New to board, first CPAP tomorrow

[robysue]

For Respironics, I would accept a REMstar PRO or AUTO. I would NOT accept a REMstar Plus. (Don't let them confuse you with "Plus" vs. "Pro." )

Clarifying something important here: The names of the current Phillips Resprionics plain CPAPs are particularly confusing since both the PR System One Pro and the PR System One Plus actually have the word "Plus" in their full name. AND some DMEs just go by the model number (even more confusing) for describing the PR machines. The FULL names and model numbers of the various PR System One CPAP/APAP machines are:

• PR System One REMstar DS150 CPAP Machine (model #DS150S) A very stripped down model that not only does not record full efficacy data, but also has no form of exhalation relief.
• PR System One REMstar Plus CPAP Machine with C-Flex (model #DS250S). No efficacy data, but does have the basic C-Flex.
• PR System One REMstar Pro CPAP Machine with C-Flex Plus (model #DS450S). This is the straight PR CPAP that records full efficacy data. Note the placement of the words Pro and Plus in its name. Exhale relief is the more sophisticated C-Flex Plus. That's why it's easy to mistake the PR S1 Plus (model DS250S) for the PR S1 Pro (model DS450S) when talking with a DME that's determined to give you a PR S1 Plus instead of PR S1 Pro you asked for and want.
• PR System One REMstar Pro CPAP Machine with AutoIQ (model #DS450SAutoIQ). This model has just been released and may not be available. It records the full efficacy data and has C-Flex Plus as the exhalation relief system. The AutoIQ feature "offers 30 nights of auto adjusting capability, during which time the system works as an Auto CPAP delivering an adaptive pressure on a breath by breath basis. After the initial 30 days in auto adjusting mode, the system switches to Auto-Check Phase and functions as a CPAP delivering the pressure that the patient was at or below 90% of the time. The Auto-Check Phase continuously verifies pressure requirements and makes adjustments every 30 hours providing the user with more effective pressure levels over time. Please note this is not an Auto CPAP Machine. It functions as an Auto CPAP during Auto-Trial Phase and switches to CPAP mode during Auto-Check Phase." (This is from CPAP.com's description of the machine. Emphasis is in the original.)
• PR System One REMstar Auto CPAP Machine with A-Flex (model #DS550P-DS550S) This is the full fledged APAP in the System One line. It records full efficacy data and the A-Flex exhalation relief system is similar to C-Flex plus)

[Dive Apnea]

Just talked to my Insurance co... PPO.

Anyway, they stated they pay 80%, and have a contracted rate with that particular DME. So, it is like everyone is saying. They can give me the cheapest machine, and make money. I suppose, they have no reason to give me one over their contracted rate? Why would they lose money.

Wow, this is overwhelming. I thought I was gonna get a machine, strap it on, wake up refreshed...

I have already reached acceptance of wearing it (due to tired of being tired, and also a side effect of stopping snoring)

[robysue]

Just talked to my Insurance co... PPO.

Anyway, they stated they pay 80%, and have a contracted rate with that particular DME. So, it is like everyone is saying. They can give me the cheapest machine, and make money. I suppose, they have no reason to give me one over their contracted rate? Why would they lose money.

Start by requesting the machine you want. And if the DME refuses to budge or they refuse or try to play games? Two ideas: First try to get your sleep doctor or your PCP to write the prescription with the phrase patient access to full efficacy data including AHI and leak rates. Or (if the doctor is cooperative) ask the doc to write the prescription for the exact machine and model you want. If the doc is also uncooperative, you might also want to do some number crunching---how much more would it be to buy the machine you want outright from cpap.com instead of accepting the brick from a DME that refuses to order a machine you're entitled to and want?

Wow, this is overwhelming. I thought I was gonna get a machine, strap it on, wake up refreshed...

If only it were this simple. *sigh*

I have already reached acceptance of wearing it (due to tired of being tired, and also a side effect of stopping snoring)

Good attitude! And that counts for a lot in making this therapy work.

But don't fall into the trap of unrealistic expectations: There are a few lucky souls who do wake up refreshed after night one and never look back. But most folks take several weeks to several months before they start to see improvement in terms of daytime fatigue and sleepiness. So be sure to give yourself enough time to put in the effort needed to make it work for you instead of giving up at the first signs of difficulty.

[archangle]

Just talked to my Insurance co... PPO.

Anyway, they stated they pay 80%, and have a contracted rate with that particular DME. So, it is like everyone is saying. They can give me the cheapest machine, and make money. I suppose, they have no reason to give me one over their contracted rate? Why would they lose money.

Is that DME the ONLY one you can use, or are there multiple DMEs you can choose from? Don't forget it's still very profitable even if they give you a top of the line machine.

If your doctor is cooperative, get him to prescribe a range of pressures, such as 9-12 if he wants to give you 10. That requires an auto machine, which eliminates many of the dataless machines. Don't go for the Escape Auto, it has poor data.

[archangle]

try to get your sleep doctor or your PCP to write the prescription with the phrase patient access to full efficacy data including AHI and leak rates.

You know, robysue, "patient access" sets off alarm bells in members of the medical mafia. It might be better if the doctor wrote something about "SD card recording of flow waveforms for physician use." That would knock out almost all the possible choices of bad machines. Of course, "nudge, nudge, wink, wink," we know who is really going to be using the data.

That wording wouldn't set off the alarm bells. They're less likely to argue with the doctor, after all he's a god. Heck, maybe we can train some doctors to write good prescriptions by default. Maybe some of them will even learn to read the data and actually treat the apnea.

[Dive Apnea]

Ok got this machine below. I asked about the pro, the person instructing us, said that the pro Has problems with the humidifier, although she said if i didn't like the plus, She'll swap for the pro. Yeah, we'll see. I guess the biggest difference is obviously you can check your info and efficacy.

[*]PR System One REMstar Plus CPAP Machine with C-Flex (model #DS250S). No efficacy data, but does have the basic C-Flex.


Been sitting in bed trying to wind down, first thing I noticed is that my cpap seems to breath kinda like me. Shoot air, slight pause, shoots air, etc. But when i briefly tried at the dme it appeared overwhelming just gushing air. Is this Normal?

Other than that my jaw seems uncomfortably clenched, due to keeping my mouth shut, so i don't gasp.

Ps: this sucks.

[Pugsy]

I asked about the pro, the person instructing us, said that the pro Has problems with the humidifier, although she said if i didn't like the plus, She'll swap for the pro. Yeah, we'll see. I guess the biggest difference is obviously you can check your info and efficacy.

The Pro doesn't have any more problems with humidifier than any other model. It's the same darn humidifier used on all the models.

Another DME lie for our DME whopper list. Why did you accept the Plus brick?

[archangle]

Ok got this machine below. I asked about the pro, the person instructing us, said that the pro Has problems with the humidifier, although she said if i didn't like the plus, She'll swap for the pro. Yeah, we'll see. I guess the biggest difference is obviously you can check your info and efficacy.

[*]PR System One REMstar Plus CPAP Machine with C-Flex (model #DS250S). No efficacy data, but does have the basic C-Flex.

Tell her you don't like the plus and want the pro before she forgets her promise.

Tell her you think you have leaks and want to see the leak data. The pro has leak data and the plus doesn't. And you think you're still having apneas because you caught yourself snorting during the night and want to see the AHI data. The plus doesn't score apneas.

Get the pro and you can see info like this with waveforms, listing of types of apneas, etc.



You can see how severe your apenas were. You can see how long you stopped breathing and when. The Plus will only tell you when the machine was turned on. Be sure and do it now, so you don't have problems with recording "compliance" for insurance purposes. Get them to print off a compliance report for your Plus machine when you return it.

You need to use the machine for 4 hours a night for a certain number of nights a month or your insurance won't pay for it. 4 is the usual number of hours, but some insurance companies may use a different number.

The graph above is from a free software program called SleepyHead. It's still under development but works pretty well. There is also commercial software, but it's not necessarily any better. It's probably better not to mention this to the DME. They don't like a well informed patient and want you to be dependent on them for checking up on your therapy.

By the way, with the Plus, not only can you not look at your data, the DME and doctor can't look at your data. There is no data, except the time the machine is turned on and off. Your DME and doctor can treat you a lot better if you have the Pro.

[Dive Apnea]

Note to OP:
Beware of the Resmed S9 models with 'Escape' in the name.
Look at the machine itself (not just the carton)--the good ones have 'Elite' or' Autoset' clearly marked on the top-
--UNDER the clear mask around the LED display--mask should be all one piece--
A fake sticker would be raised--and you can get your fingernail under the corner--Fraud.!
I wouldn't put it past some DME's--so watch out.

Just called my DME, their company only offers the RESMED S9 Escape unit. They were willing to switch it out, but considering that it would not be data capable, I dont see the point. The guy was nice enough to tell me, those are the only machines they have, I dont think he was trying to pull my leg. He said, his DME (and not implying all) only offers my machine, and S9 escape. He encouraged me to shop around, but said his DME would need to special order a data capable CPAP with an Rx from my MD.

[EO_123]

I'm in a similar situation. I got my machine last Friday 7/29 and then discovered this board.... and discovered that my DME had given me a relatively cheapo machine. So my question is - since I've accepted the machine - is it too late to do anything about it? Any advice on what I should call/say/do?

Thanks

[robysue]

Ok got this machine below. I asked about the pro, the person instructing us, said that the pro Has problems with the humidifier,

It's the EXACT SAME HUMIDIFIER for both units. This is a bunch of CROCK.

although she said if i didn't like the plus, She'll swap for the pro. Yeah, we'll see.

If you really want to *anybody*---including the doctor---to be able to see any data other than how many hours you used the machine, you are fresh out of luck. Because this machine won't tell nobody nothing. So you'd better hope that the prescribed therapy works and that you don't run into any niggling problems that need some data to solve---including questions about whether and how much you are leaking.

I guess the biggest difference is obviously you can check your info and efficacy.

That's the biggest difference, but there's also a significant difference between the C-Flex and C-Flex Plus exhalation relief systems.

Been sitting in bed trying to wind down, first thing I noticed is that my cpap seems to breath kinda like me. Shoot air, slight pause, shoots air, etc. But when i briefly tried at the dme it appeared overwhelming just gushing air. Is this Normal?

Sounds like C-Flex has been turned on. Probably on 3. And it sounds like you're one of the folks who just might not like C-Flex as well as C-Flex Plus, where the rise in pressure back up to the full pressure setting is more subtle and done in two steps instead of one. You might want to read my response to this thread to see what I'm talking about: viewtopic.php?f=1&t=66463&p=619581&hilit=+Flex#p619581

[robysue]

Just called my DME, their company only offers the RESMED S9 Escape unit. They were willing to switch it out, but considering that it would not be data capable, I dont see the point. The guy was nice enough to tell me, those are the only machines they have, I dont think he was trying to pull my leg. He said, his DME (and not implying all) only offers my machine, and S9 escape. He encouraged me to shop around, but said his DME would need to special order a data capable CPAP with an Rx from my MD.

I'd take him up on this offer: Tell him that you are going to shop around for a different DME unless he's willing to special order a PR System One PRO or a Resmed Elite for you WITH your current prescription. And start making phone calls TODAY to different DMEs.

Look at this way: You will likely use this machine every single night for the next 5 years unless you want to buy a replacement out of pocket. And five years is a very, very long time to fly in the dark if you wind up having any problems with (a) getting comfortable sleeping with the machine due to leaks and/or (b) not feeling any better or perhaps even feeling worse than you did prior to starting CPAP without any idea of whether the therapy is effective or not.

[mayondair]

Dive Apnea, what happened to the exchange for a Phillips Respironics Pro? Your DME has lied to you, get rid of that dateless brick ASAP before you are stuck with it for the next 5 years. I'd get another DME , wouldn't trust that one. A RX is not needed for data capability. Check out Janknitzs blog about what to do when you have accepted a brick. Act soon, the longer you wait, the more difficult it will be. Kathy

[robysue]

DiveApnea and EO_123,

Mayondair says:

Check out Janknitzs blog about what to do when you have accepted a brick. Act soon, the longer you wait, the more difficult it will be. Kathy

The url for JanKnitz's blog is http://maskarrayed.wordpress.com/

The entry you want to read and re-read RIGHT now is: http://maskarrayed.wordpress.com/2011/0 ... h-a-brick/

Read what JanKnitz has to say, print it out, and then steel yourself for a fight. But remember: It's YOUR life and YOUR nose and YOUR apnea. And you ARE WORTH fighting for!

Best of luck

[Dive Apnea]

Dive Apnea, what happened to the exchange for a Phillips Respironics Pro? Your DME has lied to you, get rid of that dateless brick ASAP before you are stuck with it for the next 5 years. I'd get another DME , wouldn't trust that one. A RX is not needed for data capability. Check out Janknitzs blog about what to do when you have accepted a brick. Act soon, the longer you wait, the more difficult it will be. Kathy

When I went into my "training" I was not educated enough, I got the Phllips Plus, and asked about the S9... they said as I stated earlier, they would trade our my plus for the S9.. well, they were talking about the RESMED S9 Escape unit...

The way my insurance works, is that I pay the first month rental, and if I am compliant, my insurance co will buy it. So, I think this puts me in a good situation.

I am going to call my insurance co today, and see about another DME to get another machine. Gonna look for this.

PR System One REMstar Pro CPAP Machine with C-Flex Plus (model #DS450S).