ResMed S9 & 14000 ft. altitude

[Netskier]

This was a fascinating discussion. I worked at a medical device company in the past where we had to do packaging studies related to packaging performance during air shipping. This involved testing for outer packing leaks by placing the packaged devices in various levels of vacuum to simulate various altitudes since the cargo compartments may not be pressurized. One thing to note is that the outer sealed packaging did swell up like a balloon. I think it would be a simple study for CPAP manufacturers to extend the auto altitude adjustment testing past 8500 ft altitude however if they make any kind claim they would have to fully validate that claim which would be expensive. I wonder why they stopped the original study at 8500 feet?

How high do the roads go in Australia?

[Netskier]

Thanks for all the input. The doctor's office called today with the solution of taking a second CPAP machine to use the four days we are in Tibet as the didn't want me adjusting the pressure on my machine. However, I have the information on how to adjust the pressure and could do so myself. I can't believe how overly protective they are about the "pressure information". But that's another issue. I'll let you know what happens after our return later this summer.

A second machine set for what pressures?

Remember to run the Maskfit test before sleeping every night, and to expect leakage to increase with altitude.

[Netskier]

In what seemed to me as a challenge to prior posters,

[quote='Netskier' pid='4436' dateline='1332839103']
I recommend that you take personal responsibility for your own health, and not depend too heavily on secondhand opinions.

And later

P.S. I heard someone on Sunday report that the Rand Corporation [someone else] did a study that found that Physicians diagnoses are correct 55% of the time, and wrong 45% of the time. Thus, they are only slightly better than chance. Given this, I conclude that we should be very skeptical of their opinions....

Then, on this hearsay, it seems he concludes that since doctors are only slightly better than chance in their diagnosis, we must largely rely on ourselves. Wow. Makes you wonder why doctors waste time in medical school, internships, residencies, etc. if the best they can do is about 50-50, doesn't it? Makes anyone seeking their opinion, or relying on it, seem rather dumb, right?

I heard this hearsay on the radio, by an MIT serial entrepreneur who funds the X-prizes, and who earned an MD from Harvard. He has put up a $10 million dollar prize for the first team to invite a cell phone-based medical "Tricorder" as seen on Startrek. So this guy puts his money where his mouth is. You can listen or download this at KPFK.Org, Free Forum, last Sunday, March 25, one pm. This show was extremely good.

The reality is even worse than the medical mis-diagnosis rate of 45%. The sorry state of medicine in the US is a national scandal. Google for "iatrogenic illness incidence" without the quotes to find scholarly articles on this.

The death rates from doctor's treatments are scary. Doctors are the third leading cause of death in the United States, according to
[commercial website link removed per Apnea Board rules] so read this and weep.

This news is under reported, and is actively covered up, by the corporations that run medical care in the US. Read the scholarly articles to see the reality of this.

Is it foolish to trust implicitly in doctors if they are the third leading cause of death? You will have to answer that for yourself, but for me the answer is "yes".

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[pssnn]

How high do the roads go in Australia?

Yes they may have decided that 8,500 ft was high enough and didn't need test further. Another possibility is that the data became unreliable when tested above that point and didn't correlate well with the regression curves.

[JudgeMental]

I'm not feeling any compassion here from your MD.

What kind of solution is that.. to suggest that his patient lug an additional CPAP to China for a 4 day trip to the top of the world.

[JumpStart]

I heard this hearsay on the radio, by an MIT serial entrepreneur who funds the X-prizes, and who earned an MD from Harvard. He has put up a $10 million dollar prize for the first team to invite a cell phone-based medical "Tricorder" as seen on Startrek. So this guy puts his money where his mouth is. You can listen or download this at KPFK.Org, Free Forum, last Sunday, March 25, one pm. This show was extremely good.

Netskier, what relation someone putting up money for a working "tricorder" has to do with any actual knowledge of the medical profession’s mis-diagnosis percentage somehow escapes me. It seems more likely to me he is seeking publicity with the certainty that he will unlikely ever have to pay for it, but whatever fires your rocket. However, I did not see in your statement anything to indicate he has special skills or knowledge to make such a claim, nor do I see a relationship between that and your claim of 45% mis-diagnoses. I also did not see an actual name, although that is now irrelevant.

The death rates from doctor's treatments are scary. Doctors are the third leading cause of death in the United States, according to
[commercial website link removed per Apnea Board rules] so read this and weep.

Weep? More like laugh. The website to which you refer is clearly a marketing arm for Ron Grisanti, its founder per his site, and a chiropractor (not an MD) who espouses holistic medicine. No surprise, he also runs a foundation he created which he claims trains other like-minded persons in his "functional medicine" approach - for a fee. I am simply astounded that you would cite him as a valid source of your claim of 45% mis-diagnosis by the medical profession - by which, in context, is generally meant medical doctors, not chiropractors. For most, it would require someone with actual skills and training to make such a claim before anyone could even consider it as possibly being valid. And the “article” to which you made specific reference is not only sufficiently vague as to be almost useless, almost half of the claimed deaths were, by one researcher’s own definition, “non-error” events (106,000 non-error of 250,000 total). And, of course, the totality of those articles was not included, merely bits and pieces, which enables anyone to make anything out of the work. Further, the article jumbled at least two separate reports into one (Starfield, whose date of publication was not included or I did not find it, and Leape, who published in 1991). In your original post on the subject, you claimed the Rand Corporation created the basis for the claim, not this site.

The reality is even worse than the medical mis-diagnosis rate of 45%. The sorry state of medicine in the US is a national scandal. Google for "iatrogenic illness incidence" without the quotes to find scholarly articles on this.

I also did as you suggested and performed a google search for scholarly articles. I found a few, none of which claimed that doctors misdiagnosed 45% of the time, most of which predated 1987, and some of which were from foreign countries such as Thailand. To quote you, in a prior post to Paula02, regarding both these and the before-mentioned Leape (and probably Starfield) studies:

P.S. 2. The study was published 19 yrs ago, so the work was done at least 20 yrs ago, so it is not current.

In this case, the studies you referenced had publication dates which varied from 1981 (31 years ago) to 1991 (21 years ago). Who knows when the data was collected. Certainly we can hope medicine has advanced somewhat since then, even if their content didn't supported your contention.

Is it foolish to trust implicitly in doctors if they are the third leading cause of death?

I doubt that anyone seeking information on this forum trusts doctors "implicitly". If they did, they wouldn't be here. But that is a far cry from claiming or believing that doctors are wrong 45% of the time, or that they are the "third leading cause of death". I found absolutely no evidence supporting your claim - unless it would be the chiropractor or his website in which you seem to have such confidence, and who supports a method of practice different from any mainstream medical institution, recognized medical center of learning, or the vast majority of medical doctors. Funny, but since he seems to be making his living by his claims – which support his holistic approach - don't you even wonder whether he might just possibly be biased? Certainly you are free to believe in his claims, but I can only say better you than me.

Am I a doctor? No. Do I have one in my family? No. Are there errors made by doctors? Of course – we are, after all, talking about human beings. Do these errors cause death? Sometimes they undoubtedly do. Is there ANY valid study made by any recognized authority which totals the total doctor diagnoses made during any time frame, and determines the mis-diagnoses arising from all those diagnoses? Absolutely none that I could find, and I seriously doubt that any such study exists or Netskier or the chiropractor would have cited it. And I doubt that one could exist. Anyone with mathematical knowledge can recognize that in the absence of those two figures, it is IMPOSSIBLE to determine a percentage such as has been asserted. And please don't tell me about "estimations". I would “estimate” that the chiropractor has far more to gain by trashing the medical profession than he does by supporting them. And the figure you presented was NOT an estimation.

For those whose familiarity with the mathematics involved was perhaps years ago, the method of determining a percentage such as is claimed (45% of doctors’ diagnoses wrong) would involve taking the total number of mis-diagnosed patients and dividing it by the total number of patients diagnosed[b] for the same period.[./b] The numbers for each part of the fraction would have to be for the same period of time (say Jan1-Dec31, year XXXX) for the result to be accurate. Unless you have these figures, you absolutely, positively cannot determine an accurate percentage!! For example 5 (number of mis-diagnoses) divided by 20 (total diagnoses made) equals ¼ or 25%.

What has fired me up, Netskier, is not that you have a different view of the world. You are entitled to it, and I don’t quarrel with that. I simply do not believe that this forum, where many people are seeking help with medical issues both new and frightening to them, is the proper place for gloom and doom statistics, much less those which have no actual or valid basis. And listening to, and supporting, fringe individuals that do, is your unquestionable right. Just give consideration to the mainstream who don’t support that element and who are more interested in a simple answer to their immediate questions about devices, hoses, reports, etc. You got that benefit when you first came here.

[SuperSleeper]

Thanks to everyone who participated in this thread. Since it has strayed from the original post to a great degree, I think it's best to close the thread for now.

Thanks for your understanding everyone.