DISCUSSION ON HIGH VB% on Encore Analyzer

[goose]

Now I read this thread with added interest!!! I just looked at my Encore Pro Analyzer report (thank you James Skinner) and note that since October 30th my VB rate looks to average between 30% and 40%, so I need to understand better what the VB number represents, especially when it comes out of a M-Series APAP machine....off to researchville.....
Browser, I'll be curious how your meeting comes out!!!

In the meantime, I'll be following this thread with much interest!!!
cheers
goose

[MrSandman]

Oh Boy! What a visit it was... This study was better than last - AHI=51 No PLM . Oxy. desats to 78%. All fixed so they say at 15 with Cflex of 3 and humidification and chin strap with Swift Lt. Only 4 centrals at 15 and nothing else. The Dr. visit was a disaster. She said I really was OCD when I brought up all my concerns about the VB% and the fact that I get no where near the results in my data that the study shows. She said nobody cares about VB% and it has not been shown to mean anything and she has studied with the best even at Harvard and NOBODY looks at or cares about VB%. She said it is all due to my leak issues. She is very knowledgable for sure about sleep but I didn't like her attitude to let her worry about numbers. I am torn though between agreeing with her and not. She said she gets others like me usually Engineers and Programmers that bring in stacks of reports and it is usually useless. She said there is a point where one worries too much about the data.

I got my balls back out of her hand and tried once again by telling her I take exception to her suggesting that being concerned with my treatment and monitoring the data is some form of OCD. I asked her who is going to monitor my treatment when I am not to see her again for several months. She said to call if I have issues. I asked if I could have a copy of my report and she got short with me and said she could mail it and I said I figured she could just give it to me. She said she hasn't dictated it yet and I said,my sleep report?,and she said oh she could get that for me. I don't know what report she thought I meant. I got a single page copy but didn't feel like arguing anymore. I will get the entire report. They made me sign a paper releasing the single page to myself. Seemed stupid.

They put me in a booth and gave me breathing tests and she said all of them were above average and my lung function is excellent. They set me up with a small local DME to help me fix the leak issues-I think this will be good instead of buying many masks and trying them. She also referred me to a dentist that makes a modified bite device that has rubber bands in order to keep your mouth shut. She said it usually runs $500.

But overall I feel the updated study was a complete waste of money and I learned nothing I didn't already know. I feel the Dr. visit was a waste except for the lung testing. The DME may be the best thing to come out of it.

She said it sounded like people on this site are practicing medicine without a license and when I told her about SAGs posting concerning VB and what he said he was working on she said it sounds like he is plagiarizing other peoples work in order to sound more important than he is.

[jnk]

What would Snoredog say?

. . . She said nobody cares about VB% and it has not been shown to mean anything and she has studied with the best even at Harvard and NOBODY looks at or cares about VB%. . . .

Somebody cares. Sounds to me like she is "[ignoring] other people's work in order to sound more important than [she] is." I'm basing that on the fact that I've studied with the best even at cpaptalk.com.

. . . She said it is all due to my leak issues. . .

Wish I'd thought of that.

. . . She said there is a point where one worries too much about the data. . . .

She sounds like a doctor. Data is for techs.

. . . They made me sign a paper releasing the single page to myself. . . .

Maybe they were making sure you wouldn't violate your own privacy rights. If you post that information here, for example, you may have to sue yourself.

. . . She also referred me to a dentist that makes a modified bite device that has rubber bands in order to keep your mouth shut. She said it usually runs $500. . . .

She and the dentist probably went to school together. And apparently the rubber bands are made by NASA.

. . . She said it sounded like people on this site are practicing medicine without a license . . . .

Where would she get that impression, I wonder?

. . . and when I told her about SAGs posting concerning VB and what he said he was working on she said it sounds like he is plagiarizing other peoples work in order to sound more important than he is. . . .

She must have misunderstood what you said, then. But, hey, misunderstandings happen.

[goose]

<snip> I am torn though between agreeing with her and not. She said she gets others like me usually Engineers and Programmers that bring in stacks of reports and it is usually useless. She said there is a point where one worries too much about the data.

I tend to agree with her on this one -- I used to obsess over the numbers but over time figured out they were the same whether I obsessed over them or not. I let my body tell me if the treatment is working and check the numbers a couple times a month to confirm it.....Some people like to see 'em every day.....it's individual!!

<snip> I asked if I could have a copy of my report and she got short with me and said she could mail it and I said I figured she could just give it to me. She said she hasn't dictated it yet and I said,my sleep report?,and she said oh she could get that for me. I don't know what report she thought I meant. I got a single page copy but didn't feel like arguing anymore. I will get the entire report. They made me sign a paper releasing the single page to myself. Seemed stupid.

You already know you are entitled to the whole thing. Don't know why doc's are so reluctant to provide it. Wife (the nurse) says it's because people have no clue how to interpret it.....and for the most part she's right - but that said, there are some of us that have learned it and are as capable of interpretation as the doc.....

,snip>She also referred me to a dentist that makes a modified bite device that has rubber bands in order to keep your mouth shut. She said it usually runs $500.

If you do it, keep us up on if/how it works for you.....it's an ongoing discussion.....Some poo-poo it, some don't.....

She said it sounded like people on this site are practicing medicine without a license <snip>

Wife also says the reason they call it "practicing medicine" is because they still haven't gotten it right!!!!!! Gotta agree with that one.

I think everyone here realizes that what you get here is opinion.....Ya need a license for opinion these days???

Also sounds like she thinks very highly of herself and really doesn't know what goes on here on the forum. Sounds to me like she should return to school and learn what's going on today!!!!
My doc on the other hand, told me, "There are some very smart people on that board. Smarter than me!!!"......She's a neurologist that specializes in sleep medicine, so it really told me she has a very good perspective on the whole deal.....She also embraced my controlling my own treatment.

Thanks for the update Mike -- appreciate it. Sounds like you have some food for thought.

take care
cheers
goose

[MrSandman]

I like the way your Doc thinks Goose. This Dr. has been involved in sleep for 30 years and was the only one in this area in the beginning. I told her maybe she should come here to cpaptalk and she poo pooed that idea. I told her I am a Technician so I am into numbers and troubleshooting.

Now some day I will figure out how to do all those little quotes you people do so well here. It seems VERY tome consuming unless there is a secret to it?

Thanks

[jnk]

If you click "post reply." you can then highlight groups of words in the original post (which is displayed below the reply text-entry box) and click on "quote" in the post. That automatically inserts the words in the reply-text box with the proper markup around them. I mostly do it just to be irritating, myself.

[goose]

Hey Mike,
Yeah -- I wish she was still practicing.... She decided to "retire" for the time being to raise her family (I cannot argue with that reasoning for a minute)......Ironically it was her husband, who I was seeing because my PCP wasn't available to give me the bad news about having diabetes, that originally referred me. He asked me the magic 10 questions, scored me, and said she'd never forgive him if he missed one.....
No padding of the biz though, she really didn't need the "work"....but he was right!!!!
A really good doc!!!!

yeah -- when she said "Engineers and Programmers" are the only ones that really look at or give any importance to numbers I thought to myself....."Guilty"......

jnk's way of doing the quotes is probably the easiest -- I just hit the "quote" button and get the whole post.....then I trim, cut, and quote from there.....I do a copy and paste on the initial quote with your name in it and then just type in the closing HTML tag when I'm done with that part....then move on....many moons ago I did web pages in "notepad" so I learned the basic HTML stuff....active pages left me in the dust.....

take care
cheers
goose

[SleepyinWhineCountry]

The "engineer" remark hit below the belt. Yeah, I am an engineer, so I am supposed to have the capacity and education to look at data and use it for a useful purpose. But what I really am is a sick person (OSA patient) who is trying to make this therapy work (more than half of us cannot make it work and give up A.K.A. we are "non-compliant"). Trying to manage your own health and making your life better and longer is exactly what you should be doing. Asking questions of your doctor is what you are paying her for.

Don't back down, just don't shoot yourself in the foot. Use her for what you are paying her for - to help you manage your care. Insulting her fragile ego probably won't help, not being assertive enough to get the answers you need won't help either. She may have been around a long time (remember that when you are the only one doing something, it is easy to be the best), but if she is not helpful to you and your care, she may not be the right doctor for you. There are others out there, you may need to start looking for another doctor to help you with this.

There are a lot of weird people on the internet so her questioning attitude may not be without merit, especially since she does not know what you have learned here. It is just sad that so many of us need to turn to forums like this since we do not have access to adequate healthcare and doctors who will explain things to idiots like us engineers who want to get well.....