DOC WOULD NOT PRESCRIBE AUTO C-FLEX

Mr Tired · Post by **Mr Tired** » Mon Jul 25, 2005 4:54 pm

Just got back from the doc. I asked him to change the prescription from c-flex to auto c-flex. He would not do it. He said the auto feature is unreliable & has not been perfected yet. Is this true? Is auto no good or is the doc not telling me the full reason he won't let me order an auto?
After reading the posts here I thought auto would be the way to go.

Mr Tired

fstanmyre · Post by **fstanmyre** » Mon Jul 25, 2005 5:08 pm

Your Doc is an idiot. I'll leave it to RG to explain. Ask him for any study he has that backs up his claim. I'd sure like to see it.

capt · Post by **capt** » Mon Jul 25, 2005 5:10 pm

What your doctor told you is absolutely unbelievable! If an auto machine is unreliable, I would ask him why some patients have to be prescribed an apap, because they cannot use a fixed pressure machine due to their wide pressure requirements. I am one of those patients. I have been using an apap for a number of years and have yet to have a apap machine mechanically fail.

Niteair · Post by **Niteair** » Mon Jul 25, 2005 6:13 pm

Your Doc is obviously one that hasn't kept up with the technology of his supposed expertise in his field. Personally, I would change Doc's, or take the cpap prescription, and purchase an auto on line from cpap.com.

rested gal · Post by **rested gal** » Mon Jul 25, 2005 7:14 pm

Mr Tired, it's a shame your doctor feels that way. You might find these discussions interesting reading:

Feb 19, 2005 subject: "Sleep Doctor" doesn't like autopaps (5 page topic)

Mar 05, 2005 subject: Finally slept through the whole night.... (3 page topic)

Guest · Post by **Guest** » Mon Jul 25, 2005 8:00 pm

Mr. Tired wrote:

He said the auto feature is unreliable & has not been perfected yet.

What a hill of crap. My sleep Quack. (who I have since bounced) told me that autoPAP machines were only for use in places, like Eastern Canada, that don't have sleep clinics to do titrations.

If the autoPAP can take the place of the titration that would have happened in the clinic, I think that it is likely to be both reliable and perfected.

Keep pushing for an auto. Complain about the chest pain and aerophagia, not to mention the difficulty breathing out against the pressure. Stamp your feet, be the squeaky wheel, make multiple calls to his office and send lots of faxes complaining about the above symptoms (be sure that they clearly show the date they were written/sent as they make a GREAT paper trail outlining the duration and severity of your concerns), remind him that the autoPAP can function in CPAP mode AND, that it will give you lots of information regarding your treatment. Further, the auto will give you the pressure that you need when you need it and NOT overtreat you during the majority of the night when you don't need the higher pressure.

Apologies if this sounds huffy -I just get really torqued when I hear about the dorky, insensitive things that doctors say to patients. Reminds me of how annoying it was to have asked my Quack about autoPAP just to be blown off. Then I found this forum, did a ton of learning quickly, and mounted the above-noted campaign to get him to prescribe autoPAP. Then I had to start the battle with the insurance company -managed to win that one as well.

Moral of the story: be your own best advocate. Push, push, push until you get the best treatment available.

WillSucceed · Post by **WillSucceed** » Mon Jul 25, 2005 8:04 pm

The rant above is mine; got guested.

Guest · Post by **Guest** » Mon Jul 25, 2005 8:08 pm

I am a guest for a reason. I have a comment about your doctor.

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::cough::

Liar.

bigheadr · Post by **bigheadr** » Mon Jul 25, 2005 8:27 pm

Well, I am going in tomorrow to see the sleep nurse practitioner since I have been on my 420G/S for about a month. I am going to show him the 3 weeks of data from the Silverlining that shows how I still have a mild case of apnea (AHI of 7.3 which is much better than the AHI of 43 when I started) but unstable data every day with regards to my snoring and Hyponeas. If I had the 420e, I might have had better results with the 420e reacting to the snoring and hyponeas. He rejected my request before I got the CPAP for th 420e. I wonder what excuse he will give me this time. If he doesn't give me a prescription for a 420e, I will stop going to him and find another sleep doctor who will give me an APAP prescription.

unclebob · Post by **unclebob** » Mon Jul 25, 2005 9:34 pm

Hi Mr Tired,

Are you from the Toronto, ON area? Your Doc sounds exactly my sleep MD.

Just like pyramids, some sleep docs get weathered and old but they still know how to charge the admission price.

Starting to develop a theory on sleep MD's, maybe longer term xPAPers can comment.

60+ years old.

Any MD over 60 years old who professes to be a sleep specialist needs to be closely scrutinized. He's either a bona fide pioneer expert or an MD who couldn't cut it otherwise. If he is the latter, there is no damn way he will prescribe any auto titrating unit and will not allow you as a patient any freedom to explore your own treatment. The longer you do not understand the treatment/process the more mystique, control and bucks he commands.

50 to 60 years old.

Mixed bag. MD's professing to be sleep specialists really are, or they are nerds who were once OK but have become set in their ways, or complete idiots who cannot cut it and waiting to turn 60 (see above). Only the first group will give you good treatment, the latter are hit & miss - mostly miss.

40 to 50 years old.

Two groups. Really good MD's who will give you great treatment but others who are egotistical know it all's which delay your good treatment. The other group are those MD's who cannot stay on top of their general practice and are looking for an easy way to the big bucks ( see complete idiots and waiting to turn 60 above).

30 to 40 years old.

Three groups here. Cutting edge professionals who will attend to your best interests. Techie types who align themselves with the manufacturers and treat you as a number particularly with a dollar sign in front of it. Dummies who need to pay off their student loans and see this as an easy way out while still dabbling in a newer somewhat untouched field of medicine getting more and more press all the time ( see big bucks, complete idiots and waiting to turn 60 above).

Under 30 years old.

You could have a real expert here and if he checks out, grab him. If his dad, older uncle or any close friend or relative of any distance is an evil DME you have two choices. Drop him like the plague or invest heavily in his company.

Bob F

Guest · Post by **Guest** » Tue Jul 26, 2005 11:01 pm

Think I saw the over 60 one today

He gave me a prescription but blew be off after he signed them saying "I guess youl get another thousand miles out of it" What stupid morons for doctors we have even here in Minnesota. After I get my new auto software and reader if i still have an apnia problem I will be looking in the Minneapolis area so any suggestions I will take.'

littlebaddow · Post by **littlebaddow** » Wed Jul 27, 2005 8:11 am

lol unclebob

sadly, probably accurate

lindas88 · Post by **lindas88** » Wed Jul 27, 2005 12:14 pm

unclebob...funny stuff you wrote

Guest...I am from Eastern Canada and we do have sleep clinics here....but you have to wait about two years to get into one...

elliejose · Post by **elliejose** » Wed Jul 27, 2005 8:10 pm

Just went back to my sleep doc today and got a script. sent to my DME for Auto with C-flex. We'll see what happens next. Doc says "not all insurance will pay for an auto, because they cost more than straight cpap. But will be glad to write an order and find out." And if I don't hear from them in a few days to get back in touch with him. We are going to be gone visiting family tho and won't be back until Monday. So here's hoping.

Can't Remember · Post by **Can't Remember** » Thu Jul 28, 2005 2:35 pm

He said the auto feature is unreliable & has not been perfected yet. Is this true?

You be the judge. This is my personal experience. I was prescribed straight CPAP at 16 (pressure, not age). Had a terrible time with it. Mask leaks waking me up every 10 minutes. Couldn't get used to exhaling against the pressure. Was getting less sleep than with no CPAP. After reading this Message Board for a while, looked like Auto CPAP is the answer to all my problems (and with software would give me feedback and more control).

Talked to my Doctor and he agreed to prescribe an Auto CPAP as the max pressure is not always needed and it would probably be more comfortable for me. Got my AutoPAP with C-flex and paid $200 for software/reader.

Big disappointment. Pressure runs at max 90% of the time, and C-Flex makes the mask feel like its alive (it breathes on its own). Didn't solve anything.

Here are the reasons I agree with your Doctor:
1: Put on mask, turn on machine, watch TV for 1 hour - software reports 35 snores, 12 hypopneas, 7 apneas during that hour (all while I am awake, no, I didn't doze off).

2: Machine steps up to max pressure and then gets stuck and stays there. Pressures wake me up. Lay there for two hours and pressure never lowers even though I am awake and determined to wait it out. Finally give up and pull mask off and shut off machine.

3: The software has reported some hours with over 200 apneas (is that possible?).

4: On this very message board have seen others complain about runaway pressure and unreliable/questionable data (usual reply is to spend another $700 and try a different AutoPAP - the algorithm may not be correct for you).

In my opinion the AutoPap is not perfected yet. The way it senses/reports events is suspect and appears prone to errors (at least on my machine).

Don't get me wrong, I still like my auto, it's just not perfect and not the answer for everyone. I like the control it gives me and the data over time is useful (hopefully the long term reports wash out most of the erroneous data).

I've found the mask is a much bigger issue than what machine you use. Finding the right mask that's comfortable and doesn't leak can be a very long journey, and of course, everyone has an opinion on which is the "best" mask (and you know what they say about opinions).

As for other posters calling your Doc an idiot, they're being a little quick to judge. Give whatever he prescribes some time, it may work just fine for you. If not, TALK TO HIM! You might be surprised.