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+--- Thread: First night with new Bipap after sleep study and 37 AHI mostly CA (/Thread-First-night-with-new-Bipap-after-sleep-study-and-37-AHI-mostly-CA)
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - SarcasticDave94 - 04-11-2024
I'm not nearly as good of a chart person as I'd like to be. Honestly I'm not sure what to make of it.
Getting used to the current setup. Seems like the stats and events look OK.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - Sleeprider - 04-11-2024
As a patient in AHN, they have taken over the entire therapy from diagnosis to dispensing of CPAPs. AHN has been very aggressive in recent years in buying up medical practice groups, and Premiere Health, which has been my provider for years, is among them. AHN is bureaucratic, slow and unresponsive, and was a leader in promoting mandatory vaccination for COVID, prohibited its doctors from even discussing ivermectin or hydroxychloriquin and is currently more focused on DEI than healthcare. Don't ask how I know. However assuming you have Highmark, you can still find independent practices and also request that your "treating physician" take over your sleep therapy rather than an AHN specialist. My doctor still manages my annual exam and we cover the VPAP therapy during those routine exams. He listens to my input and provides routine Rx renewal and managed to get my last replacement Vauto, which was obtained through Rotech. You probably have a choice with your insurance about who your care providers are, so my recommendation is to go ahead and use AHN for some of your healthcare needs, but don't hesitate to go outside of that realm for whatever needs you don't think are met by them, including DME. In my case, my primary doctor is now with AHN, but he is willing to manage my CPAP care, and I am using an outside DME with full coverage. There is no requirement that a sleep specialist manage your care, besides, it's obvious your test found complex apnea, and someone just checked the box for OSA. That is not smart healthcare, it is robotic.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - PandaZA - 04-11-2024
I do have Highmark but my plan is unfortunatley limited to mostly AHN doctors/providers and very few other health providers. Originally they sent me to the AHN DME and when I talked with them they were not very accomodating in letting me choose my machine. They flat out said you can have what we have in stock. Luckily there was one other DME in network and they have been very helpful but at the mercy of the AHN Sleep Center diagnosis. My primary care physician is supposedly part of a private practice and when I talked with her she didn't seem to want to take control of the sleep study decision making. This could just be a perception on my part and I will explain the situation again to see if she will take over sleep care.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - PandaZA - 04-11-2024
This healthcare system is ridiculously broken. The sleep doctor updated my report diagnosis to - Primary Central Sleep Apnea but still wants me to try a ST machine first. Even the lady at the sleep lab seemed to think this is crazy and helped get me an appoinment with a pulmologist in a month (instead of 3 months). Supposedly the quickest and easiest road to getting another ASV through insurance. Most likely will need to get a ASV titration too.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - Sleeprider - 04-11-2024
You're making me want to move to Florida. Between UPMC and AHN we are ruled by despots.
Do you own the ASV? I would put these guys on a really short leash. Their own titration study did not find a satisfactory ST setting that achieved what you have accomplished on your own with ASV so far.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - PandaZA - 04-11-2024
Are you referring to the ASV I have now, if so yes I do own it.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - Sleeprider - 04-11-2024
Then it seems you're in control. Have you ever submitted results of your efficacy on the ASV? You could provide them with SD card data or even a report from ResScan or Oscar. It's not like we don't already know the ASV works better than your ASV titration. If it was me, I'd confront the doctor with, "I have ASVauto already. Here are my results that exceed the efficacy and comfort of bilevel ST from the titration portion of my sleep test. Why are you promoting an inferior technology for my primary central sleep apnea? ASV is intended to treat central and complex apnea, but ST is intended for COPD and obesity related hypoventilation, and failed in titration. Why would you recommend the use of ST when ASV is clearly indicated by the intended use of these devices?". Feel free to attach portions of the ST and ASV from the Resmed Clinical Titration Guide.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - PandaZA - 04-11-2024
I will prupose this to the lady at the sleep lab tomorrow to see if she can convince the sleep lab doctor to order the ASV titration. It's frustrating that you can not speak to the guy directly to ask questions as to his decisions.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - SarcasticDave94 - 04-11-2024
Well, if you own the ASV, the value of those quacks and their flawed opinions just went down to that of broken 8 track tapes.
Use whichever doctor you can get to help with the script for supplies and then the replacement machine. There's no requirement for that doctor to be pulmonary or sleep specialists.
RE: First night with new Bipap after sleep study and 37 AHI mostly CA - jcp519 - 04-11-2024
UPMC isn't much better than AHN. I've had UPMC since I started working and most of the system is terrible. I'm fortunate that the sleep doctor I found is very good. He actually gave me an ASV prescription and knew what OSCAR was.
At least you already have a good ASV. You just need the updated machine.