Titration Rx: The Results are In?

[Taff]

The OFFICIAL titration study was a disaster. My husband told the sleep tech before-hand that the trial pressure of 8 cm was not enough pressure and he felt like he was suffocating. So what does the tech do? Start the study with a pressure of 5cm! Of course, he never fell asleep, and complained about not getting enough air. Finally about 4:30am, they increased the pressure to 9cm, and by that time Walter was so frustrated and just couldn't sleep, so the study ended.

Yesterday we went to discuss the 'findings' of the sleep study and get the titration pressure.

I waited to see when I would slip in the fact that I had changed the settings on the loaner pap machine, from straight cpap to auto for the month we have had the loaner. Well, I didn't have to wait long.

The Doctor stated they never found the right pressure at the titration study, and suggested a 1 month auto-home study.... great bridge huh?... My queue to jump in!

I told him plainly that I could help with that and that I had data for him from the changes I made to auto (printed Encore report) and corresponding oximetry reports.

He was shocked (and testy.)

Then he shot back at me, "What range did YOU use? and How did you even get an automatic on loan?"
I stated "8-12, and thanks to the nice DME who set it on straight cpap as per doctor's orders." (He mumbled something about how they wanted to make more on the more expensive autos.)

Then the Doctor took all the data, perused it briefly, and handed Walter an Rx of 11, and said "Well, it looks like you did that job and saved another study."

Sadly, he STILL refused a Rx for an automatic! Now telling us that it needs to be a pressure of 15 and you have to fail straight cpap. (Sounded to me like BiPap criteria, and another excuse to deny ADP Auto coverage.)

We left his office, and dropped off the loaner pap machine at the DME (conveniently located across the hall, no conflict of interest I'm sure).

I'm not sure about a 'follow-up' appointment with this Doctor. He seems like he just doesn't care.

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The machine purchase:

Plan A: Pick up a Used Intellipap Auto on Auction cheaply.
[Outbid! Congrats to the Forum Member who won!] You know who you are.
{I've never seen hubby mope about losing. }

Plan B: Order PR System One Auto from Cpap.com.

Plan C: Go through a local DME for an Auto and use ADP.

Winner was Plan B!

We want to thank our host for the terrific service and price guarantee!!! Cpap.com has been really great to deal with and stand behind their word. The System One Auto arrived just in-time. The bonus was that the machine was the Anniversary Edition with the lighted back-screen. Nice surprise. At the end of the day, going with cpap.com made the most sense. Also, the forum here is priceless, and we appreciate it.

You guys and gals at cpap.com and on cpaptalk are the best! Thanks very much.

[bap40]

Any doc can write a prescription for a machine. I did not like what the sleep doc wanted me to have so went to my family practice doc and asked him to write one for the machine I wanted. He did so without any problems. Maybe if you have a good doc they will do that for you. My doc asked me what pressure I wanted to boot. Of course that didn't matter since I got my auto and was given from this board the information to get into those lovely locked off sections.

[scrapper]

If your doc writes the prescription for cpap, you can use that to purchase either a straight cpap or an auto cpap.............

[sleeplessinaz]

Well I for one, would NOT be wasting time and money going back to that doctor. There are plenty of nicer doctors out there and I suggest you go find one!! LOL! I go to my Primary care doctor and he asks ME what kind of machine I'd like to have---:) He is very attentive and cares about my needs not his freakin ego.

How can you get a titrated pressure when you did not sleep at all that night? that is terrible to have you come in for a "follow up"--a follow up on what? they did not do anything for you---that sleep lab needs reported too--why would they set him up on pressure that is so low for him and expect him to go to sleep? Weird.

Carrie

[DoriC]

His mumbling was all about his profit(if he's connected with the DME) since cpap and auto have the same insurance code and pay the same amount for either so his profit is less for the auto. The business about failing cpap before getting an auto was all mumbo-jumbo. At this point you seem to know more than he does, thank goodness! We went to our Primary Dr for help and I dictated what I wanted on the RX and he signed it.

[Taff]

Any doc can write a prescription for a machine. I did not like what the sleep doc wanted me to have so went to my family practice doc and asked him to write one for the machine I wanted. He did so without any problems. Maybe if you have a good doc they will do that for you. My doc asked me what pressure I wanted to boot. Of course that didn't matter since I got my auto and was given from this board the information to get into those lovely locked off sections.

I agree. We're in the process of finding some good people. Funny how many Specialists that I've come across who have stopped LISTENING to their patients. They just look at numbers, end stop.

If your doc writes the prescription for cpap, you can use that to purchase either a straight cpap or an auto cpap.............

+1 After the initial PSG and consult, DH was told he had obstructive sleep apnea and we went straight to his primary care Doc to get a prescription for the machine, humidifier, mask so that we didn't have to be pressured to buy anything from anyone.

Well I for one, would NOT be wasting time and money going back to that doctor. There are plenty of nicer doctors out there and I suggest you go find one!! LOL! I go to my Primary care doctor and he asks ME what kind of machine I'd like to have---:) He is very attentive and cares about my needs not his freakin ego.

How can you get a titrated pressure when you did not sleep at all that night? that is terrible to have you come in for a "follow up"--a follow up on what? they did not do anything for you---that sleep lab needs reported too--why would they set him up on pressure that is so low for him and expect him to go to sleep? Weird.

Carrie

Haha! My thoughts exactly. The follow-up was booked... perhaps to check on progress on straight cpap 11? Walter does not do as well on straight pressure anyway, (I've used the split study mode on the PRS1) but this guy wasn't listening. I will be getting a copy of the PSG, and canceling the appointment.

His mumbling was all about his profit(if he's connected with the DME) since cpap and auto have the same insurance code and pay the same amount for either so his profit is less for the auto. The business about failing cpap before getting an auto was all mumbo-jumbo. At this point you seem to know more than he does, thank goodness! We went to our Primary Dr for help and I dictated what I wanted on the RX and he signed it.

Mumbo Jumbo! Absolutely right! This whole experience has felt more like a medical-racket, $$$ shakedown, than anyone really caring about the patient and their health.
(Present company excluded of course.) Also, thank you for the compliment DoriC! I owe this community much credit and thanks.