YAY APPOINTMENT MADE!!!

I have made an appointment for Wednesday at 9:00 with the DME. Does anyone have any advice how to get what I need/want and deal with the DME employees? I am pretty sure my doctor stated on the prescription for a Resmed Auto S9 machine. Also, how do you know which mask is right for you? I am most definitely a mouth breather and have problems with nasal congestion, so I have determined a full faced mask would probably be best, just which one is the question.
Thanks!

I'm in the same boat. Dealing with DME for the first time within the next few days.

I had to turn in my 1 week titration machine this morning I'll be without a machine for a few days.

Bummer...I never got a machine after my split night sleep study. I was quite surprised it has taken them this long to call since the doctor said I was so severe. So, once I get "my" machine I have to get used to it. I guess I might like that better than having to give it back and swith. haha. I'm getting APAP, so that might be why I didn't get a machine for titration.

There are basically three kinds of masks and they all have advantages and disadvantages:
- Nasal masks
- Full face masks
- Total Masks
The nasal masks are less intrusive and I recommend everyone either start out using this mask or at one time or another try it out. The upside is (as I said) it is less demanding and easy to work with. The downside is that you cannot be a mouth – breather. If you breathe thru your mouth at night, the cpap air will exit your mouth instead of entering your body for therapy. If you are a mouth – breather, you can use tape, a chinstrap and some folks use a strip of pantyhose to keep their mouth closed at night. Some folks, like me, encountered sores inside their nose until they are used to wearing the mask.

-The full face mask covers the nose and mouth. This allows proper therapy for mouth breathers. A hybrid mask is also considered a full face mask, but I have always thought it wasn’t. It covers the mouth and includes nasal pillows, similar to the nasal mask. The Resmed Liberty is a popular hybrid mask. The full face is more bulky and intrusive than the nasal mask and some folks, like me, encountered sores on the bridge of their nose.

- The total face mask is the type of mask I use and as you can see in my profile it resembles a gas mask. Most folks don’t like it because it is a little harder to adapt to, it’s hard to stop leaks because there is more sealing area. The flip side is that the mask sealing area is around the temple and cheeks which, with most people, are smooth. The upside is there are no more inside or out nose sore problems. I use pad-a-cheek liners and they are very comfy and reduce the redness the mask seal causes. Every time I speak to my DME, she takes it upon herself to try and get me to use a full face mask. I politely tell her that I love my mask and I’m sticking to it.

A mask is like a pair of shoes. What I like and find comfortable, may kill you and vise versa. I always recommend starting with the nasal until you decide you can’t live with it for whatever reason (sores, uncomfortable, leaks, etc…). Then I would move to the full face. If you were destine for a full face, there are so many different kinds that fit differently, you’ll find the one that’s “yours”. I would then move to the total face mask. Most folks that use the total face mask “end up” using it as I did, though I know some folks that started out with the total face mask and were very happy with it.

Whatever mask you try out, have the DME adjust it to your face. They have display cpap machines and have them hook one up to your mask with the machine set at your pressure. Lie on the floor and roll around and see if the mask leaks. A mask that leaks a lot at the DME office will leak a lot at home. Finding a comfortable mask that doesn't leak is a journey. Some find one quickly, others go thru many to find one. Work all your issue here.

Sheriff

If you are getting an S9 machine, make sure it does NOT say "Escape" anywhere on it.
The Elite and Autoset are the same HCPCS code as the 'dumb' (Escape and Escape Auto) machines.
If they try to stick you with an "upcharge" for an "upgrade",
just get your doc to specify either Elite or Autoset on your RX.
If you have to wait, it is TOTALLY WORTH IT!

z

If have not seen it: To lift it entirely out of someone else's post:
"Read and re-read JanKnitz's Mask Arrayed blog before you meet or talk with the DME and your insurance company. Her [url=http://maskarrayed.wordpress.com/what-y ... me-part-i/]What you need to know before you meet your DME is chock-full of important info. "


More interesting might be for you to state what are your specific needs, like you do not have insurance, or. something specific about your problems. Many on the board have Obstructive Sleep Apnea (OSA) and we often seem to fail to mention issues that are for other types of Sleep Apnea.

Be sure to look at my blog post "What you need to know BEFORE you meet your DME".

Hopefully you will both be pleasantly surprised with good DME's.

cosmo wrote:I didn't do an overnight study. Just a take home test with a Watch-PAT device. After my results showed signs of mild OSA, I came and picked up a CPAP machine to use for 1 week so they can do titration and see if it would help me.

Wild guess here.... KAISER ?

Thanks for all the advice on the masks and machines. I'll definitely make sure it doesn't say escape. I am a medical coder so I know how to talk my way around billing and CPT/HCPCS codes (E0601 for CPAP machines), and upcharging (balance billing). So, I have somewhat of an advantage with this. I don't think I am going to even try with nasal pillow, I breath way to much out of my mouth and have chronic nasal congestion. I don't think I would benefit from those. I am going to try full face masks. My mom is on a full face mask and i've tried hers own and it was pretty comfortable. She is allergic to the silicone so hopefully I don't have that issue. Does anyone have issue with oily skin and the oil breaking down the mask? Oh, and my appointment was changed to tomorrow at 9:00 AM.

I have read that article and again I have an advantage of being a medical coder but that article definitely helped! Thanks for all the advice!

I do not see your gender...so this a comment in the dark. Facial hair will make a big difference in your leak. Either consider a shave or look for a mask that has a dual membrane fit that is firm. The ol' comfortgel blue is this way. Also, I have use another option for masks to consider. This is the hybrid mask. Lastly, I have seen some "mouth breathers" stop being such when the OSA is treated. It may take some getting used to. Breathing via the nose is more normal, better for the lungs and oxygenates the blood more efficiently.

I suggest mask liners for anyone who is sensitive to wearing a silicone mask.
These are washable:
http://www.padacheek.com/
There are also one-use liners, or you can make your own.

z

cosmo wrote:

kaiasgram wrote:

cosmo wrote:I didn't do an overnight study. Just a take home test with a Watch-PAT device. After my results showed signs of mild OSA, I came and picked up a CPAP machine to use for 1 week so they can do titration and see if it would help me.

Wild guess here.... KAISER ?

Yep Kaiser

Do you have Kaiser? Do they offer S9 AutoSet?

I do have Kaiser, that's why I immediately recognized the Kaiser protocol for diagnosing and titrating.

The NorCal Kaisers vary -- at the Sacramento Kaiser they issue a PR machine (from Apria) but they use the S9 Autoset for home titrations. My Kaiser plan does not cover DME so I bought an S9 Autoset from our host cpap.com. I think if you want Kaiser to cover your machine (and your plan includes DME coverage), you'll likely be getting a PR machine. What Kaiser are you at? -- if you don't want to say publicly feel free to send me a private message.