New to the forum

[palerider]

Perhaps you could explain the whole condescending "failing hard" comment?

I don't see how my classifying the ineffectiveness of your current treatment as a hard fail to be in any way 'condescending',

It certainly wasn't condescending towards you, in any way... perhaps towards your apparently incompetent doctors.

Your *treatment success* is a hard fail, not what YOU are doing here on the forum, or trying to do at home.

However, it seems that my drive to help you get better sleep is being taken the wrong way, so I'll just quit responding.

[palerider]

More troll garbage.

Well, another useless troll.

Since joining five days ago, you've done nothing *at all* useful, just been another source of noise.

[SirGaspAlot]

Perhaps it was the whole "YOU" are failing hard comment. I dunno, call me silly, I dont see a misdirect there. Pretty straightforward to me. Moving on.

[palerider]

Perhaps it was the whole "YOU" are failing hard comment. I dunno, call me silly, I dont see a misdirect there. Pretty straightforward to me. Moving on.

What I said was:

To put it delicately, they're full of shit. Unless, as someone else suggested, they're waiting for you to fail [in your current treatment method], which you are failing [with your current machine], and failing hard [to get a successful nights sleep].

I can't keep you from taking offense, but absolutely NONE was directed at you.

[SirGaspAlot]

Ok, my mistake. Thank you for clearing that up.

[SirGaspAlot]

Perhaps that's a symptom of this as well. Once I get home, I've got quite a few things I can put up. I agree that they are full of shit, I can even show where the original polysomnograph showed complex apnea with serious oxygen restoration down to 70% and then they followed up with the CPAP sleep test results diagnosing as just "obstructive apnea". I dont know why they made such effort to push this machine instead of the proper one.

[palerider]

Ok, my mistake. Thank you for clearing that up.

It's your incompetent doctors and insurance that have my scorn and condescension... not you.

[SirGaspAlot]

So here is my original polysomnograph and the following sleep study while on CPAP. Granted the numbers are clearly better, but as everyone has already told me, my centrals are going ignored or being exasperated. The chronological order is actually switched if you can read the dates. You can see how severe it was on the polysomnograph and then got changed to "obstructive Apnea" on the CPAP sleep study which was followed by receiving machine a few weeks after that.

[SirGaspAlot]

And I did download and run the Sleepyhead software, Ive gotta tell you, Im impressed.

[SirGaspAlot]

I did read the link about cleaning up the reports, will definitely do that next time.

[SirGaspAlot]

Miserable night last night. Maybe two hours sleep 24.9 AHI, machine says (lies) that I got 7.24 (since I didn't turn it off while it was blasting pressure out the sides of my mask). I'm going to be a real pain in the ass to my Doc today. If the sounds premeditated, it's because it is. These nights should be getting better, they arent.

[zoocrewphoto]

Perhaps it was the whole "YOU" are failing hard comment. I dunno, call me silly, I dont see a misdirect there. Pretty straightforward to me. Moving on.

I believe this is a misunderstanding.

What we haven't explained well is that some insurance companies won't pay for a fancier machine until the patients fails at the lower machine.

For example, the person needs a bilevel machine, but they won't pay for the bilevel until the patient spends time on the regular cpap and really struggles. They want the person to try the cheaper machine and fail before they approve the more expensive machine. Especially true with the more expensive ASV machines. They may want to see you use the bilevel machine and have miserable results (fail) before they approve the more expensive machine.

It is not meant as a personal fail, or you failing. But the machine failing to solve the problem. Because it is the wrong machine for the job.

As to your insurance. Have you called them directly? It could be that they are requiring this system of trying a machine and failing. Or it could be that the doctor is mistaken or the DME is mistaken about the coverage. It already sounds like the doctor doesn't know which machine to prescribe for complex sleep apnea, so that could be part of the problem.

https://www.aastweb.org/blog/what-is-asv

You might try taking some printed info about complex sleep apnea and the ASV vs bilevel machine info with you when you go back.

[SirGaspAlot]

I think its more a issue of he has to prove the need, I'm military retired, Tricare doesn't cover ASV or APAP machines I'm assuming unless theres an established genuine must have need proven (I'm just guessing here because the websites I went simply says they don't cover them period, no give or take scenarios) and oddly enough, the original polysomnography spells out that I have severe Obstructive, moderate Central and severe oxygen desaturation with no equipment, just obstructive on the follow up ON CPAP sleep study. Its almost as if he was acknowledging I cant get it and have to be on Bipap to begin with as a trial.

So heres a question- any military retirees here on ASV machines paid for by Tricare? Maybe that will help me understand more.

[squid13]

I was in your situation, my Doctor said that the BiPap would handle the centrals. I don't use Tricare cause I'm on Medicare with Blue Cross Federal as secondary. He wouldn't approve a ASV so I got one on my own from a forum member who had one for sale, they pop up on the forum for sale by a member ever now and then at a reasonable price. When I got it I set it on the default settings and with the help of the forum members I got my settings right to where most nights my AHI is zero. I changed Doctors (female) and my new one has no problem with what I did and what I'm doing. If nothing works out for you, you may consider what I did. It's like the old saying you have to do what you got to do to take care of your self.

[chunkyfrog]

@squid: Truer words . . .
In health care, as with everything.