Holy cow, y'all were right about DME's.....

[Victoria]

The big local DME company (we'll call them company A, A for, well, you know who) just called to make my appointment to come in for a mask fitting etc. I wanted to get as much info as possible from them about what machines they typically provided, and according to the gal on the phone, they generally issue people the "Resmed Tango". I didn't recognize it from reading this forum, so I asked her more about it. I asked about some other models, but she was pretty negative about getting anything else. When I looked up the Resmed Tango, turns out that is the absolute bottom-of-the-barrel machine...you can hardly even find anyone selling that machine online, even. Basically its only feature is an on button and an electrical plug.

So I called another DME (company B) in the area, and their 'go to' machine is the Respironics M Series 'regular' machine. Well, I thought, that's at least a little bit better.....but when I asked what the possibilities were of getting one that was fully data capable, she said I would have to have the doctor write that into the prescription, and also that there was no need to have the c flex/ aflex b/c my pressure is only 5, and I would have to get the doctor to put that on the prescription too.

Um....does that sound right to you guys? I can't imagine why the doctor would object to changing the prescription, but who knows, or should I just nicely insist on what I want with company B ? What do you guys think?

[Bluebonnet_Gal]

I would recommend you ask your doctor for a prescription for the machine you want (fully data capable at a minimum). If your doc won't give you the prescription you want, find another doc. Get a FULL copy of your sleep study (you should get that whether you change docs or not) and go see another doc who will hopefully cooperate with you.

[nanuke]

Wow! I'm expecting to hear from the DME attached to the doctor's office as soon as they clear it with the insurance. I have a feeling that I'll experience the same thing... but let's give them a chance.

Sleep Well

[Kiralynx]

Get what you want written into the prescription.

For your mask, it ought to include, "full face, nasal cushion, nasal pillows or "hybrid" style mask of patient's choice".

You'll want the doctor to specify a fully data-capable machine with all the features you want on it. (There are people who know the medicalese better than I do who can tell you what it needs to say.)

But it needs to be specific... otherwise they'll probably try to weasle out of it.

[Georgio]

Have your prescription made out for exactly the brands, models and features that you select. You are paying the Dr. to do this for you. If for any reason your sleep Dr. resists, you can have your primary care Dr. prescribe it for you if you have good relationship. Depending on how your insurance works, you may have the option to purchase everything from cpap.com, your insurance company reimburse you, and both you and the insurance company save money! Check with your insurance company.

Georgio

[RipVW]

Wow! Yep, it's your money, your insurance, your health, your equipment. Don't let them try to force you to settle for anything less than you want! Good luck!

[Slinky]

Since your scripted pressure is 5 I can't imagine you need or will even want EPR or C-Flex turned on but ....

Here are two suggested scripts based on RestedGal's reccomendations some time ago.

1] Resmed S8 Elite w/EPR
2] Humidaire 3i heated humidifier
3] Pressure ---- cms (whatever your pressure is)
4] EPR setting 3 (or whatever your doctor suggests)
5] Ramp Off (unless you prefer it on)
6] Efficacy & Usage Data access turned On
7] Nasal, Full Face, Nasal Pillows or "hybrid style" mask of patient's choice

1] Respironics REMstar M Series Pro w/C-Flex (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] C-flex setting 3 (or whatever your doctor suggests)
4] Ramp off (unless you prefer it on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the REMstar Pro)
7] Nasal, Full Face, Nasal Pillows or "hybrid style" mask of patient's choice

Your script doesn't need to be this exact, these were recommended more for a family physician not familiar w/scripting CPAP equipment but it gives you an idea.

Scripts are usually much more "generic". To give you an idea, here's my script for my bi-level:

IPAP 13, EPAP 8
Mask type & Size: Simplicity
Humidifier: Heated
Comments: Resmed VPAP Auto - DAW

(DAW is "dispense as written")
Ordering Physician (typed)
Physician's Signature

Its not ideal in that this generic script (aside from the brand and model bi-level) allows the DME supplier to coast by using the Default settings for the various options this VPAP is capable of. But that was no biggie since I knew how to access the Clinicians Menu and turn on the Smart Data, choose my own Settling time, etc.

If you have more options than just these two local DME suppliers, I'd call, or better yet, visit the other options to see where I could get the best deal as far as the equipment I want and an RT who seems truthful, knowledgeable and helpful and that offer a lenient mask policy.

[RAINSUX]

You REALLY want a data capable machine. Luckily I got one and didn't know it. My titrated pressure was 7. When I found this group and bought the software and reader I found that my AHI was in the high teens. It should be 5 or less. I gradually increased my pressure and found my sweet spot to be 10.5. A long way from 7! My AHI is now around 1.5 and it isn't unusual for it to be less than 1. I have never had any followup whatsoever, and I would still be in the teens without the data feedback from the machine and software. I'm SO thankful that I was enouraged by the members here to take charge of my own therapy and do what was necessary to maximize it's benefits. I feel really good now!

[Paul56]

The big local DME company (we'll call them company A, A for, well, you know who) just called to make my appointment to come in for a mask fitting etc. I wanted to get as much info as possible from them about what machines they typically provided, and according to the gal on the phone, they generally issue people the "Resmed Tango". I didn't recognize it from reading this forum, so I asked her more about it. I asked about some other models, but she was pretty negative about getting anything else. When I looked up the Resmed Tango, turns out that is the absolute bottom-of-the-barrel machine...you can hardly even find anyone selling that machine online, even. Basically its only feature is an on button and an electrical plug.

So I called another DME (company B) in the area, and their 'go to' machine is the Respironics M Series 'regular' machine. Well, I thought, that's at least a little bit better.....but when I asked what the possibilities were of getting one that was fully data capable, she said I would have to have the doctor write that into the prescription, and also that there was no need to have the c flex/ aflex b/c my pressure is only 5, and I would have to get the doctor to put that on the prescription too.

Um....does that sound right to you guys? I can't imagine why the doctor would object to changing the prescription, but who knows, or should I just nicely insist on what I want with company B ? What do you guys think?

I think you are in one of those situations where you will need to have the Doctor write a very specific prescription for the kind of machine you want/need. Being fully data capable is the minimum requirement... so start with and build on that basic requirement.

The DME is being "difficult"... as many of them are. We just need to work around that. It is all manageable. Just remain politely courageous yet keep bombarded whoever who deal with in the process with your persistent educated opinion.

[GumbyCT]

Um....does that sound right to you guys? I can't imagine why the doctor would object to changing the prescription, but who knows, or should I just nicely insist on what I want with company B ? What do you guys think?

Not that is sounds right but it does sound like the way they operate which is why I always say have the doc write on the script what you want.

Aflex or Cflex will NOT work at or below 6cm so will only be useful if you are above that.

[Wulfman]

The $64 question is......did they get your pressure correct?
There are far too many people that did NOT get prescribed the correct pressure......and a data-capable machine will tell you.

Den

[GumbyCT]

The $64 question is......did they get your pressure correct?
There are far too many people that did NOT get prescribed the correct pressure......and a data-capable machine will tell you.

Den

How true - as described by Rainsux above, too.

[CorgiGirl]

My doc wrote "equipment per patient's choice" which has sufficed to get me the APAP I wanted and any mask I wanted to try. If you don't think you can get your doc to write for a specific machine, see if you can get them to write what mine did....

Good luck.

[Victoria]

Thanks everyone. I'm going to try to see if there are any other DME's around here, and also call the dr's office to see if they will be more specific (or less- good suggestion on having the doc write per patients preference) on the rx. So....it seems like go for the fully data capable should be the #1 priority, then.

[Slinky]

Yup, you've got it!

#1 Priority fully data capable CPAP
#2 Priority lenient mask exchange policy