what questions should I ask for at the sleep clinic

First time Tansey asked her question:

tansey wrote:Will they be able to discover central obstructions on their PC I will be connected to?

Second time Tansey asked her question:

tansey wrote:will their Pc tell if I have a central obstruction?

Folks, someone has yet to answer Tansey's question.

Tansey, if I had the answer, I'd give it to you. I don't know enough, but I think there are four kinds of events: obstructive apneas, obstructive hypopneas, central apneas and central hypopneas. When you said "central obstruction," did you mean the last two? At any rate, I think they record any and all of those things, but I'm not anywhere near certain. However, perhaps by BUMPing this to the top, someone will see it and be able to tell you.

You could call your sleep doc's office before going for your study and ask. I'm sure they'd tell you.

(Now for a hypothetical question:
How is it that two of our smartest guys are also in contention for being named Class Clown? )

Marsha

If you are talking about the mixed apnea with central and onstuction together yes. The sleep study picked up my Centrals and Obstuctions as well as the mixed. So the answer is yes. It will pick up everything. Even RLS

looking4zzzz wrote:I don't know if this will apply for you or not. I don't really understand it myself. But my sleep doctor's office said I could use any DME my insurance company allowed, but if I went through a DME, I'd have to pay my deductible and copay. They said if the doctor's office ordered the CPAP equipment directly for me, the whole thing would be covered. Not having a load of extra cash sitting around, I said, let's go with the free to me option. I don't know how this is allowed, but so far, it seems to be true that I am not being billed by the doctor or my insurance company for the machine. I have BCBS of NC. If you are going to need a machine, you might ask if there is any kind of option like that for you. Good luck!

This particular situation, where the doctor's office is also the dispenser of the equipment, is a huge "conflict of interest" and is about to become illegal......if not already. (according to some legislation/rules that were posted on the forum awhile back).

Den

Den is probably right. I thought that those rules were for Medicare reimbursement and for accredidation so such an establishment or arrangement were likely to be ineligible for Medicare participation and for accrediation by the AASM or whatever.

Thanks for your response to me, Slinky.

While I probably seem pessimistic now, I am not usually. In this case, though, I think going in well-armed with information (I've already downloaded the list of DMEs the insurance company has contracted, for example) and trying to think through every possible outcome, and expecting the worst from the doctor (personally, I really hate "old school" doctors that keep information hidden and only tell you what they think you need to know). I would love to be surprised by the experience, and so far my dealings with the sleep lab have been fine.

Also - I have to give you and the rest of this forum lots of credit. Without some rudimentary reading, I wouldn't know what "fully data capable" means (and I can see a doctor and DME pushing a "complaint" machine just because the margins are better for their wallets), or that I should ask for copies of the reports, and all that kind of stuff. You've told me there are 4 types of masks and it would be best if I tried all four, but the sleep lab said "we only have two types of masks". Makes me go "hmmmm." Through reading here, and I admit I have tons more to learn, I've added to the list of questions I have to ask the doctor next week.

In fact, after reading yesterday, I formed this question for him: "did the results of my titration test suggest that CPAP will probably work, or will we have to start looking at BiPAP or APAP?" (after checking with the insurance company, I know that only CPAP is covered, unless it fails for me).

So, really -- a heartfelt thanks to all. I hope that in due time I can contribute as much to the forum as all of you have offered me.

wlo2008 wrote:If you are talking about the mixed apnea with central and onstuction together yes. The sleep study picked up my Centrals and Obstuctions as well as the mixed. So the answer is yes. It will pick up everything. Even RLS

Thanks, the doc thinks I have both, the central being more than it was when I first went on cpap in '02.
Marshaeb, it's no big deal but I am a HE
, Tansey is used for both genders.
Tansey

GuyK wrote: ... personally, I really hate "old school" doctors that keep information hidden and only tell you what they think you need to know.

Don't feel like the Lone Ranger, Guy. I think they oughtta bucket that whole brigade. Gads! I so well remember when heaven forbid you should peek over the nurse's shoulder and actually see what she wrote down after taking your BP, pulse and temp!!! AND, good heavens!!! If you had the audacity to take your hospital chart off the wall and get caught reading it ....!!!! Pure pandemonium! My chart always ended up staying at the Nurses' Desk most of my hospital stays. Which frustrated my doctors no end. To say nothing of the battles w/the department head nurse about it. I don't remember that they had Patient Advocates in the hospitals back then. Fortunately, by my second child I had a good family doctor. He'd tell them to just leave well enough alone, no harm in my going thru my chart. Trouble is, the darn nursing department still didn't see things his - or my - way and my chart still stayed at the Nurses' Desk. Grrrrrr.

For the last several years, I've been going to such an "old school" doctor. He's retiring now, so I'm searching for the new PCP.

I'm amused more than anything else by what I've gone through with this old school doctor. I visit him, on average, four times a year. I keep a chart on all my numbers for every visit (I can easily see the trends, while he pages back through pages and pages of test results). After awhile, he just started asking me to see my chart, so he could see for himself.

But -- every time I had new test results, he'd look at the results and tell me things were fine. Every time, I'd have to ask "now what were those numbers?" and he would eventually tell me so I could write them on my chart. And I'm talking routine numbers, like results of blood lipid tests and things like that. The kinds of numbers that don't need all that much explaining. I had to drag them out of him, every time.

Anyway, with this sleep doctor, the ENT, and now a new PCP, I'm turning over a new leaf. In fact, I'm toying with the idea of telling my new PCP (on my first visit) that I'm definitely not fond of the old school style, and that I fully intend to be on top of everything there is related to my treatment. Mostly just to see how he reacts.

(one of my brothers, now deceased, told me that he liked to ask to see doctor's diplomas, and ask the doctor questions about their training -- his direct quote was "they get really peeved if they think you're questioning their credentials"...my brother's motive, which I thought was obvious, was to shatter pretense)