New with many questions (Canada)

[Alayne]

Hi everyone. I am new here. I have moderate sleep apnea and am currently on a month trial with Vital Aire (Canada). Last night was my first night with CPAP and while I know it is going to take some getting used to, I am hopeful that in the long run my quality of life will improve. This morning I felt as though my head is clearer. I am still tired, but I feel more alert than I have in a long time.

So here are some questions:
1 - I don't have medical insurance, so I will be paying for my equipment myself. After doing some research, I notice the prices online are alot cheaper than what I have been quoted by Vital Aire. Are there pros and cons for going with a company like Vital Aire versus buying online?

2 - Vital Aire says that every six months I would go in and they would read my data, so I guess if I buy my equipment online I would need to find some way to get this data checked? I am bit confused about this data and what you would do with it. I just thought you used the machine, the machine helped you sleep and that was all. Any insight on this would be great.

3 - I am currently trying the Opus 360 Nasal Pillow and it seemed to work well last night, although it is now 3 pm and I still feel like my nostrils are flared out. It's not sore but I am conscious of the tenderness. Is this normal and is there anything I could be doing that would help this?

OK, that's all. Thank you for any feedback you can provide.

[Hawthorne]

You are probably far better off financially buying online. I don't think there is any provincial assistance in Nova Scotia so you will pay it all since you don't have any medical insurance and Canadian prices are way inflated, as you know already.

My advice is - GET YOUR PRESCRIPTION from Vital Aire or your sleep specialist or your gp (whoever has it if you don't).

Without a prescription you cannot buy a machine or a mask online.

When you get your prescription, come back to the forum and let us know exactly what it says. We can then advice on which machines you could purchase.

You can buy software for many machines that will allow you to manage your own therapy. People here are able and willing to help you with all that so that you get optimal therapy.
Getting your data every 6 months is not good enough, especially when you will be overcharged for your machine, as you already know. With the software, you can check your data yourself.

The data tells you what events (apneas and hypopneas, etc, that you have during the night and what your leak line is like. All these are important to getting good therapy. We can help you adjust your pressure(s) so that you get the best results and you can certainly check it more than every 6 months (actually every night!).

The only pro to buying from VitalAire or any Canadian provider, is that you can take the machine in if something goes wrong and probably get a replacement unitl yours is fixed. When you buy online you can't so that so easily. The machines don't generally break down a lot though and there are inexepnesive ways to get a cheap backup so you have one on hand.

Getting used to a mask is the hardest part of the therapy, in my opinion. They will hurt at bit, especially nasal pillows but those are comfortable masks when you adapt. Try a little Secaris (at the Pharmacy) to help you nostrils feel better and adjust faster.

I don't know what else to tell you at this point. Get your prescription before you buy anything and come back and talk.

Good luck!

[Alayne]

Thanks for the feedback, it is much appreciated.

So my prescription, which is now with Vital Aire when I started the month trial yesterday, said CPAP Trial and the word Nitrate or Nitrite. That's all.

I am very intrigued by the whole monitoring the readings yourself. It totally makes sense.

Based on this prescription, what do you think my options are?

Thanks again!!

[sifr]

Thanks for the feedback, it is much appreciated.

So my prescription, which is now with Vital Aire when I started the month trial yesterday, said CPAP Trial and the word Nitrate or Nitrite. That's all.

I am very intrigued by the whole monitoring the readings yourself. It totally makes sense.

Based on this prescription, what do you think my options are?

Thanks again!!

I'm guessing the word was "titrate".

[naturalwoman!]

I use a cpap for snoring, long story short, if your nose piece isn't the right size you will not only loose sleep, but it does make your nose sore. My last shipment was the wrong size, but I tried to use them anyhow and it really hurt my nose , plus alot of air was leaking out and making alot of noise. So I found another business to order from it is 1800cpap.com. They were really helpful, and the prices seem very reasonable. Anyhow they sent me the right size that I needed and what a diff it makes.

Go on line and check out their prices, they always have a special they offer as well, and have a doc available for any questions you might have.
again the site is easy to remember 1800cpap.com
Good luck

[Froro]

I would definately ask Vital aire for a copy of your script. Give them any excuse you want. Tell them you might be covered under a policy but you need a copy of the script.

Sadly most of the DME's leave us all high and dry in the end of the day. There are a few good ones out there but not many unfortunately.

What you want in a machine is something that is data capable, (not just compliance). We can help you get the software and card readers needed to see your own therapy and progress.

What machine do you currently have? What are they quoting you for cost to you? The mask is the biggie as far as comfort and functionality is concerned.

Resmed machines/masks can't be sent to Canada anymore through the online suppliers courtesy of our greedy DME's. There are ways around that though. I'm having things sent to my uncle/parents in the States now who will forward them to me.

Do you have an APAP, Bipap, or straight CPAP machine?

[2flamingos]

DId you have a full sleep study, including titration (where you sleep with a cpap and they adjust pressure to find the appropriate settings)?

I would bet that the prescription actually said "Titrate", and that the machine is an auto-adjusting machine. This allows them to determine settings that may work best for you. Once completed with the trial, you would then get the actual prescription.

Those are just my thoughts!

[LinkC]

I agree with the advice from Hawthorne...and she would know all the "ins and outs" pertaining to Canada.

But I want to strongly reinforce something she said. You DO want the capability to monitor your progress yourself. That means getting a machine which records more than "compliance data" (hrs of use, basically, that's of use only to prove to your insurance co. that you are using the machine.) You want "full data" and the card-reader and software to read it. You can usually get a price break online buy getting a "bundle" that includes what you need. A DME will NOT sell you the software...they'd rather charge you to read it every 6 mos!

You use your data to verify that the therapy is working (reducing/eliminating apnea events). If it isn't, you'll need to change the machine settings...and the data (along with advice/interpretation from here...) will help you with that. Some look at their numbers every morning..others just verify once a month or so. But, as Hawthorne said, 6 months is just too long.

Welcome to the forum, and this "adventure" of CPAP. Pleasant dreams...

PS--I'm guessing the 'script said "titrate". The first sleep study just verified you have OSA. And it looks like you may have to go thru titration with your DME. It's rare, but they MIGHT have you on an "auto" machine to determine your initial settings. I don't know why else they'd have you on a machine before titration. Usually, you go thru a "titration" study to determine those numbers.

[wrenn]

Welcome to a great site. I am in Canada as well and am astounded at the difference in prices. I do have insurance that pays 80% and it still comes close in price when I pay my share and what is charged by cpap.com

I have been on cpap for 3 years and never had data checked. I have a machine that only records 'hours used'. I don't care about data but am obsessive about using cpap because I feel so much better when I do.

The mask is really important and you will discover on this site ways to avoid (or repair) mask sores if you get them...I did with my first trial at nasal prongs. Since the first month I have stuck with the Mirage Activa and loved it but this week started with the Mirage Activa Lt and it's even better.

Hang in there and I am glad you found cpaptalk. Good luck.

[LinkC]

DId you have a full sleep study, including titration (where you sleep with a cpap and they adjust pressure to find the appropriate settings)?

I'd guess not, since the 'script says to "titrate"...

[dels]

Get a copy of the scrip and buy online. Get an older back up machine and the two will be less than a new one from Vital air.

Also check with your hospitals, many have home ventilation programs and with a referal from a doctor will take patients , will give the equipment etc, making the checks and so on.

[Hawthorne]

I expect your prescription does say "titrate" and they are titrating you on an auto. You probably had one diagnostic sleep study to determine that you have sleep apnea.

My concern now is that your prescription says "CPAP TRIAL.. I'm not sure that is any use as a permanent prescription that could be used to buy online, especially since it does not have a titrated pressure mentioned.

You will need to get a prescription, when this trial is over, that has a titrated pressure on it before you can order online.

Someone will correct me if I am wrong, but I think you need the pressure setting on the prescription to get a machine online.

[Alayne]

Wow, you guys are awesome. I feel so much more informed now!

So right now I am using a Resmed S8 Vantage Auto CPAP machine with a Humidaire H3i humidifier. I am using the Opus 360 nasal pillow mask.

And correct, I was never titrated. I had the Stardust sleep study which indicated I had moderate sleep apnea. That study was sent to my family doctor and he gave me the prescription that said trial CPAP titrate on it, which I took to Vital Aire. I have the equipment for a month, after which I would buy something.

I will now have to ask the Vital Aire person if I can do the monitoring myself and also how the prescription works at the end of the trial. If They are not going to offer much by way of aftercare (seems I can do it myself) then I don't see justifying the higher price. If I had insurance I wouldn't be as concerned, but this is a major cash outlay for me.

They are quoting me 1799 for the fixed machine (with humidifier) and 2099 for the auto machine (also with humidifier). The masks are between 199 and 319, but I don't know the exact price is for each mask (the higher end would be the full face mask). These prices are Canadian, of course. Also, apparently there is a newer model for the machine, which is what I would be getting if I bought from them...they just haven't upgraded all their trial stock yet.

Another question, if anyone knows the answer...if you get an automatic machine, does it really matter what your titration is? Is auto better than fixed?

Thank you so much!!

[wrenn]

My impression was that you will take the auto machine back to vitalaire and they would then assess what pressure you needed based on the data on that machine and then send the info to your doctor who would give you a prescription listing the pressure suggested by Vitalaire. Then you could decide whether you just want a regular machine (no data) or 'the works'.

My mask was $255. in Canada and $86. at cpap.com

[Hose_Head]

Thanks for the feedback, it is much appreciated.

So my prescription, which is now with Vital Aire when I started the month trial yesterday, said CPAP Trial and the word Nitrate or Nitrite. That's all.

I am very intrigued by the whole monitoring the readings yourself. It totally makes sense.

Based on this prescription, what do you think my options are?

Thanks again!!

Contrary to the advice that some here have offered, Vital Aire will likely NOT give you a copy of your prescription. The reason is that the prescription is given by your sleep doctor; Vital Aire is not licensed to write scripps.

My guess is that after the titration study (it appears you are doing in-home titration), you will go back to your sleep doctor where he will make his final diagnosis and write the prescription. You can expect that he will send it directly to Vital Aire on your behalf. Don't be shy on insisting that he give you a hard copy, too. Remember that this is YOUR prescription, not Vital Aire's.

Sample rationale to give your doctor on why you need your Rx is that you will be travelling with your equipment and it may be required when flying; you may decide to buy supplies from a mail order source that requires a copy of the Rx; or, you want to retain flexibility to change DMEs at a later date.

Once you have your prescription in-hand, you then can send a copy to an on-line supplier like cpap.com and order your equipment there.

Important note: you will NOT be able to buy Resmed products via mail order using a Canadian Shipping address. Resmed will not allow the US mail-order houses to ship to us. Unless you have a US address to receive your shipments (e.g. US friends, relatives, or a mail-drop box), you will have to buy from a different manufacturer. For this reason, IF you decide to stay with Vital Aire (or another Canadian DME), it might be wise NOT to buy any resmed products from them. This way, you will retain flexibility to buy replacement parts and supplies (e.g. mask, hoses, machine filters, etc) via mail-order at a later date. If you buy resmed now, you will be locked into using a Canadian DME at exhorbitant costs. As far as I know there are NO Canadian discount suppliers.


Good luck with your therapy. You've come to the right place for help!