CPAP Improperly Set-Up Fails Another Patient

I scored an S9 Autoset with 10 hours on the clock from a local Craigslist ad this morning and exchanged two pieces of Monopoly Money for the machine.

Jeff was a tall guy in his early 40s. He had the appearance of someone who had recently lost a lot of weight. It turned out he had. He said he only used the machine a couple of nights and just couldn't stand the feeling of something on his face. He said he couldn't get to sleep. So it sat in the closet for two years and he decided to sell it. Said he lost a lot of weight and now isn't so tired, and won't ever use CPAP again.

I told him everyone's different, that I took to it like a duck to water and needed this machine for a backup. I didn't want to get into it too far with him, but I suspected he had the wrong mask and probably the machine wasn't setup right for him. Few sleep specialists take the time to ensure that the human/machine interface is correct. Individuals are just that. It's not like setting up an IV pump in a hospital.

The Pulmo-Doc who did my sleep study said the sad statistic that more than 50% of those who are prescribed CPAP fail to use it was, in his opinion, because the titration study wasn't done right, and/or there was no followup with the patient.

When I got home, I hooked the machine up. It still had the peel-plastic film all over it. The humidifier hadn't been touched. I looked at the setup. 10 hours total run time. Cool beans, as my son would exclaim.

As I scrolled through the settings, I found it was set for:
CPAP (! ! !)
Nasal mask,
Slimline tubing,
Pressure 5 cm. (! ! !)
Beginning ramp pressure 4 cm.
Ramp time 45 minutes.
etc.

It's a wonder the poor guy didn't turn blue! I know I would have at 4 cm.

So another patient who likely could have benefited from xPAP therapy bailed out due to failure of the clinician to follow-up with him. And he's going to tell everybody who he comes in contact with that xPAP is no friggin' good.

Well, I can't complain. I got a new machine for cheap. But I feel bad for Jeff.

I look at it like I do my animal rescue....we can't save them all. No matter how much we want to we just can't for any number of reasons.
I got a machine that was brand new some years ago from a woman who had lost a little weight and tried to convince herself that she felt better. She was still a chunky monkey ...sigh...like 100 lbs overweight.
She wasn't going to change her mind because she simply didn't want to use the machine for whatever reason.
So she wanted to sell it. I got a good deal on it and passed it along to someone in Canada because it was an APAP and back then finding an APAP in Canada was no easy feat...much less one that didn't cost an arm and a leg.

It was brand spanking new...an insurance replacement for a machine that damaged in the tornado...so she did have a machine and use it at some time.

My rule...I ask once "are you sure you want to sell it" "If you want to try again I would be glad to help"....and if they still want to sell it I don't argue with them.

Thanks for your insight, Pugsy.

I was on the fence as to whether or not to offer advice. But his demeanor and body language said he was really done and just wanted to get the transaction over with. And he showed no interest when I said that I had been using the same machine for more than 7 years. So I decided not to press the matter, and just took the machine.

Agreed!
Once the quitter puts a machine up for sale, it is past the point of no return.
Too bad we can't get to them before they pull the handle.

Well, I think we DO get to some of them. At least the ones who show up here and post messages about giving up. Some sound like they're jumpers looking for someone to talk them down. And the response is usually very helpful.

I think my pulmo-Doc was right. There's insufficient care diagnosing and especially following-up. When patients have trouble, there's not really anywhere for them to turn. Except the DME that sold them their machine. And we all know how spotty the level of expertise is there. Yes, I'm being charitable.

My wife's an insomniac.** Some friends (and I) pestered her into finally having a sleep study, hoping to find out why she has trouble sleeping. So she relented and scheduled the test. Sleep tech wired her up and stuck a FFM on her (WHY?), and, of course she failed to sleep long enough for him to get any meaningful data. Yet he called the next day, saying she needs to make an appointment to get fitted for a CPAP machine. Same guy who said he didn't get any data. Yet his boss wants to charge her insurance for a machine he has no indication she actually needs. What the heck's going on here?

**and I fall asleep within minutes of denting the pillow. It's awkward sometimes.