Patient Empowerment Wrote:It appears that I missed a wonderful opportunity to be Sleepers wingman and puncture the pretense of one who wishes to serve as a disciple of doctorial demagoguery.

This individual may in fact be a dedicated medical professional but as is evidenced by this thread as it progressed they were filled with much more passion than intellect. Taking Sleeper to task for what they chose to see and not look at what was actually being advocated, then making commentary on what was their inaccurate interpretation of the facts. Watching Chip's back peddling was indeed an enlightening experience.....for Chip mostly.

This is a great example of why you, the patient, must be an integral part of you own health care and not surrender your power to those that are assumed to know better because of their so called "station in life".

Its your health care these people work for you, ultimately the decisions are yours, regardless of who makes the final call.


Best, P.E.

RespiratoryChip Wrote: Back peddling? I would consider it being professional and apologetic. I did not mean to sound condescending toward anyone, obviously by the way all 4 of you posted, it was how it was taken. I do have passion as well and I am very offended by the insinuation that my intellect is not matching. I have been a Respiratory Therapist for 17 years now with about 2 years experience in Western Maryland Health System Sleep Disorders Center where I performed over 100 overnight polysomnographies. My state license number in Maryland is L0001759, in West Virginia LRTC00986. I currently work in the home care setting where I set up about 5-10 CPAP/RAD per month. My employer now is PharmaCare Network. You can look up this information if you all feel like I am lying.

I have never seen a group of people more intent in not trusting people who just want to help. If you all have issues with the way professionals are treating you in your area I suggest you find somewhere else to handle your CPAP needs. I would never treat my clients the way some of you have mentioned. I take much offense to those who would try to impugn my honor and dedication to my craft. By the way, Rogue, that is great you can save money on brake repair, I just won't be bringing my car to you unless you are licensed. Look, the only point I care to get across here is that it is important to have individuals with experience and training when you are dealing with medical devices. My point has been made and as for those who chose to make light of my ability to ascertain my own vocation, I hope it made your lives’ richer. I for one sleep very well at night and I am hoping you all do as well. Have a great day.

Quote:

RespiratoryChip,(time=1265038104) Wrote: Back peddling? I would consider it being professional and apologetic. I did not mean to sound condescending toward anyone, obviously by the way all 4 of you posted, it was how it was taken. I do have passion as well and I am very offended by the insinuation that my intellect is not matching. I have been a Respiratory Therapist for 17 years now with about 2 years experience in Western Maryland Health System Sleep Disorders Center where I performed over 100 overnight polysomnographies. My state license number in Maryland is L0001759, in West Virginia LRTC00986. I currently work in the home care setting where I set up about 5-10 CPAP/RAD per month. My employer now is PharmaCare Network. You can look up this information if you all feel like I am lying. I have never seen a group of people more intent in not trusting people who just want to help. If you all have issues with the way professionals are treating you in your area I suggest you find somewhere else to handle your CPAP needs. I would never treat my clients the way some of you have mentioned. I take much offense to those who would try to impugn my honor and dedication to my craft. By the way, Rogue, that is great you can save money on brake repair, I just won't be bringing my car to you unless you are licensed. Look, the only point I care to get across here is that it is important to have individuals with experience and training when you are dealing with medical devices. My point has been made and as for those who chose to make light of my ability to ascertain my own vocation, I hope it made your lives’ richer. I for one sleep very well at night and I am hoping you all do as well. Have a great day.

Quote: Back peddling? I would consider it being professional and apologetic.

Your initial post was very omniscient in its tone and tenor. I have run into more than my share of medical professionals that missed the correct side of the bell curve, however using the term "collectively ignorant" in the context you chose was not only poor, but unprofessional in any venue.

After being called out by Sleeper, and realizing the obvious, you became much less ethereal.

In this regard you alone are responsible for puncturing professional pretense.

I agree that you did find higher rational ground as the thread progressed, of which much I concur.

The approach you chose in your original post and the subsequent foray in preaching to the plebs while being clueless in certain regards, then rolling into mea culpa, is indicative of back peddling.

Quote:I did not mean to sound condescending toward anyone, obviously by the way all 4 of you posted, it was how it was taken.

So it was the four of us and not you?????

Quote: I do have passion as well and I am very offended by the insinuation that my intellect is not matching.

For better of worse, I can only judge you by what is clearly evidenced in this forum. Your post(s) speak for themselves. In my opinion the results are mixed.

Quote: I have been a Respiratory Therapist for 17 years now with about 2 years experience in Western Maryland Health System Sleep Disorders Center where I performed over 100 overnight polysomnographies. My state license number in Maryland is L0001759, in West Virginia LRTC00986. I currently work in the home care setting where I set up about 5-10 CPAP/RAD per month. My employer now is PharmaCare Network.

The louder he talked of his honor, the faster we counted our spoons.
--Ralph Waldo Emerson


Nice resume' but that is a parochial indicator of ones efficacy. Its an individuals performance that provides a true gauge of ones mettle.

Again I can only judge you by what you demonstrate in this arena.

Quote: You can look up this information if you all feel like I am lying.

Not me, I realize that anyone can represent themselves inappropriately behind a web connection. I think you have made the reality cut. Its possible you could be a gifted minor child or a composite of persons behind a keyboard but I don't think its likely. On this I believe a pass is prudent.

Quote:I have never seen a group of people more intent in not trusting people who just want to help.

Its us again???

Try this on, I have found that this forum is primarily about "people who just want to help". Remember us the "collectively ignorant"???

Its not just you Chip!!!

Quote:If you all have issues with the way professionals are treating you in your area I suggest you find somewhere else to handle your CPAP needs.

Speaking on behalf of one segment of "you all", I hand picked my own physician (without regard to network norms) and am doing well thanks.

Quote:I would never treat my clients the way some of you have mentioned.

Good, just watch the adjectives.

Quote: I take much offense to those who would try to impugn my honor and dedication to my craft.

Consider yourself, partially, self impugned.

As for me I stand behind this statement in my 11/24/2009 post: "This individual may in fact be a dedicated medical professional".

Quote:By the way, Rogue, that is great you can save money on brake repair, I just won't be bringing my car to you unless you are licensed.

Dr. Richard J. Schmidt had a license to practice medicine but apparently some would have been better off being treated by Mr. Good Wrench.

I appreciate your respect for formal training but it tends to run to the extreme. As for Rogue he will have to speak for himself.

Quote:Look, the only point I care to get across here is that it is important to have individuals with experience and training when you are dealing with medical devices.

Fine, point taken, and with some exception agreed.

Patient Empowerment Wrote:My point has been made and as for those who chose to make light of my ability to ascertain my own vocation, I hope it made your lives’ richer.

Your point has indeed been taken, some of your position(s) in a rational form have merit. Other points reside elsewhere for which we have taken note as well ( and yes Chip that is just us again ).

Quote:I for one sleep very well at night and I am hoping you all do as well. Have a great day.

Thank you.

I wish you all the best in your personal/professional pursuits and an extraordinary healthful life.


Best, P.E.

RespiratoryChip Wrote: Honesty is the cruelest game of all, because not only can you hurt someone - and hurt them to the bone - you can feel self-righteous about it at the same time. ~ Dave Van Ronk


:$ I will only apologize once more for coming through as arrogant. I don’t know the rules of writing as well as you and it is evident in your response you are well learned in grammar and English. My point is being lost in the fact I cannot formulate my thoughts into properly constructed sentences. I am not an English major.

I am sure we agree that ultimately the decision is the patient's as to what treatment they do or do not receive, however it is remiss to just lump all patients in together as being informed. My statement of the collectively ignorant just sounded harsh. The word ignorant is often misinterpreted to mean the same as rude but the definition is completely opposite. Ignorance is the state of being unaware or uninformed. After reading through all the threads I discovered I had jumped the gun a bit. For that I have made an apology and have had direct contact through private e-mail with the administrator of this site. Having made my apology I wish to reiterate I still have convictions concerning this particular issue. I personally deal with patients on a daily basis and some are capable of handling their own therapy. To them I say very well but the others who seem to need continued training or are constantly having issues with the equipment, I would say they should not be trying to make adjustments alone. I do apologize for seemingly being rude but I am passionate. In my years as a therapist I have witness several hundreds of deaths first hand and I don’t take it lightly when others question my motives.

^o) You made mention of Dr. Richard Schmidt. I personally would not send my dog to him. In this area there are two main physicians who are Board Certified in Sleep Medicine, the aforementioned, Dr. Schmidt and Dr. Mark Sagin. Dr. Sagin was the physician who brought the sleep center to our area and was the first area physician certified in sleep medicine so I always recommend patients to his care and not the other physician. This vindicates your point that not everyone with a license is reputable but further validates my point that an informed patient is one who is willing to ask questions of health professionals in order to get the most out of his/her treatment, not going it alone.

:X I know very well who I am and I am very comfortable with my own limitations. My wife set up my first e-mail account 15 years ago when we got married. chipthejackass@yahoo.com. It was not to be cute, it is simply that I am a jackass and often when I discuss matters close to my heart I become withdrawn and opinionated. Just know that I get nothing out of posting that I believe therapists, doctors and patients should all be involved, just a little peace of mind knowing that I am putting out there a statement, no matter how ill conceived or written, in which I believe. I also am proud of the fact that not matter what, I am who I am. I don’t need a thesaurus to help make me sound smart. I was never very good at English so I am not about to start trying to trade blows with someone who obviously has me outmatched. :o

B) I will leave you with these two thoughts. Rogue still ain’t fixin’ my brakes and I hope and pray for all of the people here and in the world with OSA to be treated correctly and with dignity. I also pray for your well being and fruitfulness in all your endeavors. God Bless

Matthew “Chip” Emerick CRT, RCP

By the way, Emerson is one of my favorite poets. Nice quote.
(feel free to lampoon me for my Appalachian use of ain't and fixin')

Patient Empowerment Wrote:

RespiratoryChip,(time=1265227562) Wrote: Honesty is the cruelest game of all, because not only can you hurt someone - and hurt them to the bone - you can feel self-righteous about it at the same time. ~ Dave Van Ronk


:$ I will only apologize once more for coming through as arrogant. I don’t know the rules of writing as well as you and it is evident in your response you are well learned in grammar and English. My point is being lost in the fact I cannot formulate my thoughts into properly constructed sentences. I am not an English major.

I am sure we agree that ultimately the decision is the patient's as to what treatment they do or do not receive, however it is remiss to just lump all patients in together as being informed. My statement of the collectively ignorant just sounded harsh. The word ignorant is often misinterpreted to mean the same as rude but the definition is completely opposite. Ignorance is the state of being unaware or uninformed. After reading through all the threads I discovered I had jumped the gun a bit. For that I have made an apology and have had direct contact through private e-mail with the administrator of this site. Having made my apology I wish to reiterate I still have convictions concerning this particular issue. I personally deal with patients on a daily basis and some are capable of handling their own therapy. To them I say very well but the others who seem to need continued training or are constantly having issues with the equipment, I would say they should not be trying to make adjustments alone. I do apologize for seemingly being rude but I am passionate. In my years as a therapist I have witness several hundreds of deaths first hand and I don’t take it lightly when others question my motives.

^o) You made mention of Dr. Richard Schmidt. I personally would not send my dog to him. In this area there are two main physicians who are Board Certified in Sleep Medicine, the aforementioned, Dr. Schmidt and Dr. Mark Sagin. Dr. Sagin was the physician who brought the sleep center to our area and was the first area physician certified in sleep medicine so I always recommend patients to his care and not the other physician. This vindicates your point that not everyone with a license is reputable but further validates my point that an informed patient is one who is willing to ask questions of health professionals in order to get the most out of his/her treatment, not going it alone.

:X I know very well who I am and I am very comfortable with my own limitations. My wife set up my first e-mail account 15 years ago when we got married. chipthejackass@yahoo.com. It was not to be cute, it is simply that I am a jackass and often when I discuss matters close to my heart I become withdrawn and opinionated. Just know that I get nothing out of posting that I believe therapists, doctors and patients should all be involved, just a little peace of mind knowing that I am putting out there a statement, no matter how ill conceived or written, in which I believe. I also am proud of the fact that not matter what, I am who I am. I don’t need a thesaurus to help make me sound smart. I was never very good at English so I am not about to start trying to trade blows with someone who obviously has me outmatched. :o

B) I will leave you with these two thoughts. Rogue still ain’t fixin’ my brakes and I hope and pray for all of the people here and in the world with OSA to be treated correctly and with dignity. I also pray for your well being and fruitfulness in all your endeavors. God Bless

Matthew “Chip” Emerick CRT, RCP

By the way, Emerson is one of my favorite poets. Nice quote.
(feel free to lampoon me for my Appalachian use of ain't and fixin')

Quote: Honesty is the cruelest game of all, because not only can you hurt someone - and hurt them to the bone - you can feel self-righteous about it at the same time. ~ Dave Van Ronk

Touche'

Quote: :$ I will only apologize once more for coming through as arrogant.

No need I caught it the first time but thanks!!

Quote:I don’t know the rules of writing as well as you and it is evident in your response you are well learned in grammar and English. My point is being lost in the fact I cannot formulate my thoughts into properly constructed sentences. I am not an English major.

Me either

Quote: I am sure we agree that ultimately the decision is the patient's as to what treatment they do or do not receive,

and how, from whom. Sometimes that translates into territories unfamiliar to some and may not be considered medically acceptable to some or most. The autonomy of the patient is, in my estimation, the most important characteristic in medicine.

Quote:however it is remiss to just lump all patients in together as being informed.

Agreed.

Quote: My statement of the collectively ignorant just sounded harsh.

For me it wasn't the sound, it was the underlying connotation.

Quote: The word ignorant is often misinterpreted to mean the same as rude but the definition is completely opposite. Ignorance is the state of being unaware or uninformed.

For not being an English major you hit the mark!!

Quote:After reading through all the threads I discovered I had jumped the gun a bit.

I would say you vaulted over the entire shooting range but opinions vary.

Vault:
1. to leap or spring, as to or from a position or over something. (Just in case )

Quote: For that I have made an apology and have had direct contact through private e-mail with the administrator of this site. Having made my apology I wish to reiterate I still have convictions concerning this particular issue.

Of which you are entitled.

Quote: I personally deal with patients on a daily basis and some are capable of handling their own therapy.

Possibly like some on this board??

Some that can deal with a few of the more lateral issues that don't require a high level of training???

Quote:To them I say very well but the others who seem to need continued training or are constantly having issues with the equipment, I would say they should not be trying to make adjustments alone.

Agreed. There are some people and circumstances that require the assistance of learned trained personnel.

Quote: I do apologize for seemingly being rude but I am passionate.

Let there be no doubt you are a passion player.

Quote: In my years as a therapist I have witness several hundreds of deaths first hand and I don’t take it lightly when others question my motives.

As a passion player I didn't peg you as a wallflower.

Quote: ^o) You made mention of Dr. Richard Schmidt. I personally would not send my dog to him. In this area there are two main physicians who are Board Certified in Sleep Medicine, the aforementioned, Dr. Schmidt and Dr. Mark Sagin. Dr. Sagin was the physician who brought the sleep center to our area and was the first area physician certified in sleep medicine so I always recommend patients to his care and not the other physician. This vindicates your point that not everyone with a license is reputable but further validates my point that an informed patient is one who is willing to ask questions of health professionals in order to get the most out of his/her treatment, not going it alone.

Agreed.

Adding this caveat "a Qualified medical professional(s)" which goes beyond simple licensure. True measurement of ones mettle in any avocation goes way beyond formal training.



BTW, Caveat:- Noun- A qualification or explanation.

Quote: :X I know very well who I am and I am very comfortable with my own limitations. My wife set up my first e-mail account 15 years ago when we got married. chipthejackass@yahoo.com.

YIKES!!!

I hope the honeymoon and subsequent marital cohabitation took and entirely different tack.

That "I do" stuff can get sticky.

Quote: It was not to be cute, it is simply that I am a jackass and often when I discuss matters close to my heart I become withdrawn and opinionated.

A bit of a maverick eh?? Well sometimes you have to take your licks for it, take it from one who knows. But apparently you should fit right in here, we kind of walk our own trail here.

Sometimes its a matter of cooling your passions, refining your approach and becoming a finesse' player. I think this thread can serve as a example as to how that can be more effective that being totally emotive.

Quote: Just know that I get nothing out of posting that I believe therapists, doctors and patients should all be involved, just a little peace of mind knowing that I am putting out there a statement, no matter how ill conceived or written, in which I believe

.

In optimal conditions I agree, and again you are entitled.

Quote:I also am proud of the fact that not matter what, I am who I am. I don’t need a thesaurus to help make me sound smart. I was never very good at English so I am not about to start trying to trade blows with someone who obviously has me outmatched. :o

Very well. However, being a high level communicator helps in all aspects of life. I'm not saying you have to be a Yale grade linguist but learning how to use and control your passion in concert with a healthy vocabulary can pile up the mileage.

Quote: B) I will leave you with these two thoughts. Rogue still ain’t fixin’ my brakes and I hope and pray for all of the people here and in the world with OSA to be treated correctly and with dignity. I also pray for your well being and fruitfulness in all your endeavors. God Bless

Well I have a licenced auto repair facility down the road from me and I think the owners nickname is Monkey Wrench. It has been well earned, I think given the two options Rogue would have my confidence.

As for the latter two references let me join you in wishing the greater good to all with OSA, in addition wish you much good personal health and happiness. BTW, Shut down that email address and keep a sharp eye on the Mrs.

Best, P.E.

P.S.

Quote:By the way, Emerson is one of my favorite poets. Nice quote.

Thanks!!

Quote:(feel free to lampoon me for my Appalachian use of ain't and fixin')

Ain't is now officially a word, much to my chagrin. As to fixin'.........well we all got a little redneck in us. ( Just don't look at your cousins that way anymore )

johnr Wrote:Gosh, such a good row going on and I missed it. Note to self: Log into Apnea Board more than once a year.

chellesings,(time=1270784784) Wrote:I just joined and I was scrolling through and I saw this. This is something I was considering because I still wasn't feeling rested, and was willing to try and see if changing the pressure would make a difference. Actually, I got my instructions from your site. My initial pressure was 6, my doc raised it to 8 when I was feeling fatigued, then I raised it to 8.8. I raised it to 12. Well! That was not a success. Much too high.....I felt like I was suffocating. So I hopped back up and lowered it to 9. That was a little more successful. Unfortunately my mask is still having a little leakage problem, so I'm fighting with it. This morning when I got up I was still pretty exhausted. Not sure what's going on. I'm trying to make some other changes other than the cpap. I feel I need to explain that I've been off the cpap for about a year and a half and have recently had some issues that have made me more diligent about sleeping with my cpap.

This is long, but I saw this and it reminded me of my pressure "adventure".

Starman Wrote:I'm happy this board exists. My DME and Sleep Dr are basically just an insurance mill working to get as much $$$ out of my plan as they can bill. $3k for a sleep study? Really? At the end of it, I got to see no data other than the 'you have severe sleep apnea' I asked, where is my data? I paid for it I want it. The answer "sorry we don't keep that after diagnosis"
That sounds like BS to me, perhaps it's CYA for them in the case of mis-diagnosis. OK so 3 weeks later I get a call from the DME, they have my machine. I get a scripted flip board training session and out the door I go. I don't even know the basic vocabulary at this point.
Fast forward 2 months, never got any reply to my questions, the only thing they wanted was my compliance data so they could bill the provider. I still get bills also , about $500 so far because Aetna won't pay all the charges. I make a copy of the data on the SDcard and bring it in. By this time I've found that my machine (Phillips 450P) stores more than just compliance data. I ask them to show me how the treatment is working, they refuse at first. They will not sell me the Encore2.0 software to read the card myself. They won't even let me see the screen as it reads the card with MY data on it. I did finally get them to print out some of the data, but got very little explanation of what was on the printout.
Switch DME and Dr. , sure I'd love to, but the insurance won't cover anything new for another year at least.

How was my pressure determined, got no idea, the 1st sleep study night was done with out any sort of machine at all.
The return study was done 1/2 the night without a machine, the 2nd half with. No settings were changed, the tech just plugged it in, set a mask on me and left the room. I got about 2 hrs of sleep with the machine. 3 weeks later I get the call
from the DME. So, for now I'll leave it was is, I get some leakage, was getting mouth venting, got a strap for that.
What I really want to know is AHI and the other readings, for that I need the software, or the Clinicians Menus.

I also got a machine for my partner, not covered on my insurance (there's a rant there, but not now) Easy as pie,
bought a Remstar M BiPAP for $385, it's set for 6cm, but it's seems to be helping. Used machines are available if you
know where to look.

BTW, I do my brakes, better than the monkeys at most shops. Got the shop manual, the tools and I take better care of my vehicles than most Licensed Mechanics would. Not that there aren't some that do good work, but like CPAP, wrenching is not exactly rocket science (or brain surgery)

SuperSleeper Wrote:Just wanted to bump this thread, 'cause I got a nasty email from a DME provider stating that they don't appreciate Apnea Board "handing out clinician manuals to any 'Joe Blow' who asks for one".

Well, not sure if you're out there Joe Blow, but if you want your own Clinician Setup manual, go to our page at:

http://www.apneaboard.com/CPAP%20Adjustment.htm

And, if the DME who wrote me that email wants a manual, heck, might even send them one... but then again, it does require at least a 6th grade education to understand it, so I'm not sure what good it would do them...

Sorry for ranting... we now return you to your regularly-scheduled CPAP discussion...

Oldern Wrote:After I read the first couple of posts to this thread, I couldn't wait to get to the end to add my "retort" and my rant. However, the more I read the more convinced I became that the respondents have done a much better job than I ever could. Without being downright nasty and by using wit, a few choice quotes, and much common sense, I believe the respondents and RespiratoryChip have turned this event into a truly "teachable moment". My compliments to all!

The only comment I will make is this. If I had not found this board and a couple of others like it and had I not been aggressive about my treatment, I cannot imagine where I would be in my treatment.

And to RespiratoryChip, I am looking forward to reading your future contributions to this board. I am convinced with your passion you can be a formidable ally to many who will find this site and offer a direct link into the professional side of treating "sleep apnea".

I am taking the liberty of sending a copy to you, RespiratoryChip, by PM in the event you haven't been checking the board.

Thanks to one and all. This has been one of the most enjoyable and enlightening threads I have read in my journey with sleep apnea, and I have read many!

Oldern