humidifier dry...keep using?

[Sleeprider]

Things like humidifier settings, tube temperature, Flex or EPR are all considered comfort settings. I'm not aware of these settings being specified in prescriptions. They are normally accessible to the patient to make CPAP easier to use. As far as a replacement machine, I totally endorse the Resmed Airsense 10 Autoset as the best choice. I would not allow anything less for family or friends.

[Gideon]

No issue with changing DMEs

There is a difference between the DME changing settings and you doing it.  If the DME changes them they could be considered liable for changing to other than the doctors prescribed settings.  Thus they CANNOT change prescription settings.

A list of machines http://www.apneaboard.com/wiki/index.php...AP_-_BIPAP

CPAP choice to treat OSA, CA, obstructive or pulmonary restriction[edit]
The Auto CPAP such as the AirSense 10 AutoSet is typically the initial machine of choice for treatment of obstructive apnea and hypopnea
Just to clarify The VAUTO, ASV and the ST are all BiLevel machines for treating three different conditions, they are NOT interchangeable. They are not a choice between the three to treat a single condition.
They should be chosen to treat the specific condition that the user has,

• To treat obstructive apnea and minor hypopnea and for most initial treatments a standard Auto CPAP such as AirSense AutoSet (or for her) is appropriate.
  
  
• To treat obstructive apnea and hypopnea, and a standard Auto CPAP is insufficient the treatment of choice is the Aircurve 10 Vauto (has higher pressure and greater Pressure Support (PS) (similar to EPR) available
  
  
• To treat central apnea, the only appropriate therapy would be the Aircurve 10 ASV
  
  
• To treat obstructive or pulmonary restriction including hypoventilation, would be the Aircurve 10 ST
  

(best choice) indicates a full data capable machine that has Sleepyhead software capability and an Auto Mode.  These are in general the best available machines

Always specify the exact machine you wish, This removes all ambiguities and prevents substitutions.
DAW (Dispense as Written) prevents substitutions.
General Information on DreamStation Models from Philips Respironics
Current acceptable in Production Machines (ResMed and Philips Respironics, the 2 most popular manufactures)

• ResMed AirSense 10 AutoSet (best choice) (E0601) (Fixed CPAP, Auto CPAP)
  
  
• ResMed AirSense 10 AutoSet for Her (best choice) (E0601) (Fixed CPAP, Auto CPAP)
  
  
• ResMed AirSense™ 10 Elite CPAP Machine with HumidAir™ Heated Humidifier (37205) (E0601) (Fixed CPAP)
  
  
• ResMed AirCurve 10, all models
  
  
• ResMed AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier (37211) (E0601, E0562) (best choice) (Fixed CPAP, BiLevel S, VAuto (Auto-BiLevel))
  
  
• ResMed AirCurve™ 10 ASV BiLevel Machine w/HumidAir™ Humidifier (E0471) (best choice) (Fixed CPAP, ASV, ASV Auto)
  
  
• Philips Respironics DreamStation Auto CPAP Machine (DSX500x11) (Not all DreamStation Models, Check SN on bottom, bricks look the same) (Fixed CPAP, Auto CPAP) (best choice)
  
  
• Philips Respironics DreamStation CPAP Pro (DSX400x11) (Not all DreamStation Models, Check SN on bottom) (Fixed CPAP)
  
  
• Philips Respironics DreamStation BiPAP Pro (DSX600x11) (Not all DreamStation Models, Check SN on bottom) (Fixed CPAP, Fixed BiPAP)
  
  
• Philips Respironics DreamStation BiPAP Auto Machine (DSX700x11) (Not all DreamStation Models, Check SN on bottom) (Fixed CPAP, Fixed BiPAP, Auto BiPAP) (best choice)
  

Current Machines to Avoid

• Any ResMed AirStart (Lack of full data capability)
  
  
• ResMed AirStart™ 10 CPAP Machine with HumidAir™ Heated Humidifier (all models, 37201) (Lack of full data capability)
  
  
• ResMed AirSense™ 10 CPAP Machine with HumidAir™ (37015, 37203) (Lack of full data capability)
  
  
• Philips Respironics DreamStation CPAP (DSX200x11) (Not all DreamStation Models, Check SN on bottom) (Lack of full data capability)
  

Note: These are current machines, there are older models that have full data capability that are available via secondary markets if budget is an issue. Please inquire on the forum and your questions will be answered.


Difference in Full Data Capability[edit]
We get a lot of questions about the difference so below are examples of a fully data capable machine vs a "Brick" or non-data-capable machine.
These examples are from an Auto Machine

• 
  Basic Full Data Chart
   
  
  
• 
  Breath by Breath Detail
  

A non full data Capable machine looks like

• 
  a Brick
  

The detailed data is simply just not there.

[lynneat]

You guys are the greatest!  They hardly told me anything at all!  I'll go to the next DME with some knowledge!  This one won't answer but ONE question, tell me I have to come IN if more than that.  I needed a piece replaced and Medicare even got on the phone WITH them and I heard them say it was covered.  This is Medicare's rental period.  But they sent me a letter and said I'd have to sign it before replacing the tiny clip ...said I'd have to pay for the WHOLE mask and said I'd have to sign saying I'd pay for it if Medicare didn't.  NO WAY!  They are on the other side or upper side of a sub-city and it's a 50 mile round trip.  I cannot take her in each time I have a question (or more than one).  I wrote to them....ok now I'm just venting because I'm upset.  But this is what I wrote anyway if you need reading material : You don't have to read it....but I need to write it! :  for all the information. 

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I don't understand why I have to come in if I have more than one question.  I have a few.  I cannot make it to northern Westerville with her often enough to get my questions answered.  Friday 12/29 is the only time I can bring her.  If you can take time for an appointment, why can't we do this on the phone?  Here are my questions. 
I have a few problems with her cpap. 
The heated hose near a connection has relaxed so it looks stretched out.
It says: Warning: If you are using a full face mask (a mask covering both your mouth and your nose), the mask must be equipped with a safety (entrainment) valve.  *** where is hers?  I don’t see this item on her machine.  
I want the cpap to STOP when she takes off the mask because she forgets sometimes to hit stop to stop the cpap from running, the reservoir is running dry and your people said this is not good.  You can’t run it dry. 
The DreamStation "CPAP" base model does not collect efficacy or breath by breath flow rate data, and for this reason is called a "brick". The Pro and Auto models have good data collection. So why does she have a brick cpap?  Everyone I’ve spoken to prefers the AUTO machines. Why doesn’t she have this type of machine?  
I’ve been told we should be able to see blow hours.  I can’t find it.
She doesn’t have PREHEAT as a setting that I can find.   There are no settings for this.
Philips Respironics Deamstation Review / Tutorial Part 3 of 3
https://www.youtube.com/watch?v=0BhrJPDq_5s
This shows it being done.  But Darla doesn’t have settings for this. 
There are too many straps and Velcro pieces.  This causes a lot of trouble.  Can I sew the straps together that go over the crown of the head? Or do you have another type? When she gets up in the middle of the night, she can’t get the mask back on by herself.  If a Velcro comes loose, she cannot attach it again. She is sedated at night making this a problem even more so.  When I first came to you, none of the questions I now have were talked about; I didn't know better.  I can't get answers I need.
Because I cannot get support on the phone, I believe I must change DMEs closer to home and to one that answers questions on the phone.  I'm also disabled and  traveling over 50 miles round trip is a problem. 
Because there are so many clips and we have the Velcro problem (see above) we thought we'd lost it. (we found it after I called you).  You (someone there) were on the phone with me and Medicare (who told you this was covered under Medicare) but you still sent a letter saying if Medicare didn't pay that I would have to pay for a whole new mask as I couldn't get the clip.  The whole mask is costly and I won't pay for what Medicare told me it would pay for.  I've never been asked to sign a paper like this from anyone before.  This is upsetting.

[Fats Drywaller]

Yes, DMEs can be a big pain to deal with. To preserve your sanity, it's best to try not to let it bother you, but just to switch to a different company as quickly as you can, and see if you can shrug off the hassles. If you find another DME that is good and helpful rather than being a big pain, then you're lucky and you should stay with that one.

Some of the folks here on AB have been lucky to find good DMEs. I suspect that they're in a minority in that regard. At the other end of the spectrum, in an even smaller minority, a few of us who have a low threshold for annoyance have stopped using local (brick & mortar) DMEs entirely and buy everything online instead, but that's obviously not practical when you're relying on insurance to cover it, because the machines & masks are expensive. The best you can do is to get some more local DME names & addresses from your insurer's call-center reps, keep that list, try one and see if it's any good, and if not, go on to the next. In each case there will be bureaucratic hassles and paperwork and phone calls and e-mail messages, and if you've started to use a machine the DME gave you, you'll need to return it when you switch. The important thing is to persevere and keep your cool; just explain to the insurer's rep that the DME you've just tried is a complete turkey and you want a different one. It's your choice, and the insurer has to go along with it, and the DME company is merely a subcontractor of the insurer so it has no choice in the matter.

It's analogous to deciding that the hardware store you've been shopping at has very bad customer service and high prices and ignorant, rude employees who try to swindle you. Why put up with that? In that situation, you would simply go to a different store and ignore the first one from then on. (You might also post a bad review of the first one somewhere, which can be both fun for you and helpful to some other potential customers, or patients in the case of a DME, who will then know to avoid that company.)

Theoretically, the DME's "RT" employee, respiratory therapist, is or was (a long time ago) supposed to be a junior member of the patient's medical team, carrying out the doctor's orders (mainly from the prescription) and helping the patient. But that somehow, somewhere fell by the wayside, and now DMEs/RTs in most cases are merely supply sergeants who seem to think that they ought to be as obstructive as possible (just because they can), telling the patients things like "No, we don't have that" and "No, we can't get that for you" and "No, you can't do that" and "It doesn't work that way" and "I dunno" and "Stop bothering me" and "Go away; we've got the payments from your insurer, and that's all we care about" and so on.

The good news is that you can learn pretty much everything you need here on AB. That, too, is time-consuming, but at least it's not as much of a hassle as trying to deal with defective DME personnel who should be helpful but are actually the opposite.

[Hydrangea]

You're doing a good job, mama.