07-13-2016, 06:42 PM
(This post was last modified: 07-13-2016, 06:45 PM by Dreams of Green.)
Severe Apnea - Advice Needed
I've been trying to get a family member that I was convinced had severe apnea to get himself tested for some time. He's like a textbook apnea case - overweight, constantly falls asleep out of nowhere even when sitting, you can then literally see obvious apnea events start to happen almost immediately, poor memory, and so on.
He also had an event that took him to ER a year or so ago where he woke up, got out of bed and fell over with the room spinning. No diagnosis given, it wouldn't surprise me if it was apnea related.
Well last night I finally got him to wear an oxygen meter and it was bad. Spent the majority of the night in the 80's, with the lowest reading at 73%, and some events in the 70's lasting more than a minute.
Now I need to help him get professionally tested, which we are going to do no matter what, but I'm worried how long that could take, my layman opinion is it's not safe for him to continue to sleep this way for another 4-8 weeks waiting for an appointment, then a test, then a CPAP etc. I know this area and getting quick appointments is almost impossible, it took me months to get a diagnosis.
This is someone I care about a LOT. I'm thinking about using my prescription to order an extra CPAP and mask. Comments?
If this violates forum rules and need to be closed I understand.
RE: Severe Apnea - Advice Needed
I'd get him into a GP, get them to write a prescription for an APAP machine set to 4-20 based on symptomatic evidence, and then get your local DME to to an "in home study" with the APAP machine to determine pressure levels. A full sleep study might be useful, but I agree that getting near term treatment is the bigger medical concern.
RE: Severe Apnea - Advice Needed
I understand the motivation, however......
A couple thoughts, in most cases waiting would not be a problem, the sooner the better yes, but typically not an emergency.
Does he have a history of heart issues, as this can speed things up very fast.
He does have a history of ER visits, at least one, and these are expensive-Insurance should be motivated to stop this from happening again.
Doctors will listen to history and an ER visit is a big thing to most. There are home test kits that you can get quickly and if needed will lead to a prescription Supplier #10 has them and others may also have them
No need to go around the rules, when you can use them.
07-13-2016, 07:18 PM
(This post was last modified: 07-13-2016, 07:25 PM by Dreams of Green.)
RE: Severe Apnea - Advice Needed
Really appreciate both your answers.
(07-13-2016, 06:50 PM)chill Wrote: I'd get him into a GP, get them to write a prescription for an APAP machine set to 4-20 based on symptomatic evidence, and then get your local DME to to an "in home study" with the APAP machine to determine pressure levels. A full sleep study might be useful, but I agree that getting near term treatment is the bigger medical concern.
Won't the insurance company demand a sleep study before even considering covering APAP? Or could it somehow be claimed after the fact?
(07-13-2016, 06:57 PM)PoolQ Wrote: I understand the motivation, however......
A couple thoughts, in most cases waiting would not be a problem, the sooner the better yes, but typically not an emergency.
Does he have a history of heart issues, as this can speed things up very fast.
He does have a history of ER visits, at least one, and these are expensive-Insurance should be motivated to stop this from happening again.
Doctors will listen to history and an ER visit is a big thing to most. There are home test kits that you can get quickly and if needed will lead to a prescription Supplier #10 has them and others may also have them
No need to go around the rules, when you can use them.
He is severely obese. No known heart problems yet. The ER visit happened over a year ago and he was not with the insurance company he now has at that time. But maybe the doctor could still use that?
I guess from my experience I am skeptical. When I went to see my sleep doctors I explained to them how severe it was, showed them the oxygen tests I'd done by myself, and explained my terror at having experienced events waking up not just gasping but terrifyingly literally choking. When I asked them if they could give me a prescription without waiting for the sleep test, based on the oxygen tests, and certainty and severity of my symptoms, they responded to me like i was out of my mind. But maybe that was just those doctors.
07-13-2016, 07:27 PM
(This post was last modified: 07-13-2016, 07:28 PM by srlevine1.)
RE: Severe Apnea - Advice Needed
(07-13-2016, 06:42 PM)Dreams of Green Wrote: Now I need to help him get professionally tested, which we are going to do no matter what, but I'm worried how long that could take, my layman opinion is it's not safe for him to continue to sleep this way for another 4-8 weeks waiting for an appointment, then a test, then a CPAP etc. I know this area and getting quick appointments is almost impossible, it took me months to get a diagnosis.
Might I suggest that you contact a physician who specializes in professional truck driver physicals as they are more accommodating on schedules than other doctors and have specific knowledge of sleep apnea as most states specifically target over-the-road truck drivers with high Body Mass Indices and/or neck sizes for sleep apnea issues.
They may be able to schedule faster access. A list of these doctors can be found at the DMV or by a Google search. Best of luck with your friend.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
RE: Severe Apnea - Advice Needed
Since you were going to use your prescription, I had assumed that you were not trying to do this with insurance. I am pretty sure that his insurance company is not going to be happy with your prescription. You don't give your location, but I am assuming USA. Your medical insurance down there is a source of bafflement to us Canadians. 
The price of machines on-line is pretty reasonable. It sounds like going through the insurance company is going to take time. A few people here have decided that paying out of pocket was the better course for them. It might be in this case too.
RE: Severe Apnea - Advice Needed
When I started the wait was 3 months and I went on the waiting list. less tan a week and I got a call. Was told 7-10 days for a report, got it in 2. told 2 weeks for insurance approval, got it the same day along with the machine after hours. It is possible to get them to move faster, badgering does not help from what I have seen, having a reasonable medical reason can work wonders.
Difficult to justify because of the ER visit from a year ago. Doctor shop or the on line test kit. Even a dentist "can" write a script for it, got one you are friends with?
RE: Severe Apnea - Advice Needed
(07-13-2016, 07:27 PM)srlevine1 Wrote: Might I suggest that you contact a physician who specializes in professional truck driver physicals as they are more accommodating on schedules than other doctors and have specific knowledge of sleep apnea as most states specifically target over-the-road truck drivers with high Body Mass Indices and/or neck sizes for sleep apnea issues.
They may be able to schedule faster access. A list of these doctors can be found at the DMV or by a Google search. Best of luck with your friend. Will do, I'm determined not to let this drag on for months.
(07-13-2016, 07:51 PM)chill Wrote: Since you were going to use your prescription, I had assumed that you were not trying to do this with insurance. I am pretty sure that his insurance company is not going to be happy with your prescription. Yes, I am willing to do it without insurance if we have to. What I was thinking was, if a doctor wrote a script based on symptoms, and then he was diagnosed say, within 30 days, would he be able to retroactively get it covered? I know doctors usually have 90 days or something like that to submit a claim. I have never done it but am under the impression some online places aloow the user to submit their own paperwork to insurance companies - but not sure about that. So I am wondering if he orders online, could he submit his own claim to the insurance company 30 days later after his sleep test?
Probably not, but that's what i was wondering.
RE: Severe Apnea - Advice Needed
from what I have heard Supplier #1 will submit the claim for approval once they get the script. You can always try and submit after, but I would not risk it. You can do the home test and have a script in less than a week and maybe two days for approval, then shipping time.
RE: Severe Apnea - Advice Needed
(07-13-2016, 07:54 PM)PoolQ Wrote: Doctor shop or the on line test kit. Even a dentist "can" write a script for it, got one you are friends with? A dentist can write a script for the online test? Or for the CPAP machine? Or both? I do actually know a dentist I could ask, but what I am trying to achieve by going the dentist route? Then take the results of the online test to a doctor to get a cpap prescription? Just want to make sure I'm on the same page, because this might be an option.
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