Waiting

What happened during your titration study? Your desat is low, but what was it on therapy?

plangster wrote:With such a low oxygen saturation level, I expect that you would be prescribed a supplemental oxygen bleed into the cpap line from an oxygen concentrator, also provided through CIGNA/Gentiva. I suggest you check with your physician, then call Gentiva to have the prescription filled within days, not weeks. Call your doctor to check on those readings.

Good luck with your treatment! It can make a world of difference.

Indy, I have the same CIGNA insurance and also have the added oxygyn, which is paid for by the insurance, just as Plangster said. My doctor's office had arranged for my equipment with the insurance. The doctor's office told me that normally they would have sent me to a local DME, but my type of insurance was difficult and limited, requiring this route of having my equipment delivered. What a pain doing it this way. But at least the insurance covered it.

Linda

Just a quick (or not so quick) note about my experience, this relates to CIGNA but not until the very end so you can skip most of this if you'd like.

When I first called the doctor to get an appointment the soonest they could take me was a month from the day I called. So I go to my appointment- 15 minutes early. They take me in, weight me (their scale didn't go that high so they guessed), measured my neck, took a polaroid of my head...took vitals (BP etc) and asked me to have a seat. I was then told the doctor was running late. About 35 minutes later the doctor arrives.

Very nice, personable, young guy. He takes me into his office (very plush, big mahogany desk, puffy leather chairs) and asked me a bunch of questions, thumbed through the 40 page questionare they made me fill out before my appointment. He then told me he was pretty sure I had Sleep apnea and gave me a very good explaination of exactly what sleep apnea was. He told me I would need to have a sleep study done to be sure and had me schedule it. From the 4 or 5 responses he looked at on the 40 page questionaire he indicated that he thought I had a pretty bad case and told me to tell the receptionist to get me in as soon as possible for my sleep study. Oh he also told me he didn't advise me to drive until I got this treated and he gave me some literature and joked "I'd tell you to read this but you'll probably fall asleep" "chuckle".


So...the soonest they could fit me in was 3 weeks and told me they'd keep me on the list incase they had any cancelations. At the same time they scheduled my doctors appointment - 2 weeks after my study - (Remember when the doctor told me not to drive? did he expect me to miss a month of work?) About 2 weeks later they called me and told me they had a cancelation.

I had my sleep study, it was a "double study" they first had me sleep with no gear but had me hooked up to all these wires and a glowing red clippy thing on my finger that felt like a rat had clamped on and wouldn't let go.

halfway through the night they woke me up and hooked me up to an oxygen tank. about an hour later they woke me up and hooked me up to a cpap. They tried on a few masks and settled on a nasal pillow mask that was strapped to my head with about 10 pounds of velcro.

about an hour and a half later they work me because the mask was leaking and they fixed it by taping part of it to my cheek.

about an hour and half after that they work me up and told me they were done my test. They removed the rat from my now throbbing finger anf proceded to remove all of the wires that had been taped to my VERY HAIRY body. ( I have several new bald spots that my wife laughs at now). They asked me how I slept and I told them they they should tell me but they said I'd have to wait for the doctor. They asked me how I felt, if I felt "rested".... Well lets see...I had wires taped to me all night and a rat biting my finger tip, not to mention the fact that they woke me up a bunch of times...."I feel pretty tired" I said. "OK...this won't hurt a bit" RRRRIIIIIPPPPPPP "OUCH", "Wow, look at all this hair that stuck to the tape..."



The next day I called the doctors to say I had my sleep test and asked if they could fit me in any sooner to see the doctor for the results. "Nope". they said. " Then why did you have me take my sleep study early?" I asked. Silence. "Are you there?" silence "Hello?" , "yes so we'll see you in a few weeks then, good bye"

So I finally get to the appointment with the doctor. They take me right in and he's actually in the office that day so I only had to wait 25 minutes to see him. He welcomes me warmly into his plush office and has me sit in one of his puffy leather chairs. He opens a folder and shows me a chart with a bunch of lines on it. He explained to me what the lines meant - that I was waking up once every couple of minutes and that I was never getting past stage 1 sleep. then he showed me another chart and told me this was while they were treating me with the cpap, this chart clearly showed me imediately working through stage 1,2,3&4 and ending up in REM for a solid hour and a half (remember they woke me because my mask was sleeping) then I went right back into REM for the rest of the morning.

Clearly this showed the CPAP had worked. So he said, we'll be setting your pressure to 13 (he pointed to a line on the chart that showed the pressure being adjusted through the night) He told me becuase it was so serious he'd have his office schedule the equipment to be dropped off at my house within a day. They scheduled an appointment for me to return to see the doctore with my machine for a month later. By the way I don;t have any of the stats from my test since I wasn't educated enough at the time to ask those questions.

2 days later I called the office to ask where my machine was. "Brandy" told me that she had me down to see the doctor in a month and that I wouldn't get my machine until I went over the results of my test with the doctor. I very nicely (and very slowly) explained to Brandy that I already did that and that I was supposed to have my machine the next day. Brandy put me on hold for 10 minutes and came back to say "You're right, but the girl who schedules these is working alone and she has a back up and it probably won't be until next monday or later". Shocked, and a little hurt I hung up the phone. I was speechless. It took me about 10 minutes to snap out of it and call back. Brandy answered again and I gave her a peice of my mind. I told her the doctor told me not to drive, and acted like I could DIE, TONIGHT if I didn't get treatment and did she want my death on her hands and was she going to pay for my kids to eat dinner since I was about to get fired for not coming to work because the doctor told me not to drive?!?!?!?!??!?!?

She put me on hold for 5 minutes this time, she came back on to say the office would get right on it and call me back. "Tonight?" I aksed....."if not tonight, then tomorrow morning first thing" "Fine" I said and let her go.

When I got home from work (yeah I know, of course I was driving, what am I supposed to do?!) My wife told me they called and told her an RT would be there in the morning with my Cpap machine.

THIS IS THE PART ABOUT CIGNA

So the RT gets there (30 minutes late but thats ok I live in the middle of nowhere..my street isn't on any maps yet...heck we don't even have cable) with my machine. Its a very nice Remstar Pro with C-Flex. He also had Breeze headgear for me. Sitting in the chair at my dining room table he fitted the gear on my head. he had me sign some paper work and explained that the problem is that my insurance company just sends the equipment to me, the doctors office actualy worked it out that the DME loan me this machine until I get the actual machine from the incurance company's prefered vendor.

He explained that the insurance company also pays the vendor to have an RT come out and visit me and that his company is contracted to do that anyway so when they do finally send my machine everything will work out.

Thats it. I've been using the CPAP for a few days now and I'm having a hard time with it. the gear is uncomfortable, I'm waking up a lot more and having more trouble getting back to sleep than I did before. I feel much more tired now than I ever have, my nose hurts, etc etc etc. I'm thinking the mask is the problem and I want to try a new mask but I don't have thousands of dollars to blow on a bunch of masks that may or may not work. If I knew there was one that would be perfect for me I'd happily plop down a couple hundred for it but how do I know what to get? Does the insurance company pay for masks?

Wuzer,

I also have Cigna. My doctor's office worked it out with the insurance company. I was told by the doctor's assistant that Cigna was a problem in that they do not use local distributors. And I was told my equipment would be delivered. I'm guessing that because you, uh, expressed yourself that they rushed the rental.

After I got the setup that was delivered, I phoned the distributor directly and asked what I was supposed to do if I had some problem with the machine (and mask, I think I asked). They told me that with a new prescription a representative would come to my home (like they did to you). But I didn't take advantage of that at the time.

You sound plenty miserable. Let us know how it goes for you, if it gets any better, if you're able to change to another mask, etc. I'd love to know, if you don't mind.

Linda

Well I called the DME who brought the machine to my house and told him what was going on. He agreed that I probably need a full face mask but he said the doctors office I used is very specific with their prescriptions and mine specifically said "Breeze" on it. So he told me I'd have to call the doctors office.

Even though I was prepared for another hair pulling event, the doctors office was actually very helpful - it wasn't brandy this time - I have an appointment at the doctors office tomorrow at 2pm to get fitted for another mask. She told me that the insurance company WOULD pay for it.

I cant wait to see how much they bill the insurance company for it.

I'll let you know how it goes tomorrow.

Has anyone tried OTC sleep medications in conjunction with the CPAP? I'm talking about something like Tylenol PM, tylenol also makes a medication called "Just Sleep" or something like that that has everything PM has in it to help you sleep but doesn't have tylenol in it

I'm considering trying that tonight to see if I can at least sleep through the night.

The "sleepy" ingredient in Tylenol PM is benedryl. I was told by my sleep doctor that while this antihistimine might make you sleep it is not a GOOD sleep. Try Melatonin instead. It is much better to take a prescription sleep agent like Ambian. Talk about this when you go in for the mask fitting.

Wuzer, there are lots of thinks you can do to try and make the Breeze more comfortable - pieces you can push, and pull (back of the head, crown of the head, front of the nose) , pillows you can rotate, straps you can tighten or loosen, and a pivot at the nose shell. Take 20 minutes before you go to bed tonight to fuss around with all those things - lying down to tes them - till you feel comfortable - they make a difference.
And try KY Jelly in your nostrils - this was recommended by a Resmed representative for their pillows mask - the Swift.

O.

ozij wrote:.
And try KY Jelly in your nostrils - this was recommended by a Resmed representative for their pillows mask - the Swift.

O.

Uhhh, hmmm... my KY jelly is currently tied up in more important endeavours right now....

You can also use something like Neosporin which will also help any soreness you've got.
Too,check the nasal pillow size, it might be too large or too small.

Back from the doctors office and had a very possitive experience. They actually sat me down and fit me for a mask. They had these little plastic cups they used to measure my face. Once they were done measuring the RT took out a medium Ultra Mirage FF and put it on me, adjusted the straps so it was nice and secure and hooked me up to a cpap.

I loved the feel of it. She called the DME while I was in the office and told them what I needed and asked them to get it to me right away.

The only problem came when the DME didn't have it in stock so they called me and let me know they have another store that has it in stock and they were having it overnighted directly to me.

I guess one more night won't make a difference.

I have tried the neosporin after the first night of very irritated nostrils and that helped a little bit. I think I'll be much better off with the FF mask, I found it easier to breath and it was much more secure.

Got home from work today and waiting on my door step was a brand new Ultra Mirage FF!

I tore open the package, tried it on set it all up and hooked it to my machine...no leaks and I can turn all I want and still no leaks. I wanted to lay down right then and take a nap but my wife wouldn't let me...something about kids, and dinner...

Hiya, Wuzer, and welcome to the FF world of Ultra Mirage!

A couple of hints: 1. Read the manual, read the manual, read the manual, watch the DVD! 2. Don't fasten the straps too tightly....let the seal do it's job!

I've been using mine for a couple of months and wowzers! This therapy WORKS! Best of luck to you!

I have the Ultra Mirage FF and I am the one still having trouble.

I let the machine and mask do it job of sealing and I get leaks.

Are you sure its the right size? there are 3 sizes and they come in standard or shallow in each size.

It seems that I was given a mask just by looking at my face. No measurements were taken and now I am stuck for three months before Medicare will buy me another one.

Just peachy isn't it.