Tech new to forum

[jnk]

Techs, in my not-so-humble opinion, are often the true (and sadly unsung) heroes of the sleep industry.

One of the most helpful people of all to me on my PAP journey was the tech.

[GumbyCT]

I have already been advised to be careful on this forum. I came to listen, not to preach.

I'd be interested to hear who or where you were warned by/at?

[zoocrewphoto]

Ken,

We get folks who come back for re-titration who are wearing their masks upside down (Swift), or still wearing the same mask they bought eight years ago that the dog got a hold of. You have no idea the stuff people are putting on their faces night after night. (And I wish they'd wash their gear more often.)

We do hear from folks like this here. Often times they have decided to make a second or third or fourth stab at CPAP because they have finally reached the point where they are no longer in denial. So we're not surprised by your genuine horror stories. It constantly amazes me how many of the newbies have no idea what the make and model of their machine actually is. They have no idea what their prescribed pressure is. They have no idea if the DME set the machine up with the ramp or the exhalation pressure relief turned on or off. They have no idea what the make and model and size of their mask is. And one thing that can partially explain that phenomenon of too infrequent mask washing? Many folks are NOT given any hands on training on how to disassemble and reassemble the mask they are expected to use each night. That goes a long way in explaining how a patient can go for years with wearing a Swift mask upside down or an improperly assembled FFM. It also can explain why a patient falls into the habit of not cleaning the equipment frequently enough.

My mom would fall into this category. She has been on cpap for almost 20 years. But for a long time, she was barely using it. She has started using it daily again now that I am on it, and she has a new mask (same as mine). But she clearly did not have a good sleep study either time, and very little education. She doesn't use her humidifier. She has no idea what her pressure is, and whether she has a cpap, bipap, or apap. Now that I have a Resmed S9 Autoset with lots of data, she is more active in using hers, but also disappointed that she knows nothing about hers.

She has asked about getting a new sleep study at the place I went to. The doctor said she would check on whether medicare would cover it. Her last sleep study was in 2010, but before she was on medicare. Her machine is from 2004. No answer yet, and it has been 3 weeks. After my compliance phase is over, I will let her use my machine for a couple half nights. I am a night owl, so she can use it from midnight until 6am, and then I can wake her, get her back on her machine, and then go to bed. I don't want her data to mix with mine. I do have a followup with my sleep doctor on Friday, so once I know that I am not going to need data reviewed any time soon, then I can let the data mix and make a notation of which nights are mixed. I suspect that her prescription is not accurate for her. Hopefully, she can get the new sleep study soon, but at the very least, using my auto machine a few nights may help us to adjust her current machine to something better. She is napping every day, constantly tired, and doesn't seem to get much improvement from using her machine. She says it helps, but she doesn't seem intent on using it, so it can't be feeling that useful for her. She is not the type that snores, so we can't judge her sound as an improvement. Without the machine, she looks dead, and I have to watch to see if she is breathing. With the mask on, I can''t tell any different visually or sound wise. I just watch to see if she is breathing. There is really now way without data to know if she is still having apneas with the machine and how many.

She also has issues with cleaning and replacing masks, etc. Part of it is attempt not to waste things. But part of it is an inherent distress of the people selling her stuff. Now, I suppose she could have had bad experiences with the doctors and DME, so she simply doesn't trust them. But she believes that washing the mask cushion on a daily basis will make it old faster and then she would need to replace it more often. She believes the DME told her to wash the cushion daily and the rest of it weekly and monthly so that they can make more money selling her replacements. I am less than 2 months into this, so I don't know how long things should truly last. But I know her old mask was a few years old, and there must have been a reason why she quit using it. When I asked my she no longer used her cpap, she said she needed a new mask. After I got mine, she tried it on, got a new prescription, and got her new mask 2 days later. She now uses it every night, though not for the whole night.

[jnk]

I have already been advised to be careful on this forum. I came to listen, not to preach.

I'd be interested to hear who or where you were warned by/at?

Think it was Uncle Dave?

[kteague]

Welcome to the forum. I've had more than my fair share of sleep studies and I can bring to mind at least 8 different techs, most who handled themselves professionally and came across as competent, so you won't get any flack from me just for being a sleep tech. Since patient success is important to you, I'd like to share with you the foremost reason why I quit CPAP after a few miserable months. It was misuse of the ramp feature - and I was using it as instructed by the sleep doctor and the DME. I was set up with a lengthy ramp period with a starting pressure of 4. My doctor and DME knew I fell asleep BEFORE my head hit the pillow, but I woke up in a very few minutes. Their advice - when you wake up, hit the ramp and try to go back to sleep. Hence I spent 5 months sleeping in short suffocating snatches and never therapeutically treated. During this time I lost my ability to perform my job, my health plummeted, I became unsafe to drive or cook. As soon as I arrived here, it was suggested I increase my ramp pressure and decrease my ramp time, thus began my turnaround, but so much damage had already been done. Also, my doctor seemed to not be in tune to the interactions of OSA and PLMD, thus my OSA went undiagnosed for years, and once I went on CPAP, they assumed my PLMD would maintain its pre CPAP status, though I later found it is common for PLMD to more fully manifest once the OSA is therapeutically treated. My repeated sleep studies could have been more targeted if my doctor had a clue. He kept ordering more baseline studies - a colossal waste. Even ordered one without my legs being a part of it. OK, off my soapbox. I know that none of this changes what you as a sleep tech do in performance of your duties, but it sounds like your interest in your patients goes above and beyond the call of duty. Thanks for that.

[deltadave]

I have already been advised to be careful on this forum. I came to listen, not to preach.

I'd be interested to hear who or where you were warned by/at?

Think it was Uncle Dave?

Do you mean warned by me or about me?

BTW Jeff, I took your advice and ate at one of your recommended fine dining establishments. Excellent quality, service and price!

[jnk]

. . . Do you mean warned by me or about me? . . .

Um. Yes?

. . . one of your recommended fine dining establishments. . . .

If you share my blue-collar taste in grub, then next time you come down to ride with the kids on the two-dollar Jane's Carousel in Brooklyn Bridge Park in D.U.M.B.O. ( http://janescarousel.com/ ), be sure to grab a breakfast sandwich at 7 Stars Deli ( http://www.yelp.com/biz/7-stars-deli-brooklyn ), then have a pinwheel for lunch at Front Street Pizza ( http://www.yelp.com/biz/front-street-pizza-brooklyn ), and then have the falafel plate at Tutt Cafe for supper. ( http://www.yelp.com/biz/tutt-cafe-brooklyn ) Top it all off with some wicked hot chocolate at Jacques Torres' place ( http://www.yelp.com/biz/jacques-torres- ... e-brooklyn ), and you'll have had the perfect Brooklyn-culinary-experience day!

[Madalot]

I have already been advised to be careful on this forum. I came to listen, not to preach.

I'd be interested to hear who or where you were warned by/at?

Saving Ken from having to deal with pestering over this, I'll come forward.

I warned him. And here's EXACTLY what I said to him, in case anybody tries to crucify me over it.

I saw your introduction thread and wanted to personally welcome you to the forum. I am taking a bit of a break from posting (for personal reasons) but still try to keep up with my friends here.

One thing I wanted to mention is that a lot of techs and sleep professionals don't fare well on this forum. All are welcomed, but if a sleep professional begins criticizing what people do here, it usually does not end too well. Most people are very open to hearing a professional's input, as long as it is done with a degree of respect towards the patients.

But as with any online forum, there will always be a few that will be nasty no matter what happens. We've got our fair share here as well!

You appear to be one that can understand that and do well here. I really hope you do as I think more professionals here would be helpful.

Anyway -- again, Welcome! I look forward to reading your posts.

I've watched and seen sleep professionals come with a holier than thou attitude, trying to preach to us about the error of our ways (self treating and such). Some really just want to "fix" us, while others simply want to cause trouble and chaos for the forum.

I have also seen what appeared to be very kind and caring professionals get run off because they don't realize the degree of sensitivity over this type of thing.

Good or bad, right or wrong, I decided to give Ken a head's up about how it CAN go here if a sleep professional isn't careful about how they phrase things.

Ken may have been warned by others, either here or elsewhere, but I DID decide to give him the benefit of my experience here.

[Pugsy]

Saving Ken from having to deal with pestering over this, I'll come forward.

So it was you... for a moment I wondered if it might have been me because I gave a similar warning to someone a while back but of course can't remember who.

I look at it this way...sleep study techs aren't the same animal as the DME supplier RTs that often come here with their holier than thou attitude that we lack any common sense and should never make any changes to anything and are too stupid to understand any of the data.

I will respectfully look at any thoughts presented by anyone that doesn't treat me like a moron. Talk down to me and I see red immediately and everything goes downhill from there and it doesn't matter if the thoughts were good or not. I am just that way. Fire shoots out of my eyes, ears and unfortunately usually my mouth to go along with my red hair.

[DoriC]

Hi Maddy, thanks for coming forward and sharing your experiences. I look forward to Ken's input.

[jnk]

. . . in case anybody tries to crucify me over it. . . .

Your warning to Ken sounds spot on to me.

As for being crucified, I believe that the wait if you want to get onto the crucifixion list around here is a long one, so it will cost you extra to get moved to the front of that line.

[chunkyfrog]

Naaah, I can wait. . .

[jnk]

Naaah, I can wait. . .

Due to your continuing misbehavior on the crucifixion line, chunkyfrog, you have now been moved to the very back of the burn-at-the-stake line. Please let that be a lesson to you!

[archangle]

Some techs are aholes. Some are nice.
Same goes for doctors and DMEs.
And for patients.
Some forum members are aholes, too.

[jnk]

Some forum members are . . . too.

We'll take your word for it, archangle.