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Posted: Fri Jul 28, 2006 4:36 pm
by Moogy
RestedGal,
Congrats on your premium machine! I think compliance rates could go WAY up if more doctors prescribed this machine...do you agree?
Moogy
Posted: Fri Jul 28, 2006 9:25 pm
by rested gal
Moogy wrote:I think compliance rates could go WAY up if more doctors prescribed this machine...do you agree?
Moogy
Probably so, Moogy. It sure can cover a lot of bases for different treatment comfort issues.
Actually, the main thing that I think could help improve compliance rates enormously would be DMEs that kept checking back with new users EVERY week for several months, and who were willing to swap masks over and over and over again until the person had a
mask he/she could sleep in comfortably.
Too many people are left to sink or swim out there.
Posted: Sat Jul 29, 2006 8:25 am
by Snoozin' Bluezzz
rested gal wrote:
Actually, the main thing that I think could help improve compliance rates enormously would be DMEs that kept checking back with new users EVERY week for several months, and who were willing to swap masks over and over and over again until the person had a mask he/she could sleep in comfortably.
Too many people are left to sink or swim out there.
A truer thing has never been stated on this forum!!!!!
When there is this follow up there should be specific directed questions, not just a general "how's it going?". Lots of folks know its not going well but have absolutely no idea why and are hesitant to offer just a general - "not good". Those questions should be about mask fit, mask comfort, mask leak, and how about - AHI, leak rate, etc (oh, that requires a decent machine doesn't it?)
That's why this forum is so incredibly useful.
David
Posted: Sat Jul 29, 2006 5:07 pm
by elliejose
RG,
Is it still going well with the Auto Biflex? Would really like to hear your experience with it as you go along. If I need bipap, that is what I am hoping to get. The little guy who was so good and patient with me at American Homepatient has left and he and another fellow have opened their own place here in Union so I hope my insurance will ok for me to change DME's. Have been meaning to call and check on it but decided to just wait until I see if I get a new prescription. I go Mon p.m. for next study. I'm ready to get it over with. I just really am still tired and have aerophagia and some nights when my auto goes high (which it frequently does) I have a lot of trouble exhaling. My AHI's run mostly 10-20, and sometimes higher. I hope to get a new mask also. I have only used the Swift. I have tried more but could only tolerate the Swift. I am sure you will have more info each night so please don't fail to keep us posted. If not please PM me and let me know what to expect. You have always been so helpful.
And like you, I already have the software and reader for the Remstar auto so I would really like to be able to get this one. So, so far, you have a lower AHI than with your 420E?
A Good Thing
Posted: Sat Jul 29, 2006 7:59 pm
by birdshell
elliejose wrote:
The little guy who was so good and patient with me at American Homepatient has left and he and another fellow have opened their own place here in Union so I hope my insurance will ok for me to change DME's.
WHAT! You found a good DME provider and he just went independent?
What's the contact info, and tell him to stand back: there may a charter flight coming in every half hour, full of hoseheads!
_________________
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Posted: Sat Jul 29, 2006 9:02 pm
by haynow2b
I too give it a big two thumbs up & w/ the hybrid f/f mask I'll throw in a big toe.
Posted: Sat Jul 29, 2006 9:37 pm
by rested gal
Josie, I've always gotten a very low AHI with any autopap I've used. So, even though I'm getting my lowest AHI's with the bipap auto, there's really not enough difference between getting AHI's of 3.something, 2.something, or 1.something, or even zero AHI, to make me choose the BiPAP Auto for that reason.
Except for getting quite a few 0.0 AHI nights with the BiPAP Auto, the other AHI's I've seen with it have been the same low ones I normally get with the 420E auto and the REMstar Auto/C-flex....AHI's that are usually well below 3.0, and often below 1.0. Not enough difference to shake a stick at, even when you consider the 0.0's.
There's nothing about the BiPAP Auto that I actually need. I've often said, and still do, that I could get perfectly effective treatment on straight cpap at a pressure of 9 or 10. And I'd be comfortable there, with no need for any kind of exhalation relief.
All that said, I do enjoy the feeling of "less pressure" when exhaling with any bi-level (bipap) machine. I also like the assurance of knowing IF I occasionally need more pressure than 9 or so, auto-titration can deliver more, and prevent events that would have otherwise happened.
In sum, I like having the best of both worlds going on at the same time in one machine.
Josie, since you have nights when you have a lot of trouble exhaling, this machine might very well be a good one for you. In addition to getting wonderful exhalation relief, you'd also get the varying pressure "as needed" that an autopap can deliver. It's certainly versatile in that there are several treatment modes you could try. It's a machine that lends itself well to "tweaking". If a person has several comfort issues (aerophagia, trouble exhaling against pressure) and has been prescribed a high pressure, this might be the machine they need. It's certainly the most tweakable one I've used.
If running it as both at once (bipap and auto) didn't suit you, you could always use it in just bipap mode for great exhalation relief -- throughout the entire exhalation.
Yes, I'm still doing fine with the BiPAP Auto. I expect to be using it as my primary machine for a long, long time. It's giving me very smooth, very comfortable treatment.
The only off-putting experience I've had with the BiPAP Auto was during the first few nights when I tried using my F&P HC 150 heated humidifier with it. Any autopap I've used has worked fine with that separate humidifier. But with a separate humidifier in use, this machine had difficulty in bipap/auto mode "reading" me and was running up too much pressure. When I switched to my integrated Respironics heated humidifier (thanks to Ted/Titrator for the suggestion!) the machine settled right down and has behaved beautifully ever since.
Good luck, Josie!
bipap auto - PB new nasal pillow
Posted: Mon Jul 31, 2006 12:13 am
by ghg
will post pressure graph this weekend
I guess I can keep my mouth shut. PB breeze nasal pillow mask
worked fine.. AHI down from 2-4 range to 0.5. untreated AHI 61.
had been using FFMs.
--ghg
Posted: Mon Jul 31, 2006 8:29 pm
by sthnreb
In the month I've been using the BiPAP Auto, I've been getting slightly lower AHI's than I normally got with my autopaps -- usually below 2 with the autopaps; usually below 1.0 with the BiPAP Auto. The BiPAP Auto has even been giving me several nights of 0.0 AHI's. Not that there's anything magic about an ultra low AHI...anything below 5 is fine. But those zeros are kinda' fun to see in the morning.
Wow Rested gal, and I was proud of my .3 low and 2.0's and lower. Yours barely had a mark. My AHI dropped from the Bipap Pro 2 when I swapped to the Bipap Pro Auto. I even ran it at my 12/8 setting as a regular Bipap for a bit. With the lower AHI in the auto mode you have to run it that way and for me no ramp needed as it starts in my lowest Epap setting of 8.
Posted: Fri Aug 04, 2006 9:33 am
by Guest
rested gal wrote:Moogy wrote:I think compliance rates could go WAY up if more doctors prescribed this machine...do you agree?
Moogy
Probably so, Moogy. It sure can cover a lot of bases for different treatment comfort issues.
Actually, the main thing that I think could help improve compliance rates enormously would be DMEs that kept checking back with new users EVERY week for several months, and who were willing to swap masks over and over and over again until the person had a
mask he/she could sleep in comfortably.
Too many people are left to sink or swim out there.
I was curious as to how many times CPAP.com calls and checks on its new patients? Does anyone know?
Posted: Fri Aug 04, 2006 12:57 pm
by -SWS
Guest wrote: I was curious as to how many times CPAP.com calls and checks on its new patients? Does anyone know?
I bought one CPAP machine from Apria and two AutoPAP machines from cpap.com. Neither company called me. Rather they both said if you need any help at all just give us a call. One of the AutoPAP machines developed a fault while still under warranty. Cpap.com shot several emails to me within an hour or two of my reporting the problem. Then they very efficiently facilitated a factory repair under warranty, leaving me
extremely pleased with their service. By contrast I have called Apria several times over the years and about half my calls eventually got returned. Apria charged more for my CPAP than cpap.com carged for both AutoPAPs combined.
Glad you asked! .
Posted: Fri Aug 04, 2006 1:23 pm
by Guest
-SWS wrote:Guest wrote: I was curious as to how many times CPAP.com calls and checks on its new patients? Does anyone know?
I bought one CPAP machine from Apria and two AutoPAP machines from cpap.com. Neither company called me. Rather they both said if you need any help at all just give us a call. One of the AutoPAP machines developed a fault while still under warranty. Cpap.com shot several emails to me within an hour or two of my reporting the problem. Then they very efficiently facilitated a factory repair under warranty, leaving me
extremely pleased with their service. By contrast I have called Apria several times over the years and about half my calls eventually got returned. Apria charged more for my CPAP than cpap.com carged for both AutoPAPs combined.
Glad you asked! .
Posted: Fri Aug 04, 2006 1:49 pm
by -SWS
Well, in my case the value added is that I truly received much better service from cpap.com than I did from my local brick-and-mortar DME. My local brick-and-mortar DME repeatedly left me feeling highly frustrated. Two of my consumable-supply orders from Apria got lost over the years, and, of course way more than two of my phone calls got lost. By contrast everything I ever ordered from cpap.com arrived quickly. They were always courteous in dealing with me instead of apathetic or barely tolerant of me as well. And when I needed follow up service cpap.com provided it much more efficiently than I am accustomed to at a local level. That is precisely why so many of the posters on this board are vehement cpap.com supporters. Many of us have experienced that same HUGE discrepency in customer service.
If by definition cpap.com doesn't have value added compared to some of our local DME's (and I honestly believe they do), then cpap.com simply won our loyalty by almost never dropping the ball----which makes for one huge contrast with my own brick-and-mortar alternative.
Posted: Fri Aug 04, 2006 2:47 pm
by sthnreb
Other than their Wal-mart pricing and shipping things on time, I'm still waiting to hear what value an online "distributor" adds.
First, I'm glad you do recognize they do provide at least 2 distinct advantages. That's 2 more than a more expensive DME's offers.
The value of online is someone you can make contact with for help
when you need it. The biggest
value an online distributor adds, is less cost which makes equipment more efficient. You can purchase at least 2 machines online for the cost of 1 from a DME. A new machine now, then a new machine 5 years from now will last longer and for less cost than one machine from a DME (their machine is no better). Why do DME's always only offer the cheapest machine available? For a bigger profit margin? An advantage to the Internet is that you can get a better machine for less than a DME el-cheapo. On the flip side, what advantages does a DME offer that an online provider doesn't? Someone to look you in the eye, if you go to their place, and lie to you? It is sure not service and followup. My DME charged $400 a month rental, Bipap Duet. I bought a Bipap pro for $1500 that the DME wanted $3500 for the discontinued Duet. I had a hard time getting them to pick up the rental. I assume they wanted to milk it as long as they possible could. I stopped paying when I called them even though they wanted me pay until they picked it up about a 2 weeks later. In my opinion, there is no advantage for a DME unless you call paying them more to their advantage. Perhaps the question should be, if prices were the same, where would people buy? I still opt for online. Forcing internet to raise prices to match DME's kills free enterprise. We know for a fact internet providers make a good profit from merchandise so how much more of a killing does DME's want to make? A $1000 machine on internet would probably cost over $3000 from a DME and probably closer to $4000, if they sold it. They prefer to rent and collect double or more for machines and after that, sell it. Calling a machine a medical device doesn't make the price go up, DME's do. They try to control the pricing so the profit margin is ridiculious. It must be that the internet is squeezing their business as more people become more knowledgeable about it. I'm not sure this silly topic even deserves responding too as there is very little comparison.
Posted: Fri Aug 04, 2006 2:58 pm
by KansasRT
No DME company chooses to rent a machine. All billing requirements are set by the patients insurance company.