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For those that are following my last discussion, maybe you can help with this one.

I got a new ResMed Swift FX nasal mask on Wednesday (11/10) after much discussion with me DME guy Joe. We agreed that the F&P Opus 360 was not working for me (too many leaks). I was so optimistic that this would be the answer to my waking up choking, and the feeling like I could not breath.

I used it Wed, Thurs, Friday. Well here it is Saturday morning and all 3 nights I wake up almost exactly 2 hours later with the same problem !

 I have a new machine too, ResMed S8 Escape II, with H4i heated humidifier, set at 2. Also, This new mask fits far better and there are no leaks. It is more comfortable too.

 Also as a side note: I purchased the Contour products CPAP pillow, I love it ! My neck is so much more comfortable and when I turn on my side my headgear stays in position. (Just a feedback for those that might want to purchase it)

What am I doing wrong guys???

Donna B.

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Hi Douglas, I don't think your nuts !
I am happy to report that with the chin strap and increase of humidity to 3, I MADE IT THROUGH THE NIGHT !! I didn't wake up once (that I know of ) and here I am at 6:45am typing away. I feel really good this morning. :) I hope this was not a fluke and that I actually have found the answer to my problem.
Thanks for the advice,
Donna B.



Douglas Buis said:
Donna, I may be nuts, but humor me on this one.. It will only cost you $17 to try.

Go to a drug store and pick up some Prilosec OTC, and start taking one every day according to directions. If by 14 days you don't feel better, then you know it's not acid reflux. You may have acid reflux and show no symptoms of it during the wake hours, sometimes CPAP will suck stomach acid up your throat, especially if you eat or drink soda soon before laying down and sleeping..

Try that, and take that mask back, and ask them to exchange that mask for a Resmed Liberty. It will provide you the nasal protection you need, and also provide you with a backup through the mouth if you begin mouth breathing. And have your Dr increase your pressure appropriately.

If either of those don't fix your problem, you need to keep discussions with your Dr open to find solutions, you need to ride some of them to not rely on WebMD's list of "symptoms" as a bible sometimes..
Donna, I'm a little confused as to how you're using your Ramp. The object is to get up to full pressure over a period of time so you become accustomed to it before you reach that final high pressure. You shouldn't have to stay awake waiting for the machine to reach six bars. You should be able to change the ramp time just from the front of the machine by pushing the up and down arrows. On my ResMed I hold the right and left arrow buttons down at the same time for about three seconds and it takes me to a menu where I can scroll down to check results. You want to choose "efficacy", submenu under results. If the machine is data capable this should give your numbers. Glad last night was better and you made it through.
Let us know if you can get any data. Check before noon, the numbers roll over.

Donna B. said:
Thanks sleepycarol, I will call Joe on Monday to find out why I don't have a full data machine. And as far as the ramping time, geez, it takes 20 minutes for it ramp up to the 6 bars and then settle so I can use it. I struggle to stay awake waiting for it !
Donna I do apoligize. I got the S8 elite and the s8 escape confused. Your machine is NOT a fully data capable machine. Where is Judy when you need her.
Bummer.



Rock Hinkle said:
Donna I do apoligize. I got the S8 elite and the s8 escape confused. Your machine is NOT a fully data capable machine. Where is Judy when you need her.
Hi Mary,
Well I guess I read the directions wrong, I thought I was supposed to wait for it to finishing ramping ! I was able to change the ramp time from 20 minutes to 5 minutes. Is that ok? Is 5 minutes to fast? I'm not sure what it should be.

Sunday night I slept a full 8 hours, no choking or waking up. I am so happy. I felt really good today, no afternoon exhaustion and I was able to drive home with my wits about me. I finally feel like this is working and can only get better.
Thanks for your advice,
Donna B.



Mary Z said:
Donna, I'm a little confused as to how you're using your Ramp. The object is to get up to full pressure over a period of time so you become accustomed to it before you reach that final high pressure. You shouldn't have to stay awake waiting for the machine to reach six bars. You should be able to change the ramp time just from the front of the machine by pushing the up and down arrows. On my ResMed I hold the right and left arrow buttons down at the same time for about three seconds and it takes me to a menu where I can scroll down to check results. You want to choose "efficacy", submenu under results. If the machine is data capable this should give your numbers. Glad last night was better and you made it through.
Let us know if you can get any data. Check before noon, the numbers roll over.

Donna B. said:
Thanks sleepycarol, I will call Joe on Monday to find out why I don't have a full data machine. And as far as the ramping time, geez, it takes 20 minutes for it ramp up to the 6 bars and then settle so I can use it. I struggle to stay awake waiting for it !
If you don't need the ramp, turn it off. The ramp is essentially "training wheels" to help a newbie get used to the pressure. You are doing fine with the pressure. Sounds like things are going well now, but if a problem arises, you won't have data to figure out what's going on.

You need to call your DME and get a data capable machine ASAP (wait too long and the DME will tell you it's too late to change machines).

As to why you got a machine that isn't data capable in the first place:
1. Your doctor either doesn't care one way or another, OR he hopes to make money on an expensive sleep study every time you have a problem. If he cared, he would have specified a data capable machine in your prescription, AND
2. Your DME cares what you get because data capable machines cost them more, and eat into their profit margins. Customers who are not squeaky wheels or who do not have specific scripts from doctors who actually give a hoot are suckered into non-data capable machines so that your DME can make more money. They saw a big fat sucker sign on your forhead when you walked in.

Now, go tell them where they can put that sucker sign!
Ha, wait till he gets the phone call tomorrow !! (Didn't have time to call today, work was crazy busy) I have had the new machine since last Wednesday so it will be a week tomorrow.
I am a very outspoken person, I speak my mind and won't take no for an answer. If their bottom line is a problem than I just became a bigger problem. Most people just take what the Doc says as so. If they don't do their homework/research then too bad for them. With help from folks like you I am more educated and prepared when I speak to my sleep doc. I have only been a SA patient since August so this is all very new to me, I am trying to learn as much as I can as fast as I can.
Thanks,
Donna B.


Janknitz said:
If you don't need the ramp, turn it off. The ramp is essentially "training wheels" to help a newbie get used to the pressure. You are doing fine with the pressure. Sounds like things are going well now, but if a problem arises, you won't have data to figure out what's going on.

You need to call your DME and get a data capable machine ASAP (wait too long and the DME will tell you it's too late to change machines).

As to why you got a machine that isn't data capable in the first place:
1. Your doctor either doesn't care one way or another, OR he hopes to make money on an expensive sleep study every time you have a problem. If he cared, he would have specified a data capable machine in your prescription, AND
2. Your DME cares what you get because data capable machines cost them more, and eat into their profit margins. Customers who are not squeaky wheels or who do not have specific scripts from doctors who actually give a hoot are suckered into non-data capable machines so that your DME can make more money. They saw a big fat sucker sign on your forhead when you walked in.

Now, go tell them where they can put that sucker sign!
Finally got an answer to the data question. According to me DME guy, I was prescribed the S8 because I have MILD sleep apnea. My Doc did not think I needed a full data machine. It does record hours used and and he said it does record my AHI. I go back for a follow up in January. I am still sleeping well since I last posted.





Donna B. said:
Ha, wait till he gets the phone call tomorrow !! (Didn't have time to call today, work was crazy busy) I have had the new machine since last Wednesday so it will be a week tomorrow.
I am a very outspoken person, I speak my mind and won't take no for an answer. If their bottom line is a problem than I just became a bigger problem. Most people just take what the Doc says as so. If they don't do their homework/research then too bad for them. With help from folks like you I am more educated and prepared when I speak to my sleep doc. I have only been a SA patient since August so this is all very new to me, I am trying to learn as much as I can as fast as I can.
Thanks,
Donna B.


Janknitz said:
If you don't need the ramp, turn it off. The ramp is essentially "training wheels" to help a newbie get used to the pressure. You are doing fine with the pressure. Sounds like things are going well now, but if a problem arises, you won't have data to figure out what's going on.

You need to call your DME and get a data capable machine ASAP (wait too long and the DME will tell you it's too late to change machines).

As to why you got a machine that isn't data capable in the first place:
1. Your doctor either doesn't care one way or another, OR he hopes to make money on an expensive sleep study every time you have a problem. If he cared, he would have specified a data capable machine in your prescription, AND
2. Your DME cares what you get because data capable machines cost them more, and eat into their profit margins. Customers who are not squeaky wheels or who do not have specific scripts from doctors who actually give a hoot are suckered into non-data capable machines so that your DME can make more money. They saw a big fat sucker sign on your forhead when you walked in.

Now, go tell them where they can put that sucker sign!
With your S8 try holding down the left and right arrow buttons at the same time for a few seconds and see of a prompt for a menu comes up. Scroll down, your AHI should be under results then efficacy.

Donna B. said:
Finally got an answer to the data question. According to me DME guy, I was prescribed the S8 because I have MILD sleep apnea. My Doc did not think I needed a full data machine. It does record hours used and and he said it does record my AHI. I
A practical hint about DME providers: far too many are not very well-versed or knowledgeable about the products they are providing, guilty of sins of omission, less than truthful or just plain out and out right liars.

Insurances pay by HCPCS (insurance) code, NOT by brand and model. The Resmed S8 Escape II, Resmed S8 Elite II and Resmed S8 AutoSet II are all the exact same HCPCS code: e0601.

AND Resmed is no longer producing the S8 II series. They have been discontinued. The Resmed S9 series has taken the S8 II series' place.

I am willing to bet a dinner at The Outback that your doctor did NOT write your script specifically for the S8 Escape II but rather just wrote it "generically" for a CPAP. And I'll bet a second dinner at The Outback that your doctor made no such statement to your DME provider but rather that the DME provider is putting words in his mouth that were never uttered - or written.
Ouch. Dang Judy, why does this have to be so difficult ? Why can't my Doc just let me have a data capable machine if it doesn't matter how it is coded ? And why would he not be concerned about my AHI, leaks etc? Is it because I only have Mild SA ? I thought all SA was serious and should be monitored ? Also, my DME and Doc are in the same practice and work together with their patients. I would hate to think that my Doc is letting the DME supplier give out whatever CPAPs they have in stock instead of what the patient really needs :{ So I guess a phone call to the Doc is now in order.




Judy said:
A practical hint about DME providers: far too many are not very well-versed or knowledgeable about the products they are providing, guilty of sins of omission, less than truthful or just plain out and out right liars.

Insurances pay by HCPCS (insurance) code, NOT by brand and model. The Resmed S8 Escape II, Resmed S8 Elite II and Resmed S8 AutoSet II are all the exact same HCPCS code: e0601.

AND Resmed is no longer producing the S8 II series. They have been discontinued. The Resmed S9 series has taken the S8 II series' place.

I am willing to bet a dinner at The Outback that your doctor did NOT write your script specifically for the S8 Escape II but rather just wrote it "generically" for a CPAP. And I'll bet a second dinner at The Outback that your doctor made no such statement to your DME provider but rather that the DME provider is putting words in his mouth that were never uttered - or written.
Donna B.,

From my personal experience, the experience of friends and associates, and the experience of thousands of people posting on internet forums, it is typical for sleep docs and their labs to prescribe basic machines and keep their patients in the dark about the existence of machines and software which will measure the effectiveness of the therapy.

Why this is I will leave for another discussion. But for me, it is unacceptable, even negligent. Even for a patient with a mild case.

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