Thank you CPAPtalk.com!!!

[KCDC]

I want to shout out to everyone who has replied to my posts or messaged me personally about some of my questions.

I read and read on here, ask and ask, and when it was finally time to go see my doctor, my 1st bad experience did not happen with the DME, in fact it happened at the doctors!!

So, my main doctor is like mentoring some other doctors new in sleep medicine, so I was first seen by the "new doctor". We went through my results and I finally said that I have a last question, can you tell Dr. P, my regular doctor that I would like an APAP device vs a CPAP device, showing all the reason why, printed out from articles on here.

The first thing he said was, well, you were only titrated for 1 pressure, so it is CPAP, nothing else. Then I argued that it could be plausible that that 1 pressure might not be as accurate as if I were at home blah blah blah... cited everything I've read on here.

Then he said, well, insurance won't pay for it. I replied, it doesn't matter, I want the prescription for an APAP. And he kept going on and on about how it would be a problem with the insurance and I kept telling him I didn't care, that I will deal with the insurance later. Then I cited the HCPCS code for a PAP device and he didn't even know what that was!!! Then I told him, that since I've already made my out of the pocket maximum for the year (yes, apnea has caused me ALOT of issues!!) and I want my insurance to pay for the best possible machine since the code is irrelevant, blah blah blah..... Still hard headed. He was a young out of med school know it all.

Finally I said, I want to see Dr. P. I will tell him myself. Finally Dr. P came in with the new doc, and said, yes, an APAP would be better because they actually titrated you from 4 cm to 10 cm. And for all the reasons people have written on this site, he said "get the best one, let them pay for it, I will write you a prescription for 4 - 12 cm APAP". Done deal.

If it hadn't been for this website, I wouldn't have known. I wouldn't have known to ask for all my results including graphs etc just in case I change insurance. The list goes on.

So, hurdle number 1 passed. Now, waiting for the DME...... yikes!! Wish me luck!!!

Thanks again everyone!!!

[library lady]

Just think, it may have been a bad experience for you, but that new doctor learned something by your insistence; his mentor agreed with you. That new doc probably feels like he had a bad experience with you, but in the end, that newbie has learned a valuable lesson!

I hope you have a good experience with the DME.

[Kiralynx]

Congratulations to you for doing your research... and sticking to your guns!

I know I wouldn't have been successful this last 5.5 years without what I learned here!

And may the doc in question have learned a lesson!

[Janknitz]

Sounds like you're well ready for battle with the DME. Hopefully Dr. P wrote the prescription specifically enough that you don't have too much to argue about with the DME. Watch out for Escape autos.

[OhHelpMe]

he said "get the best one, let them pay for it, I will write you a prescription for 4 - 12 cm APAP".

The stupid problem here is the requirement for a prescription. CPAP machines should be OTC. Maybe it will happen soon.

[49er]

he said "get the best one, let them pay for it, I will write you a prescription for 4 - 12 cm APAP".

The stupid problem here is the requirement for a prescription. CPAP machines should be OTC. Maybe it will happen soon.

I wish you were right OhHelpMe but I seriously doubt it will happen anytime soon.

But it is even more absurd that prescriptions are required for masks. But I know I am preaching to the choir on this one.

49er

[Chevie]

they actually titrated you from 4 cm to 10 cm

That can hardly be called a titration.

[jencat824]

KCDC,

Way to go - thank heavens you stuck to your guns with that young Dr. He learned something valuable too! You have done great research, I wish I had known about this forum when I started CPAP 14 years ago. I've learned more since I've been a member here than I did in the previous 12 years I was 'flying blind' with my PAP treatment.

Hang in there & let us know about your experience with the DME. Go knock their socks off.

Jen

[Redonthehead]

Another hurdle you will want to be ready for is getting the minimum increased from 4 - which in all likelihood will feel insufficient for airflow. I finally changed mine myself to 6 - no doc or DME ever noticed it at my 3 month check. Now running 10-13.

[zoocrewphoto]

he said "get the best one, let them pay for it, I will write you a prescription for 4 - 12 cm APAP".

The stupid problem here is the requirement for a prescription. CPAP machines should be OTC. Maybe it will happen soon.

Unfortunately, that usually means that insurance no longer covers the item. For example, I can get prilosec for FREE with insurance if it is is a prescription, but no discount on the OTC. Allergy medication, if prescribed, is at the reduced rate, but full price if OTC, same meds.

My doctor told me to get a blood pressure monitor, a good one. But no insurance will cover one since it doesn't require a prescription. So, I had to spend over $80 on one. For somebody with my income, that was a big expense. If I had to buy my cpap machine outright, I would spent months waiting for the right craigslist ad to come along. I have gone with medication for a week or more, simply because I had to wait for the money to pay for it, and that was at the discount price with insurance. if I had to pay teh cash price, I simply wouldn't be using them at all. I can't afford $200-$500 a month for one asthma inhaler. I'm currently paying over $50 a month on the daily prescription medications, in addition to the allergy meds and the "as needed" meds that I don't have to buy as often. I know that may be low compared to many, but it is still a big deal for me. I have spent $62 this year on cpap supplies. I bought two mask cushions from ebay for $55 and one climateline hose at thrift store (still sealed) for $7. I haven't opened it yet. UI make my supplies last as I can't afford to spend a lot, and I am not done with my deductible yet. Still haven't paid the last two doctor visits either. I will make a payment when I go back in 2 weeks.

At least you don't have to get the prescription from a sleep doctor. It can be any doctor, so it can be obtained and worded correctly.

I would much rather see an end to bricks so that everybody gets a full data machine.

[49er]

Good points zoocrewphoto.

Yup, using a brick would be like using a glucometer without data which medical professional would consider to be absurd. Yet, they haven no problems with bricks being issued.

49er

he said "get the best one, let them pay for it, I will write you a prescription for 4 - 12 cm APAP".

The stupid problem here is the requirement for a prescription. CPAP machines should be OTC. Maybe it will happen soon.

Unfortunately, that usually means that insurance no longer covers the item. For example, I can get prilosec for FREE with insurance if it is is a prescription, but no discount on the OTC. Allergy medication, if prescribed, is at the reduced rate, but full price if OTC, same meds.

My doctor told me to get a blood pressure monitor, a good one. But no insurance will cover one since it doesn't require a prescription. So, I had to spend over $80 on one. For somebody with my income, that was a big expense. If I had to buy my cpap machine outright, I would spent months waiting for the right craigslist ad to come along. I have gone with medication for a week or more, simply because I had to wait for the money to pay for it, and that was at the discount price with insurance. if I had to pay teh cash price, I simply wouldn't be using them at all. I can't afford $200-$500 a month for one asthma inhaler. I'm currently paying over $50 a month on the daily prescription medications, in addition to the allergy meds and the "as needed" meds that I don't have to buy as often. I know that may be low compared to many, but it is still a big deal for me. I have spent $62 this year on cpap supplies. I bought two mask cushions from ebay for $55 and one climateline hose at thrift store (still sealed) for $7. I haven't opened it yet. UI make my supplies last as I can't afford to spend a lot, and I am not done with my deductible yet. Still haven't paid the last two doctor visits either. I will make a payment when I go back in 2 weeks.

At least you don't have to get the prescription from a sleep doctor. It can be any doctor, so it can be obtained and worded correctly.

I would much rather see an end to bricks so that everybody gets a full data machine.

[OhHelpMe]

using a brick would be like using a glucometer without data

Makes no sense. Did you mean "like using insulin without a glucometer"?

That's a weak analogy also.

But I do believe everyone should at the least have a CPAP with data display and know how to read it.

[zoocrewphoto]

using a brick would be like using a glucometer without data

Makes no sense. Did you mean "like using insulin without a glucometer"?

That's a weak analogy also.

But I do believe everyone should at the least have a CPAP with data display and know how to read it.

Screen data is almost as bad as nothing. You can't see a graph of the night, if the events were clustered, or long, when leaks happened, etc. Only averages.

And what would the doctor use to help you? Last night's screen data and the average for the last 7 days and 30 days?

My mom's meter has data that her doctor can review to see how diabetes has been on a regular basis, not just the last day or that moment.

[49er]

using a brick would be like using a glucometer without data

Makes no sense. Did you mean "like using insulin without a glucometer"?

That's a weak analogy also.

But I do believe everyone should at the least have a CPAP with data display and know how to read it.

Uh, you haven't heard of using a glucometer to measure blood sugar levels?

How is it a weak analogy? If I use a glucometer and and in a hypothetical situation, get minimal data from it and no information like how much eating a candy bar raised my blood sugar level, that is the equivalent of getting a brick that just provides number of hours used and no other information.

49er

[Christine L]

Did you mean "like using insulin without a glucometer"?

I think that's what they mean. That analogy has been used on here many times before.

It's pretty extreme analogy though. Too much insulin injection can be deadly, but it's pretty hard to kill yourself with a CPAP.