The PAP Police, "THEY DO NOT EXIST!

[OMyMyOHellYes]

Ohhhhh, I am so sorry. I do not mean to yell. In fact my intention is not to yell. I do not use capitals as yelling. I have had a habbit for years of when I am attempting to imphasize something, I without knowing it always use all caps.

But we have HTML tags for that sort of thing.

[AlanE]

ooo the colors.

[DariaVader]

and bold, italics or simply *splats* if you're feeling lazy

[PsychoMike]

Gotta love the lack of knowledge of physicians and the medical mafia of the DME world. Realistically, the average physician gets what, a day (?) over the course of their degree to learn about the entire spectrum of sleep disordered breathing, treatment and such. They have no clue, but if they can make referrals they a) don't need to know about it and b) can still charge for services rendered. There's no motivation for them to learn more about it or do it themselves....as a result of not knowing it themselves, they generally don't trust the patient to figure it out.

The DME's are probably the single biggest source of the "illegal to change" lie. If you're not coming in, they're not making money. I was told by my DME that a) I couldn't make changes to my machine, b) that for warranty I had to go through them alone (not anyone else who deal with that brand of machine) and c) that an AHI of <5 was "good enough" (I'm an UARS patient...my RDI is ~9x what my AHI is...even at an AHI of 1, I'm still being sleep disrupted by "almost apnea" events 9x per hour).

Folks, I'll agree with the sentiments of many of the people posting on this board: This is about your health. Get educated and get proactive. The average doc doesn't have the time or knowledge to get you the best treatment possible (assuming that they are engaged enough to care and want to help) and the DME sees you as an income source. If you want to have the best chance of successfully treating your OSA or UARS, you need to play a significant role in your treatment. I am very fortunate...through education from places like this, looking at my information using programs like Sleepyhead and being willing to methodically go through and adjust my pressures based on my results, I have taken an AHI of 6 + RDI of 50 down to an AHI <0.1 and feel way, way better for it.

This is your health, folks....don't settle for "whatever."

[retired_guy]

Bilevel, could you please not use capitals when typing. After a day at work I come home to relax...and your posts read like someone is yelling at me. I understand you are excited to have found this board and are enthusiastic. May I suggest smilies, italics or bold instead?

My internal calm thanks you!

It's ok TR... I was awake. No harm, no fowl. (WHAT?, Another Duck joke?)

Gotta love the lack of knowledge of physicians and the medical mafia of the DME world. Realistically, the average physician gets what, a day (?) over the course of their degree to learn about the entire spectrum of sleep disordered breathing, treatment and such. They have no clue, but if they can make referrals they a) don't need to know about it and b) can still charge for services rendered. There's no motivation for them to learn more about it or do it themselves....as a result of not knowing it themselves, they generally don't trust the patient to figure it out.

The DME's are probably the single biggest source of the "illegal to change" lie. If you're not coming in, they're not making money. I was told by my DME that a) I couldn't make changes to my machine, b) that for warranty I had to go through them alone (not anyone else who deal with that brand of machine) and c) that an AHI of <5 was "good enough" (I'm an UARS patient...my RDI is ~9x what my AHI is...even at an AHI of 1, I'm still being sleep disrupted by "almost apnea" events 9x per hour).

Folks, I'll agree with the sentiments of many of the people posting on this board: This is about your health. Get educated and get proactive. The average doc doesn't have the time or knowledge to get you the best treatment possible (assuming that they are engaged enough to care and want to help) and the DME sees you as an income source. If you want to have the best chance of successfully treating your OSA or UARS, you need to play a significant role in your treatment. I am very fortunate...through education from places like this, looking at my information using programs like Sleepyhead and being willing to methodically go through and adjust my pressures based on my results, I have taken an AHI of 6 + RDI of 50 down to an AHI <0.1 and feel way, way better for it.

This is your health, folks....don't settle for "whatever."

Good B.O.T. Mike....

[novatom]

Thank you for raising this issue. I am currently in the 4th month of CPAP therapy and am confronting the dilemma of raising the pressure on my machine. Since starting Jan. 1, and despite two follow up visits with my doctor, my pressure remains at 6. I had my last visit in March. My average AHI is just over 5 and frankly I think that's too high, but my doctor seems to think it's fine (he didn't say that outright but the fact that my average AHI was just under 5 at my last visit seems to indicate that he thinks so). Since then, my average AHI has actually gone up a bit and I don't feel as I'm getting the full effect of the therapy. I don't understand why he doesn't want to raise my pressure. That is the biggest mystery to me.

My situation is compounded by my chronic insomnia, which despite seeing some improvement early in the therapy, has returned. I don't think raising the pressure will improve the length of my sleep, but dammitall, last night, after much soul searching, I watched the Youtube video, stared at my machine and ALMOST changed the pressure but I backed down.

I think my doctor is a decent man but I could see him cringe when I would mention that I was checking out forums online for more information on CPAP. He seems to dismiss a lot of it. I don't feel threatened but I know I should NOT be afraid of his reaction if he finds out I changed the pressure. I have my next follow up in June. Someone on another board suggested that I just try and raise it to 7, see what happens and, if I'm that intimidated by the reaction I get at my next visit in June, just put it back to 6 before the visit. Could he find out that I raised it anyways? If my average AHI goes down as a result, I won't change it back and won't say a thing. I hope that happens and if so, can't wait to see the look on his face when he finds out the pressure has been changed by me.

You're right. I am letting him and the DME intimidate me, but that's because I'm letting them do this to me. It shouldn't be difficult to make a decision.

[AlanE]

My doc seemed happy that I'm involved in my therapy. The DME isn't going to be happy when they discover they can't access my machine anymore.

I know they're going to need the data to prove compliance. They are a couple miles away so no big deal if I have to bring it to them. Guess I'll need to copy the data off the flashair and back onto the resmed SD card.

[eseedhouse]

I think my doctor is a decent man but I could see him cringe when I would mention that I was checking out forums online for more information on CPAP. He seems to dismiss a lot of it. I don't feel threatened but I know I should NOT be afraid of his reaction if he finds out I changed the pressure.

Well, you know what Red Green says - it's easier to ask for forgiveness than for permission.

[BiLevel48]

Ohhhhh, I am so sorry. I do not mean to yell. In fact my intention is not to yell. I do not use capitals as yelling. I have had a habbit for years of when I am attempting to imphasize something, I without knowing it always use all caps.

But we have HTML tags for that sort of thing.

OH you do? HTML? You know what? I know the Internet pretty well, but what is an HTML tag, and how would I use it? You know, I know it sounds strange, but I have the Titration Protocols down pat for CPAP, BiLevel, ASV, BiLevel S/T, and AVAPS, and I could tell you a lot about PSG, and other medical terminology like the Management of Necrotizing Enterocolitis, as well as the propper use of HFOV, and ECMO, but I really don't know a thing about HTML tags. I don't even know what it stands for and yet I know Multiple Sleep latency test is what MSLT is short for, and I could tell you that the procedure where they have the patient perform certain tasks to verify propper sensor Callibration Prior to, and After the PSG is known as the BIO-CAL. I could not tell you one thing about HTML, but I wonder if it is the emotion options you have on here like Smiley, Frown, etc.

[DariaVader]

Hyper Text Markup Language. But you don't have to use HTML, just go to Preview Post and use the rich text tools provided. when you quote something you like, you will also see the code used to create the look. On the forum, tags are inside braces [] a b inside braces makes everything after it bold to stop bolding do a /b in the braces.