MyAir.com -- PissedMeOff.com more like it...

ChicagoGranny wrote:

cathyf wrote:Yeah one of the weaknesses of counting events with no concern for duration is that an event that's long enough that it kills you doesn't count for any more than the 10.0001 second bobble.

Nooo, what you stated is not the weakness. The weakness is, for example, 45-second apneas are counted the same as 15-second apneas.

Your reductio ad absurdum argument hurts the point you are trying to make.

You said what I was trying to say, but better... A 45-second duration event and a 15-second duration event are counted the same. And I think it's worse than that -- if you have ten 10-second apneas spaced out evenly over two hours, that counts the same as ten 45-second apneas packed into 8 minutes if there are none for the rest of the 2-hour period. In the latter case you spend 7-1/2 out of the 8 minutes not breathing, and probably would not survive, and your AHI was only 5.0.

NateS wrote:Besides, it's the one way to keep in regular touch with our adult children and grandchildren and on their activities and the neat pictures they take almost every day with their cellphones. We see more ongoing activity photos of our children and grandchildren in a week than our parents saw of us and our kids in months.

I agree Nate! Five days old:



I was getting pictures within ten minutes of her birth.

And FaceTime has been a miracle this week!

cathyf wrote:

ChicagoGranny wrote:

cathyf wrote:Yeah one of the weaknesses of counting events with no concern for duration is that an event that's long enough that it kills you doesn't count for any more than the 10.0001 second bobble.

Nooo, what you stated is not the weakness. The weakness is, for example, 45-second apneas are counted the same as 15-second apneas.

Your reductio ad absurdum argument hurts the point you are trying to make.

You said what I was trying to say, but better... A 45-second duration event and a 15-second duration event are counted the same. And I think it's worse than that -- if you have ten 10-second apneas spaced out evenly over two hours, that counts the same as ten 45-second apneas packed into 8 minutes if there are none for the rest of the 2-hour period. In the latter case you spend 7-1/2 out of the 8 minutes not breathing, and probably would not survive, and your AHI was only 5.0.

This is one of the areas where the doctors and sleep tests need to change how they view the test results and how they explain them. AHI is important, but not the only thing. My mom and I both have severe sleep apnea, but in very different ways. I snore like crazy. She doesn't snore at all. Most of my events were in the 12-18 second range, but tons of them. My mom had fewer events, but much longer events. Her oxygen went down lower than mine. But if you go by ahi, I am more severe.

When I started cpap treatment, I had a noticeable improvement, and my mom admitted she didn't see that much improvement. After the 6 week followup, I set my machine for her pressure of 10 and let her use it for half a night. Her ahi was 3.4, well treated according to the standard idea of treatment. But she had a cluster of events over 30 seconds each, and one was over a minute long. Not well treated at all. We did another half night at 10-13 (I didn't want to let it go too high the first time). We took the 2 printed reports to my sleep doctor who prescribed a new auto machine for her (full data), and she started feeling more improvement too.

We really need the doctors to fully get on board with using the data and looking at more than compliance and ahi.

kaiasgram wrote:

NateS wrote:Besides, it's the one way to keep in regular touch with our adult children and grandchildren and on their activities and the neat pictures they take almost every day with their cellphones. We see more ongoing activity photos of our children and grandchildren in a week than our parents saw of us and our kids in months.

I agree Nate! Five days old:



I was getting pictures within ten minutes of her birth.

And FaceTime has been a miracle this week!

How precious!

Congratulations!

Regards, Nate

Thanks Nate!

Wulfman... wrote:It's always been a mystery to me that the manufacturers don't even factor in the end users. Oh, yeah, they've got stuff on their websites, but in reality, the "consumer" is the DME (those who sell the equipment).......it stops with them. Most of the users trying to contact the manufacturers with issues get told "don't bother us with your problems.....go see your DME" (Like W.C. Fields......"Go away, ya bother me, kid").

Talk about an upside-down industry!!!

But in reality, almost all of the products we buy in today's industrialised society are sold to us through a middleman. It is the retail stores and chains who are 'the "consumer" ' as you want to put it. I am guessing you don't order your toothpaste direct from the Crest factory; you probably buy it from some middleman (which is what the DME is.) When you need a new ream of paper for your printer, you don't wander down to the local lumberman and ask him to cut down a tree and make it into paper for you.

Wulfman... wrote:I have no problems with my Ford products that can't be resolved by the local dealerships......and don't own any Samsung or Cal-Maine products.

But again, you haven't bought your Ford directly from Ford Motor Company, you bought it from a middleman (change 'medical' to 'automotive' and they would be your DAE, so to speak.) How is that different than buying a CPAP?

Midnight Strangler wrote:If you look at all the improvements in CPAP machines in the last 15 years do you really think they were for the DMEs and not the users?

Exactly! I got my first CPAP over 20 years ago. It had 5 buttons on it: On, Off, 5 minute ramp, 10 minute ramp, 20 minute ramp (those may not be the right numbers, but you get the idea...) These days we have a plethora of options. We argue about which companies algorithms are best, we have pages and pages of advice for setting exhalation relief, we design programs to look at the data the machines collect, and we even have designer skins for them. Who in their right mind think it was the DME's asking the improvements in PAP therapy/machines? Probably the only one the DME's really wanted was the one that shows compliance...and in reality that was more from the insurance companies than the DME's. If the DME's had their way, I am sure there would be one model of CPAP - it's cheaper and easier for them.

palerider wrote:if they were making them for us, then the damnable "compliance" wouldn't be front and center and most important.

Yes, but the vast majority of improvements have been for us.

Davidwnc wrote:

Wulfman... wrote:It's always been a mystery to me that the manufacturers don't even factor in the end users. Oh, yeah, they've got stuff on their websites, but in reality, the "consumer" is the DME (those who sell the equipment).......it stops with them. Most of the users trying to contact the manufacturers with issues get told "don't bother us with your problems.....go see your DME" (Like W.C. Fields......"Go away, ya bother me, kid").

Talk about an upside-down industry!!!

But in reality, almost all of the products we buy in today's industrialised society are sold to us through a middleman. It is the retail stores and chains who are 'the "consumer" ' as you want to put it. I am guessing you don't order your toothpaste direct from the Crest factory; you probably buy it from some middleman (which is what the DME is.) When you need a new ream of paper for your printer, you don't wander down to the local lumberman and ask him to cut down a tree and make it into paper for you.

Wulfman... wrote:I have no problems with my Ford products that can't be resolved by the local dealerships......and don't own any Samsung or Cal-Maine products.

But again, you haven't bought your Ford directly from Ford Motor Company, you bought it from a middleman (change 'medical' to 'automotive' and they would be your DAE, so to speak.) How is that different than buying a CPAP?

Midnight Strangler wrote:If you look at all the improvements in CPAP machines in the last 15 years do you really think they were for the DMEs and not the users?

Exactly! I got my first CPAP over 20 years ago. It had 5 buttons on it: On, Off, 5 minute ramp, 10 minute ramp, 20 minute ramp (those may not be the right numbers, but you get the idea...) These days we have a plethora of options. We argue about which companies algorithms are best, we have pages and pages of advice for setting exhalation relief, we design programs to look at the data the machines collect, and we even have designer skins for them. Who in their right mind think it was the DME's asking the improvements in PAP therapy/machines? Probably the only one the DME's really wanted was the one that shows compliance...and in reality that was more from the insurance companies than the DME's. If the DME's had their way, I am sure there would be one model of CPAP - it's cheaper and easier for them.

palerider wrote:if they were making them for us, then the damnable "compliance" wouldn't be front and center and most important.

Yes, but the vast majority of improvements have been for us.

With the increasing use of the Internet, it's becoming more and more common to be able to buy things directly from the manufacturers and product-named companies. I'VE DONE IT......MANY TIMES.......AND RECENTLY, TOO. Remington Arms (extra shotgun barrel) and Cabela's (fishing rods with their name on them) to name two in the last couple of months.

Quit trying to twist things out of context. Many of your statements are untrue.

My own opinion about the driving force in the technology in the XPAP machines (and this is not that recent of a phenomenon) is that the manufacturers want the clinical people (doctors and RTs) to be able to look at the data, if and when they get pushed into that corner. If they'd just quit making the "bricks" altogether, they'd be money ahead. But, over the last number of years, I'm seeing more and more users being given higher-end data-capable machines. P/R doesn't make a "Plus" model Bi-PAP anymore.
A year ago, I chronicled a visit I had with a local DME one afternoon when I had some time to kill.......they ONLY give out Auto-CPAPs. And, they had a wide variety of masks for users to choose from. And, the users are allowed to keep trying masks till they find the one that works best for them.

It's hard to ship an automobile or truck back to the factory for repairs. The dealership repair shop will take care of you.
Many local stores don't even take back items if you have a problem with them......you have to send them back to the manufacturers with an RMA after you contact them. I've had a couple of situations over the years where something in a product broke and when I called the company, they asked me to send it back for replacement.
The local DMEs don't do repair work on the XPAP machines.
But, the XPAP manufacturers will only accept machines from the DMEs......NOT the end users.

Your arguments don't hold water. The REAL retail market WILL deal directly (in various ways) with the actual consumer.

Edit: One of the main reasons for purchasing XPAP equipment through a local DME is that they're SUPPOSED to help the user get it set up and provide training and support. We've seen how well that has worked from the many complaints we read here on the forum.


Den

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Wulfman... wrote:It's hard to ship an automobile or truck back to the factory for repairs.

amusing story I heard some years back about that very thing...

local girl here in texas bought a caddy, turned out that under the paint it was yellow and sour. after some time where it spent more time at the dealership than in her posession, she started making noises about being dissatisfied and wanting something more than continual repairs, like, say, a replacment.

she kept getting fobbed off, told that was impossible, couldn't be done, she'd just have it repaired again... until she had just had *ENOUGH!*

this particular gal happened to be Odeen Hibbs.... owner of Odeen Hibbs trucking company.

she told one of her drivers to load that piece of crap onto his flatbed, haul it to Detroit, and put it *ON THE LAWN* in front of the corporate headquarters... she was specific about that, so I heard.

her next contact from GM apparently was along the lines of "You just go on down to the dealership and pick out ANY car you want"

palerider wrote:

Wulfman... wrote:It's hard to ship an automobile or truck back to the factory for repairs.

amusing story I heard some years back about that very thing...

local girl here in texas bought a caddy, turned out that under the paint it was yellow and sour. after some time where it spent more time at the dealership than in her posession, she started making noises about being dissatisfied and wanting something more than continual repairs, like, say, a replacment.

she kept getting fobbed off, told that was impossible, couldn't be done, she'd just have it repaired again... until she had just had *ENOUGH!*

this particular gal happened to be Odeen Hibbs.... owner of Odeen Hibbs trucking company.

she told one of her drivers to load that piece of crap onto his flatbed, haul it to Detroit, and put it *ON THE LAWN* in front of the corporate headquarters... she was specific about that, so I heard.

her next contact from GM apparently was along the lines of "You just go on down to the dealership and pick out ANY car you want"

Now, that right there's funny.......I don't care who you are!!! (Larry the Cable Guy)


Den

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CPAP manufacturers have little choice except to sell and service through DMEs. All fifty states have a plethora of regulations prohibiting sales and most forms of service except through licensed DMEs.

her next contact from GM apparently was along the lines of "You just go on down to the dealership and pick out ANY car you want"

I do believe this illustrates the opposite of the position you are taking. It's just another example of a manufacturer requiring the consumer to get satisfaction through the middle man.

CathyF and those pretending to support her position would be better to think more and dramatize less. But then, you would not like a forum that was efficient in helping people and not so much a strange type of social outlet.

It appears to me that MyAir.com is the ResMed version of PR's SleepMapper... but with better digital trophies for posting on FB.

<high-fiving myself>

Wulfman... wrote:With the increasing use of the Internet, it's becoming more and more common to be able to buy things directly from the manufacturers and product-named companies. I'VE DONE IT......MANY TIMES.......AND RECENTLY, TOO. Remington Arms (extra shotgun barrel) and Cabela's (fishing rods with their name on them) to name two in the last couple of months.

And just what do you think the difference is between a middleman and a 'product-named company'? It's just marketing of something made by someone else... Cabela's isn't a manufacturer. They are a marketer and retailer. All they are doing is slapping their name on something that someone else made. Do you think that when you walk in Wal-Mart and buy Wal-Mart brand toothpaste that there is a Wal-Mart factory somewhere making only Wal-Mart toothpaste? No, it's the same factory that is making Crest or Colgate. Again, Wal-Mart and Cabela's are just the middlemen (even if you want to give them a fancy name.)

Wulfman... wrote:Quit trying to twist things out of context. Many of your statements are untrue.

I'm not twisting anything out of context, and if you find specific factual errors (as opposed to things you just have your own opinion about) please let me know what they are.

Wulfman... wrote:My own opinion about the driving force in the technology in the XPAP machines (and this is not that recent of a phenomenon) is that the manufacturers want the clinical people (doctors and RTs) to be able to look at the data, if and when they get pushed into that corner. If they'd just quit making the "bricks" altogether, they'd be money ahead. But, over the last number of years, I'm seeing more and more users being given higher-end data-capable machines. P/R doesn't make a "Plus" model Bi-PAP anymore.

It's a nice opinion, but in my mind, not one that is based in reality. As we all know (as do the manufacturers) that doctors looking at the data are the (rare-ish) exception rather than the rule, so why would you think they are putting it there for the doctors? Besides if it were there just for the doctors/RTs they wouldn't make it so easy to get to. They make you do something special to get into clinician's mode to change setting, but all you have to do to get the date out of an S9 is take the little SD card out of the back and put it in the computer. If it were there for doctors/RT's there would be a special command just to open it.
As for the if they would just stop making bricks they'd be money ahead thing....umm, are you kidding??? There will always be someone out there who will make the bare minimum model and sell it to the DME's based on cost. So why would they cut themselves out of that market? Hilton makes a lot of money selling upper end hotel rooms, but they are smart enough to know that there is money to be made selling middle and lower end rooms too, so that is why they have chains like Hilton Gardens and Hampton Inn. Because they want ALL sectors of the market. Ford makes Lincoln's as well as Fords. GM makes Cadillac, Buick AND Chevrolet? It would be fiscally silly to make only top end machines.

Wulfman... wrote:The local DMEs don't do repair work on the XPAP machines.

Ummm....I had one of my machines repaired by a DME.

Wulfman... wrote:Your arguments don't hold water.

It's funny, I often see you say things like that, but then make unproven statements backed up by nothing but your opinion.

Wulfman... wrote:The REAL retail market WILL deal directly (in various ways) with the actual consumer.

I don't even know what you are trying to say there....

the whole cpaps vs cars (or eggs) argument falls apart when you factor in one thing.

I've never, ever been diagnosed as "car (egg) deficient", and been given a prescription for a car (egg). and then had someone pick a car (egg) for me (probably a chevy chevette, if we keep the car analogy going), without my knowing anything at all about the car (egg) and then mandating that I use that car (egg) at least so many hours and so many days.

sure, there's some folks (looks around) that are shopping for cpaps, like we might be doing if we got told we couldn't walk to work anymore.... but far too many people get them thrust upon them out of the blue.

there's some dumbed down info from the mfgrs for us, but the vast majority of effort both in information, innovation and communication is with the DME, not the end user.

Ummm....I had one of my machines repaired by a DME.

And, I repaired one of my own CPAPs. (broken hose nipple and replaced dead battery)

There have been quite a few posts on the forum of ResMed machines being made in Singapore.
So, according to your argument, ResMed is just a middleman, too.

Most chip makers and assemblers are in Asian countries.
I have a mid-70s Ford pickup that was made in Ontario. I have a friend in Calgary who had a late 70s Thunderbird that was made in Michigan.

You have no idea what YOU'RE talking about......and I have no idea what you're trying to say, either.

PS. Hardly any company makes their OWN stuff anymore. Even if it's "manufactured" in the U.S.


Den

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