"please keep me updated about oximeters "
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American Heart Association Gives OSA Patients the Finger
I have personally approached the marketing/ communications director of the American Heart Association to work together with the NYC AWAKE group to spread OSA awareness, and she essentially told us to pound sand because the connection between OSA and heart disease was not sufficiently proven. Outrageous, huh?
Views: 1085
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Carl, just so that you know. I was in a car accident when I was 16. I broke just about every bone in my body, and spent my junior year in the hospital. Not part all! My family is middle class. Despite getting good grades, and going to school all 4 years I did not have enough credits or time to finish. I needed a decent job to help out. At least support myself. I aced the GED and started my life. I am an OJT RPSGT, and a great majority of these educational post were written by me.
I am a great RPSGT. My patients, studies, and career matter to me. I have put quite a bit of time into this personal and paid. techs like myself agree that this is not a perfect system. We push for better education, community, and state funded programs. We educate our pts on the reality of this broken system.
I began my career evaluating sleep at see level. Right now I am in Colorado learning about high altitude titrations. Next I will go to Alaska to see how people sleep in the constant dark. I have done research for ADHD and daytime fatigue. All of this with the same education you mentioned in your post.
Do you want to know what all of this experience has taught me? With or without the education that you speak of my life experiences have put me in a better position to eduacate and evaluate sleep than you. Please back off before you lose the oly group of people in this industry that are on your side. The majority of us are everyday people like yourself.
Rock Hinkle said:Thanks for your appreciation Carl.
Carl said:Ok, after reading all of this I have to admit that I felt that I was in the dark and had questions about a few things so I did some online research and here is what I have found. Much of this information is from bprt.org (board of registered polysomnographic technologists). The whole concept of being a "board registered psg technologist" sounds very official and medical, doesn't it - it sure did to me!
Anyhow, in light of the discussion on this board, I wanted to learn a bit more about it. What I found was that there are 4 ways of being able to take the RPSGT exam. Here is one way...
QUOTE
Pathway #1 - for candidates with 18-months of PSG experience (on-the-job training)
1. Candidates must complete a minimum of 18 months of paid clinical experience where at least 21 hours per week per calendar year of on-the-job duties performed are Polysomnography direct patient recording and/or scoring. Duties must be within a 3-year period prior to the exam.
2. Candidates must complete the AASM A-STEP Self-Study (online) Modules or a BRPT-designated alternate educational program. Proof of completing the modules must be submitted with the application. Acceptable forms of proof are:
1. Copies of the 14 certificates of completion from each module, or
2. An official transcript from the AASM.
3. Candidates must include proof of completing secondary education. Acceptable forms of proof are copies of transcripts or diplomas from high school, GED or equivalent, or college or university education.
UNQUOTE
So, by a) having a high school diploma or GED and 2) essentially DOING the job for 18 months - HALF TIME (ok, 21 hours/wk) and 3) taking an "online" course, you can sit for the RPSGT exam. Call me jaded, but this just doesn't sound like very much of a "real medical professional" to me.
Granted, REAL medical professionals DO have ways to take the exam and become certified, but, at the lowest common denominator, there simply isn't a whole lot here. And, I have to wonder about any job that essentially says you actually have to PERFORM the duties that you're going to be tested on before you can be tested and put some letters in front of or behind your name. I mean - seriously - think about what it would be like if that's how they approached getting an MD.... go out, be a doctor for a couple years - then you can come back and sit for the exam... Substitute ANY profession for this and see how absurd it sounds. Quite frankly, those letters "RPSGT" don't mean a whole lot, at least not to me. Now, people who have this certification and have other (TRUE) medical certs (like RN, etc) - THAT is a different story, they DO have a medical background.
At the end of the day, Judy was correct when she said.....
QUOTE
Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".
UNQUOTE
Of course any organization like this is often more about collecting dues, fees, and, of course, providing "continuing education" for those in the field. Here's what I think about that.... Years ago, when my wife was pregnant with my 1st son I took an EMT course. I figured it would be good to know some emergency procedures "just in case". The course took something like 121 hours, plus I had to observe for 8 hours in an emergency room. During the course I observed the OTHER people taking the class. The four firemen were very professional and worked diligently. MANY of the other people were kids that just graduated from high school and were looking for an easy job that paid a bit more than minimum wage - in other words - they wanted to work for an ambulance company. I had never seen such a group of people like this together before. Thankfully, my partner didn't pass the exam, but some of the kids that DID pass were, well, unbelievable (and NOT in a good way, either).
In the end, the ONE thing that this class taught me was that if I or ANY of my family members were ever injured I would NEVER let an EMT touch me - unless they were firemen, and then I would still be cautious! I maintained my EMT through a couple of re-certs, which meant CEUs. Sadly, and for the most part, the "continuing education" was useless, clearly a method of making money FAR MORE than really providing useful information. I could UNDERSTAND if you had to retake the final exam (with practical portion) periodically, but these continuing education classes were just junk. Perhaps this really skewed my opinion on putting initials around my name, but, I definitely always want to know just what do those initial represent, what do they mean, and what is REALLY behind them other than paying dues and taking CE classes from some organization.
Louise Dover said:Just so you know, Judy, my medical director (a board-certified sleep physician) comes in every single morning and reviews every study that ran the night before, meets with the patient before they leave the lab, and dictates the report before he leaves. Our patients are extremely well cared for, considering I have over 15 years of sleep experience behind me. And on the rare occasion that my medical director is unable to appear in the sleep lab the following morning, he depends on me, yes - ME - the lowly sleep tech who ain't qualified for crap as far you are concerned, to review the study with the patient and make sure they leave the lab with their CPAP prescription in place, or a follow-up study appointment - if necessary. Apparently whatever lab you went to wasn't worth their salt, because I would never work in a place that treated their patients the way you described. So before you start belittling me and my profession, back the truck up and look at who you are speaking to before you speak - it makes you appear shallow and uneducated. If you are unhappy with your sleep lab experience, I would suggest you find a PROFESSIONAL lab.
Judy said:Louise said:
"...It seems to me that the AHA is in need of "clear direction" when it comes to the link between OSA and CVD. She needs to understand that those of us in the sleep profession have no need for additional research as we see the connection quite clearly and up close every night in every sleep center across the entire world. ..."
Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional". Per centage wise, the RPSGTs are the real heroes of sleep medicine, but they aren't "good enough" to tell us patients much 'cause they "ain't" no medical professional.
Of course, your sleep doctor (the medical professional) in all too many cases can't even be bothered consulting w/us, preferring to send their dictation to our referring doctor to let him/her "waste" their time consulting w/us, or if they do condescend to consult at all w/us, its an "in and out", 10 minute, yuo've got OSA, here's your script, bye. IF we are lucky enough to get a fully data capable PAP our "medical professional" isn't interested in really looking at the data and just glances at it at best w/o paying any real heed to it.
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Permalink Reply by Jo E on
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I think that treating OSA and preventing heart problems would only free up the cardiologists to deal with heart issues that are not related to OSA. There are enough cardiac problems that are not caused by OSA to keep all of the cardiologists busy for a long time. I have to see a cardiologist every time I have surgery because I have five different (minor) congenital cardiac abnormalities. Even tho' all of the conditions are operable, my cardiologist says they "don't operate on people like you. If we did, we would not have enough time to operate on people who have real problems." They keep watching me in case that the problems become an issue, but why risk surgery for minor problems that I lived with for 55 years before they were discovered? (As it now stands. I do not meet the minimum standards for surgery.)
The emphasis should be placed on educating PCPs about OSA. If PCPs stop testing everyone for thyroid issues and quit when their first guess doesn't work out, and start testing for OSA and other disorders sooner, then the OSA patients wouldn't have to be referred to cardiologists unless they had an issue that was not related to the OSA.
Cardiologists don't need to line their pockets with OSA patient's $$. They have enough business already.
Steven Y. Park, MD said:The AHA is a trade organization, just like all the other medical organizations. Their main goal is to protect their member's professional and financial interests. Admitting that OSA is a major cause of heart disease would be upsetting the status quo, since all the entire heart health industry is based on medications and surgical procedures. Imagine what would happen if 90% of all sleep apnea patients were found and treated...
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I think someone needs to call a halt to this thread.
The idea that doctors and surgeons are turning down a whole new line of business - treating OSA patients for heart disease - because they are greedy, grasping, profits obsessed charlatans is illogical and just doesn't make any sense.
I can't believe that any business would be that schizophrenic.
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Permalink Reply by Banyon on
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Brian Smith said:I think someone needs to call a halt to this thread.
The idea that doctors and surgeons are turning down a whole new line of business - treating OSA patients for heart disease - because they are greedy, grasping, profits obsessed charlatans is illogical and just doesn't make any sense.
I can't believe that any business would be that schizophrenic.
A heart surgeon would consider it a big demotion to become a sleep doc and it would be a big loss of status.
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Rock and others...
It is amazing how some people take everything personally. It is ALSO REALLY amazing how people that consider themselves to be "great" simply overlook the LOGIC in my post and start ranting on about "personal" experiences. I sympathize with your situation, however, posting a sob story like this does not prove one single point, it only illustrates YOUR story... and it IS a great story about ONE INDIVIDUAL overcoming a great deal of adversity. It does NOT say anything about the RPGST as a "profession" just like one good doctor doesn't mean all docs are good and one bad doc doesn't mean they're all bad. This is all termed ANECDOTAL, and not statistically significant because you are only taking about ONE person or incident among many.
As to your (veiled or not) THREAT saying
QUOTE
Please back off before you lose the only group of people in this industry that are on your side. The majority of us are everyday people like yourself.
UNQUOTE
All I can say about that is, if THAT is the best that a "GREAT RPSGT" can do - threatening someone that they're going to lose their support group, well, I'd hate to see the worst and, trust me, if losing this group was the worst thing that happened to me in my life, I'd consider myself pretty lucky. As to the "on my side" - words... only words... Whether someone here is "on my side" or not has absolutely NO BEARING on my life whatsoever. This is a discussion group, nothing more, nothing less.
But to get back to the MEAT of the discussion...
ALL I stated, which is a VERIFIABLE FACT is that RPSGT is a "TITLE" given by a CERTIFYING AGENCY and I provided one of the 4 methods of obtaining that title (which included a home study course). I also said, or at least IMPLIED, that compared to REAL MEDICAL PROFESSIONALS, this training is almost nil. And, by REAL Medical Professional, I don't just mean Doctors, but that includes PA's (Physician Assistants), NP's (Nurse Practitioners), RN's, EVEN LPN's. Paramedics even have a GREAT deal more of medical training, although theirs is more related to emergency treatment and transportation - they are (AFAIK) never an "endpoint", well, unless the patient is DOA and even then, I believe a DOCTOR has to PRONOUNCE death in most jurisdictions.
If that gets your knickers all tied up in a knot, then, perhaps you should take a look INWARD and wonder why you feel you have to be so defensive. Remember, I never said YOU were good, bad, or indifferent, I'm talking specifically about the CERTIFICATION and how much or how little one can put their trust in someone with this certification.
It is LOGICAL to assert that MORE educational study and MORE time "apprenticing" will provide someone with MORE experience to draw on when they finally set out on their own. If you wish to challenge that, I welcome the challenge! It is also, therefore, logical, to state quite unequivocally that the LESS education and apprenticing time will create someone less skilled and less knowledgeable, since this is essentially the same inequality, just with the terms reversed.
I would grade the RPGST cert above the EMT, *maybe* in line with the CNA (Certified Nursing Assistant) but well below ANY other certification I have seen. Even the LPN program is at least ONE YEAR OF FULL TIME STUDY, and some programs require more than that to graduate and they must pass a state exam.
Here in NH, the CNA Test prerequisites include a current background check, two fingerprint cards, Photo ID, two photos (passport size). A negative TB test within the past 6 months and proof of immunizations will be required. You will also be required to show a high school diploma or GED. In New Hampshire, you are required to complete a minimum of 75 hours of CNA course work and 100 hours of clinical rotation before challenging the state CNA licensing exam. The nurse aide classes typically last 2-6 months. Individual schools often have special requirements to begin the training program.
As a side note, I do see that starting in 2012 and going forward, an ASSOCIATES DEGREE will be REQUIRED to start a career in sleep. A definite step forward.
I do not CARE how great you ARE or ARE NOT, the chances of me seeing you as a RPSGT personally are extremely low. I can tell you, simply saying so on this board does not make it so, it also does not mean it is not true. In my life and experiences the truly great people don't have to announce that fact, it is just obvious.
I've had experiences with both GOOD and LOUSY "technicians" at the local sleep center. The one technician that I liked and clearly had knowledge was also and originally an RN also, but the only way I knew that was because we had a conversation after I woke, first about the sleep testing, then about motorcycles, and past jobs. The one that I really didn't like wouldn't discuss ANYTHING about the test, answer ANY of my questions, and I just didn't care for her overall demeanor - she was ONLY an RPSGT without any further qualifications. In fact, if I ever have to go back for further testing, I will specifically state that I do NOT want her to run my test. This too, however, is only anecdotal. A study would have to be done to validate how satisfied patients are with their technicians and look at that versus credentials, and would probably have to correct for a whole host of other factors as well.
You further said...
QUOTE
With or without the education that you speak of my life experiences have put me in a better position to eduacate and evaluate sleep than you
UNQUOTE
Brave words - especially because you have no idea who I am, what my education or experiences are. There are opinions of ALL TYPES to be had, and, unfortunately, there is no "great god" here that is omniscient but I do know that no one, not even YOU are more knowledgeable about ME than me so there is sure a h*ll no way YOU can evaluate MY SLEEP, PERIOD. This is part of the problem of medicine today - the patients are left out of the loop when they, themselves know their body far better than any doctor, nurse, or other medical professional does. I happen to have a sleep doc that is great. When I discussed the idea of getting a recording pulse oximeter so we could review things on an ongoing basis and not just keep the treatment based on the sample of one or two nights in an artificial environment, he thought that was a fantastic idea and said that more people should take charge like that but sadly, most people just don't have the (mental) capability to do so.
And that is THE MOST important message to anyone. Don't necessarily believe or listen to anyone, whether they are RPGST, RN, PN, PA, MD, anything... If something is NOT working for you, go back, OR, eventually find someone else in the field. Remember, at the end of the day, YOUR HEALTH is YOUR RESPONSIBILITY!
Rock Hinkle said:Carl, just so that you know. I was in a car accident when I was 16. I broke just about every bone in my body, and spent my junior year in the hospital. Not part all! My family is middle class. Despite getting good grades, and going to school all 4 years I did not have enough credits or time to finish. I needed a decent job to help out. At least support myself. I aced the GED and started my life. I am an OJT RPSGT, and a great majority of these educational post were written by me.
I am a great RPSGT. My patients, studies, and career matter to me. I have put quite a bit of time into this personal and paid. techs like myself agree that this is not a perfect system. We push for better education, community, and state funded programs. We educate our pts on the reality of this broken system. I began my career evaluating sleep at see level. Right now I am in Colorado learning about high altitude titrations. Next I will go to Alaska to see how people sleep in the constant dark. I have done research for ADHD and daytime fatigue. All of this with the same education you mentioned in your post.
Do you want to know what all of this experience has taught me? With or without the education that you speak of my life experiences have put me in a better position to eduacate and evaluate sleep than you. Please back off before you lose the oly group of people in this industry that are on your side. The majority of us are everyday people like yourself.
Rock Hinkle said:Thanks for your appreciation Carl.
Carl said:Ok, after reading all of this I have to admit that I felt that I was in the dark and had questions about a few things so I did some online research and here is what I have found. Much of this information is from bprt.org (board of registered polysomnographic technologists). The whole concept of being a "board registered psg technologist" sounds very official and medical, doesn't it - it sure did to me!
Anyhow, in light of the discussion on this board, I wanted to learn a bit more about it. What I found was that there are 4 ways of being able to take the RPSGT exam. Here is one way...
QUOTE
Pathway #1 - for candidates with 18-months of PSG experience (on-the-job training)
1. Candidates must complete a minimum of 18 months of paid clinical experience where at least 21 hours per week per calendar year of on-the-job duties performed are Polysomnography direct patient recording and/or scoring. Duties must be within a 3-year period prior to the exam.
2. Candidates must complete the AASM A-STEP Self-Study (online) Modules or a BRPT-designated alternate educational program. Proof of completing the modules must be submitted with the application. Acceptable forms of proof are:
1. Copies of the 14 certificates of completion from each module, or
2. An official transcript from the AASM.
3. Candidates must include proof of completing secondary education. Acceptable forms of proof are copies of transcripts or diplomas from high school, GED or equivalent, or college or university education.
UNQUOTE
So, by a) having a high school diploma or GED and 2) essentially DOING the job for 18 months - HALF TIME (ok, 21 hours/wk) and 3) taking an "online" course, you can sit for the RPSGT exam. Call me jaded, but this just doesn't sound like very much of a "real medical professional" to me.
Granted, REAL medical professionals DO have ways to take the exam and become certified, but, at the lowest common denominator, there simply isn't a whole lot here. And, I have to wonder about any job that essentially says you actually have to PERFORM the duties that you're going to be tested on before you can be tested and put some letters in front of or behind your name. I mean - seriously - think about what it would be like if that's how they approached getting an MD.... go out, be a doctor for a couple years - then you can come back and sit for the exam... Substitute ANY profession for this and see how absurd it sounds. Quite frankly, those letters "RPSGT" don't mean a whole lot, at least not to me. Now, people who have this certification and have other (TRUE) medical certs (like RN, etc) - THAT is a different story, they DO have a medical background.
At the end of the day, Judy was correct when she said.....
QUOTE
Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".
UNQUOTE
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[QUOTE] ... When I discussed the idea of getting a recording pulse oximeter so we could review things on an ongoing basis and not just keep the treatment based on the sample of one or two nights in an artificial environment, he thought that was a fantastic idea and said that more people should take charge like that but sadly, most people just don't have the (mental) capability to do so. ... [/UNQUOTE]
A recording pulse oximeter???? What about a fully data capable CPAP? You don't think that the fully data capable CPAP can provide more and better info about your sleep? You think OSA is a respiratory problem??
[QUOTE] ... sadly, most people just don't have the (mental) capability to do so. ... [/UNQUOTE]
Of all the IGNORANT, INSULTING, DEMEANING ..... a pox on you and your sleep doctor! What a pompous, self-serving, pair the two of you make!!!! Keep the patient in the dark because the patient is too ignorant to add 2 to 2 and get 4. IF you opened your closed, egotistical minds and allowed the patients a bit of common sense at all and a chance to catch their breath you might find out what IGNORAMUSES you are!!!
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Permalink Reply by 99 on
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i think it is great to tell everyone that they should not use a basball bat to hit anyone while hiding your basball bat behind you ready for action
we do not need flame wars here , as infighting is counter productive and achive very little
let us pull together and achive results to the problem at hand
Carl said:Rock and others...
It is amazing how some people take everything personally. It is ALSO REALLY amazing how people that consider themselves to be "great" simply overlook the LOGIC in my post and start ranting on about "personal" experiences. I sympathize with your situation, however, posting a sob story like this does not prove one single point, it only illustrates YOUR story... and it IS a great story about ONE INDIVIDUAL overcoming a great deal of adversity. It does NOT say anything about the RPGST as a "profession" just like one good doctor doesn't mean all docs are good and one bad doc doesn't mean they're all bad. This is all termed ANECDOTAL, and not statistically significant because you are only taking about ONE person or incident among many.
As to your (veiled or not) THREAT saying
QUOTE
Please back off before you lose the only group of people in this industry that are on your side. The majority of us are everyday people like yourself.
UNQUOTE
All I can say about that is, if THAT is the best that a "GREAT RPSGT" can do - threatening someone that they're going to lose their support group, well, I'd hate to see the worst and, trust me, if losing this group was the worst thing that happened to me in my life, I'd consider myself pretty lucky. As to the "on my side" - words... only words... Whether someone here is "on my side" or not has absolutely NO BEARING on my life whatsoever. This is a discussion group, nothing more, nothing less.
But to get back to the MEAT of the discussion...
ALL I stated, which is a VERIFIABLE FACT is that RPSGT is a "TITLE" given by a CERTIFYING AGENCY and I provided one of the 4 methods of obtaining that title (which included a home study course). I also said, or at least IMPLIED, that compared to REAL MEDICAL PROFESSIONALS, this training is almost nil. And, by REAL Medical Professional, I don't just mean Doctors, but that includes PA's (Physician Assistants), NP's (Nurse Practitioners), RN's, EVEN LPN's. Paramedics even have a GREAT deal more of medical training, although theirs is more related to emergency treatment and transportation - they are (AFAIK) never an "endpoint", well, unless the patient is DOA and even then, I believe a DOCTOR has to PRONOUNCE death in most jurisdictions.
If that gets your knickers all tied up in a knot, then, perhaps you should take a look INWARD and wonder why you feel you have to be so defensive. Remember, I never said YOU were good, bad, or indifferent, I'm talking specifically about the CERTIFICATION and how much or how little one can put their trust in someone with this certification.
It is LOGICAL to assert that MORE educational study and MORE time "apprenticing" will provide someone with MORE experience to draw on when they finally set out on their own. If you wish to challenge that, I welcome the challenge! It is also, therefore, logical, to state quite unequivocally that the LESS education and apprenticing time will create someone less skilled and less knowledgeable, since this is essentially the same inequality, just with the terms reversed.
I would grade the RPGST cert above the EMT, *maybe* in line with the CNA (Certified Nursing Assistant) but well below ANY other certification I have seen. Even the LPN program is at least ONE YEAR OF FULL TIME STUDY, and some programs require more than that to graduate and they must pass a state exam.
Here in NH, the CNA Test prerequisites include a current background check, two fingerprint cards, Photo ID, two photos (passport size). A negative TB test within the past 6 months and proof of immunizations will be required. You will also be required to show a high school diploma or GED. In New Hampshire, you are required to complete a minimum of 75 hours of CNA course work and 100 hours of clinical rotation before challenging the state CNA licensing exam. The nurse aide classes typically last 2-6 months. Individual schools often have special requirements to begin the training program.
As a side note, I do see that starting in 2012 and going forward, an ASSOCIATES DEGREE will be REQUIRED to start a career in sleep. A definite step forward.
I do not CARE how great you ARE or ARE NOT, the chances of me seeing you as a RPSGT personally are extremely low. I can tell you, simply saying so on this board does not make it so, it also does not mean it is not true. In my life and experiences the truly great people don't have to announce that fact, it is just obvious.
I've had experiences with both GOOD and LOUSY "technicians" at the local sleep center. The one technician that I liked and clearly had knowledge was also and originally an RN also, but the only way I knew that was because we had a conversation after I woke, first about the sleep testing, then about motorcycles, and past jobs. The one that I really didn't like wouldn't discuss ANYTHING about the test, answer ANY of my questions, and I just didn't care for her overall demeanor - she was ONLY an RPSGT without any further qualifications. In fact, if I ever have to go back for further testing, I will specifically state that I do NOT want her to run my test. This too, however, is only anecdotal. A study would have to be done to validate how satisfied patients are with their technicians and look at that versus credentials, and would probably have to correct for a whole host of other factors as well.
You further said...
QUOTE
With or without the education that you speak of my life experiences have put me in a better position to eduacate and evaluate sleep than you
UNQUOTE
Brave words - especially because you have no idea who I am, what my education or experiences are. There are opinions of ALL TYPES to be had, and, unfortunately, there is no "great god" here that is omniscient but I do know that no one, not even YOU are more knowledgeable about ME than me so there is sure a h*ll no way YOU can evaluate MY SLEEP, PERIOD. This is part of the problem of medicine today - the patients are left out of the loop when they, themselves know their body far better than any doctor, nurse, or other medical professional does. I happen to have a sleep doc that is great. When I discussed the idea of getting a recording pulse oximeter so we could review things on an ongoing basis and not just keep the treatment based on the sample of one or two nights in an artificial environment, he thought that was a fantastic idea and said that more people should take charge like that but sadly, most people just don't have the (mental) capability to do so.
And that is THE MOST important message to anyone. Don't necessarily believe or listen to anyone, whether they are RPGST, RN, PN, PA, MD, anything... If something is NOT working for you, go back, OR, eventually find someone else in the field. Remember, at the end of the day, YOUR HEALTH is YOUR RESPONSIBILITY!
Rock Hinkle said:Carl, just so that you know. I was in a car accident when I was 16. I broke just about every bone in my body, and spent my junior year in the hospital. Not part all! My family is middle class. Despite getting good grades, and going to school all 4 years I did not have enough credits or time to finish. I needed a decent job to help out. At least support myself. I aced the GED and started my life. I am an OJT RPSGT, and a great majority of these educational post were written by me.
I am a great RPSGT. My patients, studies, and career matter to me. I have put quite a bit of time into this personal and paid. techs like myself agree that this is not a perfect system. We push for better education, community, and state funded programs. We educate our pts on the reality of this broken system. I began my career evaluating sleep at see level. Right now I am in Colorado learning about high altitude titrations. Next I will go to Alaska to see how people sleep in the constant dark. I have done research for ADHD and daytime fatigue. All of this with the same education you mentioned in your post.
Do you want to know what all of this experience has taught me? With or without the education that you speak of my life experiences have put me in a better position to eduacate and evaluate sleep than you. Please back off before you lose the oly group of people in this industry that are on your side. The majority of us are everyday people like yourself.
Rock Hinkle said:Thanks for your appreciation Carl.
Carl said:Ok, after reading all of this I have to admit that I felt that I was in the dark and had questions about a few things so I did some online research and here is what I have found. Much of this information is from bprt.org (board of registered polysomnographic technologists). The whole concept of being a "board registered psg technologist" sounds very official and medical, doesn't it - it sure did to me!
Anyhow, in light of the discussion on this board, I wanted to learn a bit more about it. What I found was that there are 4 ways of being able to take the RPSGT exam. Here is one way...
QUOTE
Pathway #1 - for candidates with 18-months of PSG experience (on-the-job training)
1. Candidates must complete a minimum of 18 months of paid clinical experience where at least 21 hours per week per calendar year of on-the-job duties performed are Polysomnography direct patient recording and/or scoring. Duties must be within a 3-year period prior to the exam.
2. Candidates must complete the AASM A-STEP Self-Study (online) Modules or a BRPT-designated alternate educational program. Proof of completing the modules must be submitted with the application. Acceptable forms of proof are:
1. Copies of the 14 certificates of completion from each module, or
2. An official transcript from the AASM.
3. Candidates must include proof of completing secondary education. Acceptable forms of proof are copies of transcripts or diplomas from high school, GED or equivalent, or college or university education.
UNQUOTE
So, by a) having a high school diploma or GED and 2) essentially DOING the job for 18 months - HALF TIME (ok, 21 hours/wk) and 3) taking an "online" course, you can sit for the RPSGT exam. Call me jaded, but this just doesn't sound like very much of a "real medical professional" to me.
Granted, REAL medical professionals DO have ways to take the exam and become certified, but, at the lowest common denominator, there simply isn't a whole lot here. And, I have to wonder about any job that essentially says you actually have to PERFORM the duties that you're going to be tested on before you can be tested and put some letters in front of or behind your name. I mean - seriously - think about what it would be like if that's how they approached getting an MD.... go out, be a doctor for a couple years - then you can come back and sit for the exam... Substitute ANY profession for this and see how absurd it sounds. Quite frankly, those letters "RPSGT" don't mean a whole lot, at least not to me. Now, people who have this certification and have other (TRUE) medical certs (like RN, etc) - THAT is a different story, they DO have a medical background.
At the end of the day, Judy was correct when she said.....
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Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".
UNQUOTE
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People with little minds find nothing better to do than to hurl insults, make accusations, or baseless threats.
Please note that never once did I insult Rock or anyone else. Indeed, he may be the BEST RPSGT out there, but, even if he is by and far the best, that does not say anything about the profession as a whole, it is only a statement about him!
I would have LOVED a fully data capable CPAP THAT I COULD READ, in fact, MINE, which is BiPAP with Auto SV, has a card, but that card can only be read by the company that provided the machine. They will not provide the software or ANY instructions on how to read that data. So, you see, it is really the company providing the machine that you should be putting "the pox" on.
But, and you can call me names all you want, many people simply would not be able to interpret properly the output of even a simple recording pulse oximeter, let alone a cpap or psg and so these companies have effectively prevented people from even looking at the data. Hence, my discussion with my sleep doc on my intention to procure my own recording pulse ox unit.
In case you're NOT aware - *I* am NOT in this profession. I do NOT keep anyone in the dark, I have made statements on several threads here to help people, and any statement that my doctor made to me, well, in this case I have no reason to doubt him. The fact that I happen to AGREE with him is probably what angered you - so be it. If MORE people demanded that they have access to this data, it would be far more likely to happen, but I was the FIRST one that even suggested keeping tabs on this myself to him. This pretty much proves his point. If people truly took their own health into their own hands, did the research, a lot MORE people would be asking and doing this and eventually the standard of care would probably change.
Remember... ULTIMATELY, the goal of ALL this machinery, surgery, dental appliances, Acupuncture, etc that we're discussing is to prevent O2 Sat from dropping and the CPAP or any of those machines don't record ANYTHING about O2 Sat. Secondary to prevention of low O2 sat is prevention of excess CO2 buildup.
You asked if I thought OSA was a respiratory problem. It IS a problem with RESPIRATION. If one breathed NORMALLY, one would NOT have OSA so from THAT sense, yes, it IS a respiratory problem. I guess the real question is - do you consider your throat part of your respiratory tract? If so, then OSA IS a respiratory problem. Since the nose and nasal passages, paranasal sinuses, and throat or pharynx is considered part of the Upper Respiratory Tract, then, QED, OSA IS a respiratory problem. This does not say anything about the CAUSE. As someone would note, being overweight can cause OSA, just as it can cause hypertension, CHF, diabetes, and a whole host of other things. Sure, you want to treat the root cause, BUT, and this is big but... you STILL TREAT all the symptoms along the way so they don't cause other damage or problems! And I just used overweight in this example because it's one that's easy to understand and generally accepted.
The problem with CPAP, BiPAP, etc. is that it can actually CAUSE CSA, which further complicates the whole mix... so - by fixing ONE problem (with CPAP), you can create another. The problem I have is that CPAP or even BiPAP is that it is so unnatural. Something better HAS to be found, the number of people that just can't put up with it is too great.
I'm not going further into my particular details at this point since people here simply can't accept logic and facts, rather they act on emotion, provide anecdotal evidence and expect it to be taken as gospel.
As to being called an ignoramus. I bet you don't even know the definition, so here it is:
Ignoramus
1 : an utterly ignorant person : dunce
to go a bit further...
Ignorant
1a : destitute of knowledge or education ; also : lacking knowledge or comprehension of the thing specified b : resulting from or showing lack of knowledge or intelligence
At this point I'll just refer you to the first line in my post since I am secure in my knowledge.
Judy said:[QUOTE] ... When I discussed the idea of getting a recording pulse oximeter so we could review things on an ongoing basis and not just keep the treatment based on the sample of one or two nights in an artificial environment, he thought that was a fantastic idea and said that more people should take charge like that but sadly, most people just don't have the (mental) capability to do so. ... [/UNQUOTE]
A recording pulse oximeter???? What about a fully data capable CPAP? You don't think that the fully data capable CPAP can provide more and better info about your sleep? You think OSA is a respiratory problem??
[QUOTE] ... sadly, most people just don't have the (mental) capability to do so. ... [/UNQUOTE]
Of all the IGNORANT, INSULTING, DEMEANING ..... a pox on you and your sleep doctor! What a pompous, self-serving, pair the two of you make!!!! Keep the patient in the dark because the patient is too ignorant to add 2 to 2 and get 4. IF you opened your closed, egotistical minds and allowed the patients a bit of common sense at all and a chance to catch their breath you might find out what IGNORAMUSES you are!!!
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Okay. I've had a chance to cool off a bit. I find it so VERY OFFENSIVE when the medical profession gives so little credit to the general population when it comes to their own healthcare!!!! I've talked to so many at apnea support groups, in pulmonary and physical rehab, on medical condition online support groups ... yes, often we are overwhelmed at first and don't ask pertinent questions. NOT because we are too stupid or w/o the mental capability of understanding our condition and our therapy or treatment but BECAUSE the medical profession does NOT reach out to us and HELP us accept, understand and take part in our treatment. Its easier for the medical profession to ASSUME we are not capable, not interested.
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And, IF you REALLY wanted to tackle the data from a fully data capable xPAP you WOULD be able to quite easily get the professional software for it. "I" have the professional software for both my VPAP Auto AND for my S1 BPAP Auto and I use and pretty much understand the data from both. When and if I run across something I don't understand I have my sleep doctor, my local DME provider's RRT and the apnea support forums to get the information necessary to understand it. It doesn't take much effort at all to understand the data from a recording oximeter. For understanding the data from an oximeter or an xPAP all it takes is some curiosity and a very little bit of effort.
I notice that your doctor didn't offer to write yuo a script for your VPAP Auto ST's software. Did you even bother to ask him for a script for it? I asked and my doctor did. And if he hadn't I would have still gotten a copy of both software.
You think that your stating
[QUOTE] ... most people just don't have the (mental) capability to do so ... [/QUOTE]
isn't insulting?????
For a fellow patient to take such a superior attitude is INFURIATING!! You're darn right some of your comments ARE offensive! Extremely so. YOU are so much more intelligent than the average patient???? Snort!!! I seriously doubt it.
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star trekking accross the universe always going forward cause we can't find reverse
star trekking accross the universe always going forward cause we can't find reverse
its life jim but not as we know it, its life jim but not as we know it
we come in peace (shoot to kill) we come in peace (shoot to kill)
star trekking accross the universe always going forward cause we can't find reverse
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Permalink Reply by Clueless in Redwood Shores on
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I am a big Judy fan and Carl does lack somewhat for diplomatic skills. Moreover my own life experience suggests that practical experience can often trump formal education; I respect both. I also respect both Judy's constant help to myself and to others on this forum and the content of Carl's message when you sift the nuggets from the in-artful expression in which he sometimes indulges and the collateral arguments he's provoked. Carl -- one of my favorite aphorisms is "there's nobody so worthless he can't serve as a bad example" and I apply that to myself first and foremost.
Nonetheless, I was glad to learn about recording oximeters; especially because of what I was told by one of the sleep fellows who does the heavy lifting before my sleep doc comes in for five minutes at the conclusion of biennial follow-ups (and from what I've read in other postings, that treatment is comparatively a "Cadillac Health Plan"). I have never quite trusted the read-outs after our brief conversation.
He expressed a suspicion that both Resmed's and Remstar's software are biased to congratulate themselves on the good job their machines are doing. He made this comment in the context of suggesting that too wide a band between EPAP and IPAP in auto mode left the machine chasing itself through too much of the night to be of much therapeutic value, (an opinion the doc later validated). Thus, my supposition after reading Carl's comment and Judy's comment from May 10th of last year! on her use of that equipment is that use of a recording oximeter at regular intervals is not a bad way of 1) validating the great success my machine claims I'm achieving ( I have so many other challenges between osteo-arthrititis pain, poor sleep hygiene, and financial challenges that I discount the evidence of my own senses as to whether or not I feel well-rested on awakening), and 2) postponing the need for a follow up study. I am very sensitive on that particular score because more than 8 years lapsed between the study that pronounced me "free" of OSA after a litany of surgeries and the most recent one, 15 months ago, which revealed severe OSA. That study was ordered by my cardiologist when the heart arrhythmia which had been readily controlled by meds started to run wild. (She certainly sees a connection between sleep and heart health.)
Mike and/or Judy -- when you wade through these lightly edited, heavily verbose jottings, could you either start a new thread on oximeters or let me know if there is further pertinent discussion of whether or not the SPO 7500 is indeed worth three times the price of the CMS 50E ( and Judy I promise to read the threads on cpaptalk on that latter machine while waiting your response).
Peter
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