Last time you've seen any sleep professional? (poll)

archangle wrote: Especially since, with a data capable CPAP machine, a trained monkey could do some good.

You are correct. I did.

AmandaRPSGT wrote:You didn't see a sleep specialist? I've worked at my lab going on 7 years now, and our sleep doc is a Board Certified Sleep Physician, as well as a Neurologist. 2 years ago, he "retired" from Neurology so that he could devote all of his work time to his sleep patients

We are very thorough in our follow ups. I tell all of my patients that if they are unhappy with their DME companies, to call and tell us -- and believe me, we have heard some stories. Our patients also know that if they have questions, they can call me direct at the lab. They know our hours, and when they have problems in the middle of the night...I'm up anyway!

I'm not saying any of this to brag. That's just the way we do things, here. It's the way things should be done. But, I am in a smallish town (college town, so it's really not small!), in the south..... I guess things are just done differently. I hate that patients are getting stuck with Drs and DMEs that don't care. It's really a shame.

Amanda,

I went for my sleep test on the recommendation of a pain management specialist, who said that the chronic pain issues I was having might be due to apnea. (She was right.) A respiratory specialist read my PSG. I never met her. I was sent to the DME. I was fortunate in that at that time, the DME had a very good respiratory therapist, who looked at the fact that my AHI was actually higher with CPAP than without, consulted with the doctor, and I started with a Bipap ASV, which has proved to be perfect for my needs.

I was totally freaked out at the diagnosis -- my second major diagnosis of the year, the first being cancer. (1.5 more years until I can be declared cancer free.) I so totally did not want to wear a mask at night, as I am hideously claustrophobic. But if I had to, I was going to make the therapy work. I did. With the help of the people from this Forum. However, I was the one who trouble-shot all the issues, and I was the one who called the DME to say, "I believe I need this, because...." The good RT left for another job, and there was no followup.

From what you say, your organization is the way things should be run, and I suspect many of us would have far fewer complaints if they were. And actually, I think it's more than a shame that people who need CPAP therapy are being turned out with no assistance or reassurance. Considering the health consequences of untreated apnea, I feel that those organizations who do not give appropriate treatment are guilty of criminal behavior.

I have yet to see a sleep specialist, but I'm doing quite well... I now have a different GP, and I suspect she will probably recommend a sleep specialist in about a year and a half, when I'm due for another machine. I only hope the specialist is ready for a fully informed Bipap ASV user!

Bons wrote:Saw mine this morning, while hubby was in the next room seeing my doctor's partner and going over his titration study.

Doc got a laugh out of my mummy sleeping bag solution to the PLM's and said that whatever works is good, and less problematic than medication. And we raised my minimum pressure support to see what it will do for my hypopnea.

Fortunately I had the print-outs from my downloads that were done yesterday because the fill-in RT at my DME seems to have erased my card. I should have been nervous about her when she only handed me a compliance report and I had to explain to her that I needed the 14 page download of averages and the last 7 nights' data - she didn't know that she could access stuff like that......

When you give your card to the dme, slide the lock. I think i read that the resmed software automatically deletes data from the card, but not if the card is locked

@Kira, congrats on being cancer free!! Many prayers with you on that journey!!

We have 2 major hospitals in my town, and 2 sleep clinics. We have always had a sleep specialist at each sleep clinic. We don't take direct referrals for testing from anyone. Patients are referred to us, and our sleep specialist basically screens patients. Both sleep labs here are also AASM accredited sleep facilities, which means that we have to have a board certified sleep physician and also RPSGTs. Only our sleep physician reads the studies and dictates results. There are so many rules for being accredited, but those requirements set the standard of care where it should be. We do things the right way not only because we have to, but because we want to. You definately don't want to go to just any old sleep lab... anyone can open one up, you know!

I mentioned this to someone earlier.. be sure and get a print out from your DME on when your insurance will cover you new equipment! Good luck!

AmandaRPSGT wrote:@Kira, congrats on being cancer free!! Many prayers with you on that journey!!

Thank you! I have an off-topic thread which I update each time a set of labs comes back negative. I was incredibly fortunate to have a top mark oncologist. Everything went the way we hope medical procedures will.

AmandaRPSGT wrote:We have 2 major hospitals in my town, and 2 sleep clinics. We have always had a sleep specialist at each sleep clinic. We don't take direct referrals for testing from anyone. Patients are referred to us, and our sleep specialist basically screens patients. Both sleep labs here are also AASM accredited sleep facilities, which means that we have to have a board certified sleep physician and also RPSGTs. Only our sleep physician reads the studies and dictates results. There are so many rules for being accredited, but those requirements set the standard of care where it should be. We do things the right way not only because we have to, but because we want to. You definately don't want to go to just any old sleep lab... anyone can open one up, you know!

Under my current system, my GP checks everything, and refers to specialists within the same system. So when I'm due for another machine (which will be around 5 years), she'll probably refer me to one of the specialists at the hospital. All of the specialists are AASM accredited. (I looked them up.)

So my next round will probably be closer to the set-up in your town, which will be nice.

AmandaRPSGT wrote:I mentioned this to someone earlier.. be sure and get a print out from your DME on when your insurance will cover you new equipment! Good luck!

Well, that could get tricky. My insurance says they follow Medicare guidelines, and the DME admits that my insurance follows Medicare guidelines, but disagrees with my insurance's listing of what those guidelines say. When I try to nail the DME down, they tell me I should speak to the insurance. When I try to nail the insurance down, they refer me to the DME.

Sounds fishy. Our DME companies in the area already have an insurance list printed for pts that they receive in their packets for CPAP set up. This is standard here. Most insurance companies do follow Medicare guidelines, so that list is pretty much standard. Sounds like you are getting the run-around.

I last saw my sleep medicine doctor 5 years ago. But I am a 24-25 year XPAP patient, and my pressures have been constant for over 12 years.

TheDuke

AmandaRPSGT wrote:Sounds fishy. Our DME companies in the area already have an insurance list printed for pts that they receive in their packets for CPAP set up. This is standard here. Most insurance companies do follow Medicare guidelines, so that list is pretty much standard. Sounds like you are getting the run-around.

I'm sure I'm getting the runaround, but I haven't yet figured out how to break the vicious cycle.

My latest gem was ordering a eight foot hose... and being sent a six foot hose. In 3.5 years, the DME has gotten exactly two orders straight: the original delivery of my ASV, and they did manage to send the Liberty mask correctly when I got it as a new full-face for my inevitable respiratory infections. Every other one has been bollixed up.

Oh, and I'm just west of you -- in south Louisiana.

When neither insurance nor the DME will give you a straight answer, it's time for either
a) the benefits manager where you work
b) an attorney
c) the appropriate insurance licensing board, or
d) local politicians up for re-election, or the media--newspapers, TV-(anybody with clout)

I saw my pulmonary doctor 6 weeks ago, had a sleep study 3 weeks ago, got new equipment last Friday and will see the doctor again after 30 days on the new machine. I am also being treated for asthma so have more frequent visits. He was amazed that I am 100% compliant with cpap...that doesn't seem to be the norm. And he understands and agrees with my wanting to track my treatments. I do the same for blood pressure and glucometer readings. My health is my concern and my doctor's business.