DME was PISSED.

DreamOn wrote: Maybe they have been talking about "that crazy lady" while I'm not there? They must not have many other patients who want to be intimately involved in their own therapy.
~ DreamOn

This is something I've said many many times here, but you are absolutely right.

I can easily say that something on the order of 98% of the patients I setup have zero interest in the treatment. I'm not exagerating in the least. The vast, huge and massively overwhelming percentage of patients not only aren't interested but actually get combative and angry when you try to explain it to them.

If I had a dollar for every time I heard "Just show me how to turn the damn thing on!" I would be a wealthy man. If I had a dollar for every time I heard "I don't give a damn about all this stuff, I'm not gonna use it once you leave anyway" I would be vacationing in Tahiti rather than my backyard.

Seriously. You really have no concept of how little the average person gives a crap about this stuff. Not just CPAPs, everything.

It's actually really depressing and makes you pretty jaded about people when you have to fight just to try to get them to listen to you when you explain how to use something that's designed to save their own lives. And then when you get to cleaning and upkeep, forget it. You can start speaking in tongues at that point and the average person wouldn't even notice they are so tuned out.

Anyways, just thought I'd mention that.

m

The difference is about 12-15 years of schooling,training and then ongoing education throughout his career to this day, and before my son even earned a dollar as a physician he was well over $100,000 in debt with student and personal loans. I'm not counting the help he got from Mama and Papa and several scholarships and grants he earned. An RT working at a DME is somewhat like someone selling some particular brands of washing machines for an appliance store owner. He's probably had some training on which buttons to press for hot/cold, spin,etc, but can he tell me how to wash a delicate bed spread my Mom made for me many years ago? It's a poor analogy I know, but since it recently happened when I asked that question of a salesman and got no useful information, it's all I could think of at the moment. I hope someone else has a better response to Gary's question. Sorry rjjay!

mattman wrote:
If I had a dollar for every time I heard "Just show me how to turn the damn thing on!" I would be a wealthy man. If I had a dollar for every time I heard "I don't give a damn about all this stuff, I'm not gonna use it once you leave anyway" I would be vacationing in Tahiti rather than my backyard.

m

That is why you need somebody other then an RT - They are dealing with life style changes and grieving. They don't want to having a chronic illness.

mattman wrote:The diabetes education comments amuse me. My diabetes education came from a dietician and an instructor all assosciated with the edocrinologists office.

The training wasn't really very good and the doctor got paid $670.00 for it. And I never even saw him, only a nurse. Even worse, as a DME supplier for years handling diabetic patients I actually taught my patients far more about equipment, testing and what to do than was covered in this "education seminar".

Even 30 years ago my mothers diabetes education was much better then that. Again - the profit issue. My mothers hospital clinic was not making a profit off her diabetes

mattman wrote:

DreamOn wrote: Maybe they have been talking about "that crazy lady" while I'm not there? They must not have many other patients who want to be intimately involved in their own therapy.
~ DreamOn

This is something I've said many many times here, but you are absolutely right.

I can easily say that something on the order of 98% of the patients I setup have zero interest in the treatment. I'm not exagerating in the least. The vast, huge and massively overwhelming percentage of patients not only aren't interested but actually get combative and angry when you try to explain it to them.
m

Matt,Well, I'm full of stories tonight instead of finishing up Thanksgiving preparations, but this reminded me of a story I've told here before. We were in the reception area at the DME waiting for our replacement mask and a very well dressed man holding a broken,taped up mask was talking on his cell and apparently giving very explicit, complicated instructions to some assistant at work. He sounded like an exec of some kind. When he hung up we started to talk and I asked some "gentle" questions. He said he's been on cpap about 18months, his mask broke 8 months ago and was now "hoping" he could get a replacement. I was unfamiliar with the mask but he didn't know the name of it, didn't know what machine he was using or the pressure setting. He did have a sleep study but doesn't remember his results. He was smiling at me the whole time. I was just ready to launch into a speech when his name was called and he left the room. I've always wondered about him. Matt, do you think someone like him could be doing OK? Is ignorance bliss in some cases?

What kind of specialized training are you looking for?

When I was in school to be an RT, we had a semester of just Sleep disorders and sleep disordered breathing equipment. On top of that, we do have to get 24 Continuing Education Credits every two years to maintain our license (Which is 4 more hours than they require for an RN to be licensed.) A certain number of those CEU's need to directy reflect the field in respiratory in which you work. An ICU RT has to have a certain number of critical care CEU's, same for a RT who works in sleep.

PAP therapy is not only used by an RT for an OSA patient. PAP therapy is used in critical care, pediatrics and the neonatal intensive care unit. If an RT went to an accredited respiratory program, they should have the knowledge required to educate a patient on xPAP.

The RT is the correct medical professional to be doing OSA/xPAP training.

DoriC wrote:I've always wondered about him. Matt, do you think someone like him could be doing OK? Is ignorance bliss in some cases?

Dori, I think it depends on the person.
Since I started cpap, I know of 7 people that I work with, directly.
I have questioned all of them about their therapy.

1 has asked me for help.
3 will not talk about it at all.
1 has already quit.
1 puts it on each night because the doc told him to, but doesn't feel any better...
doesn't know what his equipment is and doesn't want to know.
1 has been a hose head for 17yrs.....has no clue what he has or his study results...
it works and he doesn't care.
...and then there's me, equipment junkie, data junkie, pillow slasher, wan'a be helper....
w/just a touch of militant attitude thrown in for spice.

How's that for a cross section.
When I try to talk to them about it, they look at me like I'm a martian.

CpapRRT wrote:What kind of specialized training are you looking for?
The RT is the correct medical professional to be doing OSA/xPAP training.

Yes you can train someone in how to put on a mask and clean their humidifier but how are you on phobias, relationships, eyes, facial swelling, grieving, anger management, sleep hygiene, motivation? All of these things impact therapy.

Where do we get this bit about doctors making money off of testing?

My gastroenterologist makes money if she performs a colonoscopy - but she doesn't get anything for sending me to the hospital or imaging center for a CT Enterography or Small Bowel Follow Thru. She gets paid for the tests she performs, she doesn't get paid for the tests she refers me elsewhere for.

My Endocrinologist doesn't get paid for sending me to an imaging center or the hospital for a DEXA scan.

My gynecologist gets paid for performing and pelvic exam and PAP smear but he doesn't get paid for sending me to the hospital or imaging center for a mammogram.

My family doctor gets paid for removing a suspicious mole in his office but he doesn't get paid for sending me to the lab for blood tests.

IF they perform the "test", they deserve to get paid, if they refer me elsewhere for a test they don't get paid for that.

mattman wrote:

DreamOn wrote: Maybe they have been talking about "that crazy lady" while I'm not there? They must not have many other patients who want to be intimately involved in their own therapy.
~ DreamOn

This is something I've said many many times here, but you are absolutely right.

I can easily say that something on the order of 98% of the patients I setup have zero interest in the treatment. I'm not exagerating in the least. The vast, huge and massively overwhelming percentage of patients not only aren't interested but actually get combative and angry when you try to explain it to them.

If I had a dollar for every time I heard "Just show me how to turn the damn thing on!" I would be a wealthy man. If I had a dollar for every time I heard "I don't give a damn about all this stuff, I'm not gonna use it once you leave anyway" I would be vacationing in Tahiti rather than my backyard.

Seriously. You really have no concept of how little the average person gives a crap about this stuff. Not just CPAPs, everything.

It's actually really depressing and makes you pretty jaded about people when you have to fight just to try to get them to listen to you when you explain how to use something that's designed to save their own lives. And then when you get to cleaning and upkeep, forget it. You can start speaking in tongues at that point and the average person wouldn't even notice they are so tuned out.

Anyways, just thought I'd mention that.

m

Agreed.

What's curious to me is that the (less enlightened) DMEs/RTs who find us here would embrace the fact that there ARE users who DO take their therapy seriously and look to improve it.....via software, occasional tweaking and looking for the optimal mask. Yet, there are those who come on here and chastise us for doing just that. Seems paradoxical to me.

I'm glad you folks come here and contribute, too. Plus, the longer you hang around, you get to see more of the "horror stories" that many of us have been reading about for years......users/patients who have dealt with the not-so-enlightened DMEs and RTs.


Den

BlackSpinner wrote:

CpapRRT wrote:What kind of specialized training are you looking for?
The RT is the correct medical professional to be doing OSA/xPAP training.

Yes you can train someone in how to put on a mask and clean their humidifier but how are you on phobias, relationships, eyes, facial swelling, grieving, anger management, sleep hygiene, motivation? All of these things impact therapy.

Any accredited respiratory program requires a psych course which covers most of what you mention. Then you have 2 years of clinicals mixed in with your schooling, most of this issues are learned by most in a clinical setting, phobias, relationships, grieving, anger management and motivation. Any patient with a chronic condition has these same problems, most medical professionals are taught how to help a patient cope during their initial schooling, and the rest in learned in clinicals and on the job, some people are just better than others at it, it has nothing to do with being an RT or not.

Sleep hygiene is taught during the sleep disorders course. Some people absorb the info, some don't.

Facial swelling and eyes, something a hospital RT deals with daily. Clinical skills that are taught daily when you work in a clinical setting should give someone enough common sense to deal with the problem at hand.

mattman wrote:

DreamOn wrote: Maybe they have been talking about "that crazy lady" while I'm not there? They must not have many other patients who want to be intimately involved in their own therapy.
~ DreamOn

I can easily say that something on the order of 98% of the patients I setup have zero interest in the treatment. I'm not exagerating in the least. The vast, huge and massively overwhelming percentage of patients not only aren't interested but actually get combative and angry when you try to explain it to them.

I understand what you're saying, Mattman. I've worked in the medical field myself and observed plenty of patients like that. It must be frustrating to deal with that kind of apathy day in, day out. I'm sure that you realize many of these patients are just sick and tired.

I guess the point I was trying to get across (in one of my rambling posts yesterday ) is that when there IS a rare patient (like myself, and many others on this forum) who WANTS to be 100% involved in monitoring their own treatment, they shouldn't be discouraged from doing so (through intimidation) and have to fight for a decent machine that will allow them to do that. I can go by how well I feel (and I do), but I wanna see the numbers! I can't do that with an Escape or a Plus, which only give hours of use.

Since we are the rarities in the sea of patients who aren't interested in tracking their treatment, then profit really shouldn't be an issue. You'll make adequate profit off the other 98%. Just give us what we want (without a fight) so we can succeed at this and optimize our health.

This really isn't directed at those DME suppliers who are doing a good job (there are a few, from what I understand), but to all the others. I read about the same problems with DMEs here time and time again....

I just need to vent my frustration. Nothing personal. I am glad you and the other caring professionals are here.

~ DreamOn

carbonman wrote:...they look at me like I'm a martian.

Yeah, well, I have COPD and I've had the opportunity to talk w/plenty of RRTs the last few years and to a T those in hospitals and at the university have all said that they would need and want specific training in CPAP therapy before they would consider taking a job that entailed educating, advising and providing CPAP equipment, etc. to patients. Twice when I was in hospital since starting CPAP therapy I've had RRTs who were intrigued by and delighted w/my Resmed S8 AutoSet and its SIZE since they were used to the huge things that the hospital provides and they were grateful I had my own CPAP and didn't have to use the hospital's.

carbonman wrote:
When I try to talk to them about it, they look at me like I'm a martian.

Announcing you have Sleep Apnea elicits some very telling responses in people. I have very openly talked to co-workers about my diagnosis and the responses have been very interesting. I had one busy body come in and tell me I really should keep that information to myself as it really could hurt my career. I was momentarily speechless. I've had co-workers treat me like I'm falling prey to some snake oil salesman. One man told me "I've been waking up gasping for breath for years and it hasn't hurt me a bit". He said this while rubbing his dark circled, bassett hound eyes and letting out a big yawn. I told him to come by my office and I'd fish out his company paid life insurance form and have him write me in as a beneficiary because it would be only a matter of time. Then there were those who take me aside and in hushed, desperate tones, start asking me questions about why I went in for testing and how did I know I had a problem, etc... One woman asked if I'd talk to her husband about my experience. I've referred a few people to this forum for information. But my boss and other co-workers act like I am being obsessive about my treatment because I have done online research and have made demands re: my treatment. My boss made a comment that I need to back off and let the professionals treat me and quit asking so many questions. Now THAT put my knickers in a twist! I've come to the realization that no one can understand your reality but you!