[CPAP] Beyond ASV with Overlap Syndrome!

[SarcasticDave94]

Well well well, my coffee ain't helping much with my awareness.

I've forgotten to add any OSCAR shots of the ST-A. I'll try to fix that and post what little I have in the coming daylight hours. For giggles I'll probably add the failure got my therapy needs called AutoSet. The doc that thought that would work isn't my doc anymore. Yer fired.

Description of what I learned on ST-A in iVAPS... It can treat me reasonably well once all the settings are in place. I liked ASV with the EPAP range FWIW. It has its own wrinkle that was something different.

Unfortunate my COPD or Asthma or whatever the quacks want to call it acted up and I just couldn't get much quality time on the ST-A. There's a little, and I learned that iVAPS can be a winning thing with time invested in self Titration.

I changed insurance to Aetna Medicare Advantage and Johns Hopkins isn't on the in-network so a new referral to Penn State Hershey and a subsidiary in Harrisburg was visited this week, which is within 2 weeks of the referral. I'm amazed that most everyone else is waiting months to be seen.

Off on the wrong path already. "We don't think you have CA anymore so you don't need that type of treatment and we need a BPAP Titration..." I didn't want to beat up anyone so I held my tongue sorta. I told them I know how it's going to play, badly. I know CA are alive and well because I sleep just a poor as I was before BPAP extreme fail in '17.

Some office that messages me of Aetna insurance pre-authorization actions told me the Titration will be approved. EXCEPT I'm decided I'll refuse it. It's going to waste my time and money. Nope not happening.

Visiting primary next Wednesday to discuss me buying a machine of my choice without more stupid body paying tests. I'm getting something with iVAPS and my use will prove them to be quacks.

OUT till I post OSCAR...

[Sleeprider]

Looking forward to seeing your progress and results. I can't imagine what it must be like for those that have to navigate this process without your knowledge, determination and Black Rifle Coffee.

[SarcasticDave94]

Uh oh. So far I don't see the ST-A charts on this SD. It might be on another SD. I know it felt possible to get the
ST-A fairly tuned in with the short time I had it at my disposal. I think it's iVAPS, backup RR, and time controls that's a good fit not necessarily Astral, Stellar, ST-A machine specific.

For a laugh, here's how well an AutoSet goes, NOT WELL. I don't know, but certainly it looks like the CA are way down and not worthy of treatment like the guy at the new pulmonary believes. Focus on OA not CA? Not a chance bub.

[attachment=35785]

[Ratchick]

Be interesting to look at those OAs and if they're ACTUALLY OAs or just a wrong guess based on FOT... Doesn't matter how "obstructed" it thinks your airway is if there's no effort to breathe, after all!

[SarcasticDave94]

Yep, I know for me the AutoSet was just wrong. I didn't bother trying to avoid CA by normal methods of turning off EPR. I think it was in my mind to create the trainwreck look and tell the duck the AutoSet or any other CPAP without backup rate was wrong.

I didn't bother to explain as I already knew it to be a futile action. His mind was made up that it was right and I was wrong. So my action was cancel the future appointment, telling the staff it was a big fail and PAP was returned.

[Ratchick]

Definite quacking coming from that office...

[SarcasticDave94]

Today, I called the new pulmonary office to mention my insurance automated system called last week to tell me the BPAP Titration is approved.

During the pulmonary call, I asked the staff to request I get tested with BPAP and other modes. They needed to call me back. Just got the return call. The nurse or physician assistant named Chris just had staff call back to say no we're sticking with simple BPAP. My reply "OK thanks I'm not interested in testing at all then".

[SarcasticDave94]

OK crazy Dave got a call from the test facility scheduling. Got to chatting with the scheduling girl and she mentioned their techs will change titration test parameters as needed when issues like predominantly Central Apnea appear. I agreed to be scheduled, as it's not locked to BPAP only. I have to wait such a long time, till Monday September 27, 2021, 7:30 PM.

I still scratch my head why so many others can't get scheduling for many months away.

[SarcasticDave94]

Ok thumbnail sketch of recent events...

1. I changed to Aetna Advantra HMO, this may be short term as open enrollment being 10/15 and that there's details the salesman didn't mention of all the little fees, co-pays, etc. Ok whatever.

2. Insurance changed so I had to cancel Johns Hopkins and get Penn State Hershey umbrella pulmonary team.

3. Last Monday night 9/27/21, new BPAP Titration, discussed with tech my complex state, on waking he couldn't share specifics of test but that I knew results already and he saw very high Apnea to titrate against, he said basically what I expected was spot on

4. Initial doc from Penn State Hershey Blue Ridge just called and apologized, he initially didn't believe it when I told him there's high CA still and untreated without machine, he stated that those last tests were completely wrong, another doc is setting up next visit to discuss return to ASV at Blue Ridge office

5. I'll be asking about ST-A as alternate plan to ASV for timing settings...

Stay tuned, the saga continues.



PS I requested my copy of test results via this mornings call, he said it'll be ready my next visit

[SarcasticDave94]

ASV targets MV to key events...

ST-A, targets MV also it appears...

Same E0471 coded script gets either

Oh no I'm having conversations with myself