VAuto Journey

[SarcasticDave94]

It doesn't get much nastier looking than that. I vote ASV before OSCAR runs out of purple ink.

[lbl82]

I haven't had a sleep study since 2014.  I know I will need to get another one done.  I know I will also have to get my heart examined as well I believe.  Will I need to get a split level ASV sleep study to get one?

[sheepless]

looks like you're doing okay with very high trigger. if you feel okay and your ahi stays under 5, maybe stay the course or find a used asv. it's possible but difficult to get asv through the 'system'. I gambled on asv without a doctor because I don't have any heart issues that I know of. even though the heart test they want us to do before prescribing asv is based on a likely faulty study, it might be a good idea just to be sure.

[lbl82]

looks like you're doing okay with very high trigger.  if you feel okay and your ahi stays under 5, maybe stay the course or find a used asv. it's possible but difficult to get asv through the 'system'.  I gambled on asv without a doctor because I don't have any heart issues that I know of.  even though the heart test they want us to do before prescribing asv is based on a likely faulty study, it might be a good idea just to be sure.

What do you mean by system? Like the insurance process? Will I have to get a split study with ASV to get prescribed one? I didn’t go through insurance to get the VAuto.

[Sleeprider]

Consider very high trigger as an interim mitigation. You need ASV. We could get you that therapy for $500 out of pocket, or you can take your chances with exams, tests, studies and eventually a solution. If you have GREAT insurance, go through the system. If it is anything less, we can set you up for less and faster. You have a choice. http://www.apneaboard.com/wiki/index.php...P_Machines

The "system, is the medical mafia that consists of insurance companies, suppliers and doctors that conspire to transfer the maximum cost of therapy back onto the patient, while keeping you dependent on their services and "coverage". You can actually demonstrate the need for ASV and efficacy by buying out of pocket and short-circuiting their B.S.

[sheepless]

"What do you mean by system? Like the insurance process?"

yes, from doctors for getting a prescription to insurance approval for the expense.

"Will I have to get a split study with ASV to get prescribed one?"

I don't know the answer to that. I suspect it varies from doctor to doctor, sleep clinic to sleep clinic. call your doc and your insurance provider. if you're self paying, you can buy used from a private party without doctors and insurers. if you have a cooperative doctor, s/he may be willing to give you a prescription without a study if they're willing to review your history and machine data with you.

[lbl82]

Consider very high trigger as an interim mitigation. You need ASV.  We could get you that therapy for $500 out of pocket, or you can take your chances with exams, tests, studies and eventually a solution.  If you have GREAT insurance, go through the system. If it is anything less, we can set you up for less and faster.  You have a choice. http://www.apneaboard.com/wiki/index.php...P_Machines  

The "system, is the medical mafia that consists of insurance companies, suppliers and doctors that conspire to transfer the maximum cost of therapy back onto the patient, while keeping you dependent on their services and "coverage".  You can actually demonstrate the need for ASV and efficacy by buying out of pocket and short-circuiting their B.S.

I don't plan on going through insurance to get the ASV.  I didn't use insurance to get the VAuto.  How could I get an ASV w/o a prescription?  Wouldn't I need a heart exam first? Who would setup the device for me if I didn't get a prescription from my Doctor?

[SarcasticDave94]

Unless I'm mistaken, some of the suppliers can furnish the script to buy the ASV, though it may be an added price service.

Maybe your doc would write one after you state I'm buying an ASV doc, write me the script.

I'd steer you to get a ResMed AirCurve 10 ASV, lightly used if you can find it. You get it and with us and OSCAR you set it up yourself. I did mine as doc and DME/RT had ZERO clue what to prescribe for settings. And the RT told me she had to guess on the settings anyway. Real professional experts there.

PS the heart issue? Do you have Congestive Heart Failure? You would not have to think on the answer if it's yes. You'd KNOW.

[Sleeprider]

Consider very high trigger as an interim mitigation. You need ASV.  We could get you that therapy for $500 out of pocket, or you can take your chances with exams, tests, studies and eventually a solution.  If you have GREAT insurance, go through the system. If it is anything less, we can set you up for less and faster.  You have a choice. http://www.apneaboard.com/wiki/index.php...P_Machines  

The "system, is the medical mafia that consists of insurance companies, suppliers and doctors that conspire to transfer the maximum cost of therapy back onto the patient, while keeping you dependent on their services and "coverage".  You can actually demonstrate the need for ASV and efficacy by buying out of pocket and short-circuiting their B.S.

I don't plan on going through insurance to get the ASV.  I didn't use insurance to get the VAuto.  How could I get an ASV w/o a prescription?  Wouldn't I need a heart exam first? Who would setup the device for me if I didn't get a prescription from my Doctor?

Depending on your budget, I'm going to suggest Supplier #2 at about $1390 with low hours, great customer service and a warranty; or DotMed (go to Respiratory category and Bilevel PAP then search for Resmed). The Resmed S9 VPAP Adapt #36007 has nearly the same algorithms as the Aircurve 10 ASV and can be had for $340 with 9650 hours, $500 for 340 hour or zero hours at $700.  These are really good prices for a very good machine that will demonstrate efficacy and work for many years. 

As far as setup, there are only 3 settings, Mode (ASVauto), EPAP min, PS min and PS Max.  We would start you at EPAP min 6.0, PS min 3.0, PS max 15.0.  The machine does every thing necessary to stop both obstructive and central apnea.  You don't need a doctor, and if you're worried about left ventricular ejections fraction with your good health, well, I'd like to think you would know if you are in severe heart failure.  Most people can't walk short distances without being winded and fatigued.  The SERVE-HF is about to be replaced with the ADVENT-HF study, and it confirms that the risks identified for ASV in CHF patients with LVEF less than 45% is not repeatable. https://www.mdedge.com/chestphysician/ar...-no-safety

[lbl82]

Consider very high trigger as an interim mitigation. You need ASV.  We could get you that therapy for $500 out of pocket, or you can take your chances with exams, tests, studies and eventually a solution.  If you have GREAT insurance, go through the system. If it is anything less, we can set you up for less and faster.  You have a choice. http://www.apneaboard.com/wiki/index.php...P_Machines  

The "system, is the medical mafia that consists of insurance companies, suppliers and doctors that conspire to transfer the maximum cost of therapy back onto the patient, while keeping you dependent on their services and "coverage".  You can actually demonstrate the need for ASV and efficacy by buying out of pocket and short-circuiting their B.S.

I don't plan on going through insurance to get the ASV.  I didn't use insurance to get the VAuto.  How could I get an ASV w/o a prescription?  Wouldn't I need a heart exam first? Who would setup the device for me if I didn't get a prescription from my Doctor?

Depending on your budget, I'm going to suggest Supplier #2 at about $1390 with low hours, great customer service and a warranty; or DotMed (go to Respiratory category and Bilevel PAP then search for Resmed). The Resmed S9 VPAP Adapt #36007 has nearly the same algorithms as the Aircurve 10 ASV and can be had for $340 with 9650 hours, $500 for 340 hour or zero hours at $700.  These are really good prices for a very good machine that will demonstrate efficacy and work for many years. 

As far as setup, there are only 3 settings, Mode (ASVauto), EPAP min, PS min and PS Max.  We would start you at EPAP min 6.0, PS min 3.0, PS max 15.0.  The machine does every thing necessary to stop both obstructive and central apnea.  You don't need a doctor, and if you're worried about left ventricular ejections fraction with your good health, well, I'd like to think you would know if you are in severe heart failure.  Most people can't walk short distances without being winded and fatigued.  The SERVE-HF is about to be replaced with the ADVENT-HF study, and it confirms that the risks identified for ASV in CHF patients with LVEF less than 45% is not repeatable. https://www.mdedge.com/chestphysician/ar...-no-safety

Do I have to have a prescription to get the ASV from Supplier #2?