90 day follow up visit - surprised

I had my 90 day follow up visit today.... I was surprised at how well it went....

MY 30 day average AHI is 1.7... my 90 day average AHI is 2.9 ( sleep study AHI was 31)

My Sleep doctor actually took time to discuss my concerns about aerophagia and mask leaks...We agreed that she would lowerimy Bipap pressure, if I'm still having problems after the holidays. Amazingly enough, she told me if I could not get in to make an appointment, she would guide me through it over the phone.

She gave me a copy of the clinical tech manual to help me!! "we don't need no stinkin DME"

LOL

she reviewed all of my various data charts and we discussed each area that I had questions about.... 2AM rises in AHI are indeed due to REM!! As my body becomes accustomed to finally achieving REM sleep again, the issue will go away.

She got angry when I told her that today was the 1st time anyone had talked to me about my progress since getting the machine... she immediately went out to the office staff and confirmed the error in not contacting me and promised me it would not happen again... Then she called her DME rep into the room and ripped him for not following up on my care.

I walked out with an updated prescription with all of my out of pocket upgrades that I have purchased... climate line hose, etc..

she told me was thrilled that someone is so involved in his own treatment. I was there for close to an hour!!

THANKS CPAPTALK !!!

Sounds great. I too have a good sleep doctor, and I just had my 6 month followup (I'm at 7 1/2 months, so I had a 6 week followup and then 6 months later). My doctor is great. They were having trouble with their hardware, so the download wasn't quite ready when he came in. He knew I had data, so we started with my graphs. Overall, I am doing great, but need more time on the machine each night. He has sleep apnea himself, so he understand the adjustment difficulties, and i have had some non-related issues that have made it harder. One has been pain in my leg since September that wakes me up when I try to move over or roll over. My primary doctor ignored it in September and November. I started self medicating with aspirin in November, but had to stop a few weeks ago due to teeth extractions and tylenol usage. My tylenol usage is done now, and my doctor recommended I try aleve instead. That is working well for me. He is a neurologist who specializes in sleep and headaches, so I brought up my headaches. Fewer now with cpap, but I still have some weather related headaches that don't react to tylenol (most of my headaches go away quickly with tylenol). He asked some questions and told me that they are actually migraines, and many of my smaller headaches probably are too. I have a headache diary now, and go back in 6 months (or sooner, he said, if I feel they are bad or have any trouble with cpap).

He also did a great job with my mom, who has been a long time cpap user, but not having much improvement. He reviewed her 2 year old sleep study and 2 nights of data from my machine and upgraded her prescription to an apap machine like mine (and he always prescribes a full data machine so that he can see data). And he is totally cool with patients participating in their own treatment and viewing data.

Congratulations! I am hoping that she will continue to take time on your next visits. BTW, what are her specialties and designations?

She is board certified in sleep medicine by ABIM. Along with specialties in pulminary medicine & critical care.

Her degree is in osteopathic medicine. D. O.

Denial Dave wrote:She is board certified in sleep medicine by ABIM. Along with specialties in pulminary medicine & critical care.

Her degree is in osteopathic medicine. D. O.

Question,

Does she hold an MD in any specialty, i.e. does she state her profession, as for example: Sarah XXXX, M.D.?

I don't think my insurance lists any osteopaths as providers.
They might not even list chiro's any more--unless they are also MD's.

avi123 wrote:

Denial Dave wrote:She is board certified in sleep medicine by ABIM. Along with specialties in pulminary medicine & critical care.

Her degree is in osteopathic medicine. D. O.

Question,

Does she hold an MD in any specialty, i.e. does she state her profession, as for example: Sarah XXXX, M.D.?

Middlesex hospital
Comprehensive sleep disorders center
Middletown, ct

My doc is part of the team of physicians there.

Since it is part of the hospital, everything is "in network" as far as BCBS IS considered.

Don't you know every time you change settings on a CPAP, a kitten somewhere dies?

p.s. nice job, and glad your doctor is on board and pro-active

It's so great to hear stories about GOOD doctors here! Congratulations to both of you.

Chunky said:
"I don't think my insurance lists any osteopaths as providers.
They might not even list chiro's any more--unless they are also MD's."

There's a world of difference between osteopaths and chiropractors. Osteopaths are licensed to practice medicine (just a different pathway than MD's) and even perform surgery. I prefer osteopaths to MD's for my care because they have more training in hands on treatment and a more wholistic approach, in general, while still being able to order every test, prescribe every medicine, and do every procedure that an MD can do.

My favorite osetopathic doctor in the world became the medical director of the largest hospital in the county--he was greatly respected in the community.

chunkyfrog wrote:I don't think my insurance lists any osteopaths as providers.
They might not even list chiro's any more--unless they are also MD's.

In the US, Osteopathic Physicians (D.O.) are usually considered to be "MD+." They get all the training MDs do, plus some more. Many of them practice in specialties unrelated to osteopathy. I'm not quite sure why some choose to get an OD degree instead of MD.

In some other countries, Osteopaths don't get the same training as MDs, and may be semi-quacks.

It's a joke that an Osteopath deals with sleep Medicine. How about my son- in- law who holds a Ph. D. degree in Entomology taking a few courses
in XPAPs and hanging a shingle as a Sleep Specialist?

How about my Podiatrist who takes care of my ingrown and fungal toe nails?

avi123 wrote:It's a joke that an Osteopath deals with sleep Medicine. How about my son- in- law who holds a Ph. D. degree in Entomology taking a few courses
in XPAPs and hanging a shingle as a Sleep Specialist?

How about my Podiatrist who takes care of my ingrown and fungal toe nails?

Well, if the entomologist or podiatrist went to medical school, took the same courses, exams, residency requirements, and licensing requirements that an MD does, why not?

In theory, every US D.O. learned everything an MD did, did just as much work, is just as qualified, took equivalent tests and licensing requirements, and took some additional course work to get his D. O. They should probably just give them both MD and D.O. titles.

Janknitz wrote:It's so great to hear stories about GOOD doctors here! Congratulations to both of you.

There's a world of difference between osteopaths and chiropractors. Osteopaths are licensed to practice medicine (just a different pathway than MD's) and even perform surgery. I prefer osteopaths to MD's for my care because they have more training in hands on treatment and a more wholistic approach, in general, while still being able to order every test, prescribe every medicine, and do every procedure that an MD can do.

My primary doctor is an MD, and I didn't know until my sciatic nerve problem that she is also an osteopath. My problem came up at the beginning of a holiday weekend, so I had to go to the emergency room. They gave me a pain killer and told me it had a muscle relaxer in it (nope). It did no good, didn't even help the pain, just made me dizzy. I ended up taking a nap on the bathroom floor as I thought I would pass out and didn't want to fall and hit my head.

After the holiday, I went to my primary doctor. She told me to ditch the cane and walk as normally a spossibly. She prescribed a mild muscle relaxer. I did not need a pain killer. I just needed the muscle in my back to let go of the nerve. And she was able to do some type of massage and pop in my back and neck. I walked out better than I walked in. And the improvement was quite noticeable.

Heck, when I see my GP doc with all of his wonderful letters after his name; I'm lucky if I get 10 minutes with him before I am shuffled out the door to pay my BCBS co-pay fee.

I met with my sleep doctor for over 45 minutes. She even agreed to look at some recent overnight charts from Sleepyhead. She explained why she felt some of my 2AM rise in AHI & flow limitations events may be happening & what the numbers mean.

I personally don't really care if anyone disapproves of the letters that follow my doctors name.

but if pressed, I can tell my doc that some guy named AVI123 on a CPAP forum thinks she is not qualified to be treating me.