VA Handbook 1173.13 - Home Respiratory Care Program

[justbreathe]

I found this interesting for anyone using the VA to provide home respiratory care.

http://helpdesk.vetsfirst.org/index.php ... ter&id=300

[thud]

Good link justbreathe. Thanks.

[ameriken]

Thanks, I'll try and get through some of that this weekend. It'd be nice to know exactly what they can and cannot do.

[justbreathe]

My understanding is they will test any veteran enrolled in health care system and provide necessary cpap or bilevel device necessary as well as mask and supplies. I could not find a guide for frequency of mask exchange.

I will be talking with my VA primary care physician later this month to see about getting equipment provided. I will not be surprised if I have to see a VA Sleep doctor or lung doctor before it is approved.

[McLiam]

VA Medical centers vary, but here in Sacramento I asked for a sleep study for over seven years before I finally got one (a take home job at that) and then waited over a year for CPAP, but by that time I'd qualified for Medicare, so I took my study to a local sleep doc and had a CPAP within a couple of days. I wish now I had been more aggressive in demanding a sleep study.
Good luck,
Mac

[squid13]

I had a friend of mine that went on CPAP through the VA in July of this year. He did a home test and they gave him a good machine and mask and will furnish all his supplies. I believe they use the same schedule for replacement as Medicare.

[GumbyCT]

The VA follows Medicare guidlines for compliance, mask replacement, etc.

fwiw - I never saw a pulmonary doc before I got my equipment. I dropped off a copy of my sleep study and prescription at the Primary Clinic, never saw the doc. The doc gave his required referral to Pulmonary. About one month later the machine was delivered to my house by a contracted DME. It took that long to get my first machine from Apria (a dataless Plus model) and the sent it via UPS. The driver didn't even stay to help me put it together. I had NO CLUE how to start.

[GumbyCT]

I did see several VA sleep docs after I got my equipment.

fwiw- I knew more than most of them who were in training. BE Careful there and don't ask to many questions.

They only have one that I will see now.

[squid13]

My friend went to the VA clinic in Pensacola, FL and picked his machine up there and was given complete instructions on how to use by them. The person giving the instructions also had sleep apnea.

[ameriken]

I went through the whole routine, from the initial suspicion from my provider (Nurse Practitioner), to the initial consult with the pulmonary doc, and 2 sleeps studies. I spoke with my provider in November 2010, and got my machine in June 2011. Total of 7 months.

I am eternally grateful, it is a $3000 machine.

However the doctors there are quite lacking. The Nurse Practitioners there are awesome, and the RT's seem more knowledgable than the Doctors. But, my sleep doc stinks. I'm trying to get in to see the Doc who read my report. One of the RT's told me she is an exception and that she is (in his opinion) the best sleep doc in Denver.

[GumbyCT]

I too am grateful and they do get excellent equipment. The VA just tries to run it like they are on Active Duty and many of them are just draft dodgers.

It's back to the 'ol eat or go hungry mentality. But again I am grateful they do recognize it is a health problem.

I do wish they offered more like a support group. I know they laughed at me when I offered to help organize one. Keep in mind I don't need one but know it would be helpful to those trying to adjust to changes like this to their sleep.

To me having just one person fail cpap is too many.

[archangle]

My dad was getting apnea treatment from the VA. They were both good and bad.

At first, they wanted to do UPPP on him. Pretty stupid to do that to an 80+ year old. Luckily, one of his civilian doctors stopped that.

After that, they gave him a Legacy Auto machine, good choice at the time. However, they didn't give him a humidifier. They worked him through several different masks. They gave him an oral mask, which specified in the instructions that it should only be used with a humidifier. I went with him to the VA one time and pointed this out to the therapist and she got him a humidifier.

He was pretty happy with them, but the patient needed to be careful and "manage" them to get the right treatment.

They did have him mail them the card occasionally and check and adjust his settings.

[ameriken]

I did see several VA sleep docs after I got my equipment.

fwiw- I knew more than most of them who were in training. BE Careful there and don't ask to many questions.

They only have one that I will see now.

How did you go about getting that doctor?

The one I'm seeing is totally useless. My first post-machine meeting with him I brought my smart card and asked if he wanted to see it and he said no. Then he recommended I go to another hospital, National Jewish in Denver, to join a support group there.

Then he asked 'So what is it that the VA do for you'?

I thought, great, maybe they have some services I don't know about. So I said, "Well, what are some of the things the VA has available that would be helpful?"

His response? "You'll get more ideas over at National Jewish."

So, as I mentioned in another post, I'm trying to get in to the doc who read my PSG. One of the RT's there said she is a great sleep doc. But when I try to make an appointment, I get stonewalled and the clerk tells me "Well, you're already seeing so-and-so, he's your sleep doctor so you can't see such and such ".

I don't want to step on any toes, but on the other hand, I need to talk to someone who knows what they're doing. Any suggestions?

[Bobby269]

I had my sleep test through a civilian Doctor.Brought my paper work to the Va when I went for a new mask. They shocked me and gave me a new Resmed S9 Autoset, a climateline hose and a new mask. You can get new supplies every 6 months. They won't give you a cushion for the quatro fx, they insist on giving you a new mask. The person at the VA said from their point of view it's cheaper for them to only supply a new mask.
I love the VA.

[ameriken]

I had my sleep test through a civilian Doctor.Brought my paper work to the Va when I went for a new mask. They shocked me and gave me a new Resmed S9 Autoset, a climateline hose and a new mask. You can get new supplies every 6 months. They won't give you a cushion for the quatro fx, they insist on giving you a new mask. The person at the VA said from their point of view it's cheaper for them to only supply a new mask.
I love the VA.

Yeah, I asked them about that too, the cost 3 replacement cushions is about the same as the cost of one mask. Since the cusions are the only thing that really wear out, I'd rather have the cushions.

here's some of your government waste.