My auto BPAP cured me of all apnea events?

[congahands]

Riv,
Doctors are basically glorified service employees. Your insurance company pays most of the bill, but we've all signed those statements that say that we are responsible for the bill if the insurance company doesn't pay up. Your presence means a lot of money to these folks.

I had a fairly prominent (in this area) knee surgeon tell me in a post-operative check-up that I would never walk again, walking 18 holes of golf would be all I could ever expect, and I should take up swimming. I happened to meet another orthopedic surgeon, at the pool and he saw my scars. He asked about it, and I explained my situation, and volunteered who my surgeon was. He got a funny look on his face, and told me he wasn't looking for patients but that didn't make sense to him. Long story short, I fired my first surgeon, had exploratory surgery a year later with the second surgeon (from the pool), and (a couple years later) I ran intervals at the track the other day.

Doctors work for us. If your doctor is a jerk, FIRE THEM!!!! We pay them way too much to be talked down to. Pedastals are for vases.

[Riv]

Anne,

My PCP knows little about apnea. Few non sleep doctors know very much about it. Seems like we both have or had a couple of sleep doctors who also don't know or don't care what's going on with us..............I know I need a better, a more patient, a more communicative doctor just like I guess you found. I hope you are happy with your new doctor, you deserve to be and you deserve good treatment where you are told whatever information you need, given whatever help you need and your apnea results are looked at seriously rather than glanced at.

No matter how inconvenient or rough it is on someone to have to start over, anything is better than doctors like the ones we had.

Conga,

I agree!

[deerslayer]

only one explanation ---->check for crack pipe ..... whatever you do try not to confuse him with the facts, they hate when that happens.... hope you get the truth sorted out ...to know is everything!

[Riv]

You know something? I wouldn't be surprised to find out that this guy is on something. I wouldn't know how to tell if someone did or didn't use drugs but his treatment of me? for a doctor its pretty bizarre. It would be a real disgrace, an real UNEARNED!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! karma if he were on something because I'm 1000.1% anti dope and if anyone deserved a doctor like him possibly being high and "teasing me" (or whatever it is that drug users do) then it would only be a fellow drug user...............and not me!

[roster]

Riv,

Too bad that so many doctors are so arrogant. The personality that can do all the necessary academic work required to be an MD is often not the best personality for dealing with humans in intimate settings.

Regarding zero apneas on cpap, typically I score one to five apneas for the entire night with cpap. (Without cpap I had 285 in 5 hours.) I can't remember if I ever scored zero apneas with cpap but certainly one is close to zero.

Do yourself a big favor and buy a card reader and Encore Analyzer software. You can see yourself what is going on during the night and not rely on this 'fishy' doc. Some of us paid for this by savings on copays.

It is also a good idea to fill out your profile.

Regards,

[Riv]

The results of my smart card reading that the doctor showed me:

First page is headed Multiple Download Compliance Report:


It shows my name and my patient ID----Information for referring physician, PCP, clinician are all blank.

Then shows graphs on hours of usage between 8/28 and 10/12, shows me doing around 6 hours per night which is correct.says average humidifier setting at 1.0 but I never use the humidifier, last setting passive..........Average flex setting 1 (i'm set for 3), last setting 7 (what?).

Next on page is a graph showing 90% of EPAP and IPAP.

Next two pages show daily Patterns of use, each date is shown on left side of display but weekends are noted only as Saturday and Sunday (I wonder why)................This breakdown seems to show I use machine more on weekends but that isn't true......

The two page breakdown shows a graph next to each date, the graph shows darker colored indentations at points of the grey colored graph and some graphs show breaks (empty white spaces breaking up the daily graph) (some graphs have no indentations, those graphs are solid) and next to each graph is an hourly breakdown such as say 6:11/6:22 or 6:32/7:13. The solid graphs also show the empty white space breaking up the daily graph.

the bottom of the monthly graphs show a 12 14 16 18 20 22 0 2 4 6 8 10 and I'm sure that these are the hours when I use the machine, I'm an evening worker and I sleep from around 3AM or later.

Final page shows

Date Range
Days with device usage
Days without device usage
cumulative usage
maximum usage (1 day)
average usage (all days)
average usage(days usage)
minimum usage (1 day)
Percent of days with usage less than and percent of usage more than 4 hours.

I came to the doctor looking for help, lookimg for information, looking for any needed advice....

He was very happy wen he showed me my report. Why? Simply because the report showed that I was using the machine (I guess he probably misread me and thought I wouldn't use the machine).

What do the graphs show? What do the times mean? What should a Smart card reading show?

[rested gal]

He was very happy wen he showed me my report. Why? Simply because the report showed that I was using the machine

He should be happy that the report proved you were using the machine regularly. At least half of the people prescribed cpap treatment drop out (stop using the machine) either right away or eventually.

About an Encore Pro report....I never even glance at pages 1, 2, and 3 that contain Summary and Trend data. I look immediately at the "Daily Details" graphs for the most recent nights. The Daily Details begin on page 4 of a "Full Details" report.

A page from the download from an M series BiPAP Auto will contain one or more "Daily Details" graphs like the one below. If you see several pages on your report with similar "Sleep Therapy Daily Details" graphs, the doctor did give you a "Full Details" report. If there's no graph like this on the report, it's not the "Full Details" report. That person who downloaded your Smart Card could go back into their computer (the complete download is stored there) and select "Full Details" (instead of "Summary" or "Trend") to print out a complete report for you.

[Riv]

No, I didn't get a report like that.

Why would an accredited sleep doctor hold back on giving me information?

[rested gal]

I doubt that he was deliberately holding back on giving you a full report. He probably never even saw the Full Details graphs himself from your download.

Here's why I think that...

The ONLY thing the doctors (yes, even the accredited top notch sleep doctors) and DMEs and insurance companies are usually interested in is:

"Is the patient using the machine often enough/long enough to warrant insurance paying the monthly rental."

So, the only part of the download they are the least bit interested in looking at is the "Compliance" info... hours of use... the green bars showing you've used the machine at least 4 hours on that night.

The doctor might be marginally interested in noting the AHI somewhere on the first page or so, or seeing the 90% pressure used, if the machine is set for auto-titrating mode, but he's probably not really interested even in looking at those things, since most of the doctors assume the sleep study accurately found what pressure you need, he prescribed it, so... it's bound to be working.... IF the patient just uses the machine enough to be "compliant." (God, I hate that word... sounds like a parent watching a small child secretly to be sure he/she's behaving...lol )

After downloading the Smart Card, when the person clicks the download date to view the report, a window pops up asking if they want to see "Summary, Trend, or Full Details." I doubt if many docs or DMEs bother to put a check mark for "Full Details." They are not interested in seeing those detailed graphs for each of the most recent sleep sessions. The doctor probably would pooh-pooh "data" from the machine anyway. All they want to see is... "Is he using the machine enough that we (the DME) can get paid by the insurance company?" So...they leave the default tickmark on "Summary", or they might get really daring and click "Trend."

And that's what they print out for you...the "Summary" or the "Trend" report. They probably didn't deliberately withhold the "Full Details" report...they just weren't interested in that and it wouldn't cross their minds that anyone else (least of all a lowly "patient") would be either.

You could politely request a Full Details report, if you want to see your Daily Details graphs. The downloaded report in their computer still has it all. All they have to do is fire up their Encore Pro program, go to your "Patient" page, rightclick the date of your download, choose PDF export, then print out the PDF for you. That will contain the entire report from the download, including all the pages of Daily Details graphs. Will probably be a dozen pages or less, so it's not a big deal for them to print the whole report.

But I really don't think they were deliberately withholding info from you. They just aren't used to bringing up the report in a way that shows those graphs. They probably just hit "Print" for the few pages they were looking at themselves....the pages the doctor likes to see... "Is he using the machine, or is he not?" LOL!!