Interesting checkup today

Today, I had my 4 month checkup after starting ASV therapy in early July. It was more than interesting.

Although the actual CPAP therapy seems to be working, I still have a lot of problems with fragmented sleep. I also suspect I am still not getting much stage III/IV sleep. This happens whether I am careful about naps, caffiene, etc., or not. The result of this was something I really do not want: A prescription for a sedative (generic Ambien, 10 mg). I will give it a try though, and see how it works.

I told the doctor the story of how I came to having an ASV machine. He was reviewing my compliance numbers, and remarking that other than a couple 2.5 hour nights (those were nights were I had to go in to work in the middle of the night, a fact of life for a broadcast engineer) that I had excellent compliance. My response to him was "I had an AHI of 96 on my initial sleep study. I have no choice but to be compliant with my therapy." The Doctor's reply floored me. "No, you don't have to be compliant. You have a choice as to whether you use the machine or not." The way he worded his response was almost like 'You don't need to use the machine unless you want to'. This really surprised me, that he would respond this way, especially after I related how I had symptoms going back 20 years before I sought treatment.

In all other respects, things were very good. No machine setting changes needed or anticipated for a long time.

In any case, this came on the heels of getting a statement from my insurance yesterday that I will owe some money on supplies (on our new insurance plan ) to the tune of $100, possibly more. Probably the last time I will buy routine supplies through the DME, unless I need to satisfy them during the rental period.

When I went to get the prescription filled, the insurance company did not have me properly registered in their system. Got that fixed quickly. But then, they hit me with a double co-pay because apparently, the prescription drug provider doesn't like dispensing more than a 15 day supply at one time.

No wonder our country is going to the dogs!

Don't be too sure about the doctor... he may really have just been feeling philosophical and meant it literally - that you have a choice, though it was probably a stupid time to express it! Doctors are just as human as the rest of us and can come up with dumbass things like we all do!

timbalionguy wrote:My response to him was "I had an AHI of 96 on my initial sleep study. I have no choice but to be compliant with my therapy." The Doctor's reply floored me. "No, you don't have to be compliant. You have a choice as to whether you use the machine or not." The way he worded his response was almost like 'You don't need to use the machine unless you want to'. This really surprised me, that he would respond this way, especially after I related how I had symptoms going back 20 years before I sought treatment.

Well you do have a choice, just like you have the choice to not cross the street on a red light with a bus heading straight for you, or to go an cuddle a lion when it is not in the mood.....

timbalionguy wrote:My response to him was "I had an AHI of 96 on my initial sleep study. I have no choice but to be compliant with my therapy." The Doctor's reply floored me. "No, you don't have to be compliant. You have a choice as to whether you use the machine or not." The way he worded his response was almost like 'You don't need to use the machine unless you want to'. This really surprised me, that he would respond this way, especially after I related how I had symptoms going back 20 years before I sought treatment.

I'm too lazy to go back and check... what were your O2 stats on your sleep study? Perhaps if you were not desaturating then XPAP treatment is "optional"

I'm with Julie on this one: Chances are the doctor has dealt with many, many non-compliant patients through the years whose initial sleep study numbers were as bad or worse than timbalionguy's numbers. Patients always have a choice to make: They can either accept treatment (like timbalionguy) or not.

Of course, it helps when a patient has an attitude like timbalionguy's: He clearly realizes that for himself, accepting treatment (and working hard to make it work) is no-brainer of a choice because he genuinely understands the severity of his condition and the necessity of his treatment in spite of his current problems with fragmented sleep.

And I too feel like timbalionguy: I'm working hard trying to make APAP work for me in spite of a whole range of APAP-related issues because even my "moderate" numbers on my diagnostic sleep study are clearly enough to indicate a real problem---even though I was asymptomatic except for my husband's witnessing occasional apnea episodes. And I'd feel like I was a real idiot if I simply walked away from a treatment that's known to be effective.

timbalionguy, I tend to agree. I've known folks who should use xPAP therapy, but refuse to use it. They knew better, but refused to use the mask at night. And then they complained about cardiovascular related problems (heart issues, kidney issues). I bet your doctor has seen more than one patient like that. Go figure.

But it's great to hear that your checkup went well.

The doc gave my hubby way too much leeway when he had his 1st sleep study.
Told him that since his apnea was almost all in supine position, he could just avoid sleeping on his back.
After nearly a year of denial, my honey is using his brand new machine--EVERY night, all night; and sleeping in all positions.
He is competitive, so the efficacy data is very useful in keeping him interested.
I know he will 'beat' my numbers one of these days--but I'm setting the bar high.
I think he is feeling better, but he still doesn't admit it.

My husband wouldn't admit it either until I had to point out that he actually watched an entire TV movie without dozing off and finished reading a book he had started a year earlier. He then grudgingly agreed that he was feeling a "little" better. I guess it's a man thing! Now when he wakes in the morning and I ask him how he feels he says "Great!!"