Get A Laugh At My Expense!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
mattman
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Get A Laugh At My Expense!

Post by mattman » Wed Jan 10, 2007 7:39 pm

Okay, so a lot of folks like to poke fun at me, which I don't really mind all that much. It's the nature of the beast. For those who don't read my posts I've been a DME provider for many years now.

So I thought I'd relate something to you all for a couple reasons. One - you can get a chuckle at my expense. Two - to demonstrate that I absolutely practice what I preach.

I've been on CPAP myself now for about 9 months and I'm still not feeling great. If I was at zero before my sleep study, the morning I woke up and left the lab I was maybe 75%. Since then I've been hovering 40-50% or so.
I've had my card downloaded several times and it's consistently been around 2-5 avg AHI.

A while ago I thought about checking my overnight O2 sats. So I called up my sleep doctor and asked if she would write out an Rx for it. Yeah I could have just snagged one and taken it home but I believe it when I suggest folks talk to their doctors. She agreed, I wore it two nights and both nights the sats were fine.

So now I thought about trying an autopap. I've always advocated that if someone isn't responding to CPAP they should absolutely be allowed an Auto trial.

So what did I do? Again I could have just grabbed one and set it myself but I called up my Doc and left a message with her Secretary. Doc called me back this afternoon and we talked a bit. She didn't have a problem with it.
So what's gonna happen?
She wants to talk to my RT to help determine the best settings and pressure ranges and I have to wait until tomorrow.

So yeah, the DME guy has to wait to get his AutoPAP. Image

Anyways, I thought some of you might get a chuckle. Also wanted to let people know that I do absolutely follow and believe what I say - talk to your doctors first!

mattman
Machine: REMstar Pro 2 C-Flex CPAP Machine
Masks: 1) ComfortGel Mask with Headgear
2) ComfortSelect Mask with Headgear
3) Swift
Humidifier: REMstar Heated Humidifier

greyhound
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Post by greyhound » Wed Jan 10, 2007 7:41 pm

It will be even funnier if your RT suggests a 4-20 range.

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NightHawkeye
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Re: Get A Laugh At My Expense!

Post by NightHawkeye » Wed Jan 10, 2007 7:59 pm

mattman wrote:Anyways, I thought some of you might get a chuckle. Also wanted to let people know that I do absolutely follow and believe what I say - talk to your doctors first!

mattman
It's OK, mattman. We've seen this with other healthcare professionals who practice what they preach. It's admirable up to a point.

Realistically though, you describe a cumbersome process which mostly delays diagnosis and treatment. The more hoops one has to jump through before treatment, the less likely one is to seek treatment. That's just human nature, not to mention the cost of each of the physician consultations, time off from work, etc.

If you want reassurance from a physician then by all means consult one, but please do not preach the importance of consulting a physician for trivial, non-value-added matters.

Regards,
Bill

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Snoredog
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Post by Snoredog » Wed Jan 10, 2007 8:12 pm

you don't have a sharp tool in the shed do ya?


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Goofproof
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Post by Goofproof » Wed Jan 10, 2007 8:52 pm

Maybe they will loan you a auto bipap set 4 to 30. Jim

Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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GoofyUT
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Re: Get A Laugh At My Expense!

Post by GoofyUT » Wed Jan 10, 2007 8:56 pm

mattman wrote:Okay, so a lot of folks like to poke fun at me, which I don't really mind all that much. It's the nature of the beast. For those who don't read my posts I've been a DME provider for many years now.

So I thought I'd relate something to you all for a couple reasons. One - you can get a chuckle at my expense. Two - to demonstrate that I absolutely practice what I preach.

I've been on CPAP myself now for about 9 months and I'm still not feeling great. If I was at zero before my sleep study, the morning I woke up and left the lab I was maybe 75%. Since then I've been hovering 40-50% or so.
I've had my card downloaded several times and it's consistently been around 2-5 avg AHI.

A while ago I thought about checking my overnight O2 sats. So I called up my sleep doctor and asked if she would write out an Rx for it. Yeah I could have just snagged one and taken it home but I believe it when I suggest folks talk to their doctors. She agreed, I wore it two nights and both nights the sats were fine.

So now I thought about trying an autopap. I've always advocated that if someone isn't responding to CPAP they should absolutely be allowed an Auto trial.

So what did I do? Again I could have just grabbed one and set it myself but I called up my Doc and left a message with her Secretary. Doc called me back this afternoon and we talked a bit. She didn't have a problem with it.
So what's gonna happen?
She wants to talk to my RT to help determine the best settings and pressure ranges and I have to wait until tomorrow.

So yeah, the DME guy has to wait to get his AutoPAP. Image

Anyways, I thought some of you might get a chuckle. Also wanted to let people know that I do absolutely follow and believe what I say - talk to your doctors first!

mattman
RIGHT ON MATT-MAN!!!!!

BRAVO bro! So VERY well said!

Chuck

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http://www.savedarfur.org

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Wulfman
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Post by Wulfman » Wed Jan 10, 2007 9:03 pm

Mattman,

It'll be interesting to hear how this story plays out.
Please keep us informed......including how your experience with the Auto goes.

Den

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DreamStalker
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Post by DreamStalker » Wed Jan 10, 2007 10:14 pm

I debated whether or not to respond to this post because lately a few have opined that I should lay off poor Matt.

However, I was unable to resist this thread because I fail to find the humor suggested in Matt's situation. It is unfortunate that he had to endure 9 months of inadequate treatment. It just goes to prove that everyone should be issued an APAP from the start in order to fine tune treatment as quickly as possible. Furthermore, I agree with Chuck’s philosophy that apnea patients should not only be provided with -- but encouraged to try out the different APAP machines to determine which algorithm is best. Finally, Bill is absolutely correct that it is these types of unfortunate failures in the current professional treatment practices that result in apnea patients giving up with their treatment.

If DMEs such as Matt (having experience from both sides of the fence) would hold up the torch and help inform the professional apnea healthcare system that the technology of APAPs should be provided to all patients in order to maximize the likelihood of successful treatment and compliance, then there would be no reason to laugh at anyone’s expense.

Yes, I hope you do keep us informed and I applaud your courage to post your issue here on this forum. Best of luck optimizing your APAP treatment.

-roberto

President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.

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bravo

Post by whatrdreamsmadeof » Wed Jan 10, 2007 10:31 pm

Bravo Roberto, As always your on the mark once again.........Ellen

mattman
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Post by mattman » Thu Jan 11, 2007 7:45 am

Good Morning Everyone.

Well several interesting points have been brought up overnight, but one I want to address right out of the gate - The Quality of care. Be warned this is going to be a long post.

I want to make this perfectly clear: The quality of care that I have received all along has been nothing short of exceptional. The compassion, care and concern expressed by both my doctor, her staff and by some of our own people are beyond what I even have any business expecting.

Several factors have gone into how my treatment has progressed so far and each of them have been driven entirely by my own beliefs, by my choices and along with my doctor and RT.

Some things have occured which under other circumstances would not be anything I would even want to bring up here much less should be due to the personal nature but since the issue was raised I feel it's important.

I know good and damn well that the primary reason I'm in the position I am now with needing this treatment is because of my own actions. If I exercised daily as I am supposed to, if I didn't smoke and if I made better food choices I strongly doubt I would even NEED a CPAP.

So about a month before my sleep study I quit smoking and quit caffeine. That was my first step. Then I went to see the doctor and went for my sleep study.

Of course as part of the consult aftwards diet and excercise were hammered into me by my doc. I took it to heart since it had already been on my mind.

I hired a personal trainer and started on a diet. I lost about 10 pounds and was feeling a little better.

I firmly believed that I had to give the CPAP treatment at least a month and preferably 2 to really start to work and also for tweaking mask comfort and to just flat out get used to it at night. To me, anything less than that isn't enough time to give an accurate feel for how you are doing.

Unfortunately for me at that point due to a seperate unrelated test it was discovered that I had several tumors in my left lung. This pretty much put me into a tailspin and I stopped excersising and dieting and went right back to where I was. I stayed this way for a little over a month. I am exceptionally blessed that at this point they all appear to be benign. While I still have to have this followed and this will require treatment the prognosis is not nearly as life shattering as it was to first hear about this.

This is the single largest contributor to the delay in my seeking to further tweak things.

*I* personally did not feel I could accurately guage how I "felt" until I started excersising regularly, until I got my diet under control and until I was smoke free long enough.

*I* feel that I have no business saying 'I still feel tired' when I'm not willing to get on a treadmill for 20 or 30 minutes and I eat cheeseburgers all day.

Be ABSOLUTELY assured that my doctor at every single step of the way was constantly asking me how I felt - both before and after the initial discovery of the tumors. I was called at 1 month, 3 months and 6 months by her staff - independant of my regular appointments. She was more concerned about my feeling tired still than I was. I essentially had to insist on being given the time to address my diet and exercise.

Additionally regarding the delay in getting my autopap. I have made a point to only have 1 of our RT staff work with me on this so far. Primarly because I wanted as few people I work with knowing I was on CPAP so that I had the best chance of seeing our system as a complete unknown. Granted my information would be enough for most to realize who it was they were looking at but there are some who would not catch on right away. One of those is the new RT who was hired strictly to handle patient followup. I made a point of not getting to know her very well so she wouldn't immidiately connect who I was when my follow up came. I could have had the machine the same day if I wasn't insitent on her staff only contacting the one RT I want involved.

I was called at 2 weeks, 1 month, 3 months and 6 months by her as well as twice being mailed a new smart card. At EVERY step I was asked how I was feeling and if I needed anything. To this day she does not realize it was me that she was calling. This care is NOT anything different than any other patient gets.

So to those who expressed concern that this is the sort of delay that keeps many from being compliant I can 100% assure you that this is not the case at all. I have received care far above and beyond anything I've any business expecting.

And it's nothing special. It's the same treatment anyone going to any of my doctors would get. It's the same treatment any of our patients gets. Frankly, its' the same sort of treatment anyone going to ANY DME company I've ever been involved with would get.

I apologize for the length of this message - however I fully understand the concerns raised. More importantly though is how blessed I feel to have such compassionate, skilled and caring doctors as a part of my care and to think that anyone could feel that they have in some part failed me most definately makes me want to stand up and defend them.

Sincerely,

Matt
Machine: REMstar Pro 2 C-Flex CPAP Machine
Masks: 1) ComfortGel Mask with Headgear
2) ComfortSelect Mask with Headgear
3) Swift
Humidifier: REMstar Heated Humidifier

mattman
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Re: Get A Laugh At My Expense!

Post by mattman » Thu Jan 11, 2007 7:53 am

NightHawkeye wrote:
mattman wrote:Anyways, I thought some of you might get a chuckle. Also wanted to let people know that I do absolutely follow and believe what I say - talk to your doctors first!

mattman
Realistically though, you describe a cumbersome process which mostly delays diagnosis and treatment.
\Regards,
Bill
I find it interesting that you view this as cumbersome! To me, it's amazingly easy.

I call my doc - explain what I'm interested in doing. She calls me back to discuss with me and verify a few points. I think this is not only desireable that they do this, but would even say it's a neccessity.

She then calls the provider and orders it.

Done. That's it. 1 phone call from me. I could even have picked it up the same day if I had been a regular patient. The 1 day delay was entirely of my choosing.

Do you really feel that to be a cumbersome system? It may simply be a difference of opinions if so!

mattman
Machine: REMstar Pro 2 C-Flex CPAP Machine
Masks: 1) ComfortGel Mask with Headgear
2) ComfortSelect Mask with Headgear
3) Swift
Humidifier: REMstar Heated Humidifier

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DreamStalker
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Post by DreamStalker » Thu Jan 11, 2007 8:07 am

Sorry you had to post such a "lengthy" (not really in my opinion) message to address an issue that was not brought up - The quality of your care by your doctor and DME staff.

I was referring to the "failure" of the healthcare system processes of not providing an APAP from the start. My sleep doc and DME have provided me with quality service too ... in fact my sleep doc supported my request for an APAP early on after I had informed myself of the treatment options with the help of the great members of this forum.

I agree that we should work closely with our healthcare providers ... unless they do not respond to our concerns in which case I would find replacement healthcare professionals.

Anyway, sorry to hear about all of your set backs and I hope you get to feeling better soon.

President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.

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Post by Hurricane » Thu Jan 11, 2007 8:13 am

Admire your honesty, and values just wish health care providiers would be more informed of the pitfalls and discomforts of being given equipment that is not suited for the patient. You sound like a person who will benifit the system because of your personal exp. with cpap. When I had a question about mask, or machine change it was always see your DR have him call me, which is a 40 dollar copay each turn of his door knob. Yesterday I called the hospital I had my sleep study done at, and asked them if they had a time when reps from the leading mask suppliers would come and show their equip. she replied they tried getting that started but no response from suppliers. Some health care people must be great, but from mine there was no follow up to see how I was doing, or chosing another mask, I was handed a Swift nasal, showed me how to use it and the machine which was a cpap set at prescriped pressure, after reading these forums I learned so much, That off to my Dr again and requesting an apap to see if I was being helped, it wasn't till then that i started feeling better being I could moniter and adjust. Point here is help out as many new hose heads as you can, Stay well.
Hurricane


mattman
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Post by mattman » Thu Jan 11, 2007 8:18 am

DreamStalker wrote:I debated whether or not to respond to this post because lately a few have opined that I should lay off poor Matt.
Hey just to reiterate something I mentioned previously - I have zero problem with good discussion. In fact it's what I hope for here. It's the [not directing this at you by the way] pot shots that I do dislike and ignore. The comments like 'DME companies lie' and the like that don't contribute to a conversation. Comments that are intended as jabs rather than fact. There might even be one in this very thread, for example.
DreamStalker wrote:..It is unfortunate that he had to endure 9 months of inadequate treatment.
Hopefully, you were able to wade through that mess I posted above but just to reiterate: I did NOT 'endure 9 months of inadequate treatment'. Not by any mesaure. It HAS helped, just not as much as I would have hoped. And the delay was entirely my own choosing while I tried other things.
DreamStalker wrote:It just goes to prove that everyone should be issued an APAP from the start in order to fine tune treatment as quickly as possible.
See, I still disagree. In fact I would even say this hits again to what I started with, with me practicing what I preach.

I still FIRMLY believe it is our moral obligation and fiscal responsibility to start with the least expensive treatment first and THEN work our way up to the most expensive.
Let's all face it - diet and exercise ARE two of the biggest things that would contribute to most of us finding better success with our treatment. And not just for OSA but for every facet of our lives.
I personally chose to work with those for a couple months before moving in other directions.
Now I did use the tools at hand - a smart card and also an overnight oximetery to at least double check the equipment. I was NOT having AHI issues so I saw ZERO reason to want to move to a more expensive treatment.
To be honest, I really don't have much reason to think the auto will provide much benefit over the CPAP. I hope I'm supprised, but I don't expect to be. I still think that if I lost 50 pounds and got in better shape I will see a much more dramatic benefit than anything else I could do.
DreamStalker wrote: Furthermore, I agree with Chuck’s philosophy that apnea patients should not only be provided with -- but encouraged to try out the different APAP machines to determine which algorithm is best.
This I would agree with under the following conditions:

1) Change AUTO to just 'PAP'. See above.
2) Start with one. If after say, 2 months, the patient doesn't respond then move to another. No need to change if things are working well.
DreamStalker wrote:Finally, Bill is absolutely correct that it is these types of unfortunate failures in the current professional treatment practices that result in apnea patients giving up with their treatment.
I couldn't disagree more. For one thing, 9 months is hardly dramatic but even this long has been entirely my choosing. See long rambling post earlier.

Also, I do VERY much believe that the majority of failures are simply due to patients not being willing to put much into it. Let's face it - this is NOT an easy treatment.
I also have the benefit (or drawback) of seeing all sorts of failures on even easy treatment due to people just not caring enough. Hell, let's look at ourselves. Most of us need to diet. We KNOW this. All it really requires is us not putting food in our mouths. That's it. How successful are we at this? Yet we find fault in our doctors and healthcare providers for someone else not sticking with a program where they strap big chunks of plastic to thier faces and shove air down thier nose?!
Are you kidding me?!
Now obviously, we both (Doctors and us) DO bear a lot of responsibility to make things as easy as possible and as effective as possible. That is OUR moral and fiscal responsibility.
However, I can very honestly tell you that the majority of failures I see on a daily basis come down to someone simply not being willing to try. After a week they just give up and say 'I'm don't care'.

mattman
Machine: REMstar Pro 2 C-Flex CPAP Machine
Masks: 1) ComfortGel Mask with Headgear
2) ComfortSelect Mask with Headgear
3) Swift
Humidifier: REMstar Heated Humidifier

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DreamStalker
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Post by DreamStalker » Thu Jan 11, 2007 8:44 am

Well I guess they were right then ... I should simply give up and leave poor Matt alone to preach to his flock.

Best of luck with your health and to your flock for they may well need saving.
President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.