What to do about physician who refuses to prescribe FFM?

[Wonderbrah]

First off, I have only met with my sleep physician once and that was before I had my study done and was diagnosed and put on C-pap therapy. I found out about his prescribing habits and methodologies from my DME, a person (Scott) there who is in close contact with him. His reasoning, according to Scott, for not prescribing full facial masks is because their a much greater potential for mouth leaks. His go to choice of treatment is nasal pillows alongside a chin strap if needed, and that is exactly what he's prescribed me. Well all fine and dandy as I've been on therapy for a few weeks and it has been going swell but the last couple of nights I have had severe nasal congestion to the point where I literally could not breath through my nose at all. I took Allegra, used Flonase both to no avail. I threw the nasal pillows on anyway and hoped for the best. My AHI in the morning was near 12.0. It's usually anywhere from 0.5 to 2.0. I felt horrible. I felt like I lost all the progress I had made in the previous weeks and am now starting from scratch. I called the sleep center to try to move up my follow up appointment (remember I've only seen my doctor once) and they obliged but only by 5 days. My appointment is now July 15th.

It took my nearly 6 months to initially get in for a sleep study as this place is extremely popular, highly recommended and thus booked on the arse. They at times even reroute their phone calls to a third party who will then forward your messages to their office, which I find absolutely ridiculous and many times my messages seem to get lost in "translation".

Has anyone heard of Dr. Avram Gold? My physician, according to Scott was his apprentice and takes after his ideals regarding the nasal vs ffm. This is at Stony Brook Sleep Center on Long Island. I don't think I can take another night of nasal congestion like that as I'm left completely non-functional in the morning. Does Cpap.com require an RX for full face masks?

[BlackSpinner]

Get your regular doctor, dentist or PA to write a prescription that says "mask of patient's choice"

[Pugsy]

In the absence of a workable RX (BlackSpinner is correct in that you can get a RX for "any mask" from any one who can legally write a RX) you can buy replacement mask parts online without a RX and build your own mask.
You just need to make sure you know which "parts" to buy.
Downside is that return insurance isn't available when you build your own mask....like if you bought from cpap.com.

Unfortunately it won't help you for tonight. If you are a little clearer about where you are located perhaps one of the forum members who lives in your area could help you out with a full face mask for tonight and the weekend.
If I lived closer I have a full face mask I could loan you but I am way far away from New York.

[Julie]

If your congestion could possibly be due to a too-high humidifier setting, lower it or even turn it off for a few nights.. I never use mine as I'm near the ocean, and when I have, quickly became congested.

[BlackSpinner]

If your congestion could possibly be due to a too-high humidifier setting, lower it or even turn it off for a few nights.. I never use mine as I'm near the ocean, and when I have, quickly became congested.

Or too low setting. I always use mine even at the sea shore because otherwise I get painfully stuffed up.

[ChicagoGranny]

I found out about his prescribing habits and methodologies from my DME, a person (Scott) there who is in close contact with him.

Scott might be a damn liar. Many brick-and-mortar DME employees are. Many others are full of misinformation.

You don't mention what your current prescription says. Check it out. For all I know, it doesn't specify nasal mask. You have a legal right to the script and can get it from the doc's office.

[Gasper62]

"What to do about physician who refuses to prescribe FFM?" Find new physician.

[Julie]

+1

[chunkyfrog]

I would rule out lethal force, but mostly because it's illegal to
kill large varmints inside city limits.

[Jay Aitchsee]

A call to your doctor's office is in order. Most would consider the information given to you by "Scott" to be absolutely wrong! A FFM deliveries therapy in the presence of mouth leaks. A nasal mask and chin strap will not necessarily prevent leaking and degradation of therapy. It wouldn't surprise me if this is not actually your doctor's stance, but a fabrication by your DME.

Your doctor may well have prescribed a nasal mask because most patients probably are less put off by one initially and most DME would find them easier to fit, However, if your doctor is adamant about not changing your prescription, and you've had your 30 day review to satisfy your insurance, take your study and your prescription and find another doctor. Now that you have your study you won't have to wait 6 months for action.

[palerider]

I would rule out lethal force, but mostly because it's illegal to
kill large varmints inside city limits.

it *should* be encouraged.

[Thatgirl]

How long have you been using the Allegra and Flonase? They both require routine use to be effective if allergies are a problem for you. For a short term solution to congestion, you can use neosynephrine nasal spray for up to 3 days to quickly help.

I agree with your doctor that by and large, nasal masks are better but only IF you can breath out your nose! Not even giving you the choice is crazy.

Many have suggested good options here, but another thing to note is that Amazon and eBay often have masks that can be bought without prescriptions- sometimes you need creative search terms.

[WarmBodies]

I agree with your doctor that by and large, nasal masks are better

Nasal masks are not better than FFMs. The two types of masks are made for different purposes.

Also, you don't know what his doctor thinks. You only know what Scott at the DME said about his doctor's thinking.

Scott might be a damn liar. Many brick-and-mortar DME employees are. Many others are full of misinformation.

You are correct.

[Gasper62]

A nasal mask or pillows are approximately as useful as teats on a bull when someone is squarely in the throes of a full-blown head cold/flu (and the accompanying nasal congestion). No CPAP home should be without at least one FFM in my opinion. The doctor is an ignorant baboon for not knowing this.

[palerider]

A nasal mask or pillows are approximately as useful as teats on a bull when someone is squarely in the throes of a full-blown head cold/flu (and the accompanying nasal congestion). No CPAP home should be without at least one FFM in my opinion. The doctor is an ignorant baboon for not knowing this.

it's good to have options