RE: Do Doctors Even Have Access to Flow Limits Info?
Yeah, you gotta go with what's best overall. I think I can go most anywhere I choose, being on a Medicare Advantage Highmark Blue, a premium PPO. I'm on that because I'm on SSDI Disability.
Mask Primer
Positional Apnea
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Do Doctors Even Have Access to Flow Limits Info?
Well sleep specialists can be an issue. Sleeprider's description had me laughing. I got my new ASV and the whole 60 minute follow up was on how I must take prozac because I had a brain disease and wrote in her report that I lacked insight into a so called "psychiatric condition". All of my "anxiety" was a disorder and had nothing to do with the fact that I had just had rotator cuff surgery and hadn't slept for 6 months because of pain and being forced to sleep on my back. Because I talked back to her she wrote that I had perseverating thoughts. In other words she was covering her derrierre because for 9 years of therapy and god knows how many sleep studies I had never been diagnosed with central sleep apnea. Is it any wonder that people turn to doctor Google when they know things are not working for them. Thankfully just a few practical bits of advice have helped tremendously as I negotiate my way into new ASV territory. There is tons more to the horror story but I will spare you the details. I slept well last night.
RE: Do Doctors Even Have Access to Flow Limits Info?
Yeah the sleep Dr is a bit of a racket, have to go in every so often to remain compliant, the DME even confirms my last visit every time they call for resupply. The last time they called it was posed as a question, "Have you seen a sleep specialist in the last six months?" when I replied Nov. 27th I think... she said "Yeah, you're right." Already knew the answer but asked anyway. Every time I go in I get admonished for changing pressures, this last time I took in a stack of color OSCAR printouts along with corresponding sleep monitor screen shots, correlating poor sleep stats with OSCAR graphs. I explained that I don't adjust settings for giggles, every single settings change I make is an informed decision based on data gathered daily. Generally flow limitations are the main driver for changing a setting. I also explained that I am a very light sleeper and pressure changes caused by flow limitations degrades my overall sleep quality significantly. I strive for as flat of a pressure graph I can dial in. The sleep therapist asked If I thought the machine was helping, I responded with it's a double edge sword, when things are working as intended and I keep the flow limitations and pressure changes to a minimum, yes it it improves overall sleep quality, but when the thing gets a mind of its own and starts adjusting pressure with no signs of flow limitations it can at times degrade my sleep to the point of pre therapy exhaustion. I flipped through the charts and showed her many times that there were significant pressure changes with no flow limitations registering and very little variance in the other graphs, before I could finish she looked me square in the eye and said those pressure changes are caused by CA events... I hope she thought about it later and might have felt at least a little embarrassed... My Airsense 11 by design has never raised pressure due to a CA event, ever, but it does from time to time via its alchemy algorithms decide its time to wake ole SQ up with some mystery pressure increases. Almost like 'look at that, he's sleeping far too soundly, lets fix that'. To her credit she did note in my after visit report that she was impressed with my charts, graphs and pictures with circles and arrows, and that the patient was proactive in managing therapy but should be remanded to the group W bench for changing settings.
RE: Do Doctors Even Have Access to Flow Limits Info?
I'm not sure the correct answer is always "you don't need a sleep doctor." I have one that is excellent. I see him once a year and he is well worth the $80 copay I have. I bring my SD card and his software can analyze many aspects that I have no idea about. He also has just about every mask known to man, and can tell you the pros and cons of each. Just with the SD card he can see every setting on the CPAP machine, and we go over all of them. If we want to change a setting, he can do it on the SD card, and when I plug it back into the machine, all the settings update. I didn't know the CPAP machine could do that. You think a GP could do 10% of that? That's funny. I can imagine the blank stare I would get if I brought in an SD card to my GP.
If your sleep doctor is not good, find a better one. I live in a big city, and there aren't many, but there are good ones if you look hard.
RE: Do Doctors Even Have Access to Flow Limits Info?
We only have one. Most doctors locate in big cities. If you live in the boonies you are stuck with what you have got.
RE: Do Doctors Even Have Access to Flow Limits Info?
Limited choices due to insurance, which is excellent in many respects. Free choice of doctors isn't one of them.
Paula
"If I quit now, I will soon be back to where I started. And when I started I was desperately wishing to be where I am now."
RE: Do Doctors Even Have Access to Flow Limits Info?
Paula,
The answer to your question is influenced by the source that the DR uses in ResScan.
1) if your Dr is reading the EDF files directly from your SD card using ResScan, he probably can see a plot of flow limitations just like you do in OSCAR.
2) BUT if your DR is accessing your data in any other way (Airview or ResCloud), then at best he only sees an abridged version of flow limitations, either just a summary number for the night or a significantly less granular plot of flow limitation index versus time.
