A Reply To Leejgbt and Rooster

[mars]

Rooster

OK, so what I need to do is to try and resolve what is becoming a feud between myself and you, and try to make sense of what has been going on.

For myself I can only continue pretty much as before. If you continue to malign me (like comparing me to a Nazi just because I tell Forum members how to use an oximeter for naps) I will probably get slightly annoyed, shake my head, and respond accordingly. The same for lies and misleading posts. If I can ignore them without losing self-respect - I will.

It is possible that you do not well understand the concept (and the reality) of collateral damage. You aim your barb at a target, but other people also read and see this barb. To witness verbal and visual violence can be a (very) disturbing event, and it seems to be that your barbs are causing problems to those not your target.

So, please mate, do not throw a bomb when a bullet will do. Challenge what you see to be wrong with facts (and humour), but be precise. SAG taught me this very early on when I maligned RT's. I did not agree with the way it was done, but I was wrong, and I apologised. I am still learning.

You can still use your humour and your visuals, but in a much more clever way.

We are all looking after our own treatment here. Many professionals are taught something entirely different, and they arrive at this forum and tell us we are wrong. Let them arrive, and let us challenge them with facts, not dismiss them as idiots. Hopefully, we will learn from each other. Your method is likely to turn some of them into hating all OSA sufferers, and who will then cop it. Not you, but the people they deal with.

From your attitude shown to me, you have been as close-minded as any Professional ever mentioned. Remember -

viewtopic.php?f=1&t=44264&p=404418#p404418

Your treatment of me sharing something that could be helpful was a disgrace. I am hoping that somehow you can start to be more open-minded, and work out why you are on the forum. To help people, or to annoy and upset people.

Actually, you do both, and that is what is so sad about this whole mess.

We all have our moments, especially after having had sleep and oxygen deprivation for many years. There are times when not posting is the right and supportive thing to do.

Lets try and get this right.

cheers

Mars

[roster]

Rooster

OK, so what I need to do is to try and resolve what is becoming a feud between myself and you, .......
Mars

Sorry buddy, you are doing the feuding, not me. That's OK by me, but just don't work yourself into such a lather that it affects your health.

.... If you continue to malign me (like comparing me to a Nazi just because I tell Forum members how to use an oximeter for naps) ........

Mystery solved! Finally, I know why the sight of my avatar makes you livid.

But that I compared you to a Nazi just ain't true. Check the "offending" post again ( viewtopic.php?f=1&t=44264&p=404418#p404418 ). I did not compare you to a Nazi. In fact I said I wanted to protect you from the Nap Nazi:

...............So why do you keep trying to get me to stop doing it?

............

We are trying to protect you from the Nap Nazi who eventually strikes every unmasked napper.



Don't let this happen to you - it won't come off even with laser treament. Always mask up!

(Oximeters offer no protection from the Nap Nazi!)

Rooster
I wonder if the Nazi Nazis will attack this post?

Shucks, I should not have used a permanent marker for that photo. I scrubbed my face raw for four days before the last remanants were gone.

[mars]

Rooster

Quote - I did not compare you to a Nazi. In fact I said I wanted to protect you from the Nap Nazi: - End Quote

And as I was the one promoting naps then I must be the Nap Nazi. But that is irrelevant, what is relevant is what you did not respond to.

From your post I take it that you don't care who you hurt or how you damage the Forum; and I guess nothing can be done about that. Pity - but there it is.

Do not worry that your self-centred behaviour will affect my health, putting up with you is probably equal to 10 years recovery in a 12 step program.

Anyhow - as they say on "The X Files" - the truth is out there.

For all to see.

Mars

[GaryG]

By the way, if anyone posts a comment for which you strongly disagree with, its always an option to ignore it. (That includes this post as well).

[carbonman]

Sorry buddy, just ain't true., Shucks,

Rooster,

Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them?
-Shakespeare

I believe that I have, in fact, been collaterally damaged.
The verbal and visual violence that has been perpetrated on me has
shattered my fragile being and your barbs of unconceptualized reality are
causing me to have very disturbing events.......such as,
having to respond to this thread and lose all self-respect.......
not to mention those events that were not detected by or responded to by my therapy.......
and don't try to blame the 10cm algorithm rule.
The truth is out there.....just ask the alien tweakers.....they know.

Further, as a result of your bombs, I can not longer go to my DME,
because it no longer exists. As a result of your self-centered behavior
my beloved B&M DME is now just dust and rubble.

"sorry buddy", "just ain't true", Shucks and will no longer suffice for your defense.

I can no longer accept you as a slight annoyance and shake my head.....
I must respond.

I demand restitution.

So....at your earliest inconvenience, I will require that,
at great expense, to you, the latest and finest conceptualized carbon
be delivered to my door.

Then, and only then, will I be able to begin to remove the last remnants of this sad and
sordid mess from my mind and move on to the 11th step......

....whatever that is.

[LinkC]

lol

(All that takes on fresh meaning when you consider that Hamlet, in your opening quote, was mulling over suicide...)

[leejgbt]

I have admitted that the quote "60% compliance with DME versus 3% online" is proving difficult to find. When I talk to venders such as Respironics and ResMed this quote is used alot in regards to why their products are marketed the way they are. I will eventually produce this study as it is out there. I have some people working on it. I do remember that compliance for this study was based on 4hours per night. After reading several studies that tracked whether 4 hours was enough time to prevent any of the issues that develop from OSA I believe this should be an absolute minimum.

The point I was trying to make with this stat is that going it alone leads to less compliance. I mentioned in the same thread that the people participating in this site were probably part of the 3% that were compliant as participaing in support groups have a great inpact on compliance. The point I was trying to make was to not go it alone.

I cannot believe it but I am going to agree with autocpapdude about something. I have pushed hard within the industry for years to allow home sleep tests as only in this environment can you get a true idea of the sleep habits of the patient suspected to have OSA. Variables such as alcohol and TV watching effect the quality of sleep and even the number of apneas. More and more it is being proven that the number of apneas recorded is greatly effect by your sleep position and even pillow size you use. Medicare as of this year now allows in home sleep tests but the reimbursement is so low very few are doing them. I have pushed for the sleep lab in my town to add these tests as it does not preclude doing a PSG later. Because of reimbursement they are not interested. DME companies are prohibited from doing these tests to qualify a patient's medical necessity for Medicare.

The problem with using auto CPAP as a means of titrating is that each manufacturer uses a different algorithm and is attempting to accomplish different outcomes. The only study I have read comparing auto CPAP with sleep lab titrations recently turned out inconclusive due to the variable algorithms. I would be curious to know how autocpapdude's physician came to this conclusion. But if these units are used in conjunction with feedback from the user to the physician to titrate the optimum pressures I am all for it.

I have been a proponent of using auto CPAP for years as it only delivers the pressure needed to keep the airway open. Titrations from sleep labs use a pessimistic pressure that only accounts for the maximum pressure needed to keep the airway open. This pressure may only be becessary for 30 minutes per night.

[Scarlet834]

I am popping in here just long enough to say, Leejgbt, I'm happy you have not vanished from the forum. (Same to Rooster, as you are directly responsible for me rolling my lips inward when applying tape and eliminating the drool factor.) Play nice, guys, OK? I'm learning a great deal from everyone.

[GaryG]

The problem with using auto CPAP as a means of titrating is that each manufacturer uses a different algorithm and is attempting to accomplish different outcomes. The only study I have read comparing auto CPAP with sleep lab titrations recently turned out inconclusive due to the variable algorithms.

leejgbt, I have participated in such a study over this past week at my sleep lab. Once I get the results I'll be posting them here.

viewtopic.php?f=1&t=46294&p=415716#p415536

[steveeas]

What Slinky said. This is shabby behavior IMH.

[Kiralynx]

The point I was trying to make with this stat is that going it alone leads to less compliance. I mentioned in the same thread that the people participating in this site were probably part of the 3% that were compliant as participaing in support groups have a great inpact on compliance. The point I was trying to make was to not go it alone.

Leejgbt,

I'm not trying to be rude or confrontational, here. But I must state that based on my own experience, a brick-and-mortar DME is very nearly useless when it comes to support.

The RT at mine did help me get the right machine for my situation, but beyond that, nothing. I'm the one who trouble shot everything. I'm the one who learned, from this Forum about selecting a mask which would work for me BEFORE my titration. I'm the one who learned about the software and card reader so that I could trouble shoot my issues. I'm the one who determined that my EPAP needed to be lower -- and contacted the RT who contacted my doctor, and on being given the go-ahead, called me back and walked me through changing the pressure on my machine.

So I both am and am not a self-titrator. I determined what was needed because I educated myself in this Forum. But I worked with my doctor and RT to have my settings changed.

Every single contact with that DME has been initiated by me, including my first morning, my one week, my one month, my three month, and my six month calls. I gave up and didn't bother to call them for the nine month call because my mother was very ill and I didn't have the time or the energy to put up with the high blood pressure which any contact with that brick-and-mortar DME causes.

So I find it extraordinarily difficult to believe that a brick and mortar DME is likely to be very much help, in particular to the extent your as-yet-unsubstantiated statistics indicate.

If my situation is, in any way, similar to the experiences of others currently in this Forum, then it is wholly comprehensible why the reaction to a "Pat, pat, do what we tell you and don't question it," statement is likely to create an outpouring of vitriol.

Some months ago, an Apria RT posted here about what Apria could do to improve their service. Since very few people here have had positive experiences with Apria, the result was a thread filled with anger. I participated in that thread here: viewtopic.php?p=341974#p341974

viewtopic.php?p=339768#p339768 tells why the brick and mortar DME makes me see red.

I'm going to ask you: since it's patently obvious that many people here have little or no use for brick and mortar DMEs, how does one proceed when one cannot change DMEs because of insurance, and when the DME in question is behaving in a manner which would drive off any but a captive audience? What positive steps can a DME customer take to bring about change when the DME treats them in an inappropriate manner?

And, I'm going to ask again, you stated in another thread that DMEs might ask strange questions of their customers because they were only trying to comply with the rules. So what are examples of these strange questions?

[Guest]

Yes Kira - you're right once again with your idiotic 'paint everyone with the same brush' statements regarding how useless DMEs are. Get a clue. With your know-it-all attitude I'm not surprised your DME didn't want to initiate contact with you lol. Yikes.

Keep up the DME bashing. You assume there is some type of golden DME behavior book that, magically, everyone will follow to your liking - or else. You act like all DMEs are the same. When in God's name are you simply going to realize that, like all businesses, some suck and some excel. MOVE ON!

If you want to take your own treatment into your own hands, go ahead! Self-titrate until you're blue in the face for all I care. Wrap moleskin and panty hose around your face. Leejgbt is correct - for the anal-retentive person that likes to tweak his AHI from 1.4 to 1.6 using software, that is fine. All you get from online companies is a cheap price, distorting the real cost of this therapy. No one will follow up with your doctor or worry about your other side health issues. People that work with their doctor and DME have higher compliance rates.

[mars]

.

When in God's name are you simply going to realize that, like all businesses, some suck and some excel.

People that work with their doctor and DME have higher compliance rates.

Guest

First of all, You do realise that your first statement contradicts your second statement?

Secondly, given that about 100% of forum members have about 100% compliance, your second statement sounds like wish fulfilling fantasy. But if you have the evidence to back up that statement, by all means share it with us.

But getting nasty will not convince anybody of anything.

Mars

[ozij]

Keep up the DME bashing. You assume there is some type of golden DME behavior book that, magically, everyone will follow to your liking - or else. You act like all DMEs are the same. When in God's name are you simply going to realize that, like all businesses, some suck and some excel. MOVE ON!

If you want to take your own treatment into your own hands, go ahead! Self-titrate until you're blue in the face for all I care. Wrap moleskin and panty hose around your face. Leejgbt is correct - for the anal-retentive person that likes to tweak his AHI from 1.4 to 1.6 using software, that is fine. All you get from online companies is a cheap price, distorting the real cost of this therapy. No one will follow up with your doctor or worry about your other side health issues. People that work with their doctor and DME have higher compliance rates.

Guest, don't you have some clients to attend to, needing you precious time? Don't you have phone calls to make? What are you doing here, sufring the net, wasting your time with a bunch of idiots instead calling doctors, following up on new cpap users, making sure you've got the widest selection of masks and machines possible, so you will succeed it satisfying your clients and running your business? Don't you have some papers to read? Knowledge to gain from reliable sources? New machines to study?

MOVE ON! Guest. The milk of human kindness, pouring from all you words is really wasted here. MOVE ON!

O.

[DoriC]

This forum IS my DOCTOR and DME! And I never have to make an appointment with the "specialist" a month from now so that in less than 15mins I can be told nothing of any value that I haven't already learned here and then having a misinformed RT speak to me in a rude and condescending manner.(I call it the senior citizen syndrome!) I can't speak for anyone else but this has been my experience and I don't think I'm alone in this. Sorry.