[CPAP] Beyond ASV with Overlap Syndrome!

[cathyf]

Oh no I'm having conversations with myself

...it's one way to ensure a polite listener  

Seriously, it sounds like you might finally be on the right track!

[SarcasticDave94]

Funny there's some déjà vu going on...

First sleep doctor got tired of being outsmarted by Dave and about the time I got the ASV, he retired.

New CRNP at sleep and pulmonary office saw me once, we semi politely clashed a bit about COPD vs Asthma and whether or not pre-existing CA disappear like UPMC claim, I took a BPAP with several settings as tech saw fit Titration. Apparently as predicted, it shows highly uncontrolled CA via non-backup rate BPAP where ASV or similar with backup rate necessity is very apparent, and CRNP is transferring elsewhere.

CRNP 1 above called and said I was right, CA trainwreck showed. And to expect a return office visit soon.

Headed back to discuss with yet another CRNP and doc about next item on agenda... Correct machine is x?

BTW my conversations with myself are enlightening. I just don't know who's smarter, me or me.

[ubersteiny]

So is ASV still an option for you with the COPD? Or is the only viable machine really the ST-A?

[SarcasticDave94]

I think ASV had done all it could and ST-A might be my best bet. Both do have backup rate, the ST-A has the timing controls the ASV is missing.

My plan is to talk with the nurse and discuss that both ST-A and ASV are under the same E0471 code, that hopefully she'd listen to my explanation of ASV failing due to timing, and put me on ST-A.

The ST-A I borrowed recently felt pretty good, I'd just taken more time than planned to get self Titration solidified and had to return it. But I had enough of a taste to be quite sure it'll be better in my unique combo need than ASV, and definitely much better than no therapy.

[SarcasticDave94]

This public service announcement made possible by Dave drinking Black Rifle coffee™.

I've changed my upcoming appointments, the ASV Titration is cancelled, I already know my pressures, and I already know it'll not be any different than before on lack of synchronization. I'll go to the pulmonary team on 11/9 to discuss the request for a script for ST-A. Both ASV and ST-A are HCPCS code E0471. Enough of the laboratory rats thing.

Back to your regular coffee broadcast.

Up next, Death Wish Coffee.

[cathyf]

Dammit, Dave, it's like they are hoping you'll just die before they get around to helping you!

[Gideon]

Ahh, an AHI of 1 for the first hour than a zero for ever after.

Where are the flowers to go with the above.

[SarcasticDave94]

It's what it is. I'm hoping this new person listens to the complaints list, but I'm not holding my breath on it. But if I did, I'll flag it as Central.

Realistically at least this group of pulmonary people isn't exactly quack rated, yet.

Don't send flowers to my funeral. Coffee and Boston Creme donuts will be fine however.

[LindanHotAir]

Did the ASV fail you because of lack of timing? My sister was prescribed the Philips ASV because she did not do well on the Resmed ASV with no timing, just an auto backup rate. Some nights she has over 4000 timed breaths on the Philips and an AHi oF 0 to 2, with significantly reduced AFIB. Her untreated central AHI was 72.

[cathyf]

Did the ASV fail you because of lack of timing?  My sister was prescribed the Philips ASV because she did not do well on the Resmed ASV with no timing, just an auto backup rate. Some nights she has over 4000 timed breaths on the Philips and an AHi oF 0 to 2, with significantly reduced AFIB. Her untreated central AHI was 72.

Yeah except that the only Phillips ASV spews killer foam. I suppose if you're gonna go, it's better to get dispatched by the perfectly timed killer foam, right?

(I wonder if, like ResMed, the hardware platform on the DS2 would run their ASV algorithm perfectly fine? And I bet the ST algorithm runs perfectly on the generic A10 and A11 hardware platforms, too!)