Is it hard to change DME?

[BeepBeepNoSleep]

Unfortunately my DME sucks. I have been struggling with bipap therapy. The Doctor doesn't seem to know much, and said she would adjust pressures. I feel like the machine's in / out cycle is too short, and I wake up gagging or out of breath. This occurs every 45 minutes or so until I give up a few hours later.

After I received my sleep study I just picked a DME from the list (the Doctor said that's the one most often used). A guy showed up and dropped off the machine and mask and left. My insurance was billed $2500 and I paid $700 of that out of pocket.

I called them first week with my issues, and they have been completely apathetic to any concerns I have. I asked them about trying a different mask and was told "to just suck it up because my insurance won't cover another mask for 10 months". I asked her about just buying one and the prices she quoted were about $50 more than what I can find online.

I complained to my Dr. and she said she could "write an order" for a different company.

I called around town and found another company that seemed much more caring and had a lot better options and attitude. They are much closer to drive to as well. I asked new company about taking over the machine I just bought (It has a modem sending in data), and she said they would have to deactivate it from their system before they could add it to theirs (but suggested I could just bring in the SD card if they won't do that).

Is it going to be a pain getting DME swapped? Any advice to get crappy DME to comply if they continue to be difficult?

[SarcasticDave94]

Seemingly, it shouldn't be too hard. One thing though, if your insurance is in a rent to own agreement, you'd need to surrender that device and start over with the new DME. Insurance probably will balk at this. If it were paid in full, this is a non-issue then. If the latter, just present that new DME with copies of your paperwork should do it.

And make sure that the old DME doesn't have any auto fill on supplies. Make sure all activity will be terminated and be sure of a zero balance owed.

And if I haven't yet said so, I'd suggest getting hard copies of your sleep study, titration and scrip. You'll need these to sign up with the DME.

[BeepBeepNoSleep]

Thanks Dave

I will call my Dr. tomorrow to see about getting copy of everything and getting script to new DME. I'll see what Dr. says about getting existing machine "moved over" if that is a thing. If that doesn't work I will call old DME directly. I reviewed the agreement, and it was definitely a purchase. I wish I had done some research before committing to anything. It sounds like the ResMed ERP might help with some of the problems I am having. Lesson learned

And I will keep reading and keep learning. I'm confident I can eventually find something that works. Thanks for the advice!

[Gideon]

BeepBeep download Sleepyhead and post your daily charts (see my signature) and post your sleepstudies when you get them.  I would like to view them just to see if your current machine is the best machine for you.  

you said you had issues and 

I feel like the machine's in / out cycle is too short, and I wake up gagging or out of breath. This occurs every 45 minutes or so until I give up a few hours later.

Please elaborate on what you mean by the in / out cycle is too short.

We want you to succeed and to best advise you we need to see data.

Fred

[SarcasticDave94]

Thanks Dave

I will call my Dr. tomorrow to see about getting copy of everything and getting script to new DME. I'll see what Dr. says about getting existing machine "moved over" if that is a thing. If that doesn't work I will call old DME directly. I reviewed the agreement, and it was definitely a purchase. I wish I had done some research before committing to anything. It sounds like the ResMed ERP might help with some of the problems I am having. Lesson learned

And I will keep reading and keep learning. I'm confident I can eventually find something that works. Thanks for the advice!

Quite welcome. And good luck on this.

[BeepBeepNoSleep]

I would like to view them just to see if your current machine is the best machine for you. 

I downloaded sleepyhead and loaded data to it earlier. I am reviewing the wealth of information in your signature. Thank you so much for that. I will edit the original post and put in charts.
edit: I waited too long to edit original post. I will put them here. I know the usage is really short. I am working on it.

Please elaborate on what you mean by the in / out cycle is too short.

As I am breathing in, toward the end of my breath, the machine tries to exhale as I am still breathing in. Then as I am exhaling, toward the end of my breath, the machine starts breathing in as I am still breathing out. I try hard to breath with it but it feels like the "breath cycle" (not sure if that is a thing) is faster than my normal breathing requiring me to breath faster than I normally do to keep up with it.

Usually when I wake up, there is a brief moment of shortness of breath and I can force my way through it to "catch it" on the next "in or out of the cycle" and then fall back asleep a few minutes later. After this happens multiple times within the hours, I usually get frustrated and just turn the machine off. I am trying to make myself use it longer each night to fight through it.

I hope that makes sense. 

We want you to succeed and to best advise you we need to see data.

Thank you for that. It's amazing that random strangers on the internet can be more inspiring than the professionals who are paid to treat this.

[Gideon]

When you organize the SleepyHead charts be sure to eliminate both the pie chart and the calendar. That will show all of your settings. There are setting that will help your breath cycle but befo= adjusting those it is best to know what your current settings are.

[BeepBeepNoSleep]

When you organize the SleepyHead charts be sure to eliminate both the pie chart and the calendar.  That will show all of your settings.  There are setting that will help your breath cycle but befo= adjusting those it is best to know what your current settings are.

I noticed a setting called Rise Time that sounds similar to what I'm looking for but it requires turning the Flex function off. I need to do more reading and try some things I suppose. I think I put charts correctly in the earlier post. If there's anything else that I can provide please let me know! When I talked to Doctor earlier this week she changed some pressure settings so I am trying that for now. I am trying to not change too many things at once to see what works (or at least build up my tolerance to get to that point), and take notes of changes and results a long the way. I couldn't shake the feeling that my Dr. is just guessing at this point.

I can't help but wonder if I put this much effort into diet and exercise if the problem might fix itself anyway

I pasted in the description of Rise time from provider manual for convenience.

Rise time is the time it takes for the device to change from EPAP to IPAP. This screen
allows you to adjust the rise time so you can find the desired setting. This is only
available if Flex has been disabled and the device is in Bi-level or Auto Bi-level mode.

'

 

[Sleeprider]

BeepBeep, don't worry too much about keeping that BiPAP.  You appear to have central apnea, and probably need a ASV.  I think your doctor knows this, and prescribed BiPAP to see if your central events would be treated.  It's not, and you would more likely succeed with a fixed CPAP pressure of 7.0 with no pressure support. It will help to see a longer night of therapy.

[SarcasticDave94]

IMO the BiPAP assignment kills 2 with one stone. It would/could demonstrate ASV need and eliminates that machine class as a viable option for insurance purposes. So, another ASV patient in the works huh? We're seeing more of this over time aren't we? When I joined AB there were not so many with diagnosed central or mixed apnea detected. I guess we're evolving and learning more about the intricate things with apnea. Best towards your success BeepBeepNoSleep.

If you have any questions or whatever, do not hesitate to post. Now if it's treatment related, we try to keep things tidy via keeping things related within a single thread so the AB members can follow along easily. Don't be overly concerned if you create a new thread though. Anyway let's get you moving towards the ASV as fast as possible.