Ridiculous quotes and deeds by doctors and DMEs

[allen476]

Good thing this thread exists. As many know that the cardiologist that I saw about 3 weeks ago wants a re-titration to make sure that my apnea is under control. Well the sleep doctor's office called today and well it just about sent me over the edge.

Me: Hello (This is the only part of the conversation that made sense)

Dr: This is Dr. Moronski's office. We have a referral for you from Dr. Niceguy for a sleep study and titration. We need to set up a consultation appointment with Dr. MORONski for you.

Me: Well it is for a re-titration study. I am currently using APAP and Dr. Niceguy would like to make sure that nothing has changed since my titration 5 years ago.

Dr: Well he has it down as a sleep study then a titration study.

Me: Well then you might want to call them and sort this out. I don't need a new sleep study.

Dr: That is for us to determine.

Me: Well give them a call.

Call ends then about 3 hours later.................

Dr: Well we did get this clarified. You were right this is a re-titration. So we need to schedule the consultation.

Me: Why do I need a consultation? All I need is an appointment with your sleep lab to have a re-titration.

Dr: We need to know if you need CPAP first before we do the study.

Me: Yes I do. Nothing has changed in 5 years. I can fax you my initial sleep study as well as the initial titration. In fact I believe that my apnea has worsened as my data points to a higher pressure than the initial titration suggests. I am slowly gaining on pressure.

Dr: Well that is for the Dr. to decide. We can't schedule the re-titration until you see the Dr. first.

Me: Can you schedule the re-titration for the same day I see him?

Dr: No, he will make a determination in a week or so.

Me: I live 2 hours away. I know that I need CPAP therapy. I know that it hasn't cured itself. I know that all the Dr. has to do is interpret the results and send them to Dr. Niceguy. If you are going to harass me into a useless appointment, I think I will call Dr. Niceguy's office and ask for a referral to a different Dr. (Well I toned it down for language)

Dr: Let me talk to the Dr., and I will call you back if he will do that.

Me: I won't expect the phone to ring.

1/2 hour later.................

Me: So are we all set.

Dr: No, he wants to see you. You are a new patient.

Me: No I am not. Cancel everything. I will be in touch with Dr.. Niceguy's office about this.

2 hours later after calling Dr. Niceguy's office and venting...................Dr. Moronski's office calls again.

Me: I will not be seeing Dr. Moronski. I have called Dr. Niceguys office and ask for a referral to another Dr.

Dr: No you don't have to see the Dr.. We have it all straightened out. We just need to schedule you for the lab and the Dr. will send the results over to Dr. Niceguy the next day.

Me: Ok what do you have available?

Dr: How about June 14th?

Me: Do you have anything on the 15th as I have to see Dr. Niceguy on the 16th?

Dr: No I just scheduled the last appointment on the 15th just before I called you back. But since you have been through a lot today, I will put you in and I will reschedule them.

Me: Thank you.

Finally.......I thought that I would have to drive 2 hours to choke someone.

Allen

[SleepingUgly]

Doctor: I'm going to write a prescription for 60 pills. Take 1 a day.

Me: I don't think the pharmacy will fill it for more than a 30-day supply. If you want me to have 60 pills, you will need to write "take 2 a day".

Doctor: No, there are medical-legal issues and if something happens to you, I'll get in trouble.

Me (as Doctor is leaving): Are you going to give me a new prescription for Provigil?

Doctor: You're taking Provigil?

Me: Yes, you prescribed it, and we just discussed how I was doing on it...

[SleepingUgly]

OK, in all fairness this might have been the standard of care at the time, but surprising by today's standards. Copied from old note from doctor's visit in 1991 when my AHI was 9.9 on a sleep study (47 out of 49 hyopneas were in REM):

Doctor: Officially you have mild apnea. As far as it's clinical relevance, you don't need to treat it. It's not significant enough. I don't think apnea is what's going on. You have mainly slowed breathing during REM and we see that all the time. Usually we don't treat it until the AHI is 20 or 30.

[AndrewB]

Not quite up to the level of others - but I contacted my insurance company to find out what they would cover as the replacement cycle for my mask. This is what I got back ....

We appreciate the time you have taken to contact us regarding your benefits.

Your policy covers replacement CPAP machine masks and replacement parts at 80% of a reasonable charge. Your policy does not specify a replacement period for these items. Benefits will be considered on a reasonable and customary basis.

So - in other words, I have to guess, and submit and then "maybe" they'll cover me. Actually they've usually been pretty good but I wish I could have gotten a definate answer from them.

[oscar98]

While my RT was setting up my cpap I took the opportunity to ask several questions.

Me: Can you set my machine to allow me to see my AHI on the screen.
RT: no that can't be done
RT: I'm setting your EPR at 3.
Me: I've found and EPR of 2 to be more comfortable can you set the machine to allow me to change the EPR if I need to.
RT: no that can't be done, you can call me and I'll come change it.
Me: I've heard that for some people cpap can increase the number of central apneas they have, why is that?
RT: That is silly, where did you hear that.

At that point I figure 3 strikes and your out so I stopped asking questions.
After she left I set the machine up the way "I" wanted it with access to EPR settings, climate control settings and AHI info. As for the centrals I knew for sure it can happen because my husband has complex apnea, the higher his pressure goes the higher his centrals go.

[Muffy]

Boy, this is a great thread, SU!

Can we include stupid things said by sleep technologists as well?

I've got a HUNDRED "Stoopid Stories" from "HCPs" that were clearly about 2 clowns short of a circus!

Hmmm.

OTOH, that kinda reminds me of the THOUSAND stoopid things I've said and/or done.

Now that I think about it, I must've said TEN THOUSAND stoopid things that, since nobody told me they were stoopid, I don't even realize they're stoopid.

This past week alone.

On second thought, NM.

Muffy

[SleepingUgly]

Boy, this is a great thread, SU!

Can we include stupid things said by sleep technologists as well?

Sure!

Now that I think about it, I must've said TEN THOUSAND stoopid things that, since nobody told me they were stoopid, I don't even realize they're stoopid.

Do you want us to tell you when you say something stupid?

Of course we all say stupid things. But for some of us who are at the mercy of doctors and DMEs, their ineptitude/ignorance/laziness/disinterest/whatever makes a huge difference in our functioning. There is something therapeutic about being able to laugh about some aspect of it.

[JockLitt]

Because of the cognitive problems I have, the neurologist thought he should send me to an old friend of his - a retired GP who now does sleep studies, to see if he could assess me. I went along for the, "assessment", and took the previous week's oximetry charts and cpap reports with me. The 82 year old, "expert," took one look at the data I gave him and said,
"You obviously know more about this than I do. Once I've set the machine pressures, I don't even look at the patient's data. If they're happy, I'm happy."
That's where we are with sleep medicine in SA.

[Mary Z]

Muffy, you're right. I ought to keep my mouth shut. Shouldn't be posting this. I usually try to be quiet to avoid saying stupid things, but it makes my mate mad if I'm not outgoing and talkative, so I guess I'm doomed to be one of those on the list of saying stupid things. Like this.

[SleepingUgly]

I'm going to bump this up in case any of the new, frustrated members want to be able to laugh at some of our DME experiences, or even post some of their own. This was, IMO, a funny thread that stayed on track, and provided me at least, with tons of laughs. There was one post that I was seriously laughing about for days, at totally random times in the day.

[Julie]

Completely OT as far as Cpap goes, but when I was referred to 'the' senior dietician at a large teaching hospital years ago, we talked about various kinds of food, and I guess cholesterol came up or something, but when I said that mayonnaise was made with eggs (as the entire world is aware) she denied it... over and over, and I had to tell the Dept. Head (I worked in the hospital) what was being put out as expert advice there ... never saw someone look so horrified!

[DoriC]

I just remembered another "doozy"(sp?). A few months ago we went to the DME for a replacement mask and the RT came out to bring it to us herself. She was surprised she hadn't heard from us in such a long time. "How have you guys been doing" ?. Really? I said proudly that I'm now a member of cpaptalk and we've come a long way since we last saw her when I was frantic and crying with frustration. She chuckled awkwardly and said "Oh, that place, don't you know too much information is dangerous, ha,ha"? We said "nice seeing you again" and left in a hurry and went for a nice lunch.

[74snowman]

When I first started CPAP........

ME: I am having problems exhaling. It feels like I am trying to blow up a full balloon.

Dr: Yep, A lot of people have that problem.

Me: Is there something that we can do, maybe a different machine?

Dr: No, a lot of people have that problem. I'll see you in six months. (Dr leaves room before I can I ask anymore questions)

My GP doesn't understand why I won't go back to them.....

Allen

Just as an aside answer to this question...
It takes your diaphragm time to loosen up and become accustomed to breathing against pressure when it used to a negative pressure environment. For some people this can take 10 to 30 minutes or more. Some people are not able to adjust to the pressure, and you should consult your physician about getting EPR relief or possibly going to a bi-level machine to help with the problem. That's my standard answer for this problem. Anybody see anything wrong with that?
Snowman

[74snowman]

Good thing this thread exists. As many know that the cardiologist that I saw about 3 weeks ago wants a re-titration to make sure that my apnea is under control. Well the sleep doctor's office called today and well it just about sent me over the edge.

Me: Hello (This is the only part of the conversation that made sense)

Dr: This is Dr. Moronski's office. We have a referral for you from Dr. Niceguy for a sleep study and titration. We need to set up a consultation appointment with Dr. MORONski for you.

Me: Well it is for a re-titration study. I am currently using APAP and Dr. Niceguy would like to make sure that nothing has changed since my titration 5 years ago.

Dr: Well he has it down as a sleep study then a titration study.

Me: Well then you might want to call them and sort this out. I don't need a new sleep study.

Dr: That is for us to determine.

Me: Well give them a call.

Call ends then about 3 hours later.................

Dr: Well we did get this clarified. You were right this is a re-titration. So we need to schedule the consultation.

Me: Why do I need a consultation? All I need is an appointment with your sleep lab to have a re-titration.

Dr: We need to know if you need CPAP first before we do the study.

Me: Yes I do. Nothing has changed in 5 years. I can fax you my initial sleep study as well as the initial titration. In fact I believe that my apnea has worsened as my data points to a higher pressure than the initial titration suggests. I am slowly gaining on pressure.

Dr: Well that is for the Dr. to decide. We can't schedule the re-titration until you see the Dr. first.

Me: Can you schedule the re-titration for the same day I see him?

Dr: No, he will make a determination in a week or so.

Me: I live 2 hours away. I know that I need CPAP therapy. I know that it hasn't cured itself. I know that all the Dr. has to do is interpret the results and send them to Dr. Niceguy. If you are going to harass me into a useless appointment, I think I will call Dr. Niceguy's office and ask for a referral to a different Dr. (Well I toned it down for language)

Dr: Let me talk to the Dr., and I will call you back if he will do that.

Me: I won't expect the phone to ring.

1/2 hour later.................

Me: So are we all set.

Dr: No, he wants to see you. You are a new patient.

Me: No I am not. Cancel everything. I will be in touch with Dr.. Niceguy's office about this.

2 hours later after calling Dr. Niceguy's office and venting...................Dr. Moronski's office calls again.

Me: I will not be seeing Dr. Moronski. I have called Dr. Niceguys office and ask for a referral to another Dr.

Dr: No you don't have to see the Dr.. We have it all straightened out. We just need to schedule you for the lab and the Dr. will send the results over to Dr. Niceguy the next day.

Me: Ok what do you have available?

Dr: How about June 14th?

Me: Do you have anything on the 15th as I have to see Dr. Niceguy on the 16th?

Dr: No I just scheduled the last appointment on the 15th just before I called you back. But since you have been through a lot today, I will put you in and I will reschedule them.

Me: Thank you.

Finally.......I thought that I would have to drive 2 hours to choke someone.

Allen

Having been in the sleep lab side of this problem, I think I can shed a little light on it. Medicare patients, by Medicare mandates, must have a new sleep study every few years in order to determine necessity of the cpap equipment. This is our tax dollars at work. Some labs make it a standard practice to require ALL patient who haven't had a sleep study in a couple years or so to go ahead and have a new study just for this reason. Sometimes they let it slide on non-medicare patients, but if you're close to medicare age, they will require it because medicare won't reimburse them for the titration if they don't have recent proof of apnea.
Snowman

[montana user]

Ok I have to admit when I first saw this post I was kinda mad. I thought ok, let me post some of the stupid things patients say, like " can you really see my dreams" " do you sleep next to me all night" but after reading the posts,, they are damn funny!!! I laughed out loud on a couple of them!!!