Can't believe this

[JeffH]

I recently got health insurance and was hooking up with the DME I used to buy supplies from before I found cpap.com. She said she needed a copy of my sleep study so I told her were I got it, but that it had been about 10 years ago (12/16/98) and I didn't know if they'd still have it. She said they would so I asked her to send me a copy. A couple of days ago I got it and you won't believe what I found out. I'm going to quote the part called, "interpretation"

"During the diagnostic portion of the evaluation, a severe degree of obstructive sleep apnea (780.53-0) was documented. Apneas were not position related. The patient did not obtain and stage REM sleep during this portion of the study, therefore, a possible REM effect could not be determined.

At the cpap pressure of 12 cm h20, all obstructive apneas were abolished, however, the patient began experiencing central apneas at 7 cm h20, numbers of which increased with increased cpap pressure. While a significant number of apneaic events remained at the cpap number of 12, no clinically significant oxygen desaturations were noted at this pressure. No clinically significant amount of central apnea was documented at the cpap pressure of 12. A retitration is recommended with Bi-level positive airway pressure (Bipap ST) to better manage both the central as well as the obstructive component of the patient's apneic events.

I was never told of the need for another sleep study with Bipap. Can you believe this?

When I had my study I went to the state teaching hospital so the "Doctor" I saw was a resident doing his 6 week ENT rotation. I can't believe that the docs that were supervising him didn't intervene and tell me I needed this.


JeffH

[Babette]

J*sus H Roosevelt Chr*st. Are you going to demand a new sleep study?

Good luck!!!!
Babs

[Georgio]

I guess that's one of the reasons those here recommend getting copies of all our prescriptions and sleep studies. In our unhealthy care system, you have to be fully in charge. That's one of those better late than never discoveries.

Georgio

[JeffH]

J*sus H Roosevelt Chr*st. Are you going to demand a new sleep study?

Good luck!!!!
Babs

Believe me, I'm raising holy hell. I have the names of the two docs that were "supervising" the resident doc. I've contacted the sleep center and the clinic both and both are in CYA mode big time. I'm supposed to hear from them on Wednesday of next week. I really think I should get a free sleep study from this.

JeffH

[JeffH]

I guess that's one of the reasons those here recommend getting copies of all our prescriptions and sleep studies. In our unhealthy care system, you have to be fully in charge. That's one of those better late than never discoveries.

Georgio

In '98 I didn't know better. I sure do now.


JeffH

[Georgio]

Tell them that you want "courtesy" sleep study, re-titration, and an auto bipap or you will dial.....1-800-888-ACHE...lol......!

(I don't care what "The Dean" says.)

Georgio

[goose]

Hey Jeff,
I do hope you can schedule another PSG and titration -- post haste!!!!! You already understand the importance so I won't "preach to the choir"!!!!!!

For newbies -- this is an excellent example of why we need to have copies of our prescriptions and our sleep studies -- both the interpreted version AND the original data....You have the right to have that information, so it behooves you to ask (demand if necessary) for a copy -- be prepared to pay a nominal fee for each page, but most sleep centers and docs won't charge for that.

Good luck in getting all of this sorted out Jeff -- I'm sure you're already working on it!!!!
Take care
cheers
goose

[Wulfman]

What Babs said.

But......sadly.....hardly anything surprises me about the medical profession any more.

One question though. Do the (apparent) Centrals show up on your reports? (even though the machine wouldn't be able to tell the difference) And, are you using Encore Pro Analyzer to get the "time in apnea" or "average apnea duration"?

Den

[JeffH]

What Babs said.

But......sadly.....hardly anything surprises me about the medical profession any more.

One question though. Do the (apparent) Centrals show up on your reports? (even though the machine wouldn't be able to tell the difference) And, are you using Encore Pro Analyzer to get the "time in apnea" or "average apnea duration"?

Den

Yes, I'm using EPA. I don't know how to tell the difference between and central and obstructive on the reports. What do I need to look for?

JeffH

[Guest]

JeffH - please advise your doctor before you self-titrate. Thank you.

[JeffH]

JeffH - please advise your doctor before you self-titrate. Thank you.

The "doctor" is what got me into this mess. Say off this post, please.

[Goofproof]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

[Wulfman]

What Babs said.

But......sadly.....hardly anything surprises me about the medical profession any more.

One question though. Do the (apparent) Centrals show up on your reports? (even though the machine wouldn't be able to tell the difference) And, are you using Encore Pro Analyzer to get the "time in apnea" or "average apnea duration"?

Den

Yes, I'm using EPA. I don't know how to tell the difference between and central and obstructive on the reports. What do I need to look for?

JeffH

An "apnea is an apnea" to the machines, but some clues as to whether they MIGHT be Centrals would be events that are longer in duration or "clustered" apneas on the Encore "Daily Details Reports".

Den

[JeffH]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

It was '98 and I don't know. I'm copying this from a fax that my DME got.

[JeffH]

What Babs said.

But......sadly.....hardly anything surprises me about the medical profession any more.

One question though. Do the (apparent) Centrals show up on your reports? (even though the machine wouldn't be able to tell the difference) And, are you using Encore Pro Analyzer to get the "time in apnea" or "average apnea duration"?

Den

Yes, I'm using EPA. I don't know how to tell the difference between and central and obstructive on the reports. What do I need to look for?

JeffH

An "apnea is an apnea" to the machines, but some clues as to whether they MIGHT be Centrals would be events that are longer in duration or "clustered" apneas on the Encore "Daily Details Reports".

Den

Thanks, I'll look for that. I checked out the last 6 months a while ago and the duration tends to be from about 8 to 12 seconds with most being in the average 10 second range.

JeffH