S9 Escape

I have my 1st appointment this afternoon to have my data read. I have been keeping an eye on what limited data shows in sleepyhead and also reading alot here
about people talking of a fully data capable machine. If my insurance has already paid for the S9 Escape, how would I go about getting a machine capable of
giving me more data? Any help would be appreciated, as I have to go talk to these people this afternoon and am a bit pissed that they sold me a machine that
just charts compliance.

Thanks

Don't be too pissed. I know there are a few here who would like for everyone to believe they were "done wrong" somehow because your the DME sold you the Esacpe. But, that is a nice modern full featured machine. It does display daily and aveage AHI along with usage so it isn't worthless. It's not geared for complete home diagnosis by any means.

I have one (Escape with EPR) and although It would be nice to see every detail I am not going to freak out over everyday minor changes in the numbers. Much like my blood pressure, which is now under control, the numbers should trend down over time, more consistant use and with adjustments(with the help of a good sleep doc). You will be able to see happening or not on the Escape.

I suppose for those self-treating or in countries with sporadic or hard to access health care having clinical details may be a necessity. I'm going to collaborate with my sleep doc for a couple of months and then decide later if I have the need for the same machine, same features but with the ability to download detailed efficacy data into Sleepyhead. Then I can get the Elite model.

Heavylids wrote:Don't be too pissed. I know there are a few here who would like for everyone to believe they were "done wrong" somehow because your the DME sold you the Esacpe. But, that is a nice modern full featured machine. It does display daily and aveage AHI along with usage so it isn't worthless. It's not geared for complete home diagnosis by any means.

The Resmed S9 ESCAPE does NOT display daily and average AHI data. Such data is not even recorded by the S9 ESCAPE. Nor does the S9 Escape record any leak data.

The Resmed S9 Escape AUTO does display daily and average AHI numbers, but it does not distinguish between CAs and OAs. Nor does the Resmed S9 Escape Auto record any leak data.

You don't believe me? Then maybe you'll believe the Resmed web pages. Go to http://www.resmed.com/us/products/s9_se ... c=patients and select S9 Escape and S9 Escape Auto. And scroll through the list of "features". Yes, both the Escape and the Escape Auto tout state-of-the art patient comfort features like EPR and the ClimateLine hose. But ....

Under "Clinical Efficacy Data", there are NO check marks for the S9 Escape---NONE. That means the S9 Escape records nothing but usage data. No AHI data. No leak data. Just usage data and that's it.

Under "Clinical Efficacy Data", there are check marks that indicate the Escape Auto records data about pressure[/] and AHI. According to Resmed's own web pages, the Escape Auto records no info on leaks, nor does it provide a breakdown of the AHI into AI, HI, and CAI data.

And under "Algorithm", there are no check marks on the Escape Auto. In other words, the Escape Auto does NOT use the new, state-of-the art enhanced Auto algorithm that is found in the S9 AutoSet. The S9 Escape Auto uses the older Auto algorithm found in the S8 series APAPs. It cannot attempt to distinguish between CAs and OAs. And hence it will intentionally NOT increase the pressure in response to events that occur when the pressure setting is above 10cm.

These are serious "omissions" in a machine that is being sold as "full featured modern machine."

I have one (Escape with EPR) and although It would be nice to see every detail I am not going to freak out over everyday minor changes in the numbers. Much like my blood pressure, which is now under control, the numbers should trend down over time, more consistant use and with adjustments(with the help of a good sleep doc). You will be able to see happening or not on the Escape.

You won't be able to see any trends on a Resmed S9 Escape because the AHI data just is NOT recorded.

And now suppose you're using a brick with no efficacy data and you turn out to be like me: The first three months of therapy I felt a hariball the cat threw up. In terms of daytime sleepiness and daytime functioning, I was feeling far, far worse---as in 100 times worse with therapy than without it. I was waking up multiple times in pain from aerohpagia and my eyes were getting dried out from air that was being blown into them from inside my head through my tear ducts. And so you go into your sleep doc's office and report these kinds of problems while adjusting to CPAP and all your CPAP records is usage data. Just what is the doc (or the PA or nurse) supposed to do to help you? In the absence of efficacy data, It's a pretty sure bet that the doc (or PA or nurse) will say/do one or more of the following things:

• You must be mouth breathing or your mask is leaking. Let's switch you to a full face mask or have you try a chin strap.
  Maybe the AHI is still a bit high. Let's bump that pressure up a cm and see if that helps.
  Keep trying for another month since these things take time. And try to work on your usage.

Now, I was "lucky"---my DME provides all their new patients with the patient's choice of an S9 AutoSet or a PR System One Auto or an F&P Icon Auto. And because I had an S9 AutoSet during my early, very rough adjustment period, the PA in my sleep doc's office could tell:

1. My problem was not leaks----my median (unintentional) leak rate was 0 L/min every night and my 95% (unintentional) leak rate was usually < 10 L/min and often < 5 L/min.
2. My therapy was effective in terms of reducing my AHI. At the start of therapy my AHI was usually below 1 and often well below 1.
3. I was using the machine every night, all night long. Sometimes I was only in bed for as little as 5 hours, but sometimes it was as much as 8 or 9 miserable hours of tossing and turning and not sleeping very well.

Because of the data, the PA didn't make the standard, and in my case highly inappropriate suggestions. Instead she focused on figuring out whether we could reduce my pressure. (A week's worth of autotitration confirmed we could.) And what we could do to address the aerophagia problem. (Eventually that one needed a change in machine to a bipap.) And gently suggested that I needed to work on my sleep hygiene and offered a prescription for Ambien. (These suggestions were on the right track, but I was not yet ready to hear them until I'd been sleeping with the BiPAP for 10 days and the aerophagia was finally beginning to abate a bit.)

I'm going to collaborate with my sleep doc for a couple of months and then decide later if I have the need for the same machine, same features but with the ability to download detailed efficacy data into Sleepyhead. Then I can get the Elite model.

And how are you going to collaborate with your doc for a couple of months if there's no data to look at beyond the usage data? Your doc will be just as clueless as you are about whether the machine is really doing its job or not. Your doc will be just as clueless as you are about whether your mask is leaking like a sieve every night about an hour after you fall asleep.

Yeah, sure: If you respond to CPAP by starting to feel (much) better in a few weeks to a couple of months, it's reasonable to assume that the pressure setting is correctly set and that the OSA is under control and that you don't have much of a issue with leaks. But what if you don't respond to CPAP that way?

'Tis better to have the data and not need it than it is to need the data and have no way to obtain it. That's why folks here are so adamant about insisting on getting a full efficacy data machine.

Heavylids wrote: I know there are a few here who would like for everyone to believe they were "done wrong" somehow because your the DME sold you the Esacpe. But, that is a nice modern full featured machine. It does display daily and aveage AHI along with usage so it isn't worthless. It's not geared for complete home diagnosis by any means.

The S9 Escape shows nothing but hours of use.
The S9 Escape Auto shows hour of use and AHI and average pressure. Nothing else.

Afterhours wrote:If my insurance has already paid for the S9 Escape, how would I go about getting a machine capable of
giving me more data?

Might start reading here.."help I have been given a brick" scroll down the page till you see that blog entry.
http://maskarrayed.wordpress.com/
Depending on how long you have had the machine, is it rent or straight out purchase and how willing your DME is to getting you a full data machine, it may be difficult or easy to get a different machine.
Start now though. The longer you wait the more difficult it will be.

There must be two versions of the Escape and I have the Escape Auto. My unit absolutly displays hours used and AHI from the previous night. Access a menu another layer down by holding down the info and the other silver button below that and the detail screen comes up. Thyat area contains the average AHI for the machins use. It's set for the current month. There are also some other parameters being recorded. I realize it's not recordng leakage.


A have a visit with the sleep specialist next week and I'll discuss the data management portion of my treatment. I have no problem going back to my DME and having them order the S9 Elite if I need to. I'm going back there this afternoon and one of the things we'll discuss is swapping the unit.

Heavylids...if you have the S9 Escape Auto and are seeing AHI and pressure..you have the wrong machine chosen in your profile.
The equipment choice drop down menu on the equipment tab only offers machines that cpap.com offers or has offered for sale in the past. They have never offered the S9 Escape Auto and that is why you don't see it as a choice.

AHI and pressure are better than nothing...for many of us "better than nothing" is not sufficient. Too many other things that might need evaluation so we want all that is available...hence the "full data" discussion.

You might alter your profile and include your S9 Escape Auto in the comments to avoid confusion when discussing the 2 machines...so that we know that you know what the difference is.

Right now the way it is a newbie might see that you are using the S9 Escape and you get AHI and so it must be okay..when it isn't. Potentially confusing later.

Not everyone cares about their data. That is certainly within their right...but I do believe that theirs should be the choice to be made...an educated choice about their options and what they entail.

Heavylids wrote:There must be two versions of the Escape and I have the Escape Auto. My unit absolutly displays hours used and AHI from the previous night. Access a menu another layer down by holding down the info and the other silver button below that and the detail screen comes up. Thyat area contains the average AHI for the machins use. It's set for the current month. There are also some other parameters being recorded. I realize it's not recordng leakage.

You do indeed have the Escape Auto, which is the bare-boned, no-frills APAP. Chances are your RT set it up in straight CPAP mode if you were unaware that it was an APAP.

A have a visit with the sleep specialist next week and I'll discuss the data management portion of my treatment. I have no problem going back to my DME and having them order the S9 Elite if I need to. I'm going back there this afternoon and one of the things we'll discuss is swapping the unit.

If you are running in APAP mode on that S9 Escape Auto, you might want to ask for an S9 AutoSet.

But beware of this: The DME likely regards the S9 Escape Auto you have as the CPAP the insurance company paid for and you'll likely have a fight on your hands to get it swapped out for a different CPAP/APAP that is billed under the same insurance code----particularly if you've had the machine for more than 30 days.

Read JanKnitz's Help! I'm stuck with a brick for information about how to go about trying to get the DME to swap your current Escape Auto for either and S9 Elite or an S9 AutoSet.

A have a visit with the sleep specialist next week and I'll discuss the data management portion of my treatment. I have no problem going back to my DME and having them order the S9 Elite if I need to. I'm going back there this afternoon and one of the things we'll discuss is swapping the unit.

Good luck with that.

Sorry to say that ou may have a problem after you visit them.

The only thing I can think worse than having an Escape, would be wasting my time and money having the Escape "Data Read" by a DME or Sleep Doc.

My DME lied to me that the Escape would give me AHI every morning and Leak data. After three days' use, I called and told her I wasn't seeing the data she said that machine could do. Next she tried to "upgrade" me to an Escape Auto. I refused saying it still didn't give me Leak data. I live and sleep alone so how am I going to know if my mask is having huge leaks.

I finally convinced my DME to switch my S9 Escape for S9 Elite because the retail cost difference is only about $50. Then she did the exchange. I'm betting some ignorant new CPAPer got my "used for three-days" S9 Escape.

BTW. Why does ResMed even produce the ESCAPE and ESCAPE AUTO. On their website they are called "Economy" machines. The S9 Elite and Autoset are called "Premium." If a doctor wants to monitor a patients progress over time, the dumb bricks are no help at all. I used a ResMed Sullivan V Elite for 10 years. I didn't have a clue that the pressure was grossly inadequate until EDS set in. I don't know how many years I was inadequately treated due to both lack of data and no followup.

Now I have an Elite and can monitor it myself and bring things to the attention of my doctor when settings are no longer effective. It's like a diabetic that never tests blood glucose. How can the diabetic know if medication taken and diet adjustment are even working, let alone well-controlled. Without data, both the patient and the doctor are totally blind to current treatment and condition.

I know 5 other people who use xpap. None of them have a clue about data and don't seem to care. Or just don't know what they don't know. I know 2 have fully data capable machines.
So if they have don't feel better, I assume they go back to the sleep doc who orders an overnight oximetry, another sleep test, referrals to treat their symptoms, or who know what else. $$$

BTW. Why does ResMed even produce the ESCAPE and ESCAPE AUTO. On their website they are called "Economy" machines. The S9 Elite and Autoset are called "Premium."

Back in the 80's customer service seminars were popular in every form of businees (I worked in a hospital as an allied health professional--no sales involved, but was still required to attend these seminars). I hated them because you'd sit there for 3 hours to get maybe one or two points stated over and over again with religious ferver. Anyway, one of the key points I actually remember was "who is your customer?" As health care providers, most of us answered that it was our patients, and we were told we were wrong. True, patients were one of our customers, but the others were doctors (who referred patients to us), insurers (who paid for our services), other health care providers, vendors, etc. The patient was the lowest, least important person on this totem pole, according to these marketeers.

The same holds true for DME providers and CPAP machine manufacturers. DME's are the CPAP machine manufacturers customers, NOT us. And as for DME's, we are NOT the customers they are concerned with. Most poor shlubs of CPAP users are clueless that they have a choice and a say in their treatment. The manufacturers want to keep the DME's happy and they do so by letting the DME's make a good profit margin. Since inssurers don't pay extra for EFFICACY data capable machines, DME's are happy when they can provide us with the least expensive machine that gives them the greatest profit margin. DME's are the manufacturer's customer, and when the DME's are happy, the manufacturers are happy. Us, who cares????

Good doctors who understand the importance of EFFICACY data are few and far between, and the only reason they make EFFICACY data capable machines is that sometimes the DME's have to please their customer, the doctor. Not us.

We don't count in this equation. That's the bottom line.

I used my S9 Elite for 9 months until I bought my Autoset--100% out of pocket.
--From our hosts, it was the best $853 I ever spent. (I already had the humidifier)