1st Night Bi-Pap, high pressures = terrible

[Brando80]

Hi,
  I believe there were multiple reasons I didn't get the correct therapy. The first was probably just that my pulm MD didn't recognize that my OSA and CSA would be best served by an ASV. After I was prescribed the bi-pap at 22/17 they failed to recognize that I couldn't tolerate and failed that treatment. Only after I suggested and basically told them that I thought that was the correct treatment and why did they entertain the idea. When I went to see the second pulmonologist they stated that the 1st Dr. did everything they would have done. I actually am not sure I believe that  but maybe thats just the normal progression, failed bi-pap to ASV. The second MD was a lot more open to the idea and came to that conclusion without me suggesting that I thought it was the correct path. 

I've been wearing it almost 2 weeks now. Only once have I worn it all night. Every other night I wake up around midnight with it off and have to put it back on. I'm using a full face mask. I tried the mask that has a nasal pillow and goes over your mouth one night but it bothered my nose to much so I aborted after one night. I had the straps pretty tight once and it it caused folliculitis on the back of my head so now I'm struggling to get it tight enough to not leak when I move. All in all other than the one night when I woke up feeling good I've been about the same when it comes to daytime sleepiness, sometimes maybe a little more sleepy due to it keeping me up at night. I'm trying hard to keep it on and continue with treatment hoping it'll get a little easier. 

EDIT: One thing I forgot to mention. I tried to get a Resmed as thats what my supplier sells and thats what I did my sleep study on. They had to order the dream station because the prescription had a higher pressure than the Resmed would go to? I  didn't feel like arguing about it any more so I just went with it but in reading through the boards looks like maybe the Resmed is better, should I have stuck to my guns? I just am not knowledgeable enough to push that discussion.

   

   

[Sleeprider]

Oh good grief! Ask for the Resmed. Watch all thsi crap disappear. I get so tired of trying to fix the BS a sleep doctor causes I could spit.

[Brando80]

I've used it, not sure I can trade it in? I know, I'm so over this. They can't get anything right. I'm going to send her a message.

[SarcasticDave94]

Did this get rented via insurance? If yes, it can go back. Sorry for the bluntness, but you can't accept that chart as what you have to put up with. Make a swap for the ResMed. What pressure does a ResMed ASV not get to that the Respironics does? Mine hits IPAP Max 30 as I remember it.

What are the details/settings on this script? If it's like my Dr. Duck tried, it's something like EPAP 4-20 PS 2-20 or whatever he guessed at.

[RayBee]

What pressure does a ResMed ASV not get to that the Respironics does? Mine hits IPAP Max 30 as I remember it.

Resmed caps the pressure at 25 in ASV modes.  Not sure about other manufacturers.  As for my ASV, I'm the weakest link.  I have problems with aerophagia and mask leakage above 17, so I just make sure my max EPAP + max PS doesn't exceed that.

[SarcasticDave94]

OK thanks RayBee. I've forgotten the number parameters.

[Sleeprider]

Brando, sorry for my expression of frustration. Moving forward, if you can't exchange, let's increase EPAP min to 6.0, EPAP max 10.0, PS mn 3.0, PS max 15.0.

[SarcasticDave94]

If it were me, I'd make a strong and determined attempt getting the ResMed ASV. Off-topic but I have a point. I just was issued a power base wheelchair that cost around $29K. I am disabled but can still walk but very unsteady at times. How did I get that? This was about 2 years ago, and before I broke 6 or more vertebrae in 9 months. I told my PCP I was having walking issues from severe back pain and chronic nerve damage, and I asked PCP about a power wheelchair. So how do we get this doc? You need to do x y z. So I did x y z and here's my chair. Yes I had to have 2 doctors and 1 PT, 2 OTs, and a Numotion rep all do some work by creating medical necessity data. Oh and the Numotion rep's manager stated to my health insurance that I must have the chair as designed as the insurance didn't think I needed the suggested batteries or a padded seat and an upgraded joystick to handle the power tilt seat.

Having said all that, it is guaranteed you will not get this resolved if you do not ask. Swap the Respironics for the ResMed. Tell the doc its therapy is still VERY BAD! "I want to swap the Respironics for ResMed and no will not be accepted this time, doc. Change my script to ResMed and Dispense As Written." You should not accept this. Stand up and do!

[RayBee]

What is it that they say about the squeaky wheel?  And it definitely applies to the medical theater and getting what you need. 

Recommendation:  No more Mr. Nice Guy. Strap on your  Dr. Jekyll and Mr. Hyde pants and go for it. 

All the best.