Intro from newbie in Canada

[annasolanis]

As you see, I am in Canada. The section for newbies is good, haven't read it all yet. At first I was overwhelmed with all the info I have to learn, yet the posts from Mile High Sleeper helped.

I had a sleep study many years ago - showed some snoring, slept all of 17 minutes. I know I don't sleep well, that's a given. The sleep study failed in that there was never any follow up - a problem with health care in Canada. I am always fatigued and foggy.

I stumbled on this forum recently late one evening 'cause I could not fall asleep. I would like to if there are others from Canada on this forum. The health care system is not the same here as in the US, and would like to benefit from the experience of others.

[bap40]

I am not from Canada, close though. Only about 1-1/2 hrs away. There are many Canadians on this board and the medical issues have been discussed here. Hopefully some of them will respond and point you in the right direction. Good Luck!

Brooke

[Julie]

Hi, from an ex-Mtl/Torontonian-now-in-NS. I've been on cpap about 5 yrs, and the forum around 2 yrs. I also worked in big hosps. in T.O. and more or less know how OHIP works, as well as other insce., etc. I don't know what problem you had originally, but have you not had a more recent PSG (polysomnogram/sleep study) and why not? If you want to PM me, then maybe e-mail, click on my name and I'll get back to you later.

[Paul56]

As you see, I am in Canada. The section for newbies is good, haven't read it all yet. At first I was overwhelmed with all the info I have to learn, yet the posts from Mile High Sleeper helped.

I had a sleep study many years ago - showed some snoring, slept all of 17 minutes. I know I don't sleep well, that's a given. The sleep study failed in that there was never any follow up - a problem with health care in Canada. I am always fatigued and foggy.

I stumbled on this forum recently late one evening 'cause I could not fall asleep. I would like to if there are others from Canada on this forum. The health care system is not the same here as in the US, and would like to benefit from the experience of others.

I am located in the Ottawa area but live on the Quebec side.

My family doctor referred me for a sleep study at the lab in a local hospital. I went there 3 times. First time was a bust as I could not sleep due to muscle spasms in my back. Second time was joy and results were achieved. Third time was for titration. I was not billed a cent for this. The details were sent to my family doctor who basically wrote what I wanted on the prescription for the equipment.

The DME (VitalAire) is more of a sales agent than health care professional. Basically they place more emphasis on selling you the machine than they do on followup and ensuring you are getting good therapy. Since they sold me my machine I have not heard anything from them. They were also being picky at the start with the prescription. It did say automatic machine but did not suggest an operating range... it was meant to be implied that it should be operated wide-open. (It was my personal intention to tune that after I got the machine in my hands)... but no the folks at VitalAire had to be difficult and made me run back to the Doc for a more specific prescription. The Doc just shook his head while writing it and muttering something about "idiots...".

My group insurance paid for my machine without issue but I needed to pay VitalAire up front as they would not deal directly with insurance. It would be a whole lot more convenient if they would deal with the insurance directly as does my dentist. It all happens in seconds through the computer... sigh. In a couple of respects I also fell through the cracks. The sleep Doctor (located in Ontario) at the sleep lab refused to have a consultation with me due to me living in Quebec and him not wanting to deal with the administration to get paid for his services. Once VitalAire sold me my machine they have not followed up with me once.

I have taken management of the therapy into my own hands... and thankfully have received a lot of good information from the folks here. Most often with apnea you need to take charge of your own situation because no one else will do it for you. My family Doc doesn't know enough about it to advise on the specifics, the Doc at the sleep lab will not consult with me and the DME (VitalAire) is essentially useless except as a sales agent where I can purchase supplies and get reimbursed 100% through insurance. If my insurance plan recognized online suppliers I would purchase through cpap.com.

My Doc was very good about getting the sleep study scheduled. I mentioned a few of the symptoms I was having... and his response was simply "I will schedule you for a sleep study". You might want to start there... get another sleep study scheduled and go from there.

[MoneyGal]

I'm in Canada, in Toronto. I have severe OSA, only diagnosed about two weeks ago. I'm using the loaner machine right now until I have my second appointment with my sleep doc.

I'm interested to know what my purchase options are in Ontario, and how OHIP works. I'm not finding a ton of info about that specific issue here, and I'm in the process of figuring out what machines I can buy, and how OHIP will cover them. I will post about that once I've figured it out.

I also know that the machines qualify as an eligible medical expense for tax purposes, as well as the consumables (filters, masks, hoses).

[Hawthorne]

I am also on Canada.

annasolanis - The secret to dealing with all this, in Ontario, anyway is to be proactive about your own health!

If you had the first study years ago you are at "Square 1". You have to start all over again. Go to your GP if you feel you have sleep apnea. Ask for a referral to a Sleep Specialist. Be prepared to wait, probably months, for that first appointment. The Sleep Specialist will order a sleep study. You can wait months again for the sleep study but my advice is to KEEP PHONING to see if there is a cancellation and you can get in sooner. After your first one (unless you are really severe and they do a split night study - putting the mask and machine on you part way through that night) you will have another sleep study - same as the first only with a mask and machine. At both you will be all wired up. I assume that's the way it was with your sleep study years ago.

At that second study, your "Titration" will be determined. That is the pressure needed to keep you airway open and prevent events. After that, you will see the Sleep Specialist again. He/She will give you a prescription for your machine which will state the pressure. Odds are you will not get an auto.

You MUST call constantly through each of these steps to get the next one done without months of waiting. DON'T WAIT FOR THEM TO FOLLOW-UP! Cnstantly keep after them.

Once you get a prescription you go to a Provider (of cpap equipment) with your prescription or the doctor may fax it over. BE SURE TO GET THE ORIGINAL OR A COPY OF THE PRESCRIPTION FOR YOURSELF. At the Provider's you will choose a machine and be fitted with a mask they might recommend. I went with the one I used at my sleep study first.

The Ontario Government will pay $780 under the Assistive Devices Program. If you have an Extended Health Care Plan they MAY pay some or all of the rest of the cost. If you don't have that you will pay all of the difference yourself. THE PROVDER SHOULD DO ALL THE NECESSARY paperwork and you should get (right away or very soon ) your machine, with a humidifier, tubing and a mask.

Prices are outrageously high for this equipment in Canada. I'm talking $2000- $3000 for that beginner package). If you are going to have to spend a lot out of your own pocket, I would take my prescription and order online from, probably, cpap.com. There you will get a machine, humidifier, tubing and a mask for maybe $1000. They will need your prescription. It will be shipped via Canada Post to your door. There will be no customs or duty, only the exchange. You will have a 2 year manufacturers warranty on the machine you buy from cpap.com. If you buy in Canada, using the Government program, you will get a 3 year warranty. ANy problems can be dealt with through the Provider if you buy in Canada.

I could go on but, if you want more detail you can PM me with your email address and we can go further.

ONLY if you have good extended health coverage, is it financially worthwhile to make use of the Assistive Devices Program.

[annasolanis]

I'm in Canada, in Toronto. I have severe OSA, only diagnosed about two weeks ago. I'm using the loaner machine right now until I have my second appointment with my sleep doc.

What are the risks of using a loaner machine? I presume one uses a new mask, but is there a risk of contracting a respiratory infection?

[annasolanis]

[quote="Paul56
I am located in the Ottawa area but live on the Quebec side.
..
The DME (VitalAire) is more of a sales agent than health care professional. .
.....[/quote]
Is DME the only one in Ottawa? I am in Ottawa too. There is something on the OHIP website about being covered for sleep equipment, but I have to read it again.

[Ms Piggy]

welcome, you have found the best place to look for help.
I'm near T.O. I am not impressed with the providers of equipment here, they are just there to sell stuff at what seem to be inflated prices.
I don' t think it's worth going thru ohip for the lousy 700 as it's cheaper to buy on line and there you can take the on line insurance they have in case the mask you chose doesn't fit OR you can probably resell it to someone (reduced) if you don't insure. You will get a better machine and a wider selection of machines and masks, for less money. get a machine that gives you a read out .

You will of course need a mask for the 2nd overnight at the sleep clinic, but I am sure if you ask the test clinics,and try to set it up in advance, they will fit you up with a mask to use overnight- if not try a different clinic. Be sure to make a list of the names of the ones they try , which fitted and didn't as it's somewhere to start when you purchase.
I phoned around recently for a friend of mine and found that the waiting time for an appt. varies a lot. N of the city you can wait weeks, but in T.O. & immediately surrounding towns some can get you in within a week or a month - once they have "processed " your form. I think you go in at 6 p.m. and leave 6 a.m. approx. for the tests, take your pj's tests usually done monday to friday.
After the tests are over they will set up an appointment for you to see a Doctor, mine was at the same clinic ( this is how mine worked anyway), have your questions ready as, of course, he will be in a rush. He will give you your results from the two tests - this is the time to get your PRESCRIPTION and a COPY of your tritration results for both nights then get out of there, ( I asked at reception for mine)as, if it is anything like my experience you don't want to know - but I'll tell you a bit anyway!
. I was shunted from his office into another where a sales/expert fitter launched into her spiel and quoted to 2 outrageous prices for the choices, I went with the "cheapy" version and got a big clonky Remstar, with humidfier, that did nothing but blow and a full face mask that crucified me at twice the online prices (this mask I tried to return but they wouldn't reimburse me for it, so I returned the machine to them got a receipt, and told them to cancel their payment request to ohip - the extra I had paid over the 700 ohip money more than covered the inflated mask price. I found that they hadn't cancelled their ohip application, luckily the new provider called ohip while I was there to speak to them - even then it got screwed up but that's another story) . I went that route, feeling somewhat stunned and knowing nothing about it not having found or known about forums and it was a mistake.
You should only supply a copy of your prescription anywhere and keep the original as you will always need to produce a copy of it for any purchases, Keep a copy of your test results too. I am not sure if I got a FULL copy of my results or not.
I got 3 pages for each test, have a feeling lately that there could be more.
if it's not too late Ask your regular Dr. for a prescription for tritration tests without naming a company then you can take it where you wish, altho" maybe you can anyway.
It takes time to get the hang of it and can be very frustrating at times, you just have to hang in there and ask for help here.
The only way anyone seems to get back up is if they have private insurance. strange really as they seem to do a lot more for anyone with diabetes, unless they have cut back on that now. In the U.K. they go to the osa section of the hospital and get free machine, mask, parts, and actually have someone to talk to, imagine that, paradise for C'papper's.

Hope this makes sense to you, good luck!

[rested gal]

As you see, I am in Canada. The section for newbies is good, haven't read it all yet. At first I was overwhelmed with all the info I have to learn, yet the posts from Mile High Sleeper helped.

Welcome to the message board, Anna.

Here's a direct link to Mile High Sleeper's great information all in one place:
http://www.smart-sleep-apnea.blogspot.com

She wrote some of the best, most comprehensive info for people new to OSA and "CPAP" of anything I've read.

[Ms Piggy]

sorry, a correction to my post, it should read that I was shunted into the equipment sales office after seeing the Dr. for the result of the FIRST tritration test, the one that you do not need a mask for. so be prepared to dodge this or just chat them up for info or whatever you want at this point.

[RipVW]

Hello & Welcome, annasolanis! Glad you found this forum—SO much useful info and everyone here is so willing to help!

"You are getting sleepy . . ."

[Paul56]

[

There are two CCHSA accreded DME's in Ottawa where you can obtain xPAP equipment from:

-VitalAire
-Medigas

CCHSA is the Canadian Council on Health Services Accreditation.

At the outset I called both of them. VitalAire set me up with an appointment for the next week during my first call to them. I called Medigas twice but they were less than helpful over the phone and told me on two separate occasions that a specialist would call me back... they never called back.

If you have a group plan check if they cover purchase of xPAP equipment. I could not find anything in my group plan information about xPAP coverage so I gave them a ring... turned out they do cover but just don't mention anything about it in the information packet.

If you land up going to the Queensway-Carleton Hospital sleep lab for your study ask for one of the rooms at the back or around the other side away from the nurses station. My first time there they had me near the nurses station... the chatter from there late at night might keep you awake or wake you up.

Expect to pay ~$2,000 for your equipment if you go through a local DME. If you want a specific type of machine get the Doc to write that in the prescription. Be sure to keep the original copy of your prescription.

[tyropita]

The Ontario Government will pay $780 under the Assistive Devices Program. If you have an Extended Health Care Plan they MAY pay some or all of the rest of the cost. If you don't have that you will pay all of the difference yourself. THE PROVDER SHOULD DO ALL THE NECESSARY paperwork and you should get (right away or very soon ) your machine, with a humidifier, tubing and a mask.

Prices are outrageously high for this equipment in Canada. I'm talking $2000- $3000 for that beginner package).

Not my experience -- Resmed Elite II plus H4i humidifier plus Mirage Swift LT mask will cost me about $300 over the $780 ADP payment. I'm between you and Toronto.

[MoneyGal]

In TO I got an appointment within a week by being willing to take a cancellation appointment.

My sleep doc was NOT in a rush with my results, and I did not experience a "hard sell" at the spot where I got my loaner machine.

In fact, the doc said if I experienced ANY problems with them I should let him know, as he is their most significant source of referrals; and he could get me a machine at no charge if that's what I actually needed.

I can't comment on the "loaner" machine question - that's just what they set me up with. I had 91 apneas per hour in my sleep study; the doc said it was urgent I start treatment immediately. For sure the mask they lent me was new.