CPAPtalk.com

palerider wrote: ↑

Sun Nov 20, 2022 6:41 pm

zonker wrote: ↑

Sun Nov 20, 2022 6:34 pm

just by the way, has anyone noticed that the op hasn't come back?

kinda hard to bully someone who isn't here.

My bullying powers transcend space and time, I probably bullied him before he ever knew about the forum.

i thought maybe he lives across town from you.

One time in the third grade, a kid on the school bus who looked a lot like PR took my lunch money. Just sayin'.

Pugsy wrote: ↑

Sun Nov 20, 2022 4:49 pm

robysue1 wrote: ↑Mon Nov 21, 2022 0:43
In other words, if I tweak something (max IPAP, min EPAP, PS, Trigger, Cycle, Ti min, Ti Max) to make the machine work better for me and they happen to notice that the settings are no longer the ones they set up on the machine, are they going to have the ability to change the settings back to what they think they should be? And if they do that, will they also not bother to inform me that they changed my settings?
The ability to change settings remotely is there but whether they will make the effort is a different thing.
Plus you can always make it plain (in writing) that they are NOT allowed to make ANY changes to any of your settings for any reason.

Aren't the DME's supposed to stick strictly to the doctor's script?
Wouldn't changing a person's settings on their machine be as bad as a pharmacist giving you a wrong strength for your meds?
(Real question, because I have experience in how things work in the US).

ozij wrote: ↑

Sun Nov 20, 2022 8:15 pm

Aren't the DME's supposed to stick strictly to the doctor's script?

Yes. But they can alert the doctor than things have been changed from original RX and if the doctor tells them to "change it back"....they can do it.

ozij wrote: ↑

Sun Nov 20, 2022 8:15 pm

Wouldn't changing a person's settings on their machine be as bad as a pharmacist giving you a wrong strength for your meds?

Of course it sure could be just as bad. The doctor could easily be an idiot hard ass about the patient messing with the settings.
Lord knows we have a lot of those kind of doctors.

So while it "can" be done and all it takes is the DME to ask the doctor if he wants it changed back....in real life it isn't all that common to see it happen. Most of the time the DME is only checking for hours of use and won't even notice if anything has been changed because they don't look.

So the question was "could they do it" and the answer is yes, the ability to change the settings via the modem connection can be done is there but in real life it isn't all that commonly done and the patient does have the power to tell anyone to "don't screw with my settings" and everyone including the doctor has to abide by those wishes when expressed in writing so there is no misunderstanding.

ozij wrote: ↑

Sun Nov 20, 2022 8:15 pm

Aren't the DME's supposed to stick strictly to the doctor's script?
Wouldn't changing a person's settings on their machine be as bad as a pharmacist giving you a wrong strength for your meds?
(Real question, because I have experience in how things work in the US).

I'm not really worried about the DME changing the doctor's prescription that they have on record.

I'm worried that if I do my own tweaking of those settings (as most of us here have done) and the DME notices that the settings on the machine no longer agree with the doc's script, that they'll just change the settings back.

Sleep doc #4 (who is now retired) was cool with me changing my own settings if/when I wanted to experiment with them. He told me that I knew more about xPAP than most doctors and that it was clear I knew what I was doing. The settings that I told sleep doc #5 that I was using on the DreamStation were never written down as a formal script from sleep doc #4---they were what I'd settled on from prudent and cautious dial winging through the years, and the last titration study done at sleep doc #4's request (as part of the Second War on Insomnia), recommended bipap pressures of 6/4, which both sleep doc #4 and I knew was a significant under-titration caused by a combo of a "good night" for the OSA and a "bad night" for the insomnia. In other words, there wasn't much sleep to work with, and in what sleep I did get that night, the OSA was not at its worst.

But here's the conundrum: My DreamStation's settings: Min EPAP = 4, Max IPAP = 9, Min PS = 3, Max PS = 5 cannot be duplicated on an AirCurve 10 Vauto because Resmed uses a fixed PS. So if the script is written with my DreamStation's settings, what happens when the DME has to pick a specific PS to set up the machine's therapeutic settings?

Presumably they call the doc's office. Presumably the doc picks a number out of a hat that contains the numbers 3, 4, and 5. But unless the doc picks "4", I'll be changing that setting as soon as I get the machine home.

So if the DME chooses to monitor my compliance with cellular modem and if they notice that PS has been changed to 4, are they going to arbitrarily change it back to whatever number the doc picked out of the hat?

Now I grant pugsy's point: DMEs in the states seem to be far more worried about documenting you are using the machine for 4 hours every night so they get paid than they are about whether therapy is actually working. And compliance not going to be an issue. But my question is still relevant---what if the DME does actually pay attention to more than just usage? If they see I've changed the settings without their involvement, are they going to just change them back using the cellular modem to communicate the therapy changes to my machine without bothering to tel me?

When I showed my pneumonologist the settings I had found most effective,
he entered them onto my chart.
Yeah, he's a keeper.

lazarus wrote: ↑

Sun Nov 20, 2022 7:41 pm

One time in the third grade, a kid on the school bus who looked a lot like PR took my lunch money. Just sayin'.

And if you're not careful, I'll go back and take it the day before that too! *shakes fist*

ozij wrote: ↑

Sun Nov 20, 2022 8:15 pm

Pugsy wrote: ↑

Sun Nov 20, 2022 4:49 pm

robysue1 wrote: ↑Mon Nov 21, 2022 0:43
In other words, if I tweak something (max IPAP, min EPAP, PS, Trigger, Cycle, Ti min, Ti Max) to make the machine work better for me and they happen to notice that the settings are no longer the ones they set up on the machine, are they going to have the ability to change the settings back to what they think they should be? And if they do that, will they also not bother to inform me that they changed my settings?
The ability to change settings remotely is there but whether they will make the effort is a different thing.
Plus you can always make it plain (in writing) that they are NOT allowed to make ANY changes to any of your settings for any reason.

Aren't the DME's supposed to stick strictly to the doctor's script?
Wouldn't changing a person's settings on their machine be as bad as a pharmacist giving you a wrong strength for your meds?
(Real question, because I have experience in how things work in the US).

Yes, a DME has to abide by the prescribed settings, the user doesn't.

To further your analogy, yes, the pharmacist has to give you the right meds, but there's nothing that prevents you from deciding you don't want to take them one day, or (maybe if it's pain meds and you're hurting more than usual, taking a little extra).

robysue1 wrote: ↑

Sun Nov 20, 2022 9:40 pm

ozij wrote: ↑

Sun Nov 20, 2022 8:15 pm

Aren't the DME's supposed to stick strictly to the doctor's script?
Wouldn't changing a person's settings on their machine be as bad as a pharmacist giving you a wrong strength for your meds?
(Real question, because I have experience in how things work in the US).

I'm not really worried about the DME changing the doctor's prescription that they have on record.

I'm worried that if I do my own tweaking of those settings (as most of us here have done) and the DME notices that the settings on the machine no longer agree with the doc's script, that they'll just change the settings back.

We've run into this with other people and a terse note to the DME that they DO NOT HAVE YOUR PERMISSION TO MAKE CHANGES TO THE MACHINE tends to fix the issue.

zonker wrote: ↑

Sun Nov 20, 2022 6:34 pm

just by the way, has anyone noticed that the op hasn't come back?

kinda hard to bully someone who isn't here.

Never stopped the bullies before.

robysue1 wrote: ↑

Sun Nov 20, 2022 9:40 pm

the DME notices that the settings on the machine no longer agree with the doc's script, that they'll just change the settings back.

You made me think that a DME employee might do this "innocently".-------> "Oh, this patient's settings do not match the prescription. We must have made a mistake setting up his machine. I'm going to change it to match the script."

But, I think this would be a rare case. I never met a DME who worked so diligently and meticulously.

palerider wrote: ↑

Sun Nov 20, 2022 4:33 pm

lynninnj wrote: ↑

Sun Nov 20, 2022 3:35 pm

I don’t consider that NPR article to be Clickbait at all.

My mistake, sorry.

Dog Slobber called it clickbait.

Is that your other personality?

lynninnj wrote: ↑

Mon Nov 21, 2022 12:56 pm

palerider wrote: ↑

Sun Nov 20, 2022 4:33 pm

lynninnj wrote: ↑

Sun Nov 20, 2022 3:35 pm

I don’t consider that NPR article to be Clickbait at all.

My mistake, sorry.

Dog Slobber called it clickbait.

Is that your other personality?

Yes, and I consider it clickbait.

It is designed sensational a trigger issue, non-informative, doesn't explore why he actually didn't know that the device was transmitting. Has some technical inaccuracies . Doesn't explore that some of his ignorance was (likely) caused by incompetent DME and Doctors simply not informing him. Commented about starting to get usage messages when he registere his machine with ResMed, when in fact they would have started when he registered with MyAir. A process that clearly informs him that signing up sends such information, and informs him data is being sent from his machine to ResMed, and items of uses are presented.. Doesn't explore that signing up with insurance involves him entering into a contract, that also presents terms of service, and use.

The person in the article was an idiot, and the writers acceptd what he said as fact.

That article was clickbait.

PR apologized because of a small point he missed in a somewhat disjointed article that nevertheless well illustrated common legitimate (though often misguided in specificity) concerns many in the pubic have about hidden features of technology in general.

DS just likes the word "clickbait," since it sounds pejorative and modern in a demeaning sort of way to describe any journalistic endeavor that could have been better researched and presented. It is a word that does kinda roll off the tip of the fishing hook. Some would likely characterize the first printing of details from the Pentagon Papers as basically a form of clickbait.

These days everything must have bait or it will never get clicked.

Most journalistic truths are now hidden in works of historical fiction or in late night comedic commentary. Was it Will Rogers or Mark Twain who said that?

And to anyone on this board who has read this post this far: I have no idea what I'm talking about, so why did you just read this post instead of having put me on your foe list a long time ago?

Gawd, people are so afraid of everything these days. I mean everything - not just CPAP.

There's a thing going around on our local media that says a TikTok challenge is to steal a dog and drop it off in a faraway neighborhood. Dog owners by the dozen are quivering in fear or threatening to kill anyone that tries it. Yet, no one can cite a single case of this happening - not a local case and nothing in the national news.

Why have we become such a fearful nation?

- YourNoFearGranny