Pissed about my brick: confront doctor? Or DME?

[Black Shampoo]

So I've been on here a few days, and I have a "brick" and I'm pissed. Especially since I lost my job and don't currently have insurance to go to my doctor for new sleep studies or even to have my machine tweaked, I also have no ability to self-monitor my progress. This is total garbage, man - my machine only monitors "durr, it was turned on."

I want to confront someone over this - who is to blame primarily? Dr. or DME? I imagine it's the latter. I'm even considering asking/threatening them into a trade since I've only had mine a few months.

[caffeinatedcfo]

Start with your doctor, DMEs just fill prescriptions ... like a pharmacist. I would explain the issues you're having and that you are NOT getting any benefit from treatment due to not being able to self-diagnose your issues.

[Pugsy]

Your DME is probably the culprit. Most doctors don't write the RX for a specific brand or model machine.
Typically it is worded like
"CPAP machine with heated humidifier..pressure so and so"
and maybe mask of patient's choice or a generic mask category.
They don't often get into specifics..though some rare docs do.

So technically the DME fulfilled the the RX unless it was written differently...sometimes even if the RX pointed to a special brand or full data...sometimes they still do what they darn well please.

Getting it swapped out is going to be a challenge if you have had it for several months. You might try getting your doctor involved to see if he will back you.
If you can blame the fact that you want leak data...that's a reasonable request and DMEs or doctors can't find much fault with that request. If leaks aren't under control...therapy is pretty much useless.
If you start spouting off about AHI and all that stuff..well they tend to get their panties all in a wad because we aren't supposed to know that stuff.. BUT a machine that offers leak data also offers all the other good stuff. So if you harp on leaks then they might be more open to a different machine.
I know it isn't right...but sometimes it's easier to play their games to try to get what we want.

[Tigerlily]

I'm SO sorry!!! I felt the same exact way as you 2 months ago! I just started cpap in Feb. and joined this forum. Unfortunately I didn't join until AFTER DME screwed me over. I ended up ordering new equipment on cpap.com and threw $650 down the garbage disposal (dme).

[MagsterMile]

Perhaps a silly question but wouldn't the type of machine you get be based on your diagnosis code? Either they code you as 327.23 Obstructive Sleep Apnea or 327.21 Central Sleep Apnea. It seems to me that if your DX is OSA then you might have the problem with the DME trying to fluff you off with a regular cpap machine. If your DX is CSA they would have to give you an ASV machine, right? My initial DX was for CSA and they had me start out with a Cpap unit 12cmH2O Cflex 2. After that was used I was switched to an ASV unit.

[Pugsy]

Perhaps a silly question but wouldn't the type of machine you get be based on your diagnosis code? Either they code you as 327.23 Obstructive Sleep Apnea or 327.21 Central Sleep Apnea. It seems to me that if your DX is OSA then you might have the problem with the DME trying to fluff you off with a regular cpap machine. If your DX is CSA they would have to give you an ASV machine, right? My initial DX was for CSA and they had me start out with a Cpap unit 12cmH2O Cflex 2. After that was used I was switched to an ASV unit.

What would you have done if the cpap machine they gave you first didn't show any AHI to maybe see if you were having centrals? Or if you never had centrals in your sleep study but maybe they reared their ugly head only after the cpap therapy was started...it happens..not often but around 10 to 15 % of the time.

Yes..diagnosis often dictates type of machine and even then sometimes a person's insurance requires that a person try a cheaper machine.

Point is here...with OSA diagnosis and no centrals in the history to complicate things...a non data brick meets a RX requirement but there is zero way to monitor or evaluate anything other than hours of use and the person already knows that because they likely have a clock somewhere.
Leaks will impact therapy quality (let's assume pressure is optimal and no centrals or other complicating factors).
Kenwood (recent forum new member) was having massive, massive leaks and seriously impacting therapy quality. His AHI was still horrible because the leaks were so bad the machine couldn't do its job. If he hadn't had a full efficacy data machine we wouldn't have known that the leaks were massive.

So even with a nice plain jane simple OSA diagnosis..the model of machine dispensed is important from a data perspective.
Bricks meet the minute letter of the RX but don't meet common sense requirements.

The reason DMEs dispense bricks...cheaper...they make more money. Not because the OSA diagnosis says they should dispense a brick.

[Kenwood]

Kenwood (recent forum new member) was having massive, massive leaks and seriously impacting therapy quality. His AHI was still horrible because the leaks were so bad the machine couldn't do its job. If he hadn't had a full efficacy data machine we wouldn't have known that the leaks were massive.

...and if Kenwood had not educated himself and taken charge of his treatment he might have never known he was not getting the treatment he really needed with an untreated AHI of 131. Just read my thread in my signature and see for yourself the issues I went through and how Pugsy and this forum HELPED ME. I received better advice and treatment options from Pugsy and fellow forum members than my Sleep Doctor or DME. Ahhh...the DME battles I went through!

[jtmarten]

So I've been on here a few days, and I have a "brick" and I'm pissed. Especially since I lost my job and don't currently have insurance to go to my doctor for new sleep studies or even to have my machine tweaked, I also have no ability to self-monitor my progress. This is total garbage, man - my machine only monitors "durr, it was turned on."

I want to confront someone over this - who is to blame primarily? Dr. or DME? I imagine it's the latter. I'm even considering asking/threatening them into a trade since I've only had mine a few months.

Don't take this the wrong way, but you are. The DME will provide the highest margin product, ie the cheapest POS you're willing to take. Unfortunately, being uninformed they are able to stick you with a POS brick. Now that you've become far more informed, I would def contact them and request a data logging machine. If they refuse, then its time to get pissed.

[BlackSpinner]

Since you have had it a few months and I assume since you have no insurance anymore it is completely paid Off? In that situation they don't have any responsibility and you don't have any recourse. If your doctor creates a new script they will just make you (over)pay for a new one.

Your best best is to try second wind or craiglist/kijiji for a cheap second hand one and sell what you have.

People have, in the past before the new technology came out, titrated them selves by keeping a detailed journal of how they felt. This has been shown to work quite well. You do have average AHI on your machine.

For your personal satisfaction you can blast both but realize it will only satisfy you emotionally by letting off steam but will do nothing else. You are on your own, but we, the secret underground, have your back.

[Pugsy]

You do have average AHI on your machine.

I don't think so unless I missed something. She has the S9 Escape..no data except hours of use.
Now if she has the S9 Escape Auto then there is AHI available but I don't remember her mentioning the Escape Auto.

[BlackSpinner]

You do have average AHI on your machine.

I don't think so unless I missed something. She has the S9 Escape..no data except hours of use.
Now if she has the S9 Escape Auto then there is AHI available but I don't remember her mentioning the Escape Auto.

You are right. There is nothing. I was confused between the auto and the plain escape.

[LinkC]

Allow me to point out that the vast majority of OSA patients do quite well with a brick and don't know, or care, what their data shows.

It's only us geeks that think going without feedback data is an outrage. We are the exception.

[Hivoltfl]

Link you are correct in that a BRICK does just fine for some, worked for me for 8 years, then my trusty S7 let me down slowly to the point I was going back into congestive heart failure, pressure was dropping down to who knows what before morning, and I was getting sick again, My primary care Doc, that I see every three months threw a hissy fit, long story short I got a much better machine that I can SEE my treatment every morning, tweak it as needed, and am getting better every day again.

I think the OP is very justified in pitching a bitch, this ain't no game, it can and will kill ya.

Guy

[BlackSpinner]

Allow me to point out that the vast majority of OSA patients do quite well with a brick and don't know, or care, what their data shows.

It's only us geeks that think going without feedback data is an outrage. We are the exception.

And 50% quit because they can't get it working right, have no support system and don't understand what is happening.

We don't need data as long as everything is going well and we feel better. Just like I don't need a GPS to drive in the city where I know every road.

[jdm2857]

And 50% quit because they can't get it working right, have no support system and don't understand what is happening.

We don't need data as long as everything is going well and we feel better. Just like I don't need a GPS to drive in the city where I know every road.

+1