best sleep I have had in a long time. I have always told my docs that I do better on 4-6 hours of sleep - IF I can sleep.


But, I also went by and got my old script it is for the basic unit so I will need a new for the autos I would think. Had a heck of time getting it from them but I got it. Also, called the insurance company and they said they may/may not reimburse me for the cost of the new machine. They only pay for the basic machine and "deluxe" features are not covered. But the girl was very helpful and told me to get the machine and file anyway and put under the justification as an upgrade as the previous machine was not efficient enough. She said they would probably pay a percentage, better than nothing .....


@RipVW

Your situation sounds about like mine. My sleep doc told me to com back in a year if I had problems, and that was after I was telling him I was still tired. I think he was ignoring me because I had not lost any weight, he wanted me to lose 10lbs. If I can get some sleep and get active I have no doubt the pounds will drop. But being tired and sleepy all the time, it ain't gonna happen.



@Slinky

I believe I have a full copy of the reports, I just have to find them now that I have moved. But I think my GP will work this out next week. After all she did listen to me with my neck injury when I said I was tired of physical therapy and doctor hopping and see sent me to the pain clinic which was a life saver. So I am sure success can be duplicated, I just have to get as mad as I was then:)

[sleeplessinaz]

Hi There---Yes my general family doc wrote a perscription for my CPAP machine when I first started. Then I switched insurance companies and asked him to write another one for me to get a better machine (data Capable and with EPR relief) and he did that for me too!! So yes--no need to see a sleep doc. --I have never seen one. Most of the education you will get is from this forum and your own trial and error!!! LOL! So hang in there---get what you want!! I LOVE MY RESMED S8 ELITE machine!! It packs up and travels nicely--you won't be dissappointed with the RESMED.
Good Luck!
Carrie

[snoregirl]

You do not need a new script if you are buying on line. Doesn't matter what machine or level of machine it is written for Cpap or APAP. If you go Bi Pap it would matter but not any type of cpap.

Would be nice if your insurance would pay for an upgrade, but you may find out it is almost the same price to buy online without the hassle. Figure it out before you chase the insurance company too hard.

You can probably get some use out of the escape once you find your correct pressure with the auto, and have the escape as a backup.

[Magnum]

Online is already cheaper. From looking the better machines are cheaper with everything including software than whay the basic machine cost me locally (still makes me mad). What I should have said I would have to buy online with cash, then turn in the paperwork for the insurance. So I would pay for it eitherway, just depends on if I get reimbursed or not.


[quote="snoregirl"]You do not need a new script if you are buying on line. Doesn't matter what machine or level of machine it is written for Cpap or APAP. If you go Bi Pap it would matter but not any type of cpap.

Would be nice if your insurance would pay for an upgrade, but you may find out it is almost the same price to buy online without the hassle. Figure it out before you chase the insurance company too hard.

You can probably get some use out of the escape once you find your correct pressure with the auto, and have the escape as a backup.

[Slinky]

DreamStalker, I didn't say that Resmed was the best unit, I said that since Guest alreayd had a Resmed and presumably the integrated humidifier for it, the Humidaire 3i, it would save the cost of buying another humidifier if he stuck w/a Resmed model. That's all. READ or I'll get after you w/my broom! whack, Whack, WHACK!

Guest, insurances generally pay by insurance code, not by brand or model (or bells and whistles). A fully data capable CPAP is the exact same code as your bare bones CPAP and an autoPAP is the exact same code as an entry level bare bones CPAP. HCPCS code E0601.

Bi-levels, SBs, etc. are NOT the same HCPCS code.

[Snoredog]

[quote="Slinky"]DreamStalker, I didn't say that Resmed was the best unit, I said that since Guest alreayd had a Resmed and presumably the integrated humidifier for it, the Humidaire 3i, it would save the cost of buying another humidifier if he stuck w/a Resmed model. That's all. READ or I'll get after you w/my broom! whack, Whack, WHACK!

Guest, insurances generally pay by insurance code, not by brand or model (or bells and whistles). A fully data capable CPAP is the exact same code as your bare bones CPAP and an autoPAP is the exact same code as an entry level bare bones CPAP. HCPCS code E0601.

Bi-levels, SBs, etc. are NOT the same HCPCS code.

[Magnum]

So my next question is should I go ahead and get the new machine or wait till I see my GP and tell her I have already taken the next step:)

[Bookbear]

Snoregirl, just to clarify: if your Rx is for cpap, you can purchase any cpap or apap machine. If your RX says apap however, you are limited to apap machines only.