Newbie Question - Obstacles due to Prescription

WIth your insurances you should be covered 100% You will need an uploadable unit based on the new Medicare guidelines. I would go for a larger DME company that can make travle arrangements for you when you travel. You are not permitted to travel vis plane with most O2.

I'm feeling like a dunce on this topic, but what is the benefit of O2 with cpap? If the windpipe is being obstructed, why does it make a difference with the O2 present? I am interested because in all the craziness of the last few months (see my posts), the DME respiratory therapist recommended O2, and said with my overnight pulse oximetry results, I would be covered 100% between my insurance and Medicaid. The sleep doc "didn't want to go down that road" when I asked, but with a good explanation of the benefits, I might be able to get the primary doc to write a script.
It's a long story of what happened Friday with my sleep doc. I guess I really upset him by being melodramatic and adding the comment "and I'll keep trying not to die in my sleep" in my last (of many) appeals for help. This was after 2 months of complete inaction on his part, and I later apologized for going overboard. But anyways, he now feels that I do need a further extensive evaluation to determine if I have an underlying condition other than sleep apnea. He is supposed to be refering me to the University of Michigan (finally)... But it would be nice to have some extra help until then, which might be the O2. Lovey...

I hope you get that referral to U of Michigan soon, Lovey. I've met Dr Fernando Martinez, one of their pulmonologists there and he is GREAT, but hard to get an initial appointment with because he is so well-liked by his patients. I've seriously considered switching to Dr Martinez from my current pulmonologist. I don't know ANYTHING about their sleep department. I really fail to see why your current doctors are making such a difficult time of getting you properly Dx'd and treated! *sheesh!*

There seem to be two kinds of doctors: those who consider "difficult" to Dx & treat patients a PITA to run thru the office ASAP and those few GOOD ones who find "difficult" to Dx & treat patients a "challenge" and take particular interest in those "challenging" patients and getting to the bottom of the problem and RELIEF for the patient.

Anasazi,
If you have healthy lungs and a healthy heart, it's quite possible that as you ajdust to your therapy - as you adjust the machine to give you better therapy - you will no longer need oxygen supplementation. I suggest going with the oxygen till your nighly results stabilize and you feel good - then ask the doc. if you can try a oxygen saturation test for one night with cpap and without oxygen.

Lovey,
Continuous Posistive Air Pressure is needed to keep the airways stented and open. This is very important for those of us whose airways collapse not letting any air in.

However, an opened ("patent") airway may not be enough. Sometimes, people's lungs don't extract enough oxygen from the air they do get - so supplemental oxygen is necessary. Somtimes, people's hearts can't handle the job of moving oxyenated blood from the lungs to the rest of you body - in a way that gets the oxygen there on time. In these cases, your body maybe oxygen starved - and supplemental oxygen is needed.

And then, as long as cpap therapy is not doing a good job of keeping the airway patent - you also need supplemental oxygen.

O.

Slinky wrote:There seem to be two kinds of doctors: those who consider "difficult" to Dx & treat patients a PITA to run thru the office ASAP and those few GOOD ones who find "difficult" to Dx & treat patients a "challenge" and take particular interest in those "challenging" patients and getting to the bottom of the problem and RELIEF for the patient.

Until a year ago, I had a primary doc who loved that I was "complicated". Unfortunately, he took on so many Medicaid patients, he had to close his practice because he wasn't making it financially. He would spend up to 45 minutes in the office with me. He went off to work at Hospice, but those patients do deserve his dedication.

Since then, I have had the "attitude of PITA type" doctors. I am rushed in and out. Nobody does anything. Nobody gets past one symptom. If I am lucky, maybe I'll get 10 minutes of the doc's time. That's if he hasn't "disappeared" or not been in his office for two weeks.

I still have hope though that I will find another doctor who likes "complicated" cases, Lovey

ozij wrote:Lovey,
Continuous Posistive Air Pressure is needed to keep the airways stented and open. This is very important for those of us whose airways collapse not letting any air in.

However, an opened ("patent") airway may not be enough. Sometimes, people's lungs don't extract enough oxygen from the air they do get - so supplemental oxygen is necessary. Somtimes, people's hearts can't handle the job of moving oxyenated blood from the lungs to the rest of you body - in a way that gets the oxygen there on time. In these cases, your body maybe oxygen starved - and supplemental oxygen is needed.

And then, as long as cpap therapy is not doing a good job of keeping the airway patent - you also need supplemental oxygen.

O.

Thanks for the easy to understand explanation. I probably can justify 02 with this explanation. I will look into it. I am also seeing my cardiologist today, so maybe he can prescribe it, and bypass the other doctors.

I went to the cardiologist today, and he was astonished that nobody...the sleep doc or my primary care doc, ordered oxygen after seeing my oximetry results. Maybe someone should have listened to me and the DME respiratory therapist who a month ago thought I needed it. I was poo poo'd on the suggestion/recommendation, like I was being overreacting.
Anyways, he is going to get on my primary doc and the sleep doc to get me 02 asap, and the referral to the University of Michigan. He thinks there is an underlying cause for my deterioration over the last few months, thus the referral to U of M, but he does not feel it is cardiac based. I had an echocardiogram and a chemical stress tests with good results in July. The structure and function of my heart is in good shape. It's the "volkswagon heart trying to pull a semi" problem the cardiologists have come up with in the last few years with me. My heart would be great in a 95 lb. person, but with being morbidly obese (but working on it!), my heart is insufficient in strength to carry the heavy load, so I have trouble meeting the oxygen needs of my body.

So, I am feeling much better that I will be finally getting adequate medical care. Thanks for all the information--it did help today with the cardiologist-- I was able to have a decent conversation with him and let him know I am a pro-active patient. --- Lovey

Congratulations, Lovey!! Thank goodness you have at least one doctor w/a head on his shoulders and who has some caring and concern for your health and welfare!! Kudos to your cardiologist! And to you for persevering! Its a crock that we have to fight so hard for adequate medical care! I have to say that the sleep profession is in the sorriest state of any of the specialties I've encountered!!!! Overall they really do need to hang their head in shame, they really do need to clean up their act.

Lovey - that is SOOOOOOOOOOO good to hear!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I'm glad you FINALLY got a doc on your side!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Well, what more can I say, I'm really really happy for you!!!!!!!!!!!!!!!!!!!!!!!!


Now lest I go overboard, let's hope they can finally sort you out! Keeping my fingers and toes crossed for you.

Lovey, that' such a relief to know you're finally getting the treatment you need!

O.

I received my EncoreViewer software and Card Reader on 09Dec08, and have been studying my reports that go back to 24Nov08 when I first turned on my CPAP. Having assessed available guidance for better understanding and adjusting my therapy, it appears that the best available is http://www.cpaptalk.com. My General Practitioner (GP) physician (like most) is not and likely will not be up to speed , and the DME to whom the GP delegated is only somewhat helpful. The cpaptalk community consists of highly motivated persons with a vested interest in CPAP issues . I have seen on the board reference to local sleep labs and specialist physicians that I may contact as well.

Since my last posts I have learned one thing about my prescription that I referenced in my initial post. The DME did interpret the Doctor's hand writing. I thought it said "CPAP at 10cm with 2L bleed in O2 - Report oximetry on above" but it actually says "CPAP at 10cm with 2L bleed in O2 - Repeat oximetry on above". Big difference between "report" and "repeat" . Physician's handwriting is legendary, eh?

At present I'd like to ask persons with EncoreViewer software and Card Reader to skim through my 12 page report and comment . Posts to cpaptalk lead me to believe that having AHI below 5 is a good thing. My Average AHI is 7.5 in today's report for the 24Nov-11Dec period. Please understand that I am not asking for medical advise, but rather for the forum's collective wisdom and experience to push me toward a positive direction and indicate what factors in the report may be significant.

A phpBB can be set up to handle file attachments although there are compelling reasons to disallow that. I have created a pdf of my 12 page report. In any case, while I believe that I could post my report as an image to cpaptalk.com, many readers may be reluctant to plow through the document; therefore, I would be happy to email or (PM) it to anyone willing to skim over it and comment.

Thanks again,