Replies to This Discussion

Permalink Reply by Daniel on February 18, 2009 at 1:00pm

Cam,

The original post mentioned you are using a saliva gel. Is it Biotene? A friend who is an oral cancer survivor who lost his salivary glands tells me that this is the best product he's found.

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Permalink Reply by Cameron on February 19, 2009 at 10:41pm

Wow thanks Carol, unfortunately, it's been longer than 30 or 45 day :-(. I have gotten 3 different masks now, a full mask, a nose mask with the chin strap and now the hybrid one. As for the nasal pillow, I tried it again and yes, my mouth started opening while I was falling asleep and woke me a few times so I took off the machine :-( I'm hoping the hybrid one will be better. Tonight my wife and I attended our Financial Peace University class and came home to find that our dogs had gotten her nose mask and tore it up. It was hanging off of a light that is hooked to the top of our bed head board way up high. It appears that the larger of the two dogs (he is the only one who can jump up onto the bed) jumped onto the bed and then had to stand up on his hind legs to reach it and ripped it down and destroyed it. :-( so now my wife has to use the nasal pillows because I would assume that insurance wouldn't cover replacement from dog malling. BAD DOG!


Thank you for looking into the Sjogren's info for me, I really appreciate it. As it is now I use Biotene products that help somewhat.

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Permalink Reply by Cameron on February 19, 2009 at 10:42pm

Yup it's Biotene and it is good but I still get dried out. Guess it's something I'll have to live with. I do know they can prescribe something to help me make more saliva and I will be asking my doctor about that at my next appointment.

Daniel Levy said:

Cam,

The original post mentioned you are using a saliva gel. Is it Biotene? A friend who is an oral cancer survivor who lost his salivary glands tells me that this is the best product he's found.

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Permalink Reply by Cameron on February 19, 2009 at 10:45pm

Yes thanks Judy, unfortunately I am past the 30-45 days. I'll have to see if my insurance will pay for a new one, I have BCBS Community Blue PPO. I know the doctor will write a script for one because all I've done is email him about the mask issues and he's gotten me 3 different masks. Thanks

Judy said:

If you have had this Plus CPAP for less than 30-45 days, call your insurance, ask what local DME CPAP suppliers they are contracted with. Hopefully you have the option of more than one as that will give you more bargaining/negotiating room. Then take that Plus back to your local DME supplier and tell them it is NOT ACCEPTABLE. Insist that they provide you with the Respironics M Series Pro w/C-Flex. If you do have the option of more than one local DME supplier use that weapon as well. All of your current equipment will be compatible w/the Pro. The Pro is fully data capable. The Plus should be taken off the market as should all less than fully data capable CPAPs in my not at all humble opinion.

If you've had it more than 30-45 days then it might pay to start w/your sleep doctor. DIPLOMATICALLY lay a guilt-trip on him that he's making therapy/equipment changes "by guess and by gosh", that the Respironics M Series Pro w/C-Flex will provide the data on your nightly leak rate, AHI, AI, etc. and you want a Pro in place of this bare bone, compliance data only Plus, that your insurance DOES cover the Pro, that the Pro and the Plus are the exact same HCPCS code for reimbursement purposes. Push for a new script for a Respironics M Series Pro w/C-Flex (x ressure setting, x C-Flex setting); Show AHI/Leak feature On; Full face, Nasal cushion, Nasal pillows or "hybrid" style mask of patient's choice".

Good luck!

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Permalink Reply by Judy on February 20, 2009 at 1:08am

Unfortunately, you've had your Plus more than 45 days. Its not at all fair or reasonable to expect the DME supplier who provided you w/a brand new device to replace that now used device w/another brand new (and a little more expensive) device and yet only be paid for ONE new device. That first 30 days use and possible return is built into the contracted price from insurance to cover the compliance issue. The only way now would be for you to pay the contracted monthly payment for the number of months you've had the Plus. And MOST LIKELY, it would just be cheaper to use your original script to purchase the Pro or even a step up to the Respironics M Series Auto w/C-Flex or w/A-Flex online from a good online DME supplier such as cpap.com out of pocket. Your original generic script is good for buying a CPAP or an APAP online.

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Permalink Reply by sleepycarol on February 20, 2009 at 8:05am

What you could do as well is scour your local thrift stores, flea markets, craigslist, www.cpapauction,com, etc. to pick up a data capable machine for reasonable price. I was able to pick up an auto apap (granted it is an older one) for only $40.00 on www.cpapauction.com. You can find great deals out there if you are willing to look.

What brand is your wife's cpap? Is hers a Plus as well?

Have you tried the Hybrid and how did it work for you?

You might try adding another humidifier to your set up as well. I have the intergrated humidifier but I, also, have the Fisher and Paykel stand alone humidifier HC100. It holds more water than the intergrated humidifier and if used along with your intergrated might give you more moisture -- if it doesn't interfer with your breathing. For me too much humidity (anything past 1) causes my asthma to act up and it is hard for me to breath. But I am thinking with the Sjorgens you probably wouldn't have that problem. These humidifiers can be picked up used at a fraction of the cost of new at the above mentioned places. It might be that if the doctor thinks it would help the insurance might even cover it.

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Permalink Reply by Cameron on February 21, 2009 at 10:06am

My wife has the same exact machine as I. Yeah even with my humidifier all the way up to 5, I still get dried out. I haven't gotten the hybrid mask yet, I'll get that this wednesday. I'll let you know how that works out.


Cam

sleepycarol said:

What you could do as well is scour your local thrift stores, flea markets, craigslist, www.cpapauction,com, etc. to pick up a data capable machine for reasonable price. I was able to pick up an auto apap (granted it is an older one) for only $40.00 on www.cpapauction.com. You can find great deals out there if you are willing to look.

What brand is your wife's cpap? Is hers a Plus as well?

Have you tried the Hybrid and how did it work for you?

You might try adding another humidifier to your set up as well. I have the intergrated humidifier but I, also, have the Fisher and Paykel stand alone humidifier HC100. It holds more water than the intergrated humidifier and if used along with your intergrated might give you more moisture -- if it doesn't interfer with your breathing. For me too much humidity (anything past 1) causes my asthma to act up and it is hard for me to breath. But I am thinking with the Sjorgens you probably wouldn't have that problem. These humidifiers can be picked up used at a fraction of the cost of new at the above mentioned places. It might be that if the doctor thinks it would help the insurance might even cover it.

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Permalink Reply by Cameron on February 26, 2009 at 12:16pm

My machine has a Smart Card and they can see everything I do on it. I was at equipment place yesterday to get my new mask and the tech showed me all the information that was on it. In fact there is a thread on here that talks about how there is actually too much information LOL! Anyway, I got the new mask which the tech also said must be the new in thing because it seems everyone wants one and she's given out 3 this week in a row. I don't know why anyone would want one. I tried it last night and it leaks like crazy so unless I can figure out how to adjust it properly I am back to wearing my face mask and trying to find a way to deal with the dry mouth. I sure hope I can figure out a way to wear this mask because the nice thing about it is that there is nothing that touches the bridge of your nose and so it doesn't leave you with a red sore gouge on your nose in the morning. Thanks for all the information.

Cam

sleepycarol said:

Your Respironics Remstar PLUS M series does NOT provide useful data -- it only provides compliance data -- meaning the number of hours and days you use your machine. It does NOT provide any other data -- such as leaks, AHI, etc. It is useless as far as determining what problems might be hindering treatment. Compliance data is needed for some insurance companies and Medicare and thus the reason for the data card.

If you haven't had the machine very long (less than 30 days typically) you could switch it out by talking with your doctor have him or her write a script for a data capable machine. Explain that you are having trouble with your therapy and having a data capable machine would help him or her determine what might be going on with your therapy.

Once we get into deeper sleep it is still possible to leak without the air making a loud sucking noise. Your lips parted slightly will still allow leaks to occur that probably will not wake you. Just because you experience this loud sucking sound while awake doesn't mean that the same is happening while asleep. This is not a good comparison to see if you are leaking.

I have used full face masks and I know that my mouth will dry out with a full face mask, even with the humidifier, if my mouth drops open even slightly. Same goes for the nasal pillows.

I am familiar with Sjorgren's Syndrome as my son-in-law's aunt has it (we all live in the same small community and socialize on occasion). She is on a cpap as well -- has been for about 6 months. So I know it is possible to have Sjorgrens and still use a cpap. Like I said in my previous post she uses special mouthwash and gels as prescribed by her doctor to help with the dryness. I will try to find out from my son-in-law the names of the ones she uses but it will probably be the week-end before I see him.

Let us know how you did with the smaller size pillows.

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Permalink Reply by Cameron on February 26, 2009 at 12:18pm

To add, the hybrid mask has a nasal pillow that is attached to a small mouth mask, this is why it doesn't touch the bridge of the nose.

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Permalink Reply by sleepycarol on February 26, 2009 at 5:27pm

Are you positive that your machine is the M series Plus?

Did the tech show you your AHI numbers, snores, leak rate, etc?

Did you get a print out (always ask for one)?

In my opinion you can NOT have too much information. I don't download every day -- actually about once a month any more since I have consistently low AHI and leak rates. My AHI usually is less <1 and leak rate is in line with the mask's rate.

I did a discussion on the different full face mask and described the hybrid -- along with a picture of it awhile back.

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Permalink Reply by Cameron on March 1, 2009 at 8:43am

Yes it is the M Plus series and it has a smart card too. She showed me all of it. I have to try to figure out how to correctly wear the hybrid mask during the day before I actually need to use it so I'm not fumbling around with it while tired.

Cam

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Permalink Reply by sleepycarol on March 1, 2009 at 7:10pm

Cameron said:

Yes it is the M Plus series and it has a smart card too. She showed me all of it. I have to try to figure out how to correctly wear the hybrid mask during the day before I actually need to use it so I'm not fumbling around with it while tired.

Cam

Unfortunately, she had to just show you compliance data if it is the M Plus series. They DO have a data card that shows compliance details ONLY. This means just the hours and days used. It is probably broken down into a chart possibly -- don't really know for sure. If you check online at respironics.com and locate the M Plus series machine manual you will see that it does NOT record the USEFUL data that many of us have access to.

The USEFUL data includes the rate of leaks, large leaks, snores, apneas per hour, flow limitations, etc.

Hope you like the mask and find it comfortable.

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