ozij wrote:Ronin,
After 5 years, your pressure needs may have changed. Have you had any follow up since? If you haven't, perhaps giving you a replacement machine with your 5 year old Rx may be something the clinic simply does not want to do - for meical reasons.
A simple DME on the other hand is forbidden to change pressures without an Rx -- so they can most probably set your old Rx on a replacement machine. I would not recommend you take this path for the long run -- 5 years is a long time with the same Rx, and your machine is obsolete.
Many members of this forum have machines that track therapy quality data, and they change their own pressure based on that data and what they've learned about OSA. Those of us who do so (I'm one of them) consider monitoring and treating their OSA similar to monitoring and treating diabetes. There's free software out there to use for tracking the data in detail - e.g. sleepyhead - though I don't know if it does the M-Series machines.
So, if I were you, I'd defintiely by a new, data tracking machine ASAP, consider a follow up sleep study, and then see if my old machine can be fixed and kept as a backup.
I don't think a clinic that suggests a followup sleep study after five years is a racket. And I can well imagine a situation where a clinic refuses to do anything for a recalcitrant patient who has refused all follow ups. Not saying this is your case - I don't know of course - but, if they had been trying to get a patient to come to followups, and that patient kept refusing, or ignoring their calls, I think there is a case for calling it medically irresponsible to do anything with that patient unless they had a repeat sleep study.
You can go "underground" to buy your own machine - but if you haven't done so, do spend some time in studying how to properly control your therapy.
I am properly controlling my therapy -- which means I don't justmindlessly agree with anything a Doctor or clinic wants me to spend money on. When a clinic or a doctor who works
for the center requires another sleep study when I state flatly that I am having NO problems and NOTHING has changed, they are highly suspect. It's like doctors who send patients for unnecesary MRI's because they
own the MRI being used (and billed for).
If anything changes in my sleep patterns, I would ask for another sleep study. Being forced to have one is like the "Free Computer Checkup" racket. You think they are giving away the service for free? Of course not. They
will find something wrong that you "need to fix." -- Like "buy a new CPAP -- your Insurance company will pay for it, anyway." Unnecessary medical care and expensive testing like this is one of the reasons that as a self-employed professional, I pay $2000/month for insurance. (And everyone knows it's getting much, much worse.)
I have regular cancer screenings, because cancer cannot be reliably self-detected. ...But I am an intelligent adult and I can tell how well I'm sleeping. ...And if I can't, my wife will tell me. She's the one who got me using a CPAP in the first place... Using a CPAP is definitely life-enhancing, but again, it's not rocket science, nor does it need to be sold, managed, treated
and priced like a potentially life-threatening device. It's not.
I appreciate your telling me that data can be tracked objectively by the user, though. Neither my Doctor nor DME told me anything about that. In fact, I've only heard from the clinic for "annual checkups" for my CPAP. These consisted of taking time off work so they could read the data card, test the pressure, then try to sell me new masks and/or peripherals. After the third "check up", I stopped going. I will make sure I get a data recording model next time and make sure I have the software to read and track it.