[Equipment] New DME, New Machine - Respironics 640 ??

[MAPnea]

Hi, Everyone,

New sleep study this week with a new GREAT sleep doctor and team. So today I get a call from the new DME (70 miles from home - the closest one) and I ask, "So what kind of CPAP machine did my doctor order?" And the new DME replies "A CPAP machine, of course." Oh, dear, I think, I'm already not so sure about this.

But I persist and suggest, "Is it a ResMed?" (I wanted to give DME a clue that I actually knew I was getting a CPAP machine, but WHAT WAS THE BRAND?) So DME replies, "A Respironics 640." I ask if it's a data capable machine and DME replies, "Well, it's what the doctor ordered and we can't change the prescription and ……" So I backed off for now - after all, this is a new relationship and I don't want new, young DME lady to get her back up. So I back off a bit and chat in a friendly way and thank her for calling. But, I'm wondering just what is she talking about?

My sleep doctor's office is closed for the 4th of July holiday and I can't get an answer from her until Monday or Tuesday, but I'm just curious if anyone has a CLUE as to what machine this might be? A "Respironics 640"?

Thanks!!

[bwexler]

I am not as familiar with Philips Resperonics machines as Resmed, but my guess is it is either an old obsolete model or a misdirection. I have never heard of a 640. There is a 650


PR System One REMstar BiPAP Pro with Bi-Flex
Respironics brings "System One" to the new line of REMstar BiPAP machines. The PR BiPAP with Bi-Flex is an intelligent solution that knows when, why, and how changes should occur to consistently and effectively provide optimum sleep therapy. New System One technologies like Humidity Control with Dry Box and Resistance Control for use with any mask, all are helping users achieve effective therapy.

Manufactured by Philips Respironics.

4.5 OF 5
2 REVIEWS
Item #DS650S-AH650S
This product no longer available and this information is for reference only. Newer Model Available: PR System One REMStar 60 Series BiPAP Pro with Bi-Flex.

You will need to hang in there for a more knowledgeable answer, but I think you need to get a complete copy of your sleep study and your prescription before you drive 70 miles to see this DME, and be prepared to keep on driving if you don't get better answers.
In the PR line up I think you want a 560, 760, or 960 depending on your prescription and needs. All of these are Auto and fully data capable, which are my personal minimum requirements. The 460 and 660 are not Auto, but fixed pressure I believe. Anything less than a 60 series is old, prior model. If you have insurance assisting in payment I would want the current model. If I were paying out of pocket I might accept a 50 series at a substantial discount. You need to look at prices on the suppliers list near the top of the page to arm yourself with knowledge before your visit.

Why did you go for a sleep study, I know you have been here for a while and already have a great APAP machine. If you need to go to BIlevel you would want the PRS1 760 or Resmed S9 VPAP.

I must repeat determine exactly what you need and want and what it should cost, before you go near that DME. Then verify on the phone they can provide it. It sounds like you are going to Vegas for your DME. My experience there was less than excellent. If you have choices you might also check in ST George, Ut, and on line.

[Sleepster]

Likely it's the 460 and she just got the first two digits reversed when she said 640. The 560 is one step up from that, and with the heated hose option would be the Respironics equivalent of your ResMed S9 Autoset.

[trish6hundred]

Hi MAPnea,
What bwexler said.
I tried to look for that machine under the model number you gave and I didn't see it but who knows?
Good luck to you and hang in there for more responses to your post.

[zonk]

Hi, Everyone,

New sleep study this week with a new GREAT sleep doctor and team. So today I get a call from the new DME (70 miles from home - the closest one) and I ask, "So what kind of CPAP machine did my doctor order?" And the new DME replies "A CPAP machine, of course." Oh, dear, I think, I'm already not so sure about this.

But I persist and suggest, "Is it a ResMed?" (I wanted to give DME a clue that I actually knew I was getting a CPAP machine, but WHAT WAS THE BRAND?) So DME replies, "A Respironics 640." I ask if it's a data capable machine and DME replies, "Well, it's what the doctor ordered and we can't change the prescription and ……" So I backed off for now - after all, this is a new relationship and I don't want new, young DME lady to get her back up. So I back off a bit and chat in a friendly way and thank her for calling. But, I'm wondering just what is she talking about?

My sleep doctor's office is closed for the 4th of July holiday and I can't get an answer from her until Monday or Tuesday, but I'm just curious if anyone has a CLUE as to what machine this might be? A "Respironics 640"?

Thanks!!

System One selection guide:
http://www.healthcare.philips.com/pwc_hc...ochure.pdf

There is no model number 640, more likely 460 as Sleepster mentioned
Models numbers 460 and above are data capable machines, below 460 are not

460 Pro is fixed pressure machine, does auto trials for limited time but unlike 560 Auto which does this auto trial as the 460 Pro and full time APAP too. The doctor might be great but you want copies of the sleep study and the doctor go through them with you. Discuss machines options with the doctor and ask him to specify the machine of your choice on the prescription so this nice DME young lady would give you exactly the machine specified on the prescription

Keep in mind that you keep the doctor and the friendly DME in business, in other words 'you pay their wages'

[MAPnea]

Thanks, bwexler, sleepster, trish6hundred and zonk,

A bit of history: 19 months ago I had a sleep study in St. George. Because I live about 180 miles north of St. George, the sleep doctor prescribed my ResMed S9 so I could "get used to the machine" before my sleep test. The plan was to have a split-study. Well, the tech didn't quite "get it", I never actually got to sleep … and so I never had a titration. But the sleep doctor in St. George prescribed my ResMed S9 with the settings 6-11. My DME was in a drugstore in Delta, Utah (90 miles to the east of where I live). When they billed Medicare I was refused because the doctor prescribed a CPAP before he saw me and before I had a sleep study. Nineteen months and nothing has been paid. I never paid a dime. The DME in Delta was a Lincare provider when I started. Now they are not a Lincare provider.

So, the plan was to start all over again with a different sleep doctor, a different sleep study and a different DME. I love the new sleep "team" at the University of Utah Sleep-Wake Center (only 250 miles to the east of where I live). My new doctor was so impressed that I could read my memory card, knew what was happening AND had an affordable recording pulse oximeter. I had printed out a few pulse oximeter "previews" along with the SleepyHead summary. And I said that I thought my pressure settings might be too high because I was getting more and more apneas - most of them central. She was so happy I could "speak" some of the "speak". She thought I was desaturating during REM sleep and agreed that my pressure might be too high. She mentioned a BiPap and said she would order one that was capable of capturing data. She was intrigued by SleepyHead and thought - because I live so far away - we could monitor what was going on by sending SleepyHead data to her via email (or "My Chart"). I'm thrilled to have such a doctor. I feel totally "included" as part of a "team".

The next day my new doctor's assistant called and said I had 25 apneas per hour when my pressure was at "6", less than 2 apneas an hour when my pressure was at "9" and 15 apneas per hour when my pressure was at "11"… so "9" seemed to be the "sweet spot". SHE didn't say THAT… it's just what I gleaned from the quick summary. The assistant said my doctor would write the results of the sleep study next week when she returned to the office and would send me a copy of the study and Rx. When this was done, they would call the RX to the Lincare folks in Ely (70 miles from where I live… and they actually drive out here and DELIVER which is good because I'm "visually challenged" and haven't driven in 25 years). I also get one of those wonderful new "gel" masks that I used during the sleep test.

So I was surprised when the DME called this morning and said my doctor had FAXed my prescription to them. She did say they had the machine "in stock", but not the mask. They ordered the mask and would call me when the mask arrived to make an appointment to come out to deliver my things to me. So I was a bit surprised and excited and … well, asked a pointed question about what machine had been prescribed. Apparently this young lady "B" hasn't worked for Lincare very long and my question "threw her for a loop". Apparently, there is another lady "A" in the office who has been there "for years". All of this "info" via the local grapevine this afternoon. SO… I'm hopeful!!

I guess I'll have to wait until after this holiday weekend to really find out what I'm getting. But I do trust my new doctor. She must have wanted to get my machine to me as soon as possible. Maybe she even showed up at the office this morning to write the sleep study report. Now, that would be a change from the last sleep clinic.

Oh.. Las Vegas is 280 miles south of here. I mean, we are in the middle of NOwhere, but … you should see the stars that are out tonight.

Thanks again everyone - and I'll report back when I find out what the new machine is.

[MAPnea]

bwexler, Thank your for all the information, advice and encouragement to get what I need and what I want. Your information will be very useful to me if my prescription is for something not-so-new. I feel like my birthday is coming … only I have to get through 4th of July's long weekend first! Thanks again!!

[robysue]

But I persist and suggest, "Is it a ResMed?" (I wanted to give DME a clue that I actually knew I was getting a CPAP machine, but WHAT WAS THE BRAND?) So DME replies, "A Respironics 640."

I have never heard of a Respironics 740.

The current machines are branded as Philips Respironics machines and the current model numbers are:

• Model 220: The System One SE CPAP with Flex. This is the new "brick" in the PR Line up.
  
• Model 260: The System One Series 60 CPAP Plus with C-Flex. This is the standard brick in the current line up; the differences between the SE and the 260 is that the SE has annoying LED lights on the screen, whereas the 260 has an LCD screen with back lighting.
  
• Model 460: The System One Series 60 CPAP Pro with C-Flex+. This is a full efficacy data fixed pressure CPAP machine.
  
• Model 560: The System One Series 60 CPAP Auto with A-Flex. This is the APAP in the PR lineup. It is a full efficacy data machine.
  
• Model 660: The System One Series 60 BiPAP Pro with Bi-Flex. This is the fixed pressure bilevel machine. It records full efficacy data. The equivalent machine in the Resmed line is the S9 VPAP S.
  
• Model 760: The System One Series 60 BiPAP Auto with Bi-Flex. This is the auto bi-level machine. It records full efficacy data. The equivalent machine in the Resmed line up is the S9 VPAP Auto.
  

PR also makes a bilevel ST and an ASV machine, but I don't know their model numbers off the top of my head.

If your script is for a CPAP, my guess is that you have a dyslexic DME clerk who misread "model 460" as "model 640"

I ask if it's a data capable machine and DME replies, "Well, it's what the doctor ordered and we can't change the prescription and ……" So I backed off for now - after all, this is a new relationship and I don't want new, young DME lady to get her back up. So I back off a bit and chat in a friendly way and thank her for calling. But, I'm wondering just what is she talking about?

So am I. But I think you are being a bit too polite to the DME lady.

Look at it this way: Suppose you called your pharmacy to ask about a new medication, and the pharmacy worker you were talking to described the medication incorrectly in a way that made no sense to you. For example, suppose the name of the drug or the dose of the drug they were telling you was "just what the doctor ordered" did not match your memories about what the doctor should have ordered.

but I'm just curious if anyone has a CLUE as to what machine this might be? A "Respironics 640"?

I think the clerk you were talking to either misread the model number OR this is a sign that your DME doesn't have the foggiest idea of what it is selling when it comes to PAPs.

[bwexler]

MAPnea

You need to learn not to be so shy and timid. you will probably live with this machine for the next 5 years. You need to get a fully data capable Auto machine which is either the Resmed S9 Autoset or the PRS 1 DS560TS. Either one should include the heated hose. If you deceide you don't like the heated hose you can always turn it off, but there eill be times when you will be happy you have the option to turn it on.

DON'T SIGN ANYTHING UNTIL YOU VERIFY WHAT YOU ARE GETTING AND THAT IT IS A NEW MACHINE.
If your DME tells you its dark outside at midnight, go out and look for yourself

[MAPnea]

Thanks, robysue for the list of machines. And thanks, bwexler, too.
My new sleep doctor said she would scan and email my prescription and a copy of the sleep study to me when she got back to the office after the 4th. Everyone, of course is "out of the office" and was "out of the office" by the time I got a "surprise call" from the DME yesterday.

By the time I see the DME drive up to my door, I will have the Rx in hand along with a copy of my sleep study. AND… I will have had a discussion with my new sleep doctor, too. I just think the young DME lady is fairly new and was just giving me a "head's up" that they had gotten the Rx from the doctor, had the machine in stock, but had to order the new mask. After that, they'd call to make an appointment to drive out here to hand it over.

I think robysue hit the nail on the head (well… the DME on the head). She must be dyslexic. Fairly scary, yes. But as soon as I know what the doctor ordered (from the doctor's mouth), then I'll make certain I get what the doctor prescribed. I just wanted to download and read the clinical guide and get to know my new machine this weekend. And, yes, it will be a fully data capable, non-brick machine. I asked the doctor for that and she totally agreed. I thought - at one point - she mentioned a bipap. But that was before my sleep study. Anyway…..

I can't wait for next week to solve the "mystery" of what the DME thinks I'm getting as opposed to what I KNOW I'm getting! GADS… I hope I'm not in for another DME disaster. At least I know more this time around.

Thanks everyone. I feel like I have cheerleaders behind me!