My Doctor's staff are not happy...

[Midwest_non_sleeper]

I received a call today from my Neurologist's office and man were they upset. They noted that my machine was outside of the prescription of 5cmH20 - 20cmH20, and you'd have thought it was the end of civilization as we know it. I changed it two weeks ago to a minimum of 7cmH20 because 5 just wasn't enough airflow. I was almost choking on what little air that 5 provided. The nurse told me "ooooh, you can't do that", to which I replied, "well, it was either I change it myself or not use it at all, because I'm not going to choke all night long". She eventually said that she would ask the doctor to rewrite the prescription for a higher minimum, but she wasn't sure if he would do that before seeing me. I told her that he would either do it, or I would fire him and find a new doctor. To be fair, it was said more tactful than that, but the point remained.

I know it's not that big of a deal (it's TWO cmH20 for crying out loud, she acted like the sky was falling), and this is MY therapy we're talking about here, but I'm still well within the payment period as I've only had the machine for about seven weeks. Can these fools actually do something to have my machine taken away? Has a doctor ever canceled a prescription because they were miffed at a person being actively involved in their own health? I'm sure I could find another doctor that is ok with that, I just don't want to have to go through the trouble.

[LSAT]

Your doctor is an idiot..go somewhere else. You have your prescription, you have your machine. You don't need her. As long as you are compliant in using the machine you are home free. That's all your insurance company is concerned with. If you have had the machine for 7 weeks, it's possible that you have already passed compliance. Your doctor and the DME are separate entities.

[old dude]

What they can and cannot do has never been 100% clear to me but if a doctor were deeply enough offended and wanted to prove a point he could likely screw things up with your insurance company to the extent that they could demand full payment or perhaps make you turn it in. As I say, I've never known the absolute truth for sure. I'd guess he could make it a lot harder on you if Medicare were involved.

My experience has been that the respiratory techs are far nastier and more arrogant than the actual docs. I can usually reason with a doc, but not always with his RT. I'd consider messaging the doc directly and explain things to him. If your doc is part of one of the larger healthcare conglomerates out there today he is graded strictly on patient satisfaction, so he's likely to respond and listen to you.

[amenite]

The fact that it was stated tactfully may in itself be an indication of effective therapy I had no patience for my last Dr's shenanigans and quit at first opportunity (when I had a paper prescription in hand). At least they were looking something besides their balance sheet.

[Midwest_non_sleeper]

Your doctor is an idiot..go somewhere else. You have your prescription, you have your machine. You don't need her. As long as you are compliant in using the machine you are home free. That's all your insurance company is concerned with. If you have had the machine for 7 weeks, it's possible that you have already passed compliance. Your doctor and the DME are separate entities.

They called last Friday and told me that my compliance was perfect, so maybe I am past compliance. There was only one night in seven weeks that I did not use it for a full four hour minimum, and that was because I was severely congested. Every other night is well above that. Most nights are 6.5 hours minimum with the highest being around 8 hours.

I'm not really flustered, and I'm a big boy whom has read everything I can get my hands on regarding OSA, my machine in particular, my particular mask that I like, etc. Since I changed it to 7cmH20, I feel 100% better than I did at five. I'm not interested in going back to five and waking up choking for air. I'll just have to explain that as best I can when I see him next month. I suppose that if he's got a problem with that, then that's what it is: his problem. It's not mine. As far as I'm concerned, my body is reacting quite well to 7cmH20.

[Sluggish]

Ask your doctor and “sleep techs” if they suffer from sleep apnea.

Most likely they will answer no, in which case you probably already have more experience than they do.

If they answer yes, ask them what pressure setting they use. I bet it will be higher than 7.

After that you can pretty much rest your case I would imagine.

Insurance is not needed for any of this. In my case there was no clear benefit to using my insurance so I bought my machine brand new on Craigslist for $200.

[Goofproof]

It's not your Doctors job to be Happy, it is however to attempt to give you the best treatment you can get. Clearly he has no idea of what that is, neither does his help, they would rather blame you for their failure to learn. You can do better, by finding a knowledgeable doctor. Check with your INS on compliance . Jim

[ChicagoGranny]

a call today from my Neurologist's office

The nurse told me "ooooh, you can't do that"

I'm surprised you said "Doctor" in the title. He may have no idea what "the office" and "the nurse" have done.

On the other hand, the doctor may also be an idiot.

[zonker]

The nurse told me "ooooh, you can't do that"

as my dear departed older brother used to say "don't say i CAN'T; say i SHOULDN'T."

i don't think there are many people here who would actually give a rip about what their doctor said. i think it's patently ridiculous that they would write another script just because you bumped your own minimum.

you may want to, if you wish, talk this over with your insurance company and find out just what they mean by compliance.

due to my white male privilege, i've been able to pay out of my own pocket. and after reading stories on this forum over the years concerning insurance, i'm damned glad of it!

edited to correct stupid spelling error. grrrr.

[lliann]

i agree. at my age, and with my experience of things medical, i make it a point to be proactive in my own care. my pc doc loves it and wishes more people would do that because they just cant know us as well as we do sitting and talking for 5-10 minutes. my other opinion is the cpap lifestyle can have a lot of failure to it. not of the process but of the commitment to accept the pain in the butt nature of it all. i have been one such. the reason i can do it at all is because i have researched, asked questions and thought outside the box to improve my own chance of bonding with the octopus on my face. i am not saying resistance isa a good thing, but i suspect there can be many who respond with resistance.

[Midwest_non_sleeper]

a call today from my Neurologist's office

The nurse told me "ooooh, you can't do that"

I'm surprised you said "Doctor" in the title. He may have no idea what "the office" and "the nurse" have done.

Because she indicated that he knew. I'm assuming that they saw the numbers and got in touch with him.

I'm not worried about it, what are they gonna do? Send the CPAP police to my house?

[Janknitz]

I'm not worried about it, what are they gonna do? Send the CPAP police to my house?

Just have your bags packed and ready to run.

If the doctor's amenable, remind him that you would like to be active in your own care. If he doesn't agree with that or cites his expertise, you don't have to ever go back.

[palerider]

a call today from my Neurologist's office

The nurse told me "ooooh, you can't do that"

I'm surprised you said "Doctor" in the title. He may have no idea what "the office" and "the nurse" have done.

Because she indicated that he knew. I'm assuming that they saw the numbers and got in touch with him.

I'm not worried about it, what are they gonna do? Send the CPAP police to my house?

4:30am: *CRASH*
"WTH was that???"
"CPAP POLICE, PUT YOUR MASK DOWN, YOU'RE UNDER ARREST!"
"well, shit"

[jim22]

Last I checked, 7 is between 5 and 20. You did good, and I bet the doctor is actually fine with it. How is your typical 90% pressure, higher than 7?

[palerider]

Last I checked, 7 is between 5 and 20. You did good, and I bet the doctor is actually fine with it. How is your typical 90% pressure, higher than 7?

But, the machines *settings* were changed from 5-20 (a stupid value) to 7-20 (a more reasonable value. We're talking min/max auto pressures here. And someone got their panties in a wad about it.