Went to my doctors about my diagnosis today....

[deathscreton]

Wow! I am sorry you had that experience. I hope that you have an appointment with another doctor soon to finally get somewhere with all this!

Things happen. While it's frustrating and ultimately upsetting because it gets me no where, and the doctor seems not to care in order to save his own hide, I have to look at it as a learning experience, and look at it as I'm living proof that these boards provide the proper knowledge to arm yourself with what you need to know so you don't get caught up in the loop. At the end of this, that's all that matters.

Yeah, it is common. If this is your GP, I suggest getting another GP. If he is this weird then what else is he going to be weird about? We wouldn't hesitate to switch mechanics who said stupid false statements about how our car works but so many of us won't switch docs.

Way ahead of you. I've already setup an appointment with an office suggested to me by a co-worker of mine next Thursday. They don't have weekend hours like the last office (no that it matters because the two times I went, both ended up with me walking away empty handed), but they're open early enough for me to go in before work if need be. That and they offer a patient portal where I can gather all my medical documents without having to call and wait. As for mechanics, you're damn right. I've done it before, I won't hesitate to do it again. He's a contracted individual and those who can't perform their jobs properly are let go. Happens everywhere.

Incredible story.  Of course you can simply obtain an Auto CPAP and DIY, and your signed sleep study would be viewed as a valid recommendation by most online suppliers.  The physician that signed that report could probably write your script if you let him know you have separated from your doctor because he quacks, making rational communication impossible.

I would love to do this, believe me. But money is a barrier at the moment. That and I'm paying for insurance. I have it, I need to put it to work otherwise that deductible I spent and all that cash that goes to them every month is for naught. I would love nothing more than to drop the whole system, but in my situation, it's not plausible.  As for the physician who signed my interp, I'm already ahead of you. I have an appointment setup for Tuesday. Here's to hoping they're more malleable than the GP I left. 

Yeah, it is common. If this is your GP, I suggest getting another GP. If he is this weird then what else is he going to be weird about? We wouldn't hesitate to switch mechanics who said stupid false statements about how our car works but so many of us won't switch docs.

Sadly switching doctors is not really an option for us, it is very much a case of take what you are given.
All our GP's do is get you an appointment with a so called specialist at the hospital, change GP's you end up in the same hospital with the same specialist.

I failed to do my homework prior to attending the sleep clinic, had I done so I would have called him out on the bulldirt I was being given. Had I been aware of the information available on this site I would have been far better prepared to deal with the incompetents treating me.

On the one hand medics will tell you to educate yourself on whatever your problem is, but should you have the nerve to contradict them they will tell you not to believe everything you read on the internet, even though the information you quote may be from a legitimate hospital website.

Switching doctors is an option for some people. I don't specifically know how Medicare works, but with my insurance, I'm free to choose who I want, when I want, and not need a referral to see a specialist. I can drop a doctor like a bad habit and not look back. Your situation may be different (as it sounds), but thankfully, I have the freedom to move about. It makes this process a hell of a lot easier.

As for the homework, I was fortunate enough to read about this before I started my studies which is why I was equipped to handle this situation. That's the whole point of me posting this. It's not just SA that a patient should be familiar with, it should be everything that you have to deal with. I'll be damned if I let someone who refuses to change with the times handle my health care. 

Oh, man. The doc thinks a CPAP machine is a balloon inflator at a birthday party?

That's a great idea to get the person who signed off on the sleep study to prescribe the machine (natch, according to your specs). Even a nurse practitioner can write a prescription. Heck, you can even take him/her the prescription template in the Forum Wiki and the prescription is pretty much written for them. 

All you need is an APAP of your choice, correct? The docs can tell you not to auto-titrate 'til they go blue in the face, but they can't make you follow their directions... If you're using insurance, just make sure you meet the insurance compliance requirements so you can keep the machine.

I plan to meet my benchmarks (compliance obligations, follow-up visits etc.) and then do whatever. I probably won't even change any settings until I'm free of obligatory doc/DME visits).

Good luck!

Sure as hell sounds like he does. It's almost like he doesn't know what vents on the masks do. 
With all due respect, I've mentioned it earlier, had he been upfront about not knowing instead of trying to spoonfeed me lies, this wouldn't have been as big an issue. But what can be done. 

As for getting the sleep doc to sign off on it, you can thank Rider for that. I saw his suggestion beforehand in another thread (I don't have the bookmark, but thank him anyways). And yeah, NPs or PAs can write scripts. The new doctor's office I'm heading to actually has more than a few there who are studying under some very intelligent doctors from what I understand. So we'll see how it goes. Also, I did not realize there was a presprescription template available. I'll have to peruse the Wiki more considering there are still things I don't know about it. >.>

As for the choice of machine, I was reaching for an APAP because I figured it'd be easier to persuade him to do that, however, that's flawed logic. Using a BiPAP doesn't place you in any significant danger or necessarily change your therapy. Since I wouldn't have to pay out of pocket, and my Insurance does not require prior-authorization, it should be easy enough to get a script for one. The only problem I could think of after this is how the Insurance Company would deem it necessary or not after I've already received the item and leave me with the bill. I haven't had to make a large purchase like this before, so again, learning experience. Personally, I think a BiPAP would work much more efficiently considering the amount of flow limitation designated by my HST and the oxygen desaturation that is present in both the HST and PSG(I feel like this is Complex SA waiting to happen, fingers crossed). Not to mention that while I'm not a light sleeper, I definitely don't want to breathe into high amounts of cmH2O. That doesn't even begin to sound comfortable.

What would concern me about this particular doctor is that he cannot interpret the study or take action on his own accord.  If he gets the results of a titration study, he will take the recommended fixed pressure and prescribe that, then defend to the death that the patient should not touch that without an additional sleep study.

The whole conversation ignores the fact many patients do a home sleep study followed by self titration with auto CPAP.  The arguments present a doctor who is ignorant to the point of being incapable of performing his job, assuming he even believes what he is saying.  I would rather be treated by an intern or student who is at least interested in the basics

He seems to ignore the fact that in 34 years, a LOT of ingenuity has happened in the medical field alone. His field or not, you should be aware of at least the basics when it comes to something like this. And I concur, someone who at least shows proper interest in expanding their horizons would be preferable. 

Since the doc is sending you to an ENT, maybe get the ENT to write the prescription for an APAP?

The ENT probably could write the script. But that's another unnecessary 50 dollars I'd have to spend in the process on the off chance that they would just refer me again and not write my script. I'd rather take my chances with the sleep doctor who did my interpretation in the first place. Fingers crossed they paid attention and aren't going to be surprised when I bring in my results. 

FWIW, my primary admits he knows nothing about cpap.  He accepts that I know more than him and I can just tell him what I need the script to say.  If I needed a different machine (i.e. a bipap), then he would have to send me back to a sleep doc.

I have had doctors who have had outlandish reasons why I must do things a certain way and that was the last visit with that doctor.   Some doctors are into control, others have ego problems.  Others just are used to doing stuff a certain way and yes, are surprised when their patients disagree.

Add another mark to that checklist of yours Bait. I don't know what was affecting my doctor outside of wanting to cover his own hide from a non-existent risk, but he probably needs to be on that paper of yours.

We are in the process of firing my wife's sleep doc (PA actually) and moving her over to mine. The sleep doc was fine up until we made the initial 30 day consult compliance after starting therapy. She said everything was fine even though my wife explained she was having reactions to the headgear on her amana view mask - her face would swell and the skin was breaking out on the back of her head where the webbing made contact. Finally got the doc to order a different mask which was like pulling teeth. We have had the respiratory therapist over twice and talked to the DME about making adjustments and they said they can't do anything without the doc's permission. We have left messages for the sleep doc and refuses to return calls. So, with the reaction to the mask and a couple of other issues, she has not used her machine in over a month and nobody on the med side cares. The DME has been trying to talk to the doc also, but she has blowing them off also. 

When she wet up the appointment for the new doc, she talked to his respiratory therapist who understood what she was going thru and knows the other doc's reputation told my wife to hold off on using her machine until we look at the study and make the proper corrections. You could hear her want to say "this is BS".  We are picking up her sleep study on Monday and her appt is supposed to be the end of next week. Hopefully we can get this resolved.

Most of my wife's events are CAs and are medication related.

We shall see.

Homer

Masks are super expensive. You need a script to buy them as a set, but one of the Suppliers on the Supply List will sell them in parts to you without a script. In a case like this, I think it would be easier to go this route than to deal with both your Doctor/PA and the DME. 

As for the doctors you're currently dealing it, that's insane. If the Therapist knows your wife's issues, you'd think he'd be more willing to interact and help resolve the situation, not tell her to not use the device. From what I can understand, all she needs is another mask to help avoid the breakouts. 

If you haven't already, there are tips on helping to deal with this as well. Cleaning the mask in vinegar or rubbing it down in Dawn soap is supposed to remove any chemicals or residue that's building up and help with the rash. However, if it's being caused by an allergen, the smarter thing to do would be to get another mask via a source that ISN'T going to make your wife wait without her machine. :\

[Doza]

Man all that sounds rough.
I'm very fortunate that my GP's eyes lit up when I mentioned Sleepyhead, and that I already had my machine and had it all happening before the titration study results were even in.
He basically said 'have at it then'.
Hopefully you can find a better style of supervision at the very least.

[Phill]

Switching doctors is an option for some people. I don't specifically know how Medicare works, but with my insurance, I'm free to choose who I want, when I want, and not need a referral to see a specialist. I can drop a doctor like a bad habit and not look back. Your situation may be different (as it sounds), but thankfully, I have the freedom to move about. It makes this process a hell of a lot easier.

As for the homework, I was fortunate enough to read about this before I started my studies which is why I was equipped to handle this situation. That's the whole point of me posting this. It's not just SA that a patient should be familiar with, it should be everything that you have to deal with. I'll be damned if I let someone who refuses to change with the times handle my health care.

We don't have Medicare, we have a thing called the National Health Service, like something you would expect to have experienced in Soviet Russia, and something I feel sure you would tolerate in the States, insurance is another matter.

In the official complaint I made to the hospital I said:
1/ Either you diagnosis is incorrect, therefore you are treating me for something I don't have.
or
2/ Your diagnosis is correct, and the therapy is not working.

I go for 1/...............

You might have gone for a lawyer.