If the script states auto CPAP and the DME does not give you an auto CPAP they are changing a physician's order and can be in big trouble. That would be like a pharmacist deciding that percocet is better or cheaper than oxycodone and changing the physician's script on their own. Same principal. I live in the real world and am fully aware of DME companies that do change scripts. I worked in a sleep physicians office and had a certain nameless DME call everytime our DR wrote a script for a downloadable or Auto CPAP and say that they could get a plain jane CPAP alot cheaper and ask if I would change the script. They can be really sneaky and deceptive about it too, so if your Dr's staff is not on the ball they can be taken for a scam. I had to turn this certain DME into the Board of Healing Arts to get them to stop. I also would call tour patients the day after they got there equipment to verify what the DME gave them. Most physicians won't go that far, but it was a personal mission for me. Now that I work in a DME company, I set patients up the day the equipment is ordered and fax a list of the equipment I set a patient up with to the DR.
Results of my sleep study. . .
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inacpapfog
- Posts: 538
- Joined: Tue Nov 16, 2004 6:03 pm
- Location: SC
I think the doctor wrote up the script correctly. I can understand the reasoning behind wanting or specifying a range. Specifying a "range" might be nice for instructions to the DME on setting up an autopap but it is totally unnecessary.
KNOWING what the PSG titration pressure is/was is more important information. In fact, if you have that pressure you can set up any Autopap.
Had the doctor simply put down a range you would have NO idea of what the lab titration was.
I also do not believe there should be a range set above that titration pressure. The working "range" should be the titrated pressure and lower. The pressure above the last titration should only be increased for investigational purposes such as flat-lining or if it is suspect that a higher pressure is needed.
The titration pressure found at the lab is the pressure found that offered the most ideal sleep for the patient. If the PSG showed any kind of CA or MA events, then all the more the reason the Max. pressure should not be exceeded.
KNOWING what the PSG titration pressure is/was is more important information. In fact, if you have that pressure you can set up any Autopap.
Had the doctor simply put down a range you would have NO idea of what the lab titration was.
I also do not believe there should be a range set above that titration pressure. The working "range" should be the titrated pressure and lower. The pressure above the last titration should only be increased for investigational purposes such as flat-lining or if it is suspect that a higher pressure is needed.
The titration pressure found at the lab is the pressure found that offered the most ideal sleep for the patient. If the PSG showed any kind of CA or MA events, then all the more the reason the Max. pressure should not be exceeded.
Problem with no range on an APAP prescription is Local DME won't give you the machine.
I know from experience with Apria. I could have perfectly well set it up myself, but they wouldn't give it to me.
They also wouldn't make a range around the titrated pressure. Insisted that the Doctor write it on a prescription. Quite a go round in my case as my primary physician didn't know what to put, and the sleep doc (whom I never met wouldn't give one -- Insisted that I had been titrated for CPAP not APAP. I would like to hear from anyone out there that knows. Is there really some special titration process for APAP? I think it was a lie but I could be wrong).
So I told my doc what I wanted (thanks to the people on this forum) and he wrote it when this foolishness got out of hand.
As to knowing your titrated pressure, it should be in your sleep study report. Mine is. No need to have that on an APAP prescription.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, CPAP, DME, Prescription, APAP
I know from experience with Apria. I could have perfectly well set it up myself, but they wouldn't give it to me.
They also wouldn't make a range around the titrated pressure. Insisted that the Doctor write it on a prescription. Quite a go round in my case as my primary physician didn't know what to put, and the sleep doc (whom I never met wouldn't give one -- Insisted that I had been titrated for CPAP not APAP. I would like to hear from anyone out there that knows. Is there really some special titration process for APAP? I think it was a lie but I could be wrong).
So I told my doc what I wanted (thanks to the people on this forum) and he wrote it when this foolishness got out of hand.
As to knowing your titrated pressure, it should be in your sleep study report. Mine is. No need to have that on an APAP prescription.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, CPAP, DME, Prescription, APAP
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
KansasRT, I always enjoy reading your posts. You're one of the good'un's who is not only efficient, but goes that extra mile to really help people...in your work, and here on this message board. Thanks!KansasRT wrote:I had to turn this certain DME into the Board of Healing Arts to get them to stop. I also would call tour patients the day after they got there equipment to verify what the DME gave them. Most physicians won't go that far, but it was a personal mission for me. Now that I work in a DME company, I set patients up the day the equipment is ordered and fax a list of the equipment I set a patient up with to the DR.
ResMed S9 VPAP Auto (ASV)
Humidifier: Integrated + Climate Control hose
Mask: Aeiomed Headrest (deconstructed, with homemade straps
3M painters tape over mouth
ALL LINKS by rested gal:
viewtopic.php?t=17435
Humidifier: Integrated + Climate Control hose
Mask: Aeiomed Headrest (deconstructed, with homemade straps
3M painters tape over mouth
ALL LINKS by rested gal:
viewtopic.php?t=17435
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episodic1
well crap - not cpap - crap
Well my wife was going to run and get the scrip amended for a pressure range. Well I live in BFE. . . and my doc had to deliver a baby today. . .sigh.
Well, turns out it was a c-section, and guess who the only guy round here that does c-sections is? You guessed it. So he just closed his whole office down.
Long story short - another dadgum day I can't do jack.
I'm attending a workshop now that I cannot miss 1 day of. If I miss a day, I loose a 1500$ stipend, I can't afford to loose (half my kid's braces money). . .
Of course the workshop is an hour away and lasts from 8-4, so it is freaking impossible to get anything done. I SOOOO hate living in the middle of nowhere. I can't wait till I get to leave this area next year and return to civilization.
Basically, I guess I give up for the next three weeks. Which really sucks. I still remember when I got my sleep study how good I felt, I want to feel like that again.
I was one of those people that actually woke up feeling like superman, the first time.
I fell asleep twice in the workshop I'm attending today. I'm sure the instructor did not appreciate it, I started to doze with a little snort. I was actually even interested (we are learning to teach calculus in a different way, and I'm actually understanding more calc than when I went to college. . .but sitting there working calculus problems for 8 straight hours everyday is a little much for a sleep deprived person.
I'm wondering should I just say to heck with trying to get this fancy stuff and just take whatever they gave me. Sure I'd love a resmed autopap with cflex and all the bells, but I'm about ready to get whatever and just be happy. I did do the sleep study with a cpap, not an apap - but everyone here has kinda got me convinced to try to get this apap. Is it truly worth it to wait the next three weeks before I can get all this crud out of the way?
Well, turns out it was a c-section, and guess who the only guy round here that does c-sections is? You guessed it. So he just closed his whole office down.
Long story short - another dadgum day I can't do jack.
I'm attending a workshop now that I cannot miss 1 day of. If I miss a day, I loose a 1500$ stipend, I can't afford to loose (half my kid's braces money). . .
Of course the workshop is an hour away and lasts from 8-4, so it is freaking impossible to get anything done. I SOOOO hate living in the middle of nowhere. I can't wait till I get to leave this area next year and return to civilization.
Basically, I guess I give up for the next three weeks. Which really sucks. I still remember when I got my sleep study how good I felt, I want to feel like that again.
I was one of those people that actually woke up feeling like superman, the first time.
I fell asleep twice in the workshop I'm attending today. I'm sure the instructor did not appreciate it, I started to doze with a little snort. I was actually even interested (we are learning to teach calculus in a different way, and I'm actually understanding more calc than when I went to college. . .but sitting there working calculus problems for 8 straight hours everyday is a little much for a sleep deprived person.
I'm wondering should I just say to heck with trying to get this fancy stuff and just take whatever they gave me. Sure I'd love a resmed autopap with cflex and all the bells, but I'm about ready to get whatever and just be happy. I did do the sleep study with a cpap, not an apap - but everyone here has kinda got me convinced to try to get this apap. Is it truly worth it to wait the next three weeks before I can get all this crud out of the way?
Depends on how much value you are going to get from your insurance. I reskimmed the posts and didn't seem to see how much copay you have.
If it is $200 or 300 or more, you may want to just take your prescription and buy a machine from cpap.com right now and get started ($709). If money is tight and insurance coverage is decent then you have to decide what the fancy stuff is worth to you.
I bought a used CPAP from an online auction to use while I fought and got my apap. So I understand the frustration you are feeling.
If it is $200 or 300 or more, you may want to just take your prescription and buy a machine from cpap.com right now and get started ($709). If money is tight and insurance coverage is decent then you have to decide what the fancy stuff is worth to you.
I bought a used CPAP from an online auction to use while I fought and got my apap. So I understand the frustration you are feeling.
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Guest
Sleep Stages:
Stage 1 4.1% =this is a transitional stage of sleep , its about normal.
Stage 2 65.9% = this is a little high, it explained already
Stage 3 0% Stage 4 0%
= these stage are restorative sleep stages, but their % diminish with age...kids get allot elderly get a little.
REM sleep; 30% = This is important because adults get alit more of this restorative sleep stage than the others (3&4). Normal is around 25%. Often when people have OSA they don't have alit of this ( because it gets knocked out) and when they are first on cpap and are able to go into REM with out interruption they get REM "rebound" were the brain makes up for lost time by having extra stage REM, so to speak.
Latency to REM Cycle 140.5 minutes = normal is 90-110 or so...probably prolonged by events.
Latency to Sleep Onset 5.5 minutes = normal is 20 minutes...sleepy without the cpap? lol
Hyponeas 103 = partial obstructions that cause arousals and desaturatins like apneas do
Apneas 37 = stop breathing , we know, we know
Oxygen Saturation 92-85% =the range of your blood oxygen levels ( by pulse oximeter)throughout the night or maybe the highs and lows, depends on how they like to write stuff.
Electrocardiogram 85 = EKG 85...i guess maybe your average pulse? not sure.
Stage 1 4.1% =this is a transitional stage of sleep , its about normal.
Stage 2 65.9% = this is a little high, it explained already
Stage 3 0% Stage 4 0%
= these stage are restorative sleep stages, but their % diminish with age...kids get allot elderly get a little.
REM sleep; 30% = This is important because adults get alit more of this restorative sleep stage than the others (3&4). Normal is around 25%. Often when people have OSA they don't have alit of this ( because it gets knocked out) and when they are first on cpap and are able to go into REM with out interruption they get REM "rebound" were the brain makes up for lost time by having extra stage REM, so to speak.
Latency to REM Cycle 140.5 minutes = normal is 90-110 or so...probably prolonged by events.
Latency to Sleep Onset 5.5 minutes = normal is 20 minutes...sleepy without the cpap? lol
Hyponeas 103 = partial obstructions that cause arousals and desaturatins like apneas do
Apneas 37 = stop breathing , we know, we know
Oxygen Saturation 92-85% =the range of your blood oxygen levels ( by pulse oximeter)throughout the night or maybe the highs and lows, depends on how they like to write stuff.
Electrocardiogram 85 = EKG 85...i guess maybe your average pulse? not sure.