PaulaO Wrote:Patient Empowerment has been long proven to improve Patient Compliance which together improves Patient Condition.

Do NOT get me started on what my rights are and are not in regards to the health and welfare of my own body. That message I wrote before was written, edited, and rewritten only AFTER I had calmed down.

Ltmedic66 Wrote:PaulaO,

I read an article about CPAP compliance that offered what I think is the perfect solution. A study was done in which patients were taught how to make adjustments on thier machines, and with the initial diagnosis came a small number (like 10 or so) of phone consultations with the sleep doc or the sleep center staff. So, the idea was that you would get your new machine, have some recordable data, and be able to call the doc during your adjustment period to get advice on goofing around with the settings. It showed increased compliance over our current "take your machine and have a nice life" (maybe "take your machine and screw off" is more accurate...) model of treatment.

I think that is the perfect balance between patient empowerment and responsible CPAP tweaking under the advice of your provider. By default, I would think any doc using such a program is an advocate of patient participation in treatment.

jeffy1958 Wrote:

Ltmedic66 Wrote:...patients were taught how to make adjustments on thier machines,

Oh-oh!!! There goes the mighty $$$ for the Sleep Dr. and / or Sleep Center. How dare us for trying to put them out of business by keeping them out of ours!!! [SARCASM]

For the record. I found out it cost, you will love this, $97.00 to take my card into the DME to have them print a paper report for me to hand carry to the Dr's office. Total time was 15 minutes. WOW - I don't think hookers get paid that well!!!

The last visit, which was last week, I printed up my own report and took it with me, thank you very much. My Dr. was really impressed that I took such an active roll and wished all her patients would do the same.

Ltmedic66 Wrote:Which just points to the problem with medicine today. When an aspirin costs $40 in a hospital or a xray costs $300 at an urgent clinic (recent experience with the kids on the xray...), how do you make sense of any of it?

$97 to print out you report is an insult. And, I'll bet an HMO has a contract with your DME where they would pay them $5 and "write off" the rest. Which is the other thing that irritates me- different prices for different people.

MastaPaP Wrote:You can all purchase the Card reader, and software and do it yourself, just save the report, most Insurance wants copies of the 1st 45 days, this is sometimes a requirement. Yes Pt empowerment is important (from a Pt), but it is not going to change, and as the Medical community & Equipment manufacturers tightens their grip on Sleep medicine Field, it will probably be more controlled more strictly. not to mention, copd, chf and other cardiac conditions affecting circulation/gas absorption with unmonitored arterial blood gases, or very experienced techs can end up disastrous, after 1 night, causing respiratory failure, Mi or Stroke.

I worked with a Physician for a few years who was enjoying a 92% compliance/usage rate, in part to my programs I had implemented (45% prior to that) this person discharged anyone from her practice for altering their Rx on their Pap. They can fix any issues, if you tell them, if they don't address, find a new Sleep Doc at that time.

I am not siding with her, chip, or anyone for that matter, but I don't blame her at all, I hope some of you thought about that, the next MD you go to, may be a nightmare and not care at all, almost any good Physician would do the same if it persisted, it's basically AMA. I admit I changed mine, but I have been involved in this field for over 10 years, own my machine, my wifes a ARNP c Respiratory background of 10+years on her way to MD (my Provider :-) ), and I run a Sleep Lab with 6 techs under my supervision ... Good Luck, be smart.

jeffy1958 Wrote:

MastaPaP Wrote:You can all purchase the Card reader, and software and do it yourself, just save the report, most Insurance wants copies of the 1st 45 days, this is sometimes a requirement.

I have the reader and software and I have cut my DME out of the picture completely. Why should they get any more than necessary, with the rediculous prices they charge - they should put put up on charges for robbery!!! They charged my insurance company $4000.00+ for my equipment and supplies and I found everything - the exact same stuff all for $1200.00. Are you for real??? ...and charge me $97.00 for 15 minutes of pushing a few keys and maybe 10 cents worth of ink and paper.

Sad fact is I brought this to the attention of my insurance company and was insulted with their B.S. reply. I was told I would be contacted, personally, by a "higher level" person to discuss this in depth. That was over 2 month's ago - not holding my breath.

GOES TO SHOW YOU JUST HOW MUCH THEY (DME's & INSURANCE COMP.) DON'T GIVE A DARN ABOUT US LITTLE P-ON's.

And you wonder why we choose to EMPOWER ourselves.

How did that go... POWER TO THE PEOPLE!!!

Steven Wrote:

jeffy1958,(time=1300035134) Wrote:For the record. I found out it cost, you will love this, $97.00 to take my card into the DME to have them print a paper report for me to hand carry to the Dr's office. Total time was 15 minutes. WOW - I don't think hookers get paid that well!!!

My Blue Cross / Blue Shield PPO would NOT pay anything for this. They would write 100% of it off. So, my 20% of $ .00 would be $.00

I went to my ENT a couple of weeks ago.
Part of the charges was $ 34.00 to give me a cortisone shot. This was NOT the charge for the cortisone medication (that was another charge) but was for the nurse to ask me to pull my pants down & stick me in my upper right hip.

Blue Cross / Blue Shield allowed what it thought that was worth $ .00 and I concurred.

My insurer is brutal, but I agree with them the vast majority of the time.
Yes, sometimes I will pay extra to get a brand name of medication that they will not cover if both me and my Doctor think that the brand name is better for me.

$ 97.00 for 15 minutes. Apparently Jeffy1958 does not use the same hookers as Charlie Sheen.

zimlich Wrote:I have been driven to making small changes in my pressure because of numerous visits to Sleep docs and being told "This is your correct pressure, no apneas during sleep study at 8/4" (and various other pressures). Then I get home and my machine continues to show numerous apneas and hypopneas. I expected to wake up to good data, or even better data for a week, but it was continuously bad. I am waiting for word from my sleep doc after sending in my data card showing these ridiculous results after paying for a sleep study which obviosly was a night such as I have never had before and never since. "Come back in a year or sooner if you have problems." He charges $300+ for at most 10-15 minutes of time (insurance does not allow that much) and I can't see paying that much for him playing with my pressures. I titrate only one cm at a time and give my body time to get used to the new pressure while I keep results from each nights data and how I feel every day. I was constantly falling asleep at 8/4 so that obviously wasn't the correct pressure for me. If he would allow me to call him and discuss problems and give me pressure changes over the phone I would do that, but it's not allowed for me to change my own pressures. It's just too frustrating to see a doc every two to four months and never see any improvement. I'll try to do it myself before I'll go back.

MastaPaP Wrote:

zimlich,(time=1300373805) Wrote:I have been driven to making small changes in my pressure because of numerous visits to Sleep docs and being told "This is your correct pressure, no apneas during sleep study at 8/4" (and various other pressures). Then I get home and my machine continues to show numerous apneas and hypopneas. I expected to wake up to good data, or even better data for a week, but it was continuously bad. I am waiting for word from my sleep doc after sending in my data card showing these ridiculous results after paying for a sleep study which obviosly was a night such as I have never had before and never since. "Come back in a year or sooner if you have problems." He charges $300+ for at most 10-15 minutes of time (insurance does not allow that much) and I can't see paying that much for him playing with my pressures. I titrate only one cm at a time and give my body time to get used to the new pressure while I keep results from each nights data and how I feel every day. I was constantly falling asleep at 8/4 so that obviously wasn't the correct pressure for me. If he would allow me to call him and discuss problems and give me pressure changes over the phone I would do that, but it's not allowed for me to change my own pressures. It's just too frustrating to see a doc every two to four months and never see any improvement. I'll try to do it myself before I'll go back.

1st night effect in the Lab will make you respond to lower pressures, they were poor techs.
Some pt's require a Auto SV for things like periodic Breathing/cheyne stokes, others need an Auto Pap for constant flux in pressures.
At 8/4 you are either 130lbs 5'4", or you have Centrals more than OSA, judging from your response to pressures seem like you may need the latter, good luck & find an MD that cares .

JacoSZ Wrote:Hi all. I am a new member but a CPAP user since Feb 2009. It was LIFE CHANGING when I started CPAP and I never ever sleep without it!
Because of the enormous change it brought to my life and the long term health issues related to untreated OSA, I started to read up and experiment with various things in order to get to the perfect restful sleep.
During all the above, I learnt that in my country (South Africa) it is impossible to purchase the software if you are not a registered clinician. Then, on enquiring what and how in becoming a clinician to be able to get more insight and control over my own treatment, I learnt that the bar are set very low! If you register at the Medical Board by paying an annual fee, you are a “registered clinician”. From here you register a small business and need a “consulting room”, for which your study would suffice. The business and consulting room was a requirement of ResMed. Armed with the above, you can start selling and advising customers, which by now, gets promoted to the level of patients!
So to cut a long drama short: I have difficulty in believing that people like Respiratory Chip and the likes do have so much more knowledge on the subject that my fellow board member, which as SuperSleeper mentioned, do have a little bit of IQ to their disposal.

That said, I do admit that there are GP’s, neurologists and other, who does specialise in OSA and we definitely welcome their medical knowledge and accompanying diagnostic equipment. All of us would be far worse off without it. But there are a LARGE fraternity of people out there that sell themselves as sleep therapists, who in actual fact know less of the problem than the average CPAP user.