Another Evil DME......Cflex vs. no Cflex

CrystalP wrote: How do you guys know all this stuff? Granted, I am totally new to this but I really feel like a complete idiot! What is a DME anyway?

CrystalP,

Look at the bottom of your post. The acronym "DME" is listed there in blue. Click on it and it will take you to the CPAPopedia and the definition of DME. It stands for Durable Medical Equipment (supplier). The icons above the forum are full of very useful information. Also, read the CPAP FAQ section.
If that isn't enough to cure any insomnia you may have, here's another link that's sure to cure it:

http://www.psywww.com/resource/selfhelp/sleep.html

Have a good one.

Best wishes,

Den

CrystalP wrote: How do you guys know all this stuff? Granted, I am totally new to this but I really feel like a complete idiot! What is a DME anyway?

Hi Crystal,

No need to feel bad, it was all new to most of us at one point or another. No question is too dumb.

Well, maybe if we tried real hard, we could come up with one. Haha!
But seriously, don't be afraid to ask. Look at it this way, your question could be helping countless others who might be reading these posts. Far more people read here than post. So you never know when you might be helping others with your questions.


Linda

I will never understand reluctance of some Dr.s, DMEs, and most insurance companies in providing the best opportunity for patient compliance with CPAP and other medical and pharmaceutical solutions. My Dr. prescribed humidifier, c-flex, ramp, etc. but I was surprised later (as I learned more here and on other sites) that the wide range of pressures I needed in my sleep study between side and back sleeping positions may have indicated an APAP. The DME once mentioned (in a conspiratorial whisper) that most OSA patients may do better on APAP or Auto BIPAP but insurance companies won't pay unless they feel there is clear evidence. Insurance evidence is apparently not related to medical opinion or sleep study evidence. Insurance people seem to treat CPAP like a medical fad or voodoo science instead of an essential, life saving measure that none of us is doing because its fun or attractive.

That said, with my low CPAP pressure (8cm) I can't seem to get enough air with the ramp feature (especially on my back). Presently, c-flex is fine on a low number or off. However, it was very helpful to achieve compliance in the early weeks. I understand that relief at the end of an exhalation may be much more important with pressures like yours. For me, the humidifier is essential.

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, humidifier, C-FLEX, CPAP, DME, Ramp, auto, APAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, humidifier, C-FLEX, CPAP, DME, Ramp, auto, APAP

CrystalP, I have learned what little I know so far from reading the many posts on the forum. I have my appointment at the DME tomorrow and I want to be as prepared as I can. The way insurance companies and suppliers work these days, they want to spend as little as they can get away with and still provide you what they think you need. Not all DMEs are like that, but from what I have read, the vast majority are. I have found that you have to do your own research and be your own advocate because nobody else is going to do that for you. Too many people go into this uneducated and can never get CPAP to work for them because they are uncomfortable for one reason or another.

You are doing the right thing, read the posts on this forum, and educate yourself.

SG, I had planned about asking about a variety of masks. If nothing else, I want to find out what size of some various masks I would need. I definitely want to look at an activa from what I have read on here, and I would like to look at some pillow masks. Thanks for your suggestion.

DME = Durable Medical Equipment supplier. Most are of the evil variety but you may find the odd good one .

Edited to say oops I didn't see page 2
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CPAPopedia Keywords Contained In This Post (Click For Definition): DME

Just as a point, the fact that your insurance might be billed a certain amount from an in-network DME, well, that might not be the extent of payments there. My point is that the amounts billed may be subject to rebates based on total referral, payment processing charges, and other things.

You can't really assume that the amounts billed "in-network" are accurate or complete. In fact, they may be getting compliance payments for steering you to a cheaper machine than allowed, or a cheaper mask system. I have no idea if this is actually happening, but there have been similar situations where primary care physicians have been given kickbacks for reducing referrals to specialists, tests, and so forth, so I have no doubt that in-network DMEs are getting the same sort of payment.

Hi Sleepy Dog Lover,

First, thanks for posting. Second, get registered. Third, you sound like a reasonable person and we all need good input, so stick around!

This kind of thread seems to happen all the time. Really ticks me off!

The "miracle of political and unconscionable profit" in medicine. Aided by the " unconscionable profit and the who gives a damn" orientation of the obviously aligned insurance companies. It makes losers of all who do not do their research and take for granted that some so called professionals are here to help us unconditionally.

Buyer beware. Heard it before? It really is true.

I'm in the market for a new TV and it is a jungle out there. Options and prices galore especially with all the new technology. Kind of the same with xPAPS. It seems to me though, the pricing is less exasperated with the xPAPS in that the cost differential between the top of the line full featured units are not really that much more than the crap the politically/profit aligned local/evil DME's try to push.

In fact the top of the line units are probably cheaper, depending on where you purchase it.

So, pretend the shoe is on the other foot. You be the profit minded cost benefit analyser and actually figure out what is the best bang for the buck. In my mind you should go with the latest proven technology and get all the bells and whistles you can - you never know what the future will bring.

Don't fool around. Get an APAP with C-flex and heated humidifier. I've never used the ramp feature yet, but who knows. Get an Activa mask (if you're a nose breather) and add to your collection later.

I went through the whole rigamarole of new equipment purchase just like all new Apniacs. Man, is it frustrating. Talk about taking advantage of newbies for profit. Each so called professional points you in a very limited direction, denounces other products and took "Used Car Selling 101" before they entered the business. If you are uninformed, you don't have a chance and your medical treatment and health may suffer.

So the real question you need to ask is- " Should I wait for the new SXRD model or just get a plasma now?". When you get the answer, let me know!

Hope it all works out well for you.

Bob F

Sorry, the above post was me. Cannot seem to log in sometimes.

Bob F

Well, just back from the DME, and the news is not all bad. I told them I wanted a respironics, and ended up with a Remstar Plus with cflex, didn't even have to ask about cflex so it will be covered 100%. It still isn't the machine I want, but it is a good start, and I got cflex.

They had a wide variety of masks for me to try and choose from, all on the machine. I ended up getting the Aeiomed Headrest, seemed to fit the best and get the best seal. I told the RT about the rubberband fix, he said he would keep it in mind. Seems like I will need it.

The RT spent over an hour going over everything with me and trying on masks, so overall it was a good experience.

unclebob, thanks for the kind words, I decided to join. Now wish me luck using the set-up.

Hello all...

I've just been prescribed a Cpap and And going thru beginner frustration already (and I don't even have the thing yet). The initial prescription was for a Resmed S8 (didn't specify which S8, which was a problem), and a fisher 407 mask. Turns out that my evil (I'm convinced) DME will only give me exactly what is on the prescription, but they said I need special permission from the insurance company to get anything other than the standard Remstar equipment they carry.

Well, after talking to the Respatory tech at the sleep center (who has been very helpful), he said he could change the Rx to the Machine they have. I called the DME to ask about masks, and while they carry several, they would not give me anything other than what the Rx says... I want to try a nasal pillow system, but the DME says no... nasal mask only... no pillows on the Rx. Cflex? No. Its not on the Rx. Can I just pay the difference myself? No. Can I try on different masks. No. They have demo masks, but they can't be worn (what else is a demo mask for???) Jeez. And the insurance only covers 50%, so I have to pay $50 a month to rent a machine that I may or may not tolerate, about $350 up front to purchase a mask that I can't try on, and purchase a humidifier for a Cpap I'm only renting. And thats with insurance coverage. Thats $700 after 7 months. I can spend the same $ and own the same equip (w Cflex and any mask I want) and own it all... and thats BEFORE Insurance.

On the other hand, the guy at the sleep center I had the study done at has been extremely helpful... above and beyond actually. Hes modified the Rx to give me the option of Nasal pillow or mask, and changed the machine (he's still hesitant about C-flex though and I doubt I'll be able to get that right away ). He even let me come back to try on all the masks they had there...

Sleep study center = (American Wellness and Imaging)
DME = (Apria)

End of rant...

Question about Cflex... At the Sleep center, the mask I liked best was the Swift Pillows. Very comfortable and light, so that is what I'd like to try, however, with the pillows, I had a hard time breathing out (with the masks I had a hard time breathing in... go figure). Will Cflex really help with that? I've read mixed reviews. Does the equivilant system on the Resmed S8 work any better to make exhalation with a nasal pillow any easier?

All in all I'm hoping for the best here, but the experience so far has been a bit frustrating. I hope to have the equipment in the next few days...

Thanks

-David

Sleepy Dog Lover wrote:Well, just back from the DME, and the news is not all bad. I told them I wanted a respironics, and ended up with a Remstar Plus with cflex, didn't even have to ask about cflex so it will be covered 100%. It still isn't the machine I want, but it is a good start, and I got cflex.

They had a wide variety of masks for me to try and choose from, all on the machine. I ended up getting the Aeiomed Headrest, seemed to fit the best and get the best seal. I told the RT about the rubberband fix, he said he would keep it in mind. Seems like I will need it.

The RT spent over an hour going over everything with me and trying on masks, so overall it was a good experience.

Guest David wrote: Question about Cflex... At the Sleep center, the mask I liked best was the Swift Pillows. Very comfortable and light, so that is what I'd like to try, however, with the pillows, I had a hard time breathing out (with the masks I had a hard time breathing in... go figure). Will Cflex really help with that? I've read mixed reviews. Does the equivilant system on the Resmed S8 work any better to make exhalation with a nasal pillow any easier?

Your description makes perfect sense to a lot of us who use nasal pillows, David. Most likely you, like many of us, have some constriction in your nostrils that limits airflow. A regular nasal mask won't help with that because with a regular nasal mask the air pressure on the outside of the nostrils is the same as inside. However, with nasal pillows the air pressure inside the nostrils acts much like breathe-rite strips and pushes the nostrils open from the inside.

So, using nasal pillows solves half of your problem. The exhalation part of the problem isn't really different with nasal pillows, it's just that the inhalation part was so much worse you probably didn't notice the exhalation part.

Will C-flex solve your exhalation problem. That's what it's designed for, and many folks here rave about it. It doesn't agree with everyone though. It didn't work for me earlier, but after being on xPAP for a while, I'm now using Bi-flex and think I'd use C-flex if I were to go back to CPAP.

Hope this helps.

Regards,
Bill