I was set straight by RT at my DME! APAPs should not be used

Dale92 · Post by **Dale92** » Fri Jun 09, 2006 3:18 pm

All you are about to read is true, no names have been given, remember this is all the opinion of people who are responsible for my treatment.

Well as I stated in an earlier thread today I returned my trial APAP back to my DME because it was saturated with the smell of cigarette smoke which was pumped into my nose thank you very much. While I was exchanging the machine for another Remstar Auto w/cflex the RT who initially set up my original machine 9 months ago just happened to be at the desk doing some paper work. Of course he recognized me and asked what was new. I told him about the exchange and the reason and he wondered why I was using an APAP instead of my CPAP.

I went through the reasons for the two week trial with the APAP and told him at that time I was going to talk to the doc about switching to APAP if it made a big difference in how I was feeling.

Guess he didn't agree with me using an APAP because he told me that APAPs should only be used for a short period to determine what pressure you should be at if you are not going to do a real sleep study. He said APAPs are only machines and they cannot tell what pressure you actually need at that moment. For example he said if you are laying on your back you need a higher pressure than you need on your side. So if the APAP ups the pressure because you are having an apnea on your back and then you roll over to your side the APAP does not notice this and continues the high pressure which he said is more than you need. So during the night your pressure may go up and you fight against it because it is more than you actually need.

He told me that my pressure should be set so that my apneas are controlled while I am on my back. This way he said that since most apneas occur in the last half of the night that is what should be controlled. We should give up the first half of the night if we must to apneas and poor sleep to achieve a better sleep in the last half of the night. There was a subtle suggestion to possibly taking a sleep aid to get me to sleep deeper and so not move around in my sleep.

All I can say is I am glad for this new information now I can rest easier

Handgunner45 · Post by **Handgunner45** » Fri Jun 09, 2006 3:47 pm

I wonder if he really believed what he told you? I bet if he was to really think about it he would feel like an idiot. At least her should feel like and idiot!!!! It seems that he took you for an idiot. Aren't we all glad that we have all the wonderful people on here it make sure we have the straight story and not just some DME BS!!!!!!!!

Guest · Post by **Guest** » Fri Jun 09, 2006 3:48 pm

BEWARE THE EVIL DME! .

rested gal · Post by **rested gal** » Fri Jun 09, 2006 10:44 pm

LOL!! What a mishmash of illogical thinking and misunderstanding about what APAP's do/don't do.

How did you keep a straight face, Dale?

Whew.

ozij · Post by **ozij** » Fri Jun 09, 2006 11:33 pm

Oh God, this sounds almost like something by Mike Moran!!!!

O.

Ric · Post by **Ric** » Fri Jun 09, 2006 11:36 pm

Next time remember to bring the proper equipment:

mikemoran · Post by **mikemoran** » Sat Jun 10, 2006 12:03 am

WOW he must be right. If you keep rolling onto your back the dumb machine will just keep pumping you up more and more and we all know what happens to an over inflated tire LMAO

rested gal · Post by **rested gal** » Sat Jun 10, 2006 2:54 am

Ric wrote:Next time remember to bring the proper equipment:

ROTFL!! Good one, Ric!

tomjax · Post by **tomjax** » Sat Jun 10, 2006 6:59 am

Dale, Your RT has been infected by the diety virus that is sometimes spread by being in close contact with Docs who are in the terminal stages of this condition.
It is spread to very succeptible individuals who want to be PC and love to be in line for the follower of the year awards.

PLEASE invite him to come to this board and post his advice. Bet he will not.

You should warn him that there a few here with the virus, but not many.

Question:
If vegetarians eat vegetables,
what do humanitarians eat?

Dale92 · Post by **Dale92** » Sat Jun 10, 2006 8:16 am

Very funny comments!
Rested Gal, believe me I had a hard time not breaking down and laughing in his face. I tried a couple of times to correct him but he just brushed me off and continued. I think the lady who I usually deal with there caught me rolling my eyes a couple of times.

tomjax, I did tell him about this board when I first found it! I was very frustrated with the mask he gave me to use so I looked around the internet, found this place and looked at cpap.com found a great selection of masks. He had a follow up visit a few days later and I told him this mask and the last one did not work for me. He told me there was only one other mask that was available. I said funny I found a sight on the internet that had quite a few masks of different designs. He asked and I told him. But as you say he most likely never came to the board, or perhaps he may be one of our very knowledgable guest posters

Oh as I mentioned he also suggested I take a sleep aid to prevent me from moving around. I tried to pull his leg a bit and told him that I didn't want to take a sleep aid like Nyquil PM or Ambien because of the reported effects of some medications on apneas. What I was alluding to was the report on the board a while back of OSA sufferers needing more post operative attention because some anesthesia causing potential fatal apneas. Well he said there would be no problem so with a sly look in my eye I asked him why doctors were so concerned that I had OSA when I had my last couple of surgerys. Oh that is such a big scam he said, the insurance companys should pay me money to go into the OR and debunk these stupid myths that hospitals use to rake in extra money. He told me there is no reason for concern because during surgery the stuff a tube down your throat that extends far past the point of any apneas so there is no chance that you could have a problem.

I thanked him for his diligence and all of his information leaving with a spring in my step and a smile on my face while carrying out the replacement APAP. Of course I also had sore sides from holding it in for the 10 minutes I was talking to him.

Dale

snork1 · Post by **snork1** » Sat Jun 10, 2006 9:31 am

..." He said APAPs are only machines and they cannot tell what pressure you actually need at that moment. For example he said if you are laying on your back you need a higher pressure than you need on your side. So if the APAP ups the pressure because you are having an apnea on your back and then you roll over to your side the APAP does not notice this and continues the high pressure which he said is more than you need. "....

OMG!!!!!!!!!!!!!!!

So this "experts" solution is to have you use a machine that is ALWAYS at that highest pressure?????? And this solves that issue HOW???????????

Sorta reminds of the old joke:
"what do you call the doctor that graduated at the bottom of his class?"

....
"Doctor".

Apparently that applies to RT's too.

My sleep doc also believes only in CPAP and fights me on the APAP thing. He wanted to put me on a straight CPAP at 9cm after my nose surgery dropped my pressure. Yet on APAP I spend 90% of my time at 6cm or less, and just at rare times spike up to 10cm. i.e. I spend about 1%, if that, of the time at what would have been the prescribed pressure. I also get terrible aerophagia at 9cm compared to 5-6 cm.

rested gal · Post by **rested gal** » Sat Jun 10, 2006 10:11 am

Dale92 wrote:He told me there is no reason for concern because during surgery the stuff a tube down your throat that extends far past the point of any apneas so there is no chance that you could have a problem.

Wonder if he's given a passing thought to what happens after the tube is removed and the groggy, sleepy person is in the recovery room? Geeze.

Humidifier

Additional Comments: ResScan and SleepyHead software