Effectiveness of the doctor

Slinky · Post by **Slinky** » Tue Jul 15, 2008 11:57 am

I'm too lazy to go back to see if you mentioned whether you are in the US or another country. In the USA they can NOT get away w/refusing to give you those reports IF you put your request IN WRITING so that you have PROOF of the request. You have a LEGAL RIGHT to them under HIPAA.

FAX your WRITTEN request to them. Give them 2 weeks. If you haven't received it by then send a SECOND WRITTEN REQUEST VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED and CC'd to your state licensing board and the local medical society. You then have them by the short hairs and the state licensing board takes over and applies the heat.

Be sure to keep all copies and proofs, etc. Don't forget to put your signature on your FAX.

jmaziarz · Post by **jmaziarz** » Tue Jul 15, 2008 12:08 pm

Very good information. I live in Rhode Island USA. Thanks!

Slinky · Post by **Slinky** » Tue Jul 15, 2008 12:12 pm

I had to do that JUST ONCE. It gave me GREAT pleasure to put the squeeze on that egotistical, educated idiot.

All he got was a slap on the wrist, of course, but I got my records and I'm sure it gave him pause before refusing anyone else. I LOVE beating those types of sheisters at their own game.

Gerald · Post by **Gerald** » Tue Jul 15, 2008 12:48 pm

Jmaziarz...........

Snoredog, Slinky, and others have given you good information that you can use to dig out of the hole you've dug for yourself by depending on the medical establishment.

If you want to get better, you have to assume responsibility for your own therapy and well-being.

"Look the dragon in the eye" and don't flinch. Go for it.

Gerald

jmaziarz · Post by **jmaziarz** » Tue Jul 15, 2008 1:01 pm

I agree. Thanks you all for your replies.

OldLincoln · Post by **OldLincoln** » Tue Jul 15, 2008 1:51 pm

You can always had them a printout of this thread to show him you mean business. From there the easiest thing he can do is comply. He can charge you a copy fee and he can drop you as a patient, but I've only had one doctor drop me and I think it was because I called his bluff on flaky diagnosis. The new doc is still wonderful and an excellent partner in the struggles anfter several years.

jmaziarz · Post by **jmaziarz** » Thu Jul 17, 2008 1:39 pm

I just returned from my visit with my doc. Good news and bad news.

The good news is I took Slinky's advise and went in with a firm yet diplomatic request and he agreed to write a script for a Respironics M Series APAP with A-Flex machine. He also agreed to reading the data every two weeks for two months.

The bad news is my confidence in him is at an all time low. He admitted to not having ever read my PSGs. He only has a "dictation" of them. He also tried to dissuade from home titration by suggesting another sleep study be done (even though I have already had three). His last ditch effort was to say my insurance would not cover the new machine (even though I called verified it was covered).

What got me discouraged were his parting words though. "It sounds like you have done a lot of reading and have firm hope that this therapy will work. I think you are just setting yourself up for failure. No one can self titrate effectively, at least no one I've ever worked with."

We shall see.

DreamStalker · Post by **DreamStalker** » Thu Jul 17, 2008 1:44 pm

Take the good news and leave the bad news behind!

Get yourself that AFLEX machine and the good members here will help you get on the right track.

Next step, a mask that fits YOUR face, seals properly, and comfortable to wear all night every night.

Cheer up, you done good.

echo · Post by **echo** » Thu Jul 17, 2008 1:50 pm

Slinky - so your last visit to the new sleep doc went WELL??? Glad to hear it if that's the case...

Gerald · Post by **Gerald** » Thu Jul 17, 2008 1:59 pm

Dreamstalker is right...leave that guy behind. He wants you to fail....simply because you had the nerve to stand up to him.

I strongly urge you to purchase a card reader and Respironics software (from CPAP.com) that will allow you to read your own reports....and make your own adjustments. That doctor is domineering nuclear waste....and you can't afford to have him "reading" your reports....especially when he admitted never having read them before.

As for self-titration, RestedGal has a very good article on the subject of "Self-Titration"......and if you PM her, she'll be happy (I'm sure) to give you the link.

"Self-Titration" is NOT rocket science. It simply requires good 'ole common sense.....and the self confidence that you can do it.

We all know that you CAN.

Gerald

alnhwrd · Post by **alnhwrd** » Thu Jul 17, 2008 2:10 pm

What you NEED to succeed at CPAP therapy is:

A data capable machine and access to the data
A mask/interface that delivers the air and is comfortable
The attitude and determination to succeed

Since you have stuck with CPAP for a year and a half with poor results, it is obvious that you have determination to spare. Since you don't mention mask problems, and you have the RX for the right kind of machine, you are now set up to succeed. A caring doc would be nice, but it is what it is. I would not have a doc that predicted I would fail. Why get another sleep study if he hasn't read the ones you've already done?

Best of luck to you.

allen476 · Post by **allen476** » Thu Jul 17, 2008 2:38 pm

alnhwrd wrote: Why get another sleep study if he hasn't read the ones you've already done?

I agree.

You are having the same problems with your doctor as I am having with my Physicians Assistant. I was having problems breathing on my own in the morning along with not waking up and requested a prescription for a machine with exhalation relief and data capabilities so that the insurance would pay for it. She shot me down saying "it may take a few months to years before your body adjusts to CPAP."

I am firing them once I find a new doctor.

You should consider the same. Having a quack that doesn't cooperate or even really reading the PSG isn't going to do you any good.

Allen

P.S. After buying my own equipment, the C-Flex took care of the heavy breathing in the morning and now after 2 weeks of data, figured out what is causing me to not want to wake up in the morning.

Slinky · Post by **Slinky** » Thu Jul 17, 2008 2:46 pm

I guess I'm the spiteful type. I would HAVE to go back to see this doctor at least once more to rub his nose in my success w/the in-home auto titration!! And I would be so NICE about proving my point it would make ME sick.

Yes, Echo, this last visit w/the new sleep doc went very well. (There's hope for him yet ) I think it was just a staff mix up. They probably aren't used to patients having a fully data capable CPAP. He probably isn't either. I know when I asked if I should bring my data card, the girl on the phone didn't know and had to ask someone else who didn't really seem to know either. And he wasn't there for them to ask nor was the sleep lab manager.

I surprised myself!! These first 7 nights w/the pressure change I suggested and asked about are actually working!! The first night I was pretty sure my idea was all wet. But the next 6 nights have been great. Night before last I only slept 6 1/2 hours (for reasons other than 0SA or CPAP) and yet I didn't feel the need for or even think of a nap yesterday and didn't run outta steam until about 10PM or so. Slept my usual 7 1/2 hours last night and have been going all day w/o even thinking of a nap. And the data looks good. I dropped a printout of the statistics to the sleep lab today.

What is ALSO surprising is that when looking at the detailed graphs for some odd reason I am experiencing LESS LEAKs the last half of the night than the first half CONSISTENTLY despite not waking up to go to the bathroom or for any other reason. I haven't figured that one out yet. UNLESS it is taking the Advair and the Spiriva that long to "kick in" and take effect each night.

Anyway, when I see this sleep doc again, in a year maybe (that's what we agreed upon) I'm going to TRY to convince him that he should INSIST that EVERY ONE of his patients receive nothing less than a fully data capable CPAP. Maybe add some polish to his education and sleep accreditation, you think?

By the way, I looked him up at a couple of other sites. The first site I found was outdated. He is accredited in sleep medicine.

echo · Post by **echo** » Thu Jul 17, 2008 4:10 pm

Years to get used to CPAP therapy? That's a load of crock! I mean I can understand that it takes time to adjust to the treatment (few weeks, month or so), find the right mask (several months hopefully less!), maybe do some autotitration at home, etc, but YEARS?? That is definintely misinformation and in my opinion, nears on malpractice. If it does take people so long to get the treatment right, I only blame their doctors who are too high up on their ivory towers to listen to their own patients and work with them!

Slinky, heh heh, glad to hear it And yes I fully agree, it is also our responsibility to train our doctors, so that others who follow in our footsteps don't have to break down the same barriers! And glad to hear he's accreditied (i need to look into what exactly that means though..!).

Slinky · Post by **Slinky** » Thu Jul 17, 2008 5:04 pm

I suspect accreditation doesn't mean one h*ll of a whole lot, Echo. I was checking the accrediation for sleep labs. SNORT! Its okay for them to have a doctor doing the dictation of the results w/o him EVER seeing the patient. Just look over the RPSGT's scored data, translate the results into a FAX to the referring doctor (who most times doesn't have the slightest about OSA and CPAP). "I" for one am NOT impressed!

Nor am I impressed w/ANY sleep "doctor" who doesn't insist on his patients being provided w/a fully data capable CPAP (except in cases of no insurance or financial hardship) or who isn't interested in the data from their patients' device.