Stuck with a brick during loaner...

[SaldusMiegas]

Hi cate1898,

Maybe there is more to know than the DME is sharing with you.

Here in the US, I talked to my insurance plan administrator and learned a lot here on abneaboard to determine what my options were before meeting with the DME. It looks like there is somebody called ADP in Canada who makes the rules - see link below for more than I know about it from a casual search I did.

You can quickly scan through previous discussions by googling to see what sort of apneaboard content and forum discussions might be helpful. Here's an example I just did which produced a link I have included for you below:

google search term: site:apneaboard.com Canada

Some links and ideas I hope will be helpful...

* http://www.apneaboard.com/forums/Thread-...ine-Please

* do the above search and you might find other pertinent discussions (btw for single word or complex search terms I often find google searches more helpful than the board search function).

* you might PM some Canadian members who have made posts you want to follow up on, or you could make your own new post with some intriguing title that includes the word Canada or Canadian or some phrase that a Canadian couldn't resist clicking as a hook.

* take time to read this excellent article by Archangle to get yourself up to speed on CPAP machines to consider and ones to avoid. Brand names can be tricky, this is worth knowing when you decide on your permanent machine.

-- http://www.apneaboard.com/wiki/index.php...ne_Choices

In the meantime, if you can get your way by threatening to return the brick CPAP machine then more power to you.

Failing that, don't be discouraged. Start getting the benefits of your CPAP therapy now and work during the loaner period on nailing down the details and requirements for ADP and your sleep doctor to make the right determination for your permanent machine.

If you happen to come across some info that says you are entitled to a better loaner then take that to your sleep clinic and make demands at that point.

Otherwise just press on to figure out what you need and what your doctor and ADP need from you to make the right smart decisions for your long term therapy.

During the brick loaner period you won't have the detailed data to make your own informed changes, but you will have the benefit of the prescribed pressure from an informed sleep study that got you to here, right? So do what you can and expect to feel better.

Also realize that by the end of the loaner period you will have worked through the personal part of getting used to the equipment and the therapy, so you will have a stable routine that most people don't start with on which you can really depend on and utilize the data once it becomes available.

The log suggested by Sleeprider sounds like an excellent idea, too. This way you can talk to your sleep doc with subjective data about your progress during the loaner period. And if s/he ever says I wish we had more objective data you have a ready answer... we can have that data starting tonight if you will order me a data capable machine now.

good luck and keep your chin up. Believe that things are already getting better for you now that you have begun CPAP therapy.

Saldus Miegas

[ramblingasian]

Unfortunately most people that post on this forum, while well meaning, are very inaccurate about the ADP process in the province of Ontario. This is clearly evident through the linked thread above as well as the posts earlier in this thread.

A few things:

(1) There is an extremely small chance that anyone using the ADP process in Ontario can get an APAP machine. It's near impossible. You need a pressure difference of 4 with a base pressure of 10 - very difficult to fit within this mould. Even if the doctor prescribes it, the government will check for evidence to see if you actually require it or not.
(2) Almost all DME's in Ontario are very, very small. Hence them being limited in loaner machines. The OP is basically stuck until the full prescription is written or the OP goes and finds a larger DME where they won't mind providing a new loaner.
(3) In Ontario, you have the right to purchase another machine outright without ADP assistance. That is the only way for most people to be able to get an APAP. There is no other way.

[OpalRose]

ramblingasian,
What is the purpose of a loaner machine given out in Canada, especially one that gives no data?

How is the OP supposed to prove a pressure difference of 4 with a base pressure of 10 when you are given a machine to use that can't possibly give you this information?

Just trying to understand the system.

[zonk]

Unfortunately most people that post on this forum, while well meaning, are very inaccurate about the ADP process in the province of Ontario.

Assistive Devices Program http://www.health.gov.on.ca/en/public/pr.../cpap.aspx
How do I apply?
You will be referred to a registered ADP sleep clinic by your family physician where you will undergo diagnostic tests to determine the underlying cause of your disruptive sleep by a physician that specializes in sleep medicine. If you meet the ADP medical eligibility criteria and your sleep physician confirms that you have obstructive sleep apnea syndrome, an Application Respiratory Equipment and Supplies form will be completed. Your sleep physician and sleep clinic staff will decide what type of equipment you require

I think, we have more members from Ontario than anywhere else in Canada. I happen to know, in Ontario the law require doctors to report patients to the ministry of transport and if not mistaken, they get few dollars for their trouble

[pholynyk]

(1) There is an extremely small chance that anyone using the ADP process in Ontario can get an APAP machine. It's near impossible. You need a pressure difference of 4 with a base pressure of 10 - very difficult to fit within this mould. Even if the doctor prescribes it, the government will check for evidence to see if you actually require it or not.

Although my report did 'adequate response at 11 cm H2O' and 'snoring eliminated at 5 cm H2O'. It certainly didn't seem to surprise my doctor. And he didn't say there was anything unusual about prescribing an APAP machine. As for the ADP people checking, I got my machine the same day I picked up my prescription six months ago and haven't heard anything more.

BTW, the OP hasn't mentioned which province she is in, and they all have different policies on health matters. All this discussion of ADP policies may be moot for her.

[cate1898]

I am in Ontario so the comments about Ontario do unfortunately apply.

I've been mulling this over in my mind, trying to reason this out. So, after my sleep titration study at the sleep lab I await a call from the DME to pick up my loaner CPAP machine. I go for my appointment during which time I mention that if I do not qualify for an APAP (which I didn't) then the machine I will be looking to purchase when the time comes is a ResMed AirSense 10 Elite. Due to that information I am provided a ResMed machine as my loaner, but it's an S9 Escape dataless POC.

The next step in this process is to go back to see the sleep Doc in 8 weeks or so. WHY?? Is he just going to ask me how I feel and if I notice any improvements? I would have assumed that he would be looking at the data a CPAP machine could provide him with before my final consultation with him following which I purchase a machine of my own. THAT would make sense to me. But apparently he won't be looking at any data, cause my machine is incapable of anything but hours used. Completely useless.

So then bearing all this in mind, why do I wait 8 weeks (in my case 10 due to scheduling issue) to go back in to see him before he writes a prescription??? He will not have any further data with which to decide what to write on my prescription than he had following my overnight sleep titration lab test, with the exception of my subjective uneducated non-medical opinion of my treatment thus far. It seems that everyone borrowing a loaner machine should have either an Elite or Auto type that provides their sleep Doc with data before purchasing their own CPAP machine. After all, a person only qualifies to get another machine in 5 years time unless their diagnosis changes or they can afford to buy one with no financial assistance.

Maybe someone can shed some light on why things are done in Ontario in this manner cause I'm baffled by it the more I think about it.

Also, exactly what information do the fully data capable machines like the Resmed A10 Elite provide and how is the machine able to do this considering the user is not wired up to it in any way like in a lab test?

[Sleeprider]

If you're willing and financially able to work outside of the public health system, you can get whatever machine you want, very quickly, new or used. Otherwise, you'll deal with the delay and minimal equipment. As much as I have heard of people point to the Canadian health system as a model, I doubt I could live with its limits and delays over a matter of about $1000 USD.

Edit to add: http://www.apneaboard.com/forums/Thread-...0-machines

[cate1898]

As I took early retirement 2 years ago to get out of a stressful rotating shift-work job, it would certainly be beneficial for me to work within the confines of the Ontario healthcare system (aka ADP). They cover 75% of the machine which the Government only allows DME's to charge a maximum of $860 for non-auto machines. This ends up being $645 Cad and I pay the rest but will be reimbursed by my private health benefits insurance of up to $1000. My private insurance will not kick in until I have used the ADP allowance of $645, then they'll cover the balance up to a limit of $1,000 lifetime. Yes, that sucks too.

I agree our healthcare system it is not really an enviable one, but it's the only one we have. If I ever do consider buying a CPAP privately, I'll buy a lightly used but guaranteed APAP machine from a reliable source and hopefully get for under $500 Cad (approx $350 Usd currently).