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Lee Dryden posted a discussionSleeping with CPAP blog post
Hi,This post is about sleep apnea and blood sugars. Thanks for reading.http://sleepingwithcpap.blogspot.com/See More
ZolliStar replied to ZolliStar's discussion What's the Right Machine?"Thanks for this, Mary.
Worse comes to worse, I'll buy a used machine from Second Wind. First I'm going to see if I can get my doctor to prescribe one.
Maybe this is the final answer. Meanwhile, I'm surely happy to have…"
Mary Z replied to ZolliStar's discussion What's the Right Machine?"Zollistar, I think the ASV is hands down the best machine. It took me four years to get hooked up. Because of lingering depression and continued day time sleepiness with a high AHI my doctor suggested a night in the lab with an…"
ZolliStar replied to ZolliStar's discussion What's the Right Machine?"May I ask two dumb-dumb questions? What do "Dx" and "CSA" mean?
And here is a not-so-dumb-dumb question (I hope!): From your experience, do people sleep better using an ASV machine?
I look forward to your answer.
"
RockRpsgt replied to ZolliStar's discussion What's the Right Machine?"You will most likely not be able to get insurance approval for an ASV without a Dx of CSA. I think that saying that an ASV breathes with you is false. ASV does however provide a better breath support and algorithm for auto use. The newer ASV units…"
Mary Z replied to ZolliStar's discussion Beating Sleep Maintenance Insomnia"Zollistar, what a good idea! The music is nice and relaxing on some of them."
ZolliStar replied to ZolliStar's discussion What's the Right Machine?"Thanks for this information Lisa. It really helps.
Anyone else?
"
Lisa replied to ZolliStar's discussion What's the Right Machine?"Hi Zollistar, I much prefer using an Apap to a straight Cpap. I changed over a few years ago and found straight away that I had much less of a problem with leaks. Another thing that I have noticed is I used to have ongoing problems with my nose…"
Terry Vella replied to ZolliStar's discussion What's the Right Machine?"He's still going, a bit of a pain sometimes but that's life, thanks for asking."
ZolliStar replied to ZolliStar's discussion What's the Right Machine?"This helps a lot, Terry! Thanks for letting me know.
How is your dog??
"
Terry Vella replied to ZolliStar's discussion What's the Right Machine?"ZolliStar, I went straight to an auto so can't really compare but from what I have heard there are two major benefits, first, the comfort factor of not having the high pressure all night and second, it adjusts to what you require, so if you use…"
Mary Z replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"Ginny, they are probably not doing anything against the law- though it may seem like fraud to us it may be an accepted practice. I would rather change DME's. Have you talked to the manager. They don't want to lose your…"
Ginny Edmundson replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"It really burns me up that they are doing things like this. Monday I am going to lok up th eMedicare complaint number and give them an ear full.
"
RockRpsgt replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"Companies like this will have to pay in the end. Medicare is taking no prisoners in their effort to reform medicare fraud."
RockRpsgt replied to Mary Z's discussion Symptoms"I had zero symptoms. I was testing equipment one night and fell asleep hooked up. When I woke up my doc said I had an AHI of 10 with 30 second events. I have been on PAP ever since."
Ginny Edmundson replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"I just use a large rubber band and safety pin to attach i tho the sheet. It doesn't exactly kink, but rather seems to have almost bends that don't quite ever go away. I have one that doesn't but all the others seem to.…"
Mary Z replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"My light weight tubing does not have a tendency to kink. It just hangs down from the stand and comes back up to the bed. I tried a hose hanger, but bought the cheaper travel model and it just wasn't up to the task."
Ginny Edmundson replied to Ginny Edmundson's discussion New "Rant" about DME/Wisp"I was really surprised when the congestion improved without the humidification. Yes, I use the lighter weight tubing too. Do you have trouble getting the bends and kinks out of them???? I have one favorite that is broken in and I hate…"
What To Expect From Your Local Durable Medical Equipment Provider
These are compliments of rjjayrt, a DME RRT who has been gracing cpaptalk's forum w/his patience and presence:
What To Expect From Your Local Durable Medical Equipment Provider
1. DME should explain to the patient what their insurance requirements will be.
2. Should discuss the cost schedule based on coding, and what the patient will be responsible for.
3. Should provide the patient with dispute resolution options.
What To Expect From Your Local Durable Medical Equipment Provider's Registered Respiratory Therapist
1. The RT should have a discussion with the patient concerning Diagnosis (make sure the patient understands what the diagnosis is), and treatment (explain what Cpap, bipap, fully data capable, auto titrating mean)
2. Discuss the available machine options. If the patient wants an auto titrating machine the RT should be agreeable to pursue with the physician the ability to do so.
3. Once a machine is decided on discuss and demonstrate all functions of the machine. Show the patient a demo download and explain what each value means.
4. Discuss with the patient their sleep habits, if they sleep on their back or stomach, if they're a mouth breather or nose breather. Find out if the patient is claustrophobic or not.
5. Based on #4 discuss the available mask possibilities, let the patient try the mask on while under pressure.
6. After a mask is decided upon, demonstrate proper donning and removal of mask.
7. Assuming you've discussed and demonstrated everything in a way the patient understands, you should be able to have the patient setup their machine, apply their mask, set their humidifier and start therapy. If the patient has problems or is hesitant repeat instruction until patient can complete the task from start to finish without error.
Before the patient leaves discuss known problems with cpap, discuss with them the problems they may have over the next few days or so and discuss with them ways to avoid the problems or ways in which to deal with the problems.
8. Ensure the patient understands accessory replacement schedule, cleaning procedures and most importantly has a way to get in touch with you if there's a problem.
9. Finally make a follow up schedule with the patient so downloads can be done to check progress. I suggest one at 1 week, at 1 month and again at 6 months.
And I would suggest printing these out and taking them to your next local apnea support group meeting!
What To Expect From Your Local Durable Medical Equipment Provider
1. DME should explain to the patient what their insurance requirements will be.
2. Should discuss the cost schedule based on coding, and what the patient will be responsible for.
3. Should provide the patient with dispute resolution options.
What To Expect From Your Local Durable Medical Equipment Provider's Registered Respiratory Therapist
1. The RT should have a discussion with the patient concerning Diagnosis (make sure the patient understands what the diagnosis is), and treatment (explain what Cpap, bipap, fully data capable, auto titrating mean)
2. Discuss the available machine options. If the patient wants an auto titrating machine the RT should be agreeable to pursue with the physician the ability to do so.
3. Once a machine is decided on discuss and demonstrate all functions of the machine. Show the patient a demo download and explain what each value means.
4. Discuss with the patient their sleep habits, if they sleep on their back or stomach, if they're a mouth breather or nose breather. Find out if the patient is claustrophobic or not.
5. Based on #4 discuss the available mask possibilities, let the patient try the mask on while under pressure.
6. After a mask is decided upon, demonstrate proper donning and removal of mask.
7. Assuming you've discussed and demonstrated everything in a way the patient understands, you should be able to have the patient setup their machine, apply their mask, set their humidifier and start therapy. If the patient has problems or is hesitant repeat instruction until patient can complete the task from start to finish without error.
Before the patient leaves discuss known problems with cpap, discuss with them the problems they may have over the next few days or so and discuss with them ways to avoid the problems or ways in which to deal with the problems.
8. Ensure the patient understands accessory replacement schedule, cleaning procedures and most importantly has a way to get in touch with you if there's a problem.
9. Finally make a follow up schedule with the patient so downloads can be done to check progress. I suggest one at 1 week, at 1 month and again at 6 months.
And I would suggest printing these out and taking them to your next local apnea support group meeting!
Tags: DME, RRT, durable, equipment, medical, provider
Views: 27
Replies to This Discussion
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Permalink Reply by Virginia Smith on -
Judy you made me LOL I also have to deal with Apria what a joke. I have been on CPAP for 7 yrs. with no monitoring I finally requested a sleep study be done again. I use the CPAP because of breathing restriction from throat cancer. I have found out more just reading some of the discussion on this website then I have from my DME.
Judy said:Well, it certainly does NOT speak well for the DME provider profession. And what is REALLY scarey is that Medicare/CMS and the health care reform movement is pushing for bidding for providers. Can you imagine all of us being victims of Apria as the lowest bidder???
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Permalink Reply by Dan Lyons on -
I have kept my mouth shut since this was first posted for fear of reprisals, but the BS meter was continually going off with each visit to this posting.
When I read it, I had to step outside and do a reality check, once I figured out how to get off the ladder without falling into the pile of crap that this posting poured out.
The patient/customer who walked into the DME and received this treatment and service must have walked in waiving hundred dollar bills in the air.
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Permalink Reply by Judy on -
It does sound like DreamLand, Dan Lyons, but take it up w/rjjayrt over at cpaptalk.com who insists he is a DME RRT.
HOWEVER, given the markup on xPAPs and accessories that local DME providers receive, even allowing for the expense of insurance paperwork and the necessary staff to complete it .... it is what EACH and EVERY xPAP patient SHOULD encounter from their local DME provider.
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Permalink Reply by Dan Lyons on
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Judy said:It does sound like DreamLand, Dan Lyons, but take it up w/rjjayrt over at cpaptalk.com who insists he is a DME RRT.
HOWEVER, given the markup on xPAPs and accessories that local DME providers receive, even allowing for the expense of insurance paperwork and the necessary staff to complete it .... it is what EACH and EVERY xPAP patient SHOULD encounter from their local DME provider.
Judy,
I so do agree with your statement that every patient should expect this type of treatment. I will also state that the greater majority of patient can only dream of this type of fantasy service.
It is such a shame that greed has become the standard of service in almost every industry. The only way that this will be changed is by forcibly making the industry comply with a set of standards.
I for one am not afraid of pursuing external measures against a "professional." Respect is a two way street.
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Permalink Reply by Judy on
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Yeah, from the posts we read in the various apnea support forums, I reluctantly have to agree w/you, Dan Lyons. *sigh*
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Permalink Reply by Banyon on -
Does the patient have any responsibility? I would like to see a post, "The Patient's Responsibilities."
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Permalink Reply by sleepycarol on -
As the world of sleep medicine matures, hopefully all involved will become more informed and better able to provide the support needed. As it stands I am sure glad I was dxed in the early beginnings. We complain and gripe now, just think how horrid it was back then when little was known. For those brave souls, I salute them.
Unless the RT/DME reps have used some type of machine, mask I don't think they really have an understanding of it all. Not making excuses for them, but face it -- they don't have a clue as to the comfort of masks, the feeling of suffocation when the pressure is too low, the gale force winds of the higher pressures, etc. They have nothing to base how we feel as they have not experienced it.
It is like I have always said about male OB's. They can't know what it is like to give birth as they have never done it.
As far as patient responibilty, yes we should have some -- but when you are looking to the medical profession to guide you and it isn't forthcoming how is the patient going to learn what THEIR responsiblities are.
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Permalink Reply by Dan Lyons on
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Banyon said:Does the patient have any responsibility? I would like to see a post, "The Patient's Responsibilities."
Banyon,
We as patients and as human beings, through our upbringing, have been taught that "professionals" would not cheat, deceive or mislead a person intentionally. These “professionals” were supposed to be above questionability, and they made sure you knew it.
Our "responsibility" was to listen and pay attention to these "professionals" and to follow their directions and instructions.
The reality of the situation is, we now have to approach every situation we face in our life with total speculation and caution. That these "professionals", and every other person has but one goal in their life - THEMSELVES. If that involves cheating, lying or misleading, they will do it.
The desire for the almighty dollar has taken over their scruples. Not to stand on a soap box and preach, but this is clearing referenced in the Bible where greed is the sin.
We, as patients, don't realize the facts of the business world until after we have been victimized. What is even more revolting is the fact that we though of these folks as "professionals".
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Permalink Reply by Teresa Hoehn on
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This is exactly what you should expect from a provider. If the provider does not know the anything about sleep they should not be providing service to a patient.
Sleep apnea is so much more improtant then anyone realizes.
Make sure you change companies if you are not receiving the services listed up above. Usually smaller companies go over and beyond and hire really good people. Look for a good therapist. It is your health and you deserve the best care. After all you pay for the services they are providing.
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Permalink Reply by Judy on
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I won't get into Patient Responsibilities because I have a husband who still for some unknown reason blindly accepts and never questions his doctor. I don't understand that type of person and never will.
The majority of patients would never be able to stand up to my personal list of Patient Responsibilities and they/we would probably antagonize 95% of the medical profession.
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