"please keep me updated about oximeters "
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Non compliance
I have been struggling for about 6 weeks to deal with the bipap machine and have not been having good luck. Between coughing from new blood pressure meds, poorly fitting masks, and the general pain in the butt that this has become, my doc tells me that I have past the 30 day window that Medicare uses to get patients up to a compliance level and that the machine will soon be taken back by DME because of non-compliance. The DME is telling me that the window is 90 days, not 30. Is my doc just trying to screw with my head and make me try harder or is he right on this issue? I want this to work, but until I feel I am being pushed way too hard too fast to get this done. Anyone with thoughts on this issue, I would appreciate hearing from you.
Views: 266
Replies to This Discussion
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Permalink Reply by Chris H on
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Hi Bill, I have switched 3 different BP meds in the last few months Are you on ACE or Beta blockers? Good Sleep,Chris
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Permalink Reply by Bill Love on
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Originally on lisinopril (ace inhibitor) then switched to metorporol but not quit that as well. Started prescription zantac to fend off GERD coughing and only being somewhat helpful. Am I overly optimistic about getting a mask that really works and won't go into major leaks that keep me awake all night. Now the damned bipap machine has failed and it took them five days to get me a new one. I am so close to just saying screw it all and if I die of heart attack or stroke as they threaten will happen, so be it.
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Hi Bill, The third bp med lostartin has no cough side effect so you may want to look in to that.
It took 5 + weeks to loose my ace cough.
Humidification also is important more is better for me.( pap dries you out)
Getting the mask for you figured out is trial and switch till you find something that works.it can be done.
raising the bed head, not eating late, acid reducers have been helpful with my gerd
Do not give up yes its a suckey process but you have gotten threw suckey things in the past just keep at it.Good Sleep,Chris
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Permalink Reply by Mary Z on
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I don't know who is right about the compliance window- your doc or dme, Bill, but I would believe the DME. Are you doing any better now and able to improve your compliance? I'd hate to see you lose the machine over BP meds and the mask. How's the cough? How are you doing with the mask? I must have tried 15 before I found the one that worked. Some I just tried on briefly, but a few- a good five or so, I used for some time before I found the one that works for me (FitLife Total Face Mask).
Keep us posted, Bill
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Permalink Reply by Patricia Jokerst on
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HI , I am Sleep Center Manager, I have been in sleep medicine for 11+ years. The actual dates for PAP compliance for Medicare patients is 31-91 days. Medicare will have the DME pull the Machine from the patient, if they are not 70% compliant (at least 4 hours each night) with PAP therapy. Most good DME company will give you 30 day trial of each mask while acclimating to PAP therapy, ( they are given the same courtesy by big production companies like RESMED, RESPIRONICS, FISHER PAYKEL etc) which is critical within the first 2-3 weeks of new PAP patients, and should be contacting them to do a monthly download and sending to the physician whom is following your PAP therapy.
Proper education is also VERY important in ones therapy. This includes all : Information from the referring physician, sleep physician, technologist, DME. Each play a vital role in ones PAP therapy and none are less important from the next.
Now, if you are a medicare patient struggling with PAP therapy, and the physician whom wrote you the order for your PAP machine and supplies should be aware of all your issues. There are thousand of nasal and nasal/oral masks in the industry. Every effort should be taken on all levels, contact the physician, DME, Sleep Center. Discuss these issues with anyone whom will listen! Hopefully they all will, otherwise they are not doing a good job, to help educate you on such a detrimental element to your health. If they do not, look into find a new facility who will!!!
To add something that may help you, is this. Try sitting on the edge of your bed at night, (before lying down) holding your CPAP-BIPAP-APAP mask (with the pressure on) to your nose/face for several minutes at a time. This will allow your sinuses to adjust to the pressures you are breathing in and out on them. Do this until, you are well acclimated to those pressures so that when you do lay down, it is just as easy to breath out, as it is to breath in on these separate pressures. It is purely your sinuses that need to adjust to them, concentrate on breathing in and out of your nose ONLY! Even if you have a Full Face Mask, your body will chose the pathway least resistant, ie... when you are asleep your body will chose to breath through your nose all by its self, when you are being feed air through your nose by PAP therapy. Let me know if that helps.
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Thanks for the information, Patty. I appreciate the encouragement to be proactive in your care and keep talking to everybody until someone listens and change providers if you have to do that.
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After thinking about the way the bipap machine failed, I think I have had a faulty machine all the time. It would just go into uncontrollable high pressure without any warning. The new machine (actually an older version of the Resmed System One AVS) the leakage problem has been reduced. Between that and finally finding what I hope is a solution in a workable mask. Tried the life Fit mask and it leaked worse than all others I tried. Got a Quattro fx and with the addition of a anti leak strap from pad a cheek, I think I have it under control, FINALLY. Saw pulmonologist this week and seems much more positive in his review of my progress. The cough seems to have subsided at night, although still coughing during the day. Seeing the GI specialist Friday to arrange for further testing there. Thanks for all the advice. Hopefully Medicare will recognize the problem and let me continue with therapy on their nickel, so to speak.
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Bill, Re the leaks, It is great that you have them under control, have you tried mask liners and have you raised the hose above your head? I have found that the biggest help for me in reducing leaks.
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Permalink Reply by Kristi Halsey on
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For leaks you may also find something useful at www.cpapseal.com
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