Newbie with Questions

[Guest]

Hi,
I was diagnosed with mild apnea and had 2 sleep studies done in Nov/Dec 2011. I am a heavy snorer. So here is my stor/questions

Knowing nothing the Doc ordered me a machine and I got it on 12/29. I needed to get it before the year end since my insurance changed and it would be covered by my existing insurance and new insurance would be a larger out of pocket.

So they gave me a S9 Escape with Climate Control and a humidifier and a gel type nasal mask. I asked a few questions whether it was auto, saved data, etc and the DME person said it is what the Doctor Ordered and the insurance OK'd. So beggers can't be choosers I guess.

So night 1, I put it together, got a few questions.
1) can I change the humidity or just the temperature? Temp is 76 degrees, is that too cold? I noticed I had most of my water left
2) Ramp time is 20 minutes, but when I first turn it on I feel short of breath unless it is claustrophobia, I done a lot of Scuba diving and have good lungs so wearing a mask was no biggie and I don't think it is Claustrophobia.
3) How can I tell if the heater is working or whatever? Do I have to worry about the heat ruining the finish on my night stand?
4) I noticed when I woke up, I guess the pressure which is set to 8, blows out the exhaust of the mask constantly.
5) When I woke for the restroom I turned it off then unhooked and restarted, is that proper, since it free flows air if I unhook and it is on, but when I do this it needs to ramp again and I feel like I don't get enough air for a bit.
6) Sleeping was OK, I did wake once with a slight leak but I readjusted, but the mask pushes hard under my nose, she gave me a s/m nasal thing with a small gel pack, she said it was because the bridge was narrow?
7) As for the machine what info does it capture, it is an escape, can I bring the card to my doctor. It said I used it for 9.5 hours and quite honestly I fell back asleep this morning when the sun was out which I never do until a phone awoke me.
is humidity directly related to temperature? Should I turn it up ot get more humidity?
9) So my wife said I did snore some last night, she said it started then stopped, not like before. Is that normal?
10) initially I had a hard time exhaling, One of the settings I changed was from pillows to nasal mask. Not sure if that was an oversight by them or if I should have messed with it.

If some of these are answered elsewhere I apologize. All in all it went OK, but I am really wondering if I should try the nasal pillow things. I will try the mask a few more days. But today I kind of feel refreshed even though I did wake up tired. Kind of an Oxymoron I guess.

Thanks

[rjg202]

Hi, I just posted this.

Hi,
I was diagnosed with mild apnea and had 2 sleep studies done in Nov/Dec 2011. I am a heavy snorer. So here is my stor/questions

Knowing nothing the Doc ordered me a machine and I got it on 12/29. I needed to get it before the year end since my insurance changed and it would be covered by my existing insurance and new insurance would be a larger out of pocket.

So they gave me a S9 Escape with Climate Control and a humidifier and a gel type nasal mask. I asked a few questions whether it was auto, saved data, etc and the DME person said it is what the Doctor Ordered and the insurance OK'd. So beggers can't be choosers I guess.

So night 1, I put it together, got a few questions.
1) can I change the humidity or just the temperature? Temp is 76 degrees, is that too cold? I noticed I had most of my water left
2) Ramp time is 20 minutes, but when I first turn it on I feel short of breath unless it is claustrophobia, I done a lot of Scuba diving and have good lungs so wearing a mask was no biggie and I don't think it is Claustrophobia.
3) How can I tell if the heater is working or whatever? Do I have to worry about the heat ruining the finish on my night stand?
4) I noticed when I woke up, I guess the pressure which is set to 8, blows out the exhaust of the mask constantly.
5) When I woke for the restroom I turned it off then unhooked and restarted, is that proper, since it free flows air if I unhook and it is on, but when I do this it needs to ramp again and I feel like I don't get enough air for a bit.
6) Sleeping was OK, I did wake once with a slight leak but I readjusted, but the mask pushes hard under my nose, she gave me a s/m nasal thing with a small gel pack, she said it was because the bridge was narrow?
7) As for the machine what info does it capture, it is an escape, can I bring the card to my doctor. It said I used it for 9.5 hours and quite honestly I fell back asleep this morning when the sun was out which I never do until a phone awoke me.
is humidity directly related to temperature? Should I turn it up ot get more humidity?
9) So my wife said I did snore some last night, she said it started then stopped, not like before. Is that normal?
10) initially I had a hard time exhaling, One of the settings I changed was from pillows to nasal mask. Not sure if that was an oversight by them or if I should have messed with it.

If some of these are answered elsewhere I apologize. All in all it went OK, but I am really wondering if I should try the nasal pillow things. I will try the mask a few more days. But today I kind of feel refreshed even though I did wake up tired. Kind of an Oxymoron I guess.

Thanks

[Janknitz]

I asked a few questions whether it was auto, saved data, etc and the DME person said it is what the Doctor Ordered and the insurance OK'd. So beggers can't be choosers I guess.

First, you are not a beggar. I'm pretty sure you or your employer paid the premiums on that insurance for a long time. You are insured, and entitled to the full measure of whatever your insurance covers. That's WHY you have it.

Second, I highly doubt your doctor ordered the ResMed Escape. It's a lousy brick--no data except hours of use. Your doctor probably ordered a CPAP. It was the DME who chose the Escape for you, because it's the cheapest machine, and since your insurance pays a set fee no matter what machine you get, the DME makes more money when you get a cheap brick of a machine. Ask to see the prescription from the doctor and look for the word "Escape" on it. I'll bet you a doughnut it's NOT there.

If you'd like to try to get a decent machine with data, take a look at "help, I'm stuck with a brick" on my blog in my signature below. DON'T wait--first thing Tuesday morning, you should call your insurance company to confirm your benefits, and then be at your DME's to swap out this lousy machine.

[rjg202]

Man, I hope I am not screwed over. My insurance that I have til the end of the year authorized the purchase. My new insurance will require my deductible to be met. Here is what went down.

The DME person told me I can take my card to the Doc and have it read to see if there are any adjustments required. Well I see that is not the case. I asked if it was data capable and she said the DOC did not write for that. On the sleep study he wrote for REMSTAR prod CPAP unit with heated humidification set at a pressure of 8 and a ramp of 20 minutes. The Flex mode should be engaged at 2 whatever that means. Diagnosis 327.23 Now the prescription states same thing. I read your article and I wonder if I have a leg to stand on. Would it be in my best interest to call the Doctor since they faxed all this to the DME provider. The DME asked if I wanted a copy and I took it, so I have both sleep studies and the prescriptions. Also wonder if I should just call the Doc, arrange a return and buy another machine and pretty much pay my full deductible to get the machine since the insurance that paid it will no longer be in effect. Or do I take the card to the DME on tuesday and say it is not working to read my settings? They are a big company not sure if I can list the name or not. But now I am depressed. I should have known when they had awards in the waiting room for biggest sales, fastest time to collect payments, etc.

Something is wrong with this picture, I really think I need to engage the Doctor since they sent me there, I really don't want to go through more studies for a lousy $50 in cost differences.

Thanks

[rjg202]

Maybe I do have a leg to stand on, The Doctor wrote in the sleep study for a REMSTAR Pro, looking at the specs it monitors AHI, FL, RERA, snore, leak, CA, OA, HY, PB. The only thing working against me is the prescription does not say Remstar PRO and my insurance situation. Any suggestions, since Tuesday will be into my new insurance whereas I would need to pay. I think I am needing to run this by the Doctor and see what he says, evidently he has a relationship with the DME provider

[indyzoom]

First of all, I would just tell the DME you want to exchange the machine. I know they have exchange policies for masks, I'd imagine they'd have it for machines too. I would explain to them that your doctor requires a data-capable machine and the one they gave you doesn't cut it.

As for your other questions, and this is coming from a newbie as well, so perhaps someone else can jump in if I'm incorrect:

1) If you have a climate hose, you probably just change the temperature and it adjusts humidity (higher temp = higher humidity) -- I tend to have most of my water left too, but haven't had any problems
2) I get that feeling too, I think it's part of getting used to it. I find myself taking slow, deep breaths to get used to it. Think of meditation and how you breath when meditating, that's what I do and it helps me adjust and even helps me fall asleep as I focus on my breathing.
3) It's working, and no
4) Masks have a place for air to blow out, the machine knows this and adjusts the pressure to make sure you're getting the proper amount -- don't worry about it.
5) I turn mine off, leave my mask on but unhook from the hose, then reverse when I'm done
6) The machine will tolerate much more leakage than you'd expect. Unless its bothering you, I wouldn't worry about it and loosen your mask a bit. Might also want to try other masks too to find one you like best.
7) Somebody else already answered this one
Yes, higher temp = more humidity. Find what temperature is comfortable for you and I wouldn't worry too much about humidity.
9) Not sure, might need to see data to know for sure
10) From what I understand, this setting doesn't do much except adjust the data recording. Try my breathing suggestion above.

[rjg202]

Will know Tomorrow, DME will swap with S9 Auto/Data provided the Doc gives a new prescription. All information supplied to Doc today, hopefully will have good news tomorrow. The DME does not carry the Elite for one reason or another. They also mentioned a S8 Elite but after a callback and they said I needed a new script to say S9 Auto on it. Thanks

[idamtnboy]

Will know Tomorrow, DME will swap with S9 Auto/Data provided the Doc gives a new prescription. All information supplied to Doc today, hopefully will have good news tomorrow. The DME does not carry the Elite for one reason or another. They also mentioned a S8 Elite but after a callback and they said I needed a new script to say S9 Auto on it. Thanks

So, what happened today? Don't worry about the year change. Since the diagnosis and prescription all were in 2011 your 2011 insurance is responsible. Your first round of supplies, etc., will come under your 2012 coverage.

[rjg202]

Doc agreed to new machine at 3:30 today, they were writing the prescription and faxing to DME provider. I made a hard sell to the nurse that I really want to be able to monitor my progress and take the reports to the Doc in the future. I have still been using my escape for a week now. Getting used to it, but I tend to wake once or twice sucking for air. Happened 3 nights so far, so not sure if that could be an 'event'. Hopefully DME don't go back on their decision but no complaints thus far.

Does the nasal pillows work with a climate line? My blue gel mask irritates the cartilage above my upper lip.

Thanks

[Pugsy]

Does the nasal pillows work with a climate line? My blue gel mask irritates the cartilage above my upper lip.

Yes. Nasal pillows will work just fine with any hose, standard or the climate line.

Congrats on getting the S9 Autoset.

[rjg202]

Ok, final offer, they are willing to swap me a F&P Premo for the S9 escape. I am not too concerned about the software at this point since the DME will do it for free so they tell me. Or else I am stuck with escape. need

Is this a quiet machine, I see it is rated at 30DB where s9 is 24 DB. Not sure if that is a big deal. My wife said it better not 'tick' all night. Actually the S9 ticks, when I turn it off.

But questions (I also posted elsewhere, trying to get many opinions)



1) quiet, how quiet is it
2) does it turn off/on when mask is removed
3) Heated tube, I think you can only change humidity, is that an issue?
4) can I just collect AHI data and leak data from previous night and record in spreadsheet
5) What about S9's EPR for exhaling, is this even a concern. My lungs are fine fortunately, I just snore bad
6) s9 had settings for masks, like full/nasal/pillows, any concerns
7) IS this a step up from the escape, is it a fair swap?
cost and availability of consumables
9) differences in tubing sizes between climateline and Primo


I like the smaller footprint, what I am concerned with Is I cannot separate humidifer from unit. I am mixed on that, but I guess premo would work if humidifier broke and I assume it works similar where air blows over it.

Thanks