Help! Need new machine advice

CalicoskiesNC · Post by **CalicoskiesNC** » Tue Jan 08, 2008 8:24 pm

Please help. I've spent hours and days reading so much information here and my head is just spinning. I can't seem to get all the facts organized. I have been using CPAP for exactly 2yrs, with great results. I'm 100% compliant and I use the CPAP nightly for probably 7hrs avg. My pressure is 11.

I want to ask my dr for a new prescription so that I may get a data capable machine. I very much want to see my AHI and leak rates to ensure that I have the most success possible with CPAP therapy. My insurance company (BCBS) has said that I can have a new machine but I need a RX to specify data capable CPAP. I have copied the posts here that show me how to specify what is needed on the RX.

I currently have a REMstar Plus with C-flex. I "think" I want a Respironics M series Pro with C-flex and heated humidifier.

I am confused as to the CPAP vs APAP thing. I understand the APAP can be used as a CPAP only. I understand what APAP is: that it can provide therapy in a range of pressures depending on what I need while sleeping. What would be the best option for me? Since I am doing so well with the CPAP, is that what I should go with?

Thanks so much for all the fabulous information and resources you all provide. I've done CPAP for 2yrs and feel like I still have so much to learn.

Wulfman · Post by **Wulfman** » Tue Jan 08, 2008 8:45 pm

Welcome to the forum.

I personally stress a person getting a data-capable machine as a first priority.....BEFORE the APAP capabilities. If a person can swing the APAP, then that's fine, too.....because ALL APAPs record nightly data and they all can be set to CPAP mode.

Here's my story.
I started about 3 years ago with the REMstar Pro 2 (CPAP) and the Encore Pro software. EVERYBODY was talking up the APAPs/Autos and it almost made us single-pressure folks feel like second-class PAPpers. Well, my curiosity finally got the better of me and about a year later (2006), I acquired a REMstar Auto w/C-Flex. I did a one-week test with a pressure range of 10 - 15 and found out that my AHI numbers were higher and I didn't sleep as well with the pressure changes. I switched back to CPAP mode and now all of my machines are set the same way and same pressure.

If you've been on single pressure for 2 years, you may have trouble adjusting to the pressure changes of an APAP, too.

Den

CalicoskiesNC · Post by **CalicoskiesNC** » Tue Jan 08, 2008 8:57 pm

Thanks Den for the reply, you said what I thought. That by doing so well on a single pressure I should leave it at that. I will ask my dr for a script that lists the REMstar M Series Pro w/CFlex.

Slinky · Post by **Slinky** » Tue Jan 08, 2008 9:06 pm

I'm not one to particularly recommend an auto as some here are - but - since your insurance is willing to buy a new xPAP for you and autoPAPs can be used as a straight CPAP, I'd go for the autoPAP unless the doctor or DME created too big a hassle about it. Nothing venture, nothing gained.

Wulfman · Post by **Wulfman** » Tue Jan 08, 2008 9:21 pm

Since you've already got the "Tank" version of the Plus machine, have you considered getting one of the Pro 2 models?

https://www.cpap.com/productpage-advanced.php?PNum=1608

Your existing humidifier would fit right on it.....filters and all that would be the same, too. You'd be saving a pretty sizeable amount of money over buying the M series Pro because you'd have to get a different humidifier with it. AND....it won't lose data on some nights like the M Series machines do. According to CPAP.COM's site, they're showing 3 left in stock. They seem to have been able to come up with some of these and the Autos, yet.

Think about it.....

Den

CalicoskiesNC · Post by **CalicoskiesNC** » Wed Jan 09, 2008 6:55 am

Is the Smartcard reader proprietary or will any standard reader work?

Slinky · Post by **Slinky** » Wed Jan 09, 2008 9:13 am

You can get the card reader at twofactors in HongKong cheapest. About $32 w/the shipping included. Do a search on Mako Infineer 3500 and you should find some posts w/the exact correct URL for twofactors.

You might want to check w/billmyinsurance.com to see if you could get one of those remaining pre-M series recommended above thru your insurance.

rested gal · Post by **rested gal** » Wed Jan 09, 2008 9:53 am

CalicoskiesNC wrote:Is the Smartcard reader proprietary or will any standard reader work?

A standard card reader won't work.

The Hong Kong store (two-factor) that Slinky mentioned is the least expensive place I've seen the correct card reader at. I've bought from two-factor with no problem. It's this reader:

http://www.two-factor.com/shop/index.php?productID=115

For the software itself (EncoreViewer), I'd shop around the online cpap supplies stores, including cpap.com who own this message board.

If you find the software cheaper than what another store sells it for, cpap.com will price match, I believe.

CalicoskiesNC · Post by **CalicoskiesNC** » Wed Jan 09, 2008 2:22 pm

Ok, after more research and detailed note taking I have decided to go with the REMstar M Series Auto CFlex CPAP w/heated humidifier. My BCBS insurance will help with the cost, I have to pay 20% plus my deductible.

I will get this machine up and running and then see about getting the software and reader to see the data at home.

For now, my DME said she would be happy to look at the data and print it out for me and tell me the results. But this is the same DME that didnt know that the Resmed S8 Vantage did not have expiration relief in APAP mode, only in CPAP mode. She said "Hmm, I didn't know that...I'll make a note of that." She had been pushing the Resmed machine and I told her I wanted to research them both more before making the decision. I went with the REMstar based on the Cflex working in both modes.

What I have found out concerning insurance and DME in the last few days is disconcerting, to say the least. It has really highlighted that the healthcare system in US is just broken.

Gerald · Post by **Gerald** » Wed Jan 09, 2008 3:32 pm

Calico.....

It would be smart if you spend $20 more and buy the "M" Series Auto with AFLEX. That way, you essentially get (3) machines in one:

Straight CPAP
Auto with CFLEX
Auto with AFLEX

That way, you can take your pick....experiment with all three....to find the one you like best.

Personally, I like "Auto with CFLEX"....but others like AFLEX. I recently purchased a back-up machine....for me....and my honey (she runs an Auto CFLEX machine too......and I purchased the "M" series Auto with AFLEX.

If either one of us ever decides to run with AFLEX, we can do it. Also, If I decide to sell it, the AFLEX machine will sell quicker. Otherwise, we have the AFLEX back-up machine set in CFLEX mode now......cocked and primed to take over if either of our front-line CFLEX machines go down.

Gerald

wolftracker · Post by **wolftracker** » Wed Jan 09, 2008 3:38 pm

also it mite be better not to get the integrated humidifier but to
get the hc150 stand alone humidifier.

my .02
wolf

DreamStalker · Post by **DreamStalker** » Wed Jan 09, 2008 3:47 pm

Yes ... the AFLEX w/o integrated HH + stand-alone HC150 humidifier is your best choice.

rested gal · Post by **rested gal** » Wed Jan 09, 2008 4:07 pm

Add my vote:

Respironics REMstar Auto with A-flex M series machine. Not just an Auto that says "C-flex." The one to get is the Auto with A-flex. As Gerald said, the A-flex machine has C-flex in it, so you can use it whichever way you like...even with both turned off. I like A-flex very much.

I would not buy the integrated humidifier for an M series machine.

Instead of the integrated humidifier, I add another vote to what wolftracker and DreamStalker said about getting the Fisher & Paykel HC 150 heated humidifier. Comes with a short connector hose and can be used with any brand/model of machine.

CalicoskiesNC · Post by **CalicoskiesNC** » Wed Jan 09, 2008 5:55 pm

Thanks for that help. I will call tomorrow and see if she can change it to the AFlex machine. Am I correct that AFlex means it will have relief on inhalation as well as exhalation, but only if I choose that option?

Does the F/P humidifier need to sit close to the unit, on the nightstand also? I'm not sure I have room there for another machine.

DreamStalker · Post by **DreamStalker** » Wed Jan 09, 2008 7:46 pm

Both AFLEX and CFLEX are exhalation relief options but differ slightly in the timing of the relief. There is no inhalation relief and no need for it.

The HC150 does sit close to the blower unit but the foot print is small (about 5x5 inches).

Help! Need new machine advice

Help! Need new machine advice

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