The sleep center technician lied

[brain_cloud]

I am livid. White-hot rage.

Quick backstory: I had a 2nd titration study on 3/19 since 14cm setting established at my first titration did not seem to be controlling the apneas. They got up to 17 this time although the AHI "remained elevated at 14.2" as the summary report put it. I woke up at 5:15, 45 minutes short of official quitting time and would no doubt have quickly fallen back asleep had not the tech come over the intercom with something like "are you done, do you think?" It was clear she wanted a "yes" so I said okay. After I saw the report I was perplexed that the study was cut short before getting to a nice low AHI was achieved.

So after I sent a very clear letter (none of my usual purple prose) requesting a copy of all my records to the sleep center, they first sent me just the 2-page summaries/interpretations (which I already had). So there were further phone conversations with them on the meaning of the English word "all", and dealing with questions like "why do you need it?". But yesterday I got their 2nd pitiful attempt, which also contains 5-7pg reports for two of the three studies I had there. Not the one I wanted the most from 3/19 of this year. Gosh, that's strange; it's almost as if they are intentionally thwarting me. Nah, that can't be right. That's just paranoid thinking. It must be a coincidence. Also there were a few other odds and ends, including something called a Tech Sheet from the 3/19 titration study with my techs notes on it. In the middle of the page there is an interesting line. It reads "Lights on: 05:20 Reason for ending study: pt request" I gloss that as "patient request".

That is a damn lie.

I have a new reason for living.

[blakepro]

How infuriating.
Those dang polysomnograms (sp?) aint cheap either.

[echo]

Time to write a nice but direct letter to your sleep lab, the hopsital management, the hospitals' ombudsman, and if necessary another organization like JCAHO:

http://www.washingtonpost.com/wp-dyn/co ... 01705.html
http://www.jointcommission.org/GeneralPublic/Complaint/

That really sucks. I'm sorry you had such a bad experience.

[robmax]

". . . a new reason for living."

Remember, you're likely on video. Ask to see the part of the video where you initiated the request to "terminate" the study.

[GumbyCT]

I had a similar experience with my 1st twp PSG's. I won't bore you with the details.

I think the ONLY way to get thru to these kinds of places is to file your request thru your states licensing board.

[brain_cloud]

". . . a new reason for living."

Remember, you're likely on video. Ask to see the part of the video where you initiated the request to "terminate" the study.

Right; funny thing about the video recordings. I was told on the phone a few days ago that as soon as the doctor has done the interpretation, the video recordings are destroyed.

I'm hoping though, that an audio "snore" track ought still to exist. Not sure what all that captures though. We shall see.

My new handle will be "Cpap'n Ahab".

[SleepingUgly]

I don't know if you'd want to go through the study all over again, but if you wanted it, you may possibly be able to get it if you insist on it and raise enough hell (at no cost to you).

[GumbyCT]

I don't know if you'd want to go through the study all over again, but if you wanted it, you may possibly be able to get it if you insist on it and raise enough hell (at no cost to you).

My sleep center wouldn't budge when I asked. That's why I no longer spend my money there - nor do I recommend anyone else spend money there.

[brain_cloud]

I don't know if you'd want to go through the study all over again, but if you wanted it, you may possibly be able to get it if you insist on it and raise enough hell (at no cost to you).

And thusly Gumby:

My sleep center wouldn't budge when I asked.

Asking is a mode of relatedness that finds its completion in the arbitrary will of another. In its very concept it is weakness. No, I prefer the "hell" approach. We're going to see who asks who how to make things right.

This turned out to be a perfect time for me to go off my meds.

[kteague]

Oh yeah, this stuff can be maddening. I would think that the tech, knowing you weren't yet successfully titrated, should not have even presented the option to stop, but rather waited to see if you did fall back asleep enough to get more data. However, if their cutoff time was in 45 mins, there's a chance of you wouldn't have reached REM (if yours is worse in REM - not sure) or given them any more useful data. Maybe her being willing to cut it off was in light of that. Or in wanting to go home - who knows?! But just on principle, I'd want my full night that was paid for if there was ANY chance of gaining more info. That "patient request" part would yank my chain too.

About the video. In days gone by when VHS tapes were used, the videos were deleted and the tapes reused in one sleep lab I went to. With today's technology, I don't see the need for quick deleting of the video. One tech told me the video is as much for their protection as anything, so there can't be unfounded allegations. If that's the purpose, why get rid of them? Sure hope our industry professionals will weigh in on this.

While you're at it, take a look at the timing and data around the pressure increases to see that proper protocol was used. You wouldn't believe what some have reported on here that was passed off as a titration, though violating procedures and standards. Wish I had the very old thread discussing that, but wouldn't begin to know what to search on. In the end, you may find a first class effort was made in a difficult situation with a complex case. But bottom line is you still need help, and you're not getting it. Hope things improve for you soon.

[superjet]

Hey kteague,

I was just wondering if you could show me what you were talking about ''horrible stuff being passed off as titrations''. Were you talking about pressures being changed seemingly unnecessarily, too quickly, slowly, not enough sleep time, etc... I'm interested to see what the general consensus here about titration protocol you're talking about. I've seen it so many different ways in the places I've worked.

On a side note, more than one a sleep deprived patient has ''remembered'' things which didnt happen during the titration or that happened differently and when I've been called out on the carpet about it by a supervisor a fair review of the video exonerated me. I think that's what the tech was referring to. Doing a couple studies a night can fill up HD space pretty quickly with a gig of video stored with every one. That's the only reason I can see to delete it, but we still dont.

-sj

[Redeye]

My center told me the recordings are deleted for privacy reasons. There's much less chance that way that a recording could find its way to YouTube, e.g. an executive talking in their sleep, or someone making "hillarious" movements, etc.

Redeye

[akcpapguy]

Brain_cloud,

I think you have a valid reason to question why the tech stated that in their notes. However (you knew there would be one), I feel you would only be stressing yourself out and raising your blood pressure and getting nowhere. In the end who suffers from that, only you, the doctor, the tech, and the sleep facility aren't going to loose any sleep over it.

I have worked in multiple sleep labs, some delete the video and some don't. While I was a sleep lab manager I was questioned many times (by both physicians and patients) about something the tech wrote in the notes about patient behavior, both verbal and physical. I can safely say that the video was used in around 75 or so cases and the tech notes were correct in every case we reviewed. Now that's not to say that your case fits that mold, I'm just saying that people do and say VERY strange things that they don't remember even when they appear to be awake yet are still asleep. There has only been one time in my 16 year career as an RT that I have seen the video prove anything and that was a case where the tech was molesting male patients in their sleep.

So I'm not saying that your wrong, just don't get yourself over heated about it if you hit a brick wall, just stay calm and state your reason for requesting a second study based on the incomplete titration.

[brain_cloud]

Brain_cloud,
I think you have a valid reason to question why the tech stated that in their notes. However (you knew there would be one), I feel you would only be stressing yourself out and raising your blood pressure and getting nowhere. In the end who suffers from that, only you, the doctor, the tech, and the sleep facility aren't going to loose any sleep over it.

I have worked in multiple sleep labs, some delete the video and some don't. While I was a sleep lab manager I was questioned many times (by both physicians and patients) about something the tech wrote in the notes about patient behavior, both verbal and physical. I can safely say that the video was used in around 75 or so cases and the tech notes were correct in every case we reviewed. Now that's not to say that your case fits that mold, I'm just saying that people do and say VERY strange things that they don't remember even when they appear to be awake yet are still asleep.

Great Hera's Ghost, 75 to Nothing!!! Those are horrible odds; I almost begin to doubt myself. It seems so long ago. And the techs are never lazy, corner-cutting assholes, you say, except when they are molesters! Well, I'll take my oath upon it that my tech never laid a finger upon me, except in my own feverish fantasies.

So I'm not saying that your wrong, just don't get yourself over heated about it if you hit a brick wall, just stay calm and state your reason for requesting a second study based on the incomplete titration.

You seem like a good guy and I don't want to be any more of a jerk than I can help being, but, I don't plan on making any requests to this bunch at all. I will stay calm though.

And to the tech above that posts at 4:19am, 1G of drive space is less than $1.

[GumbyCT]

And to the tech above that posts at 4:19am, 1G of drive space is less than $1.

Lots of em come on here while their patients are sleeping or walking or talking