I am so angry at "the system" right now.

[Want2SleepInMT]

I just had another pointless follow up with the PA at our sleep clinic. She has known since the morning after I changed my settings, the exact same time that my DME found out. Now, today, she wanted to force me back to straight pressure, which, works for some, but leaves me waking up feeling good some days, and like a mac truck hit me on others. There is no point in continuing if the "treatment" I am forced into makes me feel worse than I ever did before starting on this road. She was mad that I "didn't call her" to get the issues worked out. Now, part of me is afraid I'll be marked "non compliant" and be screwrd.

[FrankNichols]

I am sorry for the difficulty you are having. I would suggest that it might be in your best interest to bite your tongue and play nice with your doctor until after the compliance test is completed. I would discuss with her why you were concerned with the original settings not working and how the two of you can get back on track. Playing by the rules most often results in getting what you want in the long run, being right is not always the best policy when going up against the system.

[AlanE]

She can mark you non-compliant but she would be lying since your machine says you have been using it >4 hours a night for more than 70% of the time during the compliance period. They can't change that on your machine.

[OpalRose]

I just had another pointless follow up with the PA at our sleep clinic. She has known since the morning after I changed my settings, the exact same time that my DME found out. Now, today, she wanted to force me back to straight pressure, which, works for some, but leaves me waking up feeling good some days, and like a mac truck hit me on others. There is no point in continuing if the "treatment" I am forced into makes me feel worse than I ever did before starting on this road. She was mad that I "didn't call her" to get the issues worked out. Now, part of me is afraid I'll be marked "non compliant" and be screwrd.

How long have you been on Cpap therapy? Compliance must be met within the first 90 days.

To meet compliance rules, you must show that you have used the device at least 4 hours per night on 70% of nights for a 30 day consecutive period during the first 90 days after starting treatment. You must also have a face to face doctor appointment anytime after the first 31 days, but before the 90 days is up.

Nowhere does compliance have anything to do with changing pressure settings. Your insurance could care less.

You are being bullied by your doctor/PA/sleep clinic.

Now if you haven't met compliance, and if insurance is paying, they can take your machine back. So you do have to play their game (to some extent) untill the compliance period is over.

[bwexler]

My wife would advise me to play nice with the PA.
My wife would be too late with that advice because I would have already put that PA in her place. I always start out polite and gentle. But, if she didn't come around to my way of thinking, she might leave the room in tears. When I know I am right and it is important to get what I want, I won't take no for an answer

[PoolQ]

It's an iffy thing, working with medical "professionals". I went the same route and changed my prescription pressure, it was explained kind of like this:
1. This is the same as changing the dose for a prescribed medicine
2. It makes it very difficult for me (the Doctor) to treat you if I have no idea what your settings have been
3. There is a reason I chose those settings

Part of it is a matter of professional curiosity on MY part. What I started doing was sending the office an email about what was going on and to my surprise, after the long waits for most things, got an appointment the same week to go over my treatment.

All Doctors are different and take a different interest in our treatment. I decided that if I am going to ask my Doctor to treatment then I should do what they ask, give feedback, and ask before I change something-or change Doctors.

My father in law changes his dose and even has been known to stop some medications based on how he is feeling at the time. This totally drives me nuts and he does not tell his Doctor. So I decided that if this drives me nuts, then I should not change my prescription settings without at least telling my Doctor, in advance what I wanted to do and why. My Doctor is a good one and I want to keep him.

As for compliance, see above- they have posted the rules.

[FrankNichols]

It's an iffy thing, working with medical "professionals". I went the same route and changed my prescription pressure, it was explained kind of like this:
1. This is the same as changing the dose for a prescribed medicine
2. It makes it very difficult for me (the Doctor) to treat you if I have no idea what your settings have been
3. There is a reason I chose those settings

Part of it is a matter of professional curiosity on MY part. What I started doing was sending the office an email about what was going on and to my surprise, after the long waits for most things, got an appointment the same week to go over my treatment.

All Doctors are different and take a different interest in our treatment. I decided that if I am going to ask my Doctor to treatment then I should do what they ask, give feedback, and ask before I change something-or change Doctors.

My father in law changes his dose and even has been known to stop some medications based on how he is feeling at the time. This totally drives me nuts and he does not tell his Doctor. So I decided that if this drives me nuts, then I should not change my prescription settings without at least telling my Doctor, in advance what I wanted to do and why. My Doctor is a good one and I want to keep him.

As for compliance, see above- they have posted the rules.

I totally agree with this approach. Also, my experience is that getting up in people's face is not often conducive to a good working relationship.

As a consultant my entire career it always drove me crazy when people would pay me to study a problem and make recommendations and then ignore those recommendations. The way I see it is I pay an expert (the doctor) for their knowledge. If I disagree with their conclusion then I discuss it with them and try to understand why they are prescribing what they are. If they do not want to discuss it, I find a new doctor.

Oh, and I thought part of compliance test was that the treatment has to be effective? At least I am pretty sure, Medicare will not continue paying after the first 3 months if the treatment is not working.

[justMongo]

After 6.5 years on PAP, not once have I been asked for data from my machine.
They cannot see it remotely like on some of the newer machines.

I see my doc on a 6 month schedule to keep my Rx current so I can order supplies.
My usual visit is: How do you feel? - Do you need any supplies? - See you in 6 months.
If it wasn't for a mask requiring an Rx, I'd not visit the doc at all.

As for interaction with medical people, a patent has a right to be spoken to in a polite manner; not brow-beat into submission.
(That works both ways.)

[FrankNichols]

As for interaction with medical people, a patent has a right to be spoken to in a polite manner; not brow-beat into submission.
(That works both ways.)

Absolutely agree.

[sdb7802]

Some doctors use a cookbook approach and can't cope with deviations. Some are way in over their heads.