Keeping up with the Jones's

[gailzee]

Just remember: Doctors, half graduate in top half of class, and then there's the bottom half...........haha.

All kidding aside, dr. set me up for astraight CPAP, I told him re: sinuses, headaches, I may as well been watching PAINT DRY. I demanded (yes in a bitchy woman phone call voice) I WANT APAP. And guess what, I GOT APAP. So he had to ''re-do'' the scrip, gee that's hard.

Get a pap than can do either, and then listen to Liam, he is the man.

G.

I am in a position where I need to make a decision on a CPAP machine soon.

Like everyone on this site and most people who have access to the internet, I have spent hours researching and reviewing information and opinions regarding what is the "best" machine to get.

I've heard and read all about the advantages of APAP vs CPAP. I spoke to my Dr. about this today and he said something that I wasn't really expecting...that APAP has a "marketing driven approach to get customers to buy and that it is not totally supported by the medical OSA field."

That leads me to a rather disappointed conclusion, that a CPAP machine with a good warranty is all I really need. I'm bummed. I so wanted to keep up with the hosehead Jones's, but now realize it would only be a waste of money.

Oh well, I think I'll use my money to be the first of my friends to have one of those cool new flat screen TV's instead.

[-SWS]

I should also point out that the Joneses just seem to sleep and breathe better!

The CPAP Smiths fare okay too for the most part...

[Mikesus]

Ok, here is a REAL good reason for an auto. Just took a nap and downloaded the data (I am such a hosehead already!) and guess what? My 10cm H20 setting was off!! According to my data I my 90% setting should be 12.5cm H2O and the machine Avg was 14.9 cm H2O!!! What does this mean? That the one night study that was done reflected conditions that DO NOT exist in my home! If I didn't have an Auto, I would be getting 1) less therapy 2) Prolly still snoring some (which after all the costs would irritate the better half) and 3) Not getting as good sleep as possible.

I truly feel the only reason the dr's and sleep center's do NOT want you to have an auto is to ensure their cash flow. If you know its not working you have to see the doc to get a script to change it (he will prolly bill your insurance co!) Your DME will prolly charge (your insurance again!) to change the pressure, and if it has to be changed more than 2cm H20 they will want to order another kilobuck sleep study! Now, I am not saying that my Remstar Auto pro equals a kilobuck sleep study, but if you read the info that comes with the machines, they are used for people that can not do a traditional sleep study! (In other words, sleep centers are using these to determine titration!!)

/rant off

Make sure that you get an auto!!

[-SWS]

Mike, be sure to thoroughly analyze the apparent pressure discrepency both ways before finalizing your conclusion. Neither PSG sleep studies nor AutoPAPs are infallible. Either one could be in error----or because of night-to-night variability both could have been correct as you imply.

[Mikesus]

Mike, be sure to thoroughly analyze the apparent pressure discrepency both ways before finalizing your conclusion. Neither PSG sleep studies nor AutoPAPs are infallible. Either one could be in error----or because of night-to-night variability both could have been correct as you imply.

From my wife's description I vary a lot. Last night she had to check to see if I was breathing ok cuz I wasn't snoring, actually got her worried! I think that in most cases a single sleep study can get a number that is good most of the time. Unless you are one of the lucky ones that vary night to night...

[-SWS]

I think that in most cases a single sleep study can get a number that is good most of the time.

I agree with that, Mike!

[Liam1965]

I should also point out that the Joneses just seem to sleep and breathe better!

The CPAP Smiths fare okay too for the most part...

But the Johnsons... Not so well. (Yes, that's really my last name).

Oh, and if you try to strap your mask to your johnson, it just doesn't work at all.

Liam, who figures now that everyone ELSE is doing these closing lines, maybe he should stop.

[UKnowWhatInSeattle]

Ok, I am now a veteran PB420E user (1 night.). That "one number" I scoffed at in a previous post was 8 as determined by titration at my sleep study last March. Now with the fancy Auto machine, it tells me that my actual preferred pressure is, (ta da!) 7. So, on the basis of one entire night on my Auto machine, it looks like the sleep clinic was just about right. Frankly, that doesn't surprise me. They sure seemed like they knew what they were doing.

I'm a tech geek, so the idea of being able to track my usage is pretty exciting.

[Liam1965]

I truly feel the only reason the dr's and sleep center's do NOT want you to have an auto is to ensure their cash flow.

Wow, and I thought I was cynical and jaded. I maintain that the average American is not well informed, and not particularly interested in being so.

AutoPAP is, IMO, great for those of us who CARE, who try to become INFORMED about our condition and want to take an active hand in our treatment. I'm not as convinced that patients who DON'T have that level of involvement should be able to do without the doctor's care, because for better or for worse, SOMEONE needs to pay attention.

(Not that AutoPAP wouldn't help them as well, but letting someone get the impression they can do without ANYONE (themselves OR a doctor) coordinating their care is probably not in their best interests. And I'd like to think that's where MOST doctors are coming from.)

Liam, the second most cynical, jaded person in the room.

[lynn]

"Liam, who figures now that everyone ELSE is doing these closing lines, maybe he should stop. "

Hey, Liam, you can't stop because yours are the BEST! I have been exchanging email with a friend for years, and both he and I have been using closing lines in that style for years - SELDOM as entertaining as yours, of course!

lynn, at a loss for words for a closing line

[LDuyer]

If Liam stops writing his closing one-liners like he threatens (and I don't believe it for a minute), then we might all have to give it up. We need the master jokester to set the bar for the rest of us.

Linda, whos peeps would be sad if Liam stopped his one-liners.

[rested gal]

Hmmmm..dunno. I've got a feeling that doctors prescribe straight cpap rather than autopap for a simpler reason (or more complex, depending on how on looks at insurance companies.)

From what I've read on the message boards many (not all) insurance companies will not "ok" paying for rental or purchase of a more expensive machine (autopap) unless it can be proven (through first using straight cpap) that the patient is not receiving adequate treatment from a straight cpap.

As far as I know, when an insurance company stubs up that way (Southern phrase meaning: "refuses or acts stubborn") a patient isn't going to get an autopap unless the doctor is willing to go toe-to-toe with the insurance company over it. Letter of medical necessity, etc.

Most doctors don't seem to understand much about any of the equipment anyway. They just diagnose and then leave it up to the DME (home health care provider) to handle the nuts and bolts of treatment. The DME has no real interest in bucking the insurance company. The cheaper the machine, the more profit to the DME, if the DME has an agreement with some insurance companies to receive a fixed amount regardless of what machine is used.

I really don't think the doctors themselves are trying to keep patients from autopaps. I think it's more a matter of ignorance on the doctors' part about possible better treatment. The doctors are busy and would just as soon leave everything "mechanical" to the DME's. And then there are the doctors, of course, who have a kneejerk antipathy toward autopaps in general due to studies, experiences or things they've heard in the past about problems that were troubling in earlier autopaps.

All in all though, I don't think it's that the doctors themselves are thinking, "I won't prescribe an autopap because the patient might get such good treatment he won't have to consult with me as often." I think it's ignorance of what the machines of today do, and not wanting the hassle of arguing with an insurance company.

Even without a sinister pall over it, I do think doctors are failing their patients right and left, when it comes to treatment of sleep apnea. It's sad.

[Mikesus]

Liam, the second most cynical, jaded person in the room.

Why thank you!

There is good reason for it tho. I have adult onset asthma as well as OSA. Until I got extremely proactive with my healthcare, a number of Doctors, as well as specialists just threw meds at it expecting it to go away. When it didn't I did a LOT of research and found a place that could figure it out. Today I am no longer having asthma attacks. If I had not been proactive, I would be still suffering... So, I think I am allowed to be cynical...

[Mikesus]

Just remember: Doctors, half graduate in top half of class, and then there's the bottom half...........haha.

And the ones that don't pass are at DME's?



No offense meant to people that failed that aren't DME employees


Ok... No offense to the few good DME's

[chrisp]

Ok... No offense to the few good DME's

Thats you Christine

Chris