Thank you, almost got a brick.

fredr500 · Post by **fredr500** » Thu Feb 21, 2013 12:17 pm

Got to my appt today and was handed paperwork to fill out accepting my machine but no model was listed. I asked what I was getting and told an S9. I asked for the model, he seemed surprised but said Escape.

I said I wouldn't accept it and he said I could have an Elite but it wouldn't be in until tomorrow or Monday. I said call me, he said ok, and I left.

I asked about an auto set but he said my numbers were all single digit and I couldn't get that. Does that make sense?

If it wasn't for what I learned here I'd be home with a brick.

Thanks all!

Pachyderm's Nose · Post by **Pachyderm's Nose** » Thu Feb 21, 2013 12:22 pm

I think he's using the setting from the prescription (was probably listed as a single pressure, not a range) as an excuse to give you the elite.

cosmo · Post by **cosmo** » Thu Feb 21, 2013 12:24 pm

What does the prescription say?

kaiasgram · Post by **kaiasgram** » Thu Feb 21, 2013 12:28 pm

Deleted and deferring to Pugsy's response below.

Pugsy · Post by **Pugsy** » Thu Feb 21, 2013 12:28 pm

fredr500 wrote:I asked about an auto set but he said my numbers were all single digit and I couldn't get that. Does that make sense?

No.

First of all don't know what his "numbers" were...Secondly my initial pressure RX was for 8 cm pressure...come to find out I needed 10 cm starting pressure and in APAP mode often saw over 16 cm for part of the night.
So RX pressure has nothing to do with things unless he was thinking bilevel machine which is often used when people need higher pressures (double digit).

The Elite is a good machine though. Main drawback would be inability to use higher pressures for part of the night IF you needed them and not everyone has a chance to need them. It's just kind of nice to have it available in case you are one of those who might need higher pressures for part of the night...like supine sleeping or REM sleep which both can sometimes require higher pressures.
You may not be one of those that even has a need or you may not even like APAP mode. It isn't for everyone.

fredr500 · Post by **fredr500** » Thu Feb 21, 2013 1:39 pm

Removed personal information.

cosmo · Post by **cosmo** » Thu Feb 21, 2013 1:47 pm

fredr500 · Post by **fredr500** » Thu Feb 21, 2013 2:06 pm

cosmo wrote:Wish I had a real titration study done. Looks like you should be fine with a cpap pressure of 9cm. I'm using cpap mode at 12cm and I'm perfectly happy with the setting.

Yes, I have great insurance. Paid a $30 copay for each study, my CPAP and all accessories are covered 100%.

I asked for my script, was told it is in the report, page 3 under recommendation.

kteague · Post by **kteague** » Thu Feb 21, 2013 2:45 pm

Since it looks like they were able to capture (what seems to me to be) a significant period of time while supine and in REM (41 mins) at the prescribed pressure of 9, I'd guess your pressure is pretty spot-on. I think most people with that pressure wouldn't need an APAP to allow them to be a bit lower part of the night if 9 isn't always needed. However, there are those who have reported on here that even at what is considered lower pressures that a digit or 2 has made the difference in their ability to tolerate the treatment, I think mostly due to excessive air in the belly. Did you have any air-in-the-belly problems at the study?

You will probably be just fine with the Elite, however, there are exceptions, so please communicate any problems to your doctor promptly and don't delay on seeking a swap if needed. Or you can fight up front for an autopap and maybe delay things a few days. If your study looked questionable, you'd have more leverage to request that. It can be a battle. Some insurances won't replace a machine for 5 years, so maybe it's a battle worth fighting. I did fight that battle (and lost) and nearly had a meltdown over it as I was not in a good state of mind to give that much energy and attention to anything but survival. Loved my self-purchased used auto and the data it gave me, but my next insurance provided machine was again a fixed pressure CPAP which I've had several years. My sleep was so fragile due to limb movements, my doctor thought the changing pressures just might be one more sensory stimulus, which I didn't need. My treatment turned out to be rather monotonous with so few variations in the data that to fight for an auto next go-round just wasn't worth it to me.

Everyone has to pick their battles. One battle I will always fight though is for a machine that gives treatment data (not just compliance or hours of use). Glad you escaped getting stuck with an Escape.

After you get settled in with your CPAP treatment being consistent for a while, if you are having trouble sleeping or waking tired you may want to revisit the limb movements mentioned on your report. Were there any more details on those limb movements? Sometimes they are resolved with treating the OSA, sometimes not. Just something to keep in the back of your mind "just in case".

Sheriff Buford · Post by **Sheriff Buford** » Thu Feb 21, 2013 3:02 pm

Fred: if I was you, I'd call the doctor (probably speak to a nurse) and tell them you want a autopap machine, and you'll come by and pick up the prescription. It's no skin off their backs to write it down, and it appears your insurance will cover it. You can run an autopap in the cpap mode or autopap mode... whichever you prefer. Tell them you want the comfort of a low pressure when going to sleep and you want the machine to ramp up (later on) to treat the apnea event. Tell them you are uncomfortable with the straight cpap flow (all night) and may need some exhale relief. If they start with the ramp business, tell them you take a while to fall asleep and the ramp won't last long enough. That should be enough info for them... Then, use the machine in either mode... whichever is more comfortable to you.

That's what I would do.

Sheriff

Janknitz · Post by **Janknitz** » Thu Feb 21, 2013 7:10 pm

I asked about an auto set but he said my numbers were all single digit and I couldn't get that. Does that make sense?

It makes perfect sense to the DME who can squeeze another $30 to $50 profit out of you by giving you the Elite instead of the Auto. Whether or not it makes sense for you depends, as outlined above. Sometimes that single night's titration isn't a good picture of what you really need in your own bed and usual sleeping conditions. With an APAP you have the flexibility to use APAP mode to see if it helps or use CPAP mode. With a CPAP you don't have that option.

Whether or not it's worth the fight is up to you. I think picking your battles makes sense. At least the DME didn't fight you over Elite vs. Escape. It might not be worth the battle, because if they have to give you an Auto they may try to foist an Escape Auto on you, and battle round 2 begins. The Elite is a fine machine, unless you really need an APAP.

khauser · Post by **khauser** » Thu Feb 21, 2013 7:47 pm

fredr500 wrote:
cosmo wrote:Wish I had a real titration study done. Looks like you should be fine with a cpap pressure of 9cm. I'm using cpap mode at 12cm and I'm perfectly happy with the setting.
Yes, I have great insurance. Paid a $30 copay for each study, my CPAP and all accessories are covered 100%.

I asked for my script, was told it is in the report, page 3 under recommendation.

That is not your script, it is what it says, a recommendation. You need to ask the doctor for the actual prescription. Tell him or her you aren't sure you're going to use that DME, and you want the script in hand so you can go where you want for the machine.

msradar65 · Post by **msradar65** » Thu Feb 21, 2013 7:55 pm

I will share with you that I was titrated at 8...but I got Autoset...so when my symptoms started return again. I was switched to auto 10-15. I stay around 12 most nights. So I am glad I got the Autoset and not the Elite because I can self titrate and adjust as needed.

I would really push for the Autoset.

ughwhatname · Post by **ughwhatname** » Thu Feb 21, 2013 9:50 pm

Sheriff Buford wrote:Fred: if I was you, I'd call the doctor (probably speak to a nurse) and tell them you want a autopap machine, and you'll come by and pick up the prescription. It's no skin off their backs to write it down, and it appears your insurance will cover it.

When I saw my doctor for my results, he was very clear about giving me a copy of my prescription and told me I had a right to it, and to be sure to keep a copy. It has come in handy to order from cpap.com, I carry a copy with my cpap bag for traveling in case TSA has troubles, etc. That was great advise and I didn't even know to ask for it.

fredr500 · Post by **fredr500** » Fri Feb 22, 2013 9:21 am

It sure pays to be educated, this never would have happened without all of your support.

This morning I asked for a copy of my scrip, told them I needed it so I could shop DMEs to find one that would supply an S9 autoset. Here is their reply:

I talked to our Finance Mgr and she is willing to order the Autoset if you will do the setup with us.
If we order it we should have it by the middle to end of next week.

Since they are the most convenient to me I told them to order it.
Thanks for all of your help.

Thank you, almost got a brick.

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