Please tell me it's going to be OK!

You guys are making me nervous.

To calm my nerves a delicious snail salad will be prepared for lunch.

No worries about the side discussions or dissenting voices. It's a sign of a good forum that threads roam off into different tangents and people are allowed to dissent. Right now I'm taking Roster's advice and focusing on the thursday appointment and looking ahead to the next step of equipment selection.

Thanks for the tip about elevation as I'm moving from 3000ft to sealevel. It makes a difference in how one makes dill pickles so I shouldn't be surprised it makes a difference in cpap. I'll ask. Electricity is quite dependable where I'm going (Canadian Arctic) and there's a good medical center, doctors are rotational though so this month there may be someone quite familiar with apnea and next month not so much. If anybody does a lot of camping I would be interested to know how that works out...what machines and batteries ect work best. There is also the cold which means cool bedrooms and subzero field trips. Thanks again for the amazing welcome!

snipsnsnails wrote: Electricity is quite dependable where I'm going (Canadian Arctic) and there's a good medical center, doctors are rotational though so this month there may be someone quite familiar with apnea and next month not so much. If anybody does a lot of camping I would be interested to know how that works out...what machines and batteries ect work best. There is also the cold which means cool bedrooms and subzero field trips. Thanks again for the amazing welcome!

Invest in an Ausi heated hose so that you don't get "rainout" (condensation in the hose leading to a snout full of water) also make a hose cover from a scarf or a couple of dollar store socks.

If you do a search you will find there are dozens of threads on camping an types of batteries.
Note that Resmed will not allow shipping to Canada so make sure you have lots of supplies if you go the S9 route.

snipsnsnails wrote: If anybody does a lot of camping I would be interested to know how that works out...what machines and batteries ect work best. There is also the cold which means cool bedrooms and subzero field trips. Thanks again for the amazing welcome!

One of my hiking buddies tells about a hunting trip, camping in tents, in Alaska with a CPAPer. One night he was awakened by his friend's gasping. Rainout had frozen in the curl of his CPAP hose and was blocking the airflow.

I am not a fan of heated hoses, but in the conditions you describe one may be called for. Don't forget it takes extra power for the heated hose on your field trips.

OK, it's official. Doctor's office called this morning and said that I had sleep apnea and that my doctor would be recommending c-pap therapy. No surprise. They asked if I wanted to go ahead and set up an appointment with "the" c-pap supplier. I said yes since I want to go ahead and see (and feel and hear) a c-pap machine and mask in the light of day and with a fully concious mind, even though I have no intention of getting saddled with the first box that gets opened. Just got a call from Kelly's Home Health...googled them and see that they are a rotech (?) company. I go there after the doctor tomorrow.

There have been several comments made about insurance. I have a Health Savings Account and still have a lot on my deductible this year (don't have the bill for the sleep study yet though ) so I won't sweat a bit about using c-pap.com if I can't get satisfaction locally. The yellow pages list 3-4 more medical equipment suppliers in my area as well.

Doctor's appointment tomorrow and I'm loaded with a printout of the questions from Roster's post and have some additional information about the town I'm moving too and the fact that I will be so far out in the boonies. I've read the excellent wiki you folks have taken the time to put up and browsed around C-pap.com and other internet sites. I looked at the product comparison's on this site and searched for threads about software and some specific machines. I've made note that resmed does not ship to Canada so will concentrate on the other manufacturer's since that sounds like a problem I don't want.
Thanks once again for making this seem like a doable job that will be worth the effort. My fiance sends her thanks as well . Any last minute advice before D (diagnosis) day?

You have prepared yourself well for tomorrow's appointment and should sleep well tonight.

Er, uh, strike that last part - it will have to wait a few days.

Try sleeping on your side or tummy until you get your CPAP system going. There is a 50% or so chance that this will help reduce the respiratory problems (but not eliminate them).

nosnore wrote:Just for fun, google: "cpap failure rate." One site states,
"Why has the 50-60% failure rate not changed over the last decade?"
Guess I'm not the only one who quit that nightly hell.

You wouldn't happen to live under a bridge would you?

By the way, sns, I invite you to read my thread that details my struggles through the process. It's 24 pages long, so you'll need some extra time to go through it. A lot of people have found it interesting and helpful.

viewtopic.php?f=1&t=38502&hilit=kenny's

snipsnsnails wrote: Just got a call from Kelly's Home Health...googled them and see that they are a rotech (?) company.

The DME I'm using is also Rotech and the problem I'm having is that they only sell Respironics. (at least the one here), so I can't get the mask I want. So check with them to see what they sell before you commit.
I have an appointment with the sleep doc next week and I'll get my prescription then so I can get what I want.

" I looked at the product comparison's on this site and searched for threads about software and some specific machines. I've made note that resmed does not ship to Canada so will concentrate on the other manufacturer's since that sounds like a problem I don't want. "




Is it possible to have it shipped in care of you to a friend where resmed does ship, and have them forward it to you?

I know you need a prescription, but perhaps if its in care of you, that would work..

This may be something you are already aware of, but do you know the difference between CPAP and APAP?

"C"PAP is CONSTANT Pressure. ONE setting and that is it. It may start lower and ramp up over time, but it is CONSTANT. "A"PAP is AUTO Pressure, the machine senses apneas and hypopneas and adjust air pressure accordingly. When you don't need the high pressure, it backs down. This is generally more comfortable and can reduce Xpap induced Central Apneas.

I would suggest you ask your doc to write the script for APAP. It can always be run in CPAP mode, but gives you more options down the road as you find your right settings. If you buy a CPAP, you may find yourself needing to buy an APAP down the road.


So what was your AHI? Did your Doc give you any numbers yet?

Two of the most popular APAP models right now are:

Resmed S9 Autoset with humdifier and ideally Climateline tubing to eliminate rainout (there are two types of humidifiers--one is disposable and near impossible to clean well, and the other supposedly can be cleaned--I'd recommend the latter to you, especially if you can't get new supplies easily).

and

Phillips Respironics System One Auto (also prevents rainout)

I prefer the S9 because: (1) it is quiet and the variability noise of the PR1 drove me nuts, and (2) the PR1 has test puffs of air in an attempt to detect clear airway vs. obstructed airway, and those test puffs were disturbing. The S9 has some method of detecting them, too, but I don't notice it and am not disturbed by it.

There are a lot of threads on here comparing the two machines, and it's an individual decision. I am not sure whether your inability to get Resmed supplies shipped directly to you should factor heavily into a big decision like this, especially if you can do what someone suggested and get it sent to you by someone else.

djr1215 wrote:

snipsnsnails wrote: Just got a call from Kelly's Home Health...googled them and see that they are a rotech (?) company.

The DME I'm using is also Rotech and the problem I'm having is that they only sell Respironics. (at least the one here), so I can't get the mask I want. So check with them to see what they sell before you commit.
I have an appointment with the sleep doc next week and I'll get my prescription then so I can get what I want.

One more thing with Rotech - they automatically enroll you in "sleep central" and their CPAP Resupply program where supplies are sent out to you automatically on a schedule (unless you are on Medicare). You have to tell them you don't want this done automatically if you'd rather get what you need when you need it.

My doctor had the sleep study results ready for me including a copy for me without my asking. The first portion of the study was 175 minutes in bed. Sleep time of 132 minutes. N1 was 12%, N2 was the remaining 88%. 77 obstructive apneas, 8 mixed apneas, 58 hypopneas, and 61 additional respiratory event related arousals. AHI (yep already getting the lingo here) of 65. It says "the respiratory disturbance was 93". I don't know what that last one means and neither did my doc who is a PA by the way...I still like him better than any MD I've ever had cuz he has always shot fairly straight in the past. Oxygen desaturation down to 85% with a mean of 92%. No evidence of periodic limb movements, tachyarrythmias or bradyarrythmias. No wonder my fiance is worried! It must be like sleeping in a model T idleing with a clogged fuel pump!

The second portion of the study consisted of 221 minutes with a long period of wakefulness and just 89 minutes of sleep. N1 at 7%, N2 at 39% and Stage R at 53%. It says " CPAP was titrated up fairly quickly, given the limited time that was available. At the final titration of 14 there was a period of 23 minutes of Stage R sleep in which the AHI was 0 and the respiratory disturbance was 0. Mean oxygen saturation of 96%. Minimum oxygen saturation of 93%"

I asked about central apneas even though the report said nothing about them only mixed and was told what I could already read...there were no purely central apneas.

I asked if there were any comorbidities indicated besides the "being fat and high blood pressure that I already know about". He laughed and said he was actually really jealous of my genetics cuz I was too healthy to have HBP and obesity, that my bloodwork (taken at my last visit) was better than his. He's rail thin and I highly suspect veganism, no offense to any vegans on the forum. LOL

I slept on my side the whole night according to the report so the positional sleep apnea question was moot.

When I started asking about prescriptions and data capable machines he told me that he didn't understand what I meant that the girls in the office handle all the paperwork, just pick out a machine and mask I'll use and if the provider has any questions to call his office and he will sign off on it. He pointed to a line in the sleep study report that says "It appears that a continuous positive airway pressure of 14 is optimal using a medium Quattro full face mask and heated humidity." and said that "right there" is your prescription...yeah I know, but I still like him and figure he'll sign off on whatever works.

Well this is a mile long so I'll tell you all about the DME fiasco in another post. I'm sure glad I found cpaptalk before finding those people!

I like that doctor. He accepts his limitations and wants to help you.

Sounds like a good prescription (14 cm and FFM) for a starting point.

Next, a data-capable machine is critical for feedback and tweaking to an optimal therapy.

Whatever bloody DME story you have, similar versions have likely often been posted here.

This would be funny if it were not so sad. I've been reading about people's experiences with CPAP equipment suppliers and thinking "It can't be that bad." OH MY!

I walked in and my "respiratory therapist" was summoned to greet me. She led me back to a room with a sort of old style padded medical examining table and a couple of chairs. There was a brand new Respironics machine on the table along with a couple of masks. I looked quickly at the machine and was relieved to see it was a System One...top of my list. I wasn't going to have to argue if this was the machine she wanted to sell me. She began to explain to me how it worked and paused to ask if I had any questions so far. I said "No, in fact I've been reading all I can about CPAP and reading reviews and the PR System One is at the top of my list to try, it sounds like a good machine."

"Well, this is actually called an Respironics M Series Plus. We don't have any PR machines in stock"

*Blink, Blink* I look again more closely...it says System One on the humidifier just like the pictures. "Umm, then this is just a demo and not the machine you want me to have?"

"No sir, you misunderstand me we don't have any PR machines, this exact machine is the one you'll be taking home. I've already set it up for you. It's an APAP because we don't have a CPAP machine in stock but it will be running in CPAP mode at the pressure your doctor recommended, that's umm, 14 psi. "

I almost giggled at psi. I look very closely just to make sure she is the one having the brain fart and not me. Yepper. Remstar Auto A-flex right above the lcd screen Phillips Respironics right below and System One on the humdifier box...just like the pictures on cpap.com. "

I'm starting to think just maybe the screw ups are going to go right in my favor. "OK, what about masks?" I'd like to try a few different ones to see how they fit."

That's when my luck ran out...