New and confused. *UPDATED IN NEW THREAD*

[dsm]

I might have missed it, but does your current CPAP have EPR? 16 cmH2O is pretty tough to breathe against. If it does not have EPR, then use that as yet another reason you need a new machine. And while you're getting a new machine anyway, it might as well be data compliant...

AND if you're having some difficulty with 16 (or even if you aren't), propose to your doctor to let you have an Auto machine (APAP) so you can begin your session at a range that maxes out at 16. He might say something about the ramp feature, but tell him that you'd really like to make sure that 16 is REALLY what you need and that once you (and your doctor) are absolutely sure that 16 is your ideal pressure, then you'll run it in CPAP.

Auto machines have everything you'll want/need...

RM

That issue of EPR is a good one. EPR acts like a bilevel and for anyone on 16 CMs and who has shown up a few centrals EPR is an answer.

All you have to do is say - sorry but I just can't tolerate 16 CMs through the night & need a machine with EPR (which the Elite II has).

If you really want to push it just take the Escape back & say "sorry, can't handle the 16 CMs & ramp doesn't help - want a machine with EPR relief " (specify EPR as they could try to give you an M basic series which has CFlex but still doesn't record nightly data - CFlex is not as effective as EPR for a number of reasons).

So

1) Walk in with the Escape & hand it over
2) Say - cant handle 16 CMs through the night - want the machine with EPR
3) Don't leave without an EPR machine (the Elite II)

Handing the Escape back will make it very hard for them to deny you what you want.

Good luck

DSM

[goose]

RM - If you end up returning the machine you have, make sure you write the serial number, model number etc. down somewhere and make sure they give you a receipt that says you returned it - and also make sure they note the serial/model numbers on the receipt.
If you go to the other DME (which you probably should given the bozo's you've been dealing with, but with the loss of a "customer" imminent, they may change their tune).
When you're visiting your doctor tomorrow ask him/her if they will write you a script for an auto with a range of say 14-18 which leaves your 16cm in the middle of the range.
You might also ask about the centrals mentioned in the report and how they're being dealt with if you don't have a Bi-PAP machine. You want that DME to be reaching for a scoop, go back with a Bi-PAP prescription (and make sure it's Bi-PAP auto!!! ). With a single split test, I'd be wanting the auto so that you can titrate yourself and validate the results of the test.
Example: I was titrated at a 5cm pressure. I can't breathe at 5cm!!!! I'm on an auto with a range of 11-15 doing very well!!!
How they came up with that number I'll never know, but after a week with a straight CPAP (data capable) I asked for an AUTO CPAP from the DME which they said they don't/won't provide. Right!!! Let the games begin!!!!
I called my doctor and asked her to please write me a new prescription for an AUTO CPAP machine ( I asked for an M-Series Auto with A-FLex and Humidifier), which she did and immediately faxed it to the DME. I waited a couple days then called the DME back, talked to the same bozo that told me they didn't provide APAP's, and asked her, when I could come pick up my AUTO CPAP machine....When she argued about it, I asked if she was telling me that they were not going to provide me with the equipment that my doctor had ordered......Silence.
She immediately reviewed my file, found that the prescription had been re-written and I got my machine later that day. It can be done, it has been done and I'm only one example.
You are in the right. They are just trying to maximize their profits by giving you a down level machine.

The insurance company doesn't care what you get really. The billing code is the same for a straight CPAP machine and for the Auto CPAP machine, so the insurance company pays for either at the same rate -- which is why the DME is trying to pawn off a cheapo on you!!!!
Their profits aren't your worry!!! Your treatment is!!!! As everyone else has said, stick to your guns, see if the doctor will help you get a data capable Auto machine -- whatever manufacturer -- by re-writing the script for what you want (I'm not a Resmed "expert" but I'm sure the Resmed version of the Auto CPAP machine has been mentioned here) !!!
Once you get that data capable machine, come back, let us know what you got and we'll let you know what software and card reader you'll need to take full advantage of that data!!!!

Stick to it Mama!!!! You're doing good!!!!!
Take care
cheers
goose

[SharkBait]

I think one of the strongest is your wanting to know if the therapy is working.

I disagree. That will not carry any weight with the DME.

I think it is a mistake to surrender authority over your therapy, RM, by allowing them to think that you must convince them to give you the machine you want.

Agreed, I thought she was talking with her doctor...

[ThomasMcKean]

So after speaking with my husband again, I have decided to call my PA/MD about this and see if they can give me the proper tools to go forth with changing my machine. I have my first follow up appt with my ent on weds, but im not all too sure i want to wait that long... Unless some of you here can give me the paperwork i need to print out to show without having to utilize my ENT..

I am loving this thread. I can't wait to keep reading and see how this turns out. Will she get the Elite II? Will she need to be happy with the Escape? Will her husband buy her the Elite II? ACK! I better read the next post!

[ThomasMcKean]

As people said, be firm but diplomatic. NEVER EVER be drawn into a discussion of whether you NEED that machine. If they say, "You don't need a .... machine, the Escape will do fine" then I would say, "No, that is not the machine I want. I want the .... machine, which my prescription allows. Will you give me that one or not?" You will NEVER convince them that you need a fully data capable machine, so don't try.

Don't forget, you can do this in multiple conversations, especially if you are exceedingly polite. If you start to feel frustrated, tell them you need to go but will call them back. Take some time to get your mind straight and calm, and then call again.

Thank yew for this information. I will be using it later today with my zero personality DME.

[ThomasMcKean]

Agreed, I thought she was talking with her doctor...

Is this where the thread ends? Doggone it I wanted to see how this turned out before I went to bed!

Guess I will have to "stay tuned..."

[Rockin Mama]

Agreed, I thought she was talking with her doctor...

Is this where the thread ends? Doggone it I wanted to see how this turned out before I went to bed!

Guess I will have to "stay tuned..."

For now it is! I have my doctors appt today at 1:30 and i WILL be taking it up with her to insure i receive the therapy possible for my situation!

[ThomasMcKean]

For now it is! I have my doctors appt today at 1:30 and i WILL be taking it up with her to insure i receive the therapy possible for my situation!

Right now yew and I are in a very similar situation (which was NOT the case when I read this last night).

I hope it works out...for BOTH of us!

[JimW203]

This is an amazing thread. In a few short days a vast body of knowledge has been arrayed to provide the information and moral support needed for a new user to gain control of what will be a 'rest-of-the-life' situation. I cannot imagine a doctor telling a Diabetic patient "you don't need a blood glucose meter, just inject this much insulin every day for the rest of your life, you'll be fine."
Someday, the sheep will turn on the wolves.

JimW203

[Rockin Mama]

I am on my way out the door.... please, please give me the strength to tell me doctor exactly what i want to say.

[MoneyGal]

oh, of course, of course!

RM - I haven't responded yet on this thread but my story is similar to yours. I'm older than you are (I'm 41) but I've probably had OSA my whole life and when I was diagnosed, earlier this year, I had stats similar to yours (91 events per hour).

If you want to know what's possible, read my threads about how I feel after treatment: Like I'm FLYING. I have the machine you are intending to get and it totally works for me. I monitor my treatment every day and I am consistently at less than one apnea event per hour all night.

This post is just my personal wish and vibe for you to get WHAT YOU NEED to have fantastic results!

[ThomasMcKean]

This is an amazing thread. In a few short days a vast body of knowledge has been arrayed to provide the information and moral support needed for a new user to gain control of what will be a 'rest-of-the-life' situation. I cannot imagine a doctor telling a Diabetic patient "you don't need a blood glucose meter, just inject this much insulin every day for the rest of your life, you'll be fine."
Someday, the sheep will turn on the wolves.

You're right. And if yew have been to support sites (for whatever yew may need support with), yew know that many of them (MOST of them in fact) prefer fighting and arguing and flaming and name calling to support. I am also amazed. I hope I can find a way to fit in here.

[rested gal]

I hope I can find a way to fit in here.

You already have, Thomas. You already are fitting in very nicely, indeed!

Thomas's trek toward a "More data, please" machine:

Call Me: "Rockin Mama - Take II" (Update: RESOLVED!)
viewtopic.php?p=347584#p347584

[OldLincoln]

As Goose pointed out, they must fill the Rx if it specifically lists the equipment. When I had my CPAP replaced, per instruction I received here, I handed him a list of exactly what I wanted and explained I came to that conclusion through research with the hundreds of users on this forum. He didn't care what it was as long as I like it, so he wrote the Rx specific to the machine and humidifier, and added "mask and hose of patients choosing and all associated supplies". In my case he called them on the speakerphone and made sure they would fill it that way.

Sometimes when it costs the DME money you have to remove all their wiggle room. BTW, I just love my NEW DME!

[ThomasMcKean]

BTW, I just love my NEW DME!

I love mine, too. Didn't think I ever would, but I guess she was just hiding behind the boss.

That's okay. I understand.