[CPAP] Running through hoops - Just venting

[dad2crazykids]

Hi, I have been using a resmed S8 elite CPAP machine for 5 years. Background I saw the doctor regularly for about the first 2 to 3 years. I have not seen the sleep doctor because of the following: I did not make a followup, forgot about it and did not see the need to worry about it as I was doing fine and was busy with everything else going on. Well the machine broke about a month ago with the vague message "Call Service" and I now regret not keeping in touch with the doctor.

The service provider for the machine did not want to touch it as they don't do much work with the respiratory market anymore since their merger with another company. The offered to send it to the manufacturer for $200 which only covers getting the machine there and having someone look at it, repairs if possible would cost more (much more I was afraid). Thus I decided to see if I could get a new machine but apparently I need a new prescription to get a new machine so I needed to see my sleep doctor.

Well my sleep doctor had a three month wait for me to get in but I could go on a waiting list and maybe get in a little sooner that admin informed me. I pleaded my case that I had no machine as was having a lot of headaches, trouble staying awake..etc. and was able to squeeze in a visit to a nurse practitioner two weeks out. I did not quite like waiting the two weeks but I figured I messed up but not keeping up appointment so there you go.

The visit went better than I expecting, the front staff had me fill out all sorts of paperwork like I was a new patient which made me worry my file had been discarded but it turned out they did have it and my history. I brought in my old machine and they were able to download my current history from the machine. The practitioner wanted me to do a new sleep study as my machine was showing 7's which I must admit my ignorance I did not know what it means other than it was worse the five and under I am supposed to be achieving but better than the 100+ I racked up in my sleep study. Anyways I talked her into not doing a study not but issuing a new machine and coming back in two months (which apparently the insurance company is insisting on anyways) for a followup and then see. (I am thinking the machine could have been the problem as I felt like either I am getting used to the pressure or the machine is not putting out as much force as it used to)

That was about two weeks ago apparently the new service provider I have did not send something they should have to my insurance provider and everything has been delayed waiting for those two to sort things out, I been involved making calls every day for the most of the second week trying to move things along.

Now I have to schedule an appointment with the provider of the machine to come down and get fitted? and get the machine which worries me as I always used the nasal mask as a full face mask makes me too claustrophobic to use the machine. (I am certain that was what I agreed with the practioner a nasal mask so I am crossing fingers that the lady on the phone was had not looked through the notes throughly). All in all I should be out a machine for about 5 weeks. This makes me think I will be religiously scheduling my follow ups in the future if it will cut my down time in the future as I have not felt good at all and my caffeine habit is back full force as it is my safeguard to keep my from fall asleep during the day which I could easily do more and more these days. That is my story and my vent, thanks for listening.

[PaytonA]

Welcome to the forum dad2crazykids

Actually your primary care physician could have written the prescription but I am not sure what effect that would have had on the insurance. Sorry you are being delayed. Keep plugging at it and do not accept a full face mask if they bother you. Nasal masks or pillows are easier to keep sealed anyway.

Best Regards,

PaytonA

[trish6hundred]

Hi dad2crazykids,
WELCOME! to the forum.!
If you prefer a nasal mask, make sure you tell them that and do keep calling them, I know it's a giant hassle but that's what they are getting paid for.
I'm sorry you are having such trouble with getting your treatment straightened out, but just keep on trying.
Best of luck to you.

[retired_guy]

This doesn't need to be that stressful an ordeal for you.

First let's establish a couple of goals:

1. You need a machine now. Not in 5 weeks. So you would be willing to accept a "loaner" if they have to order you one.

2. You want a data-capable machine so that you don't have any more 5th year surprises of "Oh! You're doing 7's! You should be less than 5." With a data capable machine you can know this daily. So you want a Resmed S9 Autoset. There are others, but you have already been using Resmed, so why not continue on.... They will probably say they don't have one right now, at which time you will be happy to accept a "loaner" while they order one. If they are hell bent not to provide you with a data capable machine, ask them for a copy of your prescription - which they legally should provide you, or go back to the sleep lab and get one, then order your machine from an on-line supplier that can handle your insurance situation for you.

3. Getting fitted just means they want to figure out what mask you need --- small, medium, large.... They won't really care if you use a full face, pillows, or nasal. That's up to you to decide. So since you're used to a nasal just tell them that. On the other hand, since you already have a nasal that works for you, you may want to try something else such as new Resmed N10 nasal, or the Resmed P10 pillows.

4. You're not the patient. You're the customer. Don't let them kid you into thinking otherwise.

p.s. "7" is really not a big deal. It's a bigger deal than you should have to have, but in the scheme of things still not a big deal. But if they "think" it's a big deal, then let them think that so they can justify getting you your gear as quickly as possible.

[vsheline]

Hi dad2crazykids,

I sent you a Private Message with more info.

In brief, I urge you to inform the DME now, while things are still getting arranged, what machine you want and will accept. Be prepared to say "no" to the first couple machines they offer to sell you.

You might be stuck for 5 yrs with whatever machine you accept from the DME, so only accept a fully data capable model, and I highly recommend refusing anything but an Auto machine. An Auto machine can always be operated in fixed-pressure CPAP mode, if necessary, or can be operated in Auto mode. Two machines in one, so you can use an Auto even if (presently) your prescription is for a fixed pressure.

But also work now to get your prescription changed to the specific model you want and will accept.

Guidance on what machine to buy:

http://www.apneaboard.com/wiki/index.php...ne_Choices

Good luck!

[Sleepster]

This makes me think I will be religiously scheduling my follow ups in the future if it will cut my down time in the future

Check Craig's list and buy a machine. That way you'll have a back up and you won't have to rely on the maze that is our system of medical treatment.

I would be willing to drive for hours to get a machine rather than go a single night, let alone five weeks, without a machine.

[retired_guy]

Craigslist is not a bad idea... I recently looked at Craigslist in our area and found a S9 Autoset with no miles on it just 3 blocks away from where I live. Price they were asking? $500.00.

Hmm, maybe I should go get it as a backup myself.

[Peter_C]

Welcome to the forum, and take note of the great replies you've gotten thus far. I too am one of those guys that won't even take a nap without my dream machine~! My spare is nothing to brag about - a single pressure 'brick' model - but much better than doing without.

Fighting (if needed) now, is much better than dealing with what you don't want later. Also, you can choose to use whichever DME you want to use. Possible phone calls may land you at a good DME willing to do as you hope and expect, as you really are the customer, though most DMEs do not see to act like you are.

[Doc J]

I got a S9 autoset for $350 with case masks hoses humidifier off CL. You could find lesser machines for temp use or back up even cheaper than that. I jump through no hoops, haven't talked to DME for awhile. I got my nasal pillows off auction site (new) by ordering short tube and pillow and headgear on separate auction. I am not saying going alone is for everyone but it's where I ended up.
Good Luck
Doc J

[dad2crazykids]

Thanks for the advice everyone I appreciate it. I had my appointment to get my equipment today and got a resmed s9 autoset. After reading your replies yesterday I was concerned I was getting something else as I told the practioner that I was not certain if I would like auto pressure as she kept insisting most patients complained that they felt like they were suffocating using it. She told me I had to choose fixed or variable as a variable could not act as a fixed pressure machine. I chose fixed as that is what I am used to and did not want the problem of having to exchange a variable machine later if the practioner was right. Well the nice lady at the DME pulled out an autoset s9 when I arrived and told me off the bat that it is a variable machine but she set it to act as a fixed one for me. You think they would train the staff at the doctors office better on the machines capabilities. Anyways I have the machine with a heated tube and the resmed air fit nasal pillows instead of the swift nasal mask I've used. (Both seem to be nice upgrades from what I have used and the machine is so different from my s8 much quieter). I see how the unit works tonight. Only weird thing is now I have a cell modem attached to the unit to report my data to the DME so they can verify my usage to the insurance provider (did not have to do that 5 years ago) at least it is only necessary for the first 90 days then I can send the cell component back to the DME. Anyways I am just glad to have the machine.