BPAP Titration Sleep Study

[Sleeprider]

I had forgotten the suggested pressures, and how no pressure or pressure support scheme provided any efficacy. Carry on, you're on the right path.

[HalfAsleep]

Are you ready for this?

I was at the point in this thread adventure where I had a BiPAP titration study which produced numbers (AHI 18) EXACTLY like the diagnostic (no machine) study (AHI 18). Nothing happened. BiPAP was a null experiment.

The Sleep doc kept insisting the BiPAP worked. She even prescribed a BiPAP, ordered it, and proclaimed which settings were required, even though I was never titrated at those settings. Per her, most events in the sleep study were obstructive and minor. I might have a few centrals but those were with arousals or stage shifts (I go through 120 of these a night), so they weren't important.

Even with the BiPAP, I had my signature ultra-long (sometimes 88 seconds) events.

The doc wouldn't be convinced of anything I said. I tried 5 email exchanges. She was in denial about my comments. She dug in.

Hold onto your hat while the wind blows in the exact opposite direction....

I went to see my brand new PCP. At first glance over the sleep study summaries, he agreed that something must be very off (in addition to the fact that I did the diagnostic study in two different beds.).

The PCP called the Sleep Doc. He bought her argument and her position about the data.

Ready? She went along with everything I argued as though it was all her idea!   She even drew the obvious conclusion!

Upshot? All my untreated events are centrals, she now says...CPAP/BiPAP can't do anything for them. I'm to get a second opinion about treatment from the opposite end of the state.....

Seriously.

SCORE!

      

[SarcasticDave94]

Did someone drink some spiked Kool-aid? Or what happened?

getting the and

[HalfAsleep]

With that cup of coffee, SarcasticDave, albeit soaked up with popcorn, you'll be up all night.     

I have no idea what happened, although my last email to the Sleep Doc—well within the bounds of decorum—mentioned something about how the BiPAP titration study was a null experiment: 4th grade science. That was the entire email. 3 lines.

This has been 2 months of my presenting my same old, same old bullet points with every ounce of savvy (helped along by this board), circumspection, introspection, perspicacity, and fortitude, all which genius she now owns as hers.... Such is the wont of the humiliated.

Nighty night!

[kiwii]

Funny what a little exposure to the light of day can do.

I wonder what her motivation was for the stance she'd originally taken. What I find repugnant is the inability (or unwillingness) to even look at the data/situation without bias until another medical professional was brought into the picture.

[Sleeprider]

No other conclusion was defensible, and when faced with questions from a peer, she had to produce correct statements based on the facts presented. I think this is just disrespect for you as a patient, and CYA amongst her peers. Of course you have the contradictory documentation. That's just wild. I hope you are finally on your way to a therapy based on a real assessment of your needs.

[Fixit50]

...What I find repugnant is the inability (or unwillingness) to even look at the data/situation without bias until another medical professional was brought into the picture.

I agree, that is stunning! 

Half Asleep: What is your next step?  Will you be getting another titration?  ASV titration??

[HalfAsleep]

Gosh only knows.... I forgot ‘til you mentioned it that I’d likely need a titration. Too bad someone can’t just write the script for a machine.

[Fixit50]

Gosh only knows.... I forgot ‘til you mentioned it that I’d likely need a titration. Too bad someone can’t just write the script for a machine.

That is too bad!  It's also too bad you can't just walk into Fry's and buy one at something more like market-value!

[Sleeprider]

There is a slim chance you could obtain a script for ASV and self-titration if you were following a standard protocol  You certainly can demonstrate the knowledge to do this, and have done your time at titration trials.  Really the only reason to do a titration is to make some doctor look smarter than a smart machine.