Son-in-law has begun his journey

[sleepycarol]

My son-in-law (Joe) called me last night as I was leaving for work. He told me that he received his paperwork from his titration study, which was done last Thursday Jan. 14, 2010. I told him I would stop by prior to going home.

He was full of questions when I arrived. Good for him!! Wanted to know what the various numbers and terminology meant. I explained what the numbers and terms meant. He seem to soak it up. I think he has caught my drive to learn as much as he can. I will be encouraging him to join the forum.

He asked if I could go to the DME with him. I told him first to call the insurance company to find out about coverage and in-network providers. He hopped right on that and placed the calls. His only option of DME is Lincare. Coverage is 80/20 after deductible has been met. His titration study will catch the deductible probably.

His script is written for a "cpap ----- autocpap with a pressure of 10 to 15/ heated humidifier/ c-flex setting of 2 / full face mask / data capable with smart card.

I called Lincare and asked if they carried the Resmed line. Was told no. I asked if which machine he would be getting (actually on the phone I inferred it was my script). Was told there are several various apaps and it would depend on his script. When I told her that he had a pressure of 10 to 15, was told that he would need another study to determine "which pressure". I explained that no he was ordered an apap and that his pressure would be set to a range of 10 to 15. Again I asked which apaps they carried and was told there were "too many" to go over the phone and she would have to see the script.

We went to the DME after my call. The LPN looked at the script and said "good". I asked for copies of the script and reports. She looked surprised, but copied them and gave them to us. I then asked about machines and was told he would get an M series. I asked about the System One and was told that she had never heard of it and I must be thinking about the M series. I explained no -- she needed to look it up. I asked about the Resmed system and was told they only dealt in Respironics machines. I asked about their mask policy and was told that he could change if it took place within 2 weeks. But then she looked at him and said "we do a good job with fitting and patients do not come back to do exchanges." I asked if he could try different mask before settling on one. She again looked at him and said they could tell which mask by looking at facial features and they "only" carried masks that worked for people and didn't carry those that didn't work. I asked how many they stocked and was told just a few.

It was soo funny to see her face when I was asking my questions. I could add more but need to get to work.

[roster]

Your son-in-law is so lucky to have a brilliant DME who knows exactly what is good for him.

[KatieW]

Does your son-in-law know how lucky he is, to have you as his advocate? He's going to do great!

[allinknots]

Your son-in-law is so lucky to have a brilliant DME who knows exactly what is good for him.

All in Knots

[Kiralynx]

It was soo funny to see her face when I was asking my questions. I could add more but need to get to work.

I think it's fabulous that your son-in-law has you for a knowledgeable advocate.

I also think it's sad to consider what might have happened with his therapy with a "know it all" DME -- who doesn't actually know it all!

[Judy R]

Wow! I want his DME, they are so perfect ! just kidding. It's great that he's got you, and we all are excited to have him join the group. Good job Mom-in-law!

[Rossiemo]

Great.... I have my first appointment with my DME tomorrow. My DME. That sounds funny and I should rephrase - I have an appointment tomorrow with a complete stranger who knows more about this than I do who is going to give me a ton of instructions and send me on my way. Don't get me wrong, I am ecstatic that I may finally be able to get some sleep tomorrow night, but I am a little more than concerned that I'll not get the "right-stuff".

Does anyone know if you can control who is your DME? The morning after my night with the CPAP mask, I was handed a form with 4 or 5 company names on it and was told to circle the provider I wanted to use. I simply chose the one closest to my house. Can I interview or use my prescription to select the DME best for me?

[Lee Lee]

Sleepycarol, that's so funny! My Lincare carries and PUSHES ResMed products. Hmmm.
Hope he does well!!

[DoriC]

Oh, we also got the old "we can tell by your facial features" routine! You also remind me of the looks we got when I started to ask one too many questions, priceless! Your SIL is lucky to have you by his side. Stick to your guns and keep us posted.

[allinknots]

Great.... I have my first appointment with my DME tomorrow. My DME. That sounds funny and I should rephrase - I have an appointment tomorrow with a complete stranger who knows more about this than I do who is going to give me a ton of instructions and send me on my way. Don't get me wrong, I am ecstatic that I may finally be able to get some sleep tomorrow night, but I am a little more than concerned that I'll not get the "right-stuff".

Does anyone know if you can control who is your DME? The morning after my night with the CPAP mask, I was handed a form with 4 or 5 company names on it and was told to circle the provider I wanted to use. I simply chose the one closest to my house. Can I interview or use my prescription to select the DME best for me?

Do you have medical insurance? The insurance co. usually contracts with certain DME's.

All in Knots

[sleepycarol]

Lee Lee Yep that is funny. I wonder what the difference is between the different offices? Are they franchise owned? Where a local entity pays to use the company name and follows whatever rules that the company has?

It doesn't make sense that one office would push one machine brand and another office a different brand. But hey this is the crazy world of DME companies!!

I called my son-in-law tonight and asked how he did last night. He said he wore the mask until between 1 and 2 and he had some facial pain from the mask and so took it off. I will stop by tomorrow and see how tight he has it. I gave him four or five masks to try so he is trying a different one tonight. I know it isn't a good idea to keep switching, but figure he is like a kid with a new toy.

Since Lincare said it would be a week to 10 days before they could supply him with a machine, he is using my M series apap with c-flex. I am still using the Resmed machine I purchased from cpapauction so we are both covered.

He did say he felt better today and could tell a difference in his fatigue level. I told him that is a good sign and a good motivator.

[rested gal]

[quote="sleepycarol]I asked about the System One and was told that she had never heard of it and I must be thinking about the M series. I explained no -- she needed to look it up.[/quote]

Since the DME your son-in-law will be getting his equipment from said they carry "Respironics", I'd dig in my heels and insist that they order the PR System One autopap for him. It will almost surely be MUCH quieter than any M series machine they would give him. The PR System One's integrated humidifier is said to control rainout MUCH more effectively than the integrated humidifier that would come with an M series machine. It also provides more information about his therapy than the M Series does....if you acquire the Encore Pro 2 software for the PR1 machine. Which you most surely will.

I don't care how much delay they might claim there'd be... I wouldn't settle AT ALL for an M series machine when the PR System One is already out there and could certainly be ordered by the DME directly from Respironics.

Besides, he can just keep using your extra machine until the PR 1 finally arrives.

I think it's fabulous that your son-in-law has you for a knowledgeable advocate.

Ain't it the truth!!

I also think it's sad to consider what might have happened with his therapy with a "know it all" DME -- who doesn't actually know it all!

Yup.

[sleepycarol]

Things just get better and better with the DME (Lincare).

Today I stopped by my son-in-law's to see if he had heard from the DME. My daughter told him she had forgot to tell him when he came in from work, but that he had message to call them back. He called Lincare and was told that his insurance only covered prescription drugs and he didn't have any other coverage as far as medical goes. Joe pulled his insurance card from his billfold and asked them what number they had called. There are two numbers on the card -- one for medical and one for prescriptions. Yep, they had called the number for prescription coverage. Joe patiently explained that they needed to call the OTHER number on the card. Well they give him a hard time telling them that they had verified the insurance coverage and he only had prescription benefits. It took being very adamant that they had to call the OTHER number to get prior approval for DME benefits. I looked at his insurance card and they are plainly marked which number is for what!!!

Before he made the call I told him to go ahead and ask for the PR System One auto. They had told him at the beginning of the week that he would get the M series auto. They told him he could only get the PR System One auto with a script written for that particular machine. Not a problem, a quick call to the doctor and he picked up the scipt written as requested within a half hour. After he picked up the script he took it to Lincare. When he gave the script to the same lady that had talked to him at the beginning of the week, she said there had to be a mistake since the PR System One was a mask and not a machine. Joe explained that no -- it was a machine and that is the one he wanted and he had the script for it. Then the lady became flustered and told Joe that "doctors around here don't write prescriptions for certain machines since they didn't have any expertise in that area." Joe said "well I have a script for a certain machine and I expect it to be filled as written." She then turned around and told him that "his mother-in-law was troublemaker and didn't have a clue as to which machine was best suited for him." I guess they went around and around about it, but Joe held his ground and told her to get the prescribed machine. He was told that "they would try, but couldn't promise anything since they had never heard of this machine and didn't know if it was any good."

I did download his data from the last three nights. He has good numbers and has averaged 7 hours each night the last 2 nights. His leak line is acceptable (which I told him to try to lower some), AHI was less than 1. He says he already notices a difference in how he feels. He said he gives me the credit for helping him get started.

Unfortunately, his mom is on a cpap. She used the same doctor as we did for the sleep study. Guess which machine she is stuck with -- yep the M series Plus. She wonders why she doesn't feel better. She had taken her "smart card" to the DME to have the info downloaded and was told her "numbers look great". Yep, they look great -- how many days and hours she has used the machine. Too bad for her.

[roster]

Anecdotal support for our contention that equipment needs to be made OTC so WalMart, Target and Best Buy can sell equipment at a decent price and we can avoid all this inefficiency and nonsense.

[DoriC]

It's really scary that a large DME never heard of the PR System One and besides that, thinks it's a mask! This forum knew about it months before it even came on the market. I'm worried about all those who don't have MILs like you and what would have happened to my DH . Your descriptive post made me feel right there in the line of fire with you.

Rooster, your mention of Walmart had me thinking of exactly which part of the store they could put their shelves full of cpaps! I like that idea! See what you can do!