ASV and LVEF<45%

[zzzZorro]

No Bill, I'm on medicare so I have to play the game.  I don't know if the DME has any rentals or not but if I allow for the prescription to go forward I will have to go back to 'them' for a re-evaluation.  "Back" ain't a-gonna to happen if I can figure out another way.

[Sleeprider]

Your APAP cannot duplicate the prescription. That prescription is EPAP 7.0, IPAP 15.0 on every breath. It will be a mess, so no need to try it, but if I was to try that on my bilevel, it would be a mess for me...worse for you.

[Spy Car]

No Bill, I'm on medicare so I have to play the game.  I don't know if the DME has any rentals or not but if I allow for the prescription to go forward I will have to go back to 'them' for a re-evaluation.  "Back" ain't a-gonna to happen if I can figure out another way.

So you have to pay for some percentage of this machine upfront? I'm not sure how Medicare works.

I understand needing to play the game. But I suspect it won't take long for you to know it is a fail. Seems wasteful of your funds (and those of the US Treasury) to buy a machine that isn't going to work.

Supplier #2 had some pretty reasonable deals on new, gently used, and one moderately used ASVs if you decide to self-fund.

I had you prove Bi-level failure too. Fortunately, I have no known contra-indications. Sorry that you're in a predicament.

Bill

[zzzZorro]

Your APAP cannot duplicate the prescription.  That prescription is EPAP 7.0, IPAP 15.0 on every breath.  It will be a mess, so no need to try it, but if I was to try that on my bilevel, it would be a mess for me...worse for you.

From the sleepyhead charts I posted earlier today that would be proven out.  Although it isn't necessarily worse than some of the 'fishing' trials previously.

I thank you very much for helping me forward to this point and will check back when/if I get any equipment to work with.

ZZZ

[ajack]

@deepbreathing, we have posted before about the 5 fold death rate. Then without a defib, the rate is, as I said astronomical. The source previously given to you being a 2017 symposium educating other doctors at this marked video timeline
http://www.apneaboard.com/forums/Thread-...#pid216221

zzzZorro, I'm not anti-ASV, I use one as my primary machine, I also have a S/T and iVAPS machines. Unlike the ASV, these are true non invasive ventilators, but I like the ASV for me. These 3 machines were purchased secondhand for less that the price of an apap.

Pressure induced centrals from cpap/bipap subside within 3 months for most people. If you had bad centrals in a normal seep study without a mask, I would think the odds are you are going to keep them. That raises a bigger question of why your central nervous system is playing up. As you know, with the US insurance system, you are going to have to fail the bipap to be titrated for one of the back-up breathing machines. (EDIT : I just had a look at your chart. with a central rate of 3 an hour, it's doubtful that an ASV will be approved by insurance. I think they like over 5 with the obstructive sorted. You may find a bipap is the machine for you.)

An ASV isn't an automatic choice, there are other factors and needs that require a more advanced treatment machine and why it needs to be done in conjunction with a good doctor. I still work with my doctor and by chance, had a lab ASV sleep study last night using my machine and need to go back for another lab sleep study.. Why? is a long story.

I found this YouTube channel very informative, there are several respiratory videos on ASV, as you scroll down.
https://www.youtube.com/user/emjreviews/videos

[Sleeprider]

Ajack, good summary.  I'll repost here.  Go to 36:40 for the comments referenced above.