After your initial diagnosis did you get to meet w/a Dr.?

[SoCal Guy]

What I want to know is, after referral from your primary care dr. or employer was your first encounter with a doctor specializing in sleep or a tech to fit you with the sleep study gear?
Did you see a doctor right after the study or just go straight to getting the CPAP from a tech?
Anybody out there go through this process with Kaiser?

I never got a chance to review in detail my results either with a doctor or a tech. That seems weird, is that normal?
1. I got mine through the VA. My first step was to attend a class with 8 other veterans. A nice man and long time CPAP user explained how to hook up our sleep study gear and what to expect.
2. I returned the gear and was told I need a CPAP.
3. I attended another group class lead by two very experienced Respiratory Techs (one of which is a CPAP user) on how to use my cool, new CPAP. On the desk was a summary of my results. The techs gave a brief overview of what the terms (AHI, O2 desat, etc.) meant. Then they taught us to use the CPAP.

All I want is one session with an MD that goes into more detail of my sleep study. At the VA , that's not a part of the typical process. I haven't requested a doctor appointment as I have another sleep study coming up at Kaiser. I'm hoping to get a bit more detail and a meeting with a doctor.

For the record the VA La Jolla sleep department is a large department, is quite responsive and does an excellent job. Your experience at a different VA may be dramatically different. La Jolla VA is a gem among VA hospitals

[BlackSpinner]

The respiratory tech using the cpap machine probably knows more then the MD re the sleep study.

[LSAT]

They gave you a great machine...top of the line. The second sleep study is normally to determine the proper pressure. It's strange that they gave you the machine before the second study.....The VA does everything different. Once you start your therapy, you can get most of your questions answered here.

[Julie]

Even so called 'sleep' doctors often know little about equipment or software... they may know the science of apnea, but not necessarily useful info to go forward with... and this forum is probably one of the best places to learn. Most GPs know nothing at all, and what they think they know is so often based on way outdated stuff like 'only men over 50 who are obese get apnea". Very sad. Unfortunately many techs have odd ideas as well and DMEs are more concerned with profit. Of course there are terrific people out there, but finding them, knowing enough to recognize that they're good can be a long, hard slog. Haven't seen a doctor since diagnosis, saw a tech who set me up (a smart one) and haven't seen anyone since.

[SoCal Guy]

I've received 3 replies so far all contain good info, so thanks.

But....not one answers my question

- Did any of you meet with a Doctor specializing in sleep after initially being diagnosed?
- Is it normal to be well into CPAP therapy and never meet with a MD specializing in sleep?
- Did anyone go over your detailed, full sleep study with you or just give you a summary?

Sorry, I'm cranky from lack of sleep, really

[ChicagoGranny]

not one answers my question

- Did any of you meet with a Doctor specializing in sleep after initially being diagnosed?
- Is it normal to be well into CPAP therapy and never meet with a MD specializing in sleep?
- Did anyone go over your detailed, full sleep study with you or just give you a summary?

Yes/Yes/Yes-detailed.

But, what does it matter except to a curious mind? The important thing is going to be using SH to optimize your therapy over some days in your own bed.

You want to make the way you were breathing in your sleep into forgotten history.

[LSAT]

YES...NO...NO....Chances are the only thing the doctor will tell you is that you need a CPAP because your AHI was____. Be sure to use it every night.

[Bons]

In many cases the doctor doesn't see the patient until he or she has used the machine for awhile. The doc prescribes the machine and settings based on the sleep study and it can be a waste of time and money to spend time with the doctor before there is data from the machine to discuss. There are exceptions. There is a hospital in Allentown PA where the doctor meets you over breakfast as you complete the sleep study.

[SewTired]

My BIL also goes through the VA. First, get a copy of your study (not just the summary report, but the raw data). Once you have that, contact the VA and tell them that you want your follow-up appointment with a DOCTOR and not a PA or someone with other initials after their name. You want an MD to go over your test results. Be insistent. I would even recommend calling the day before your appointment and making sure that they have the appointment scheduled with the doctor and not a PA or someone without an MD after their name. My BIL has had this bait and switch in the diabetes dept.

Honestly, I have never had more trouble with seeing a DOCTOR vs. a PA or some other person than I have with sleep doctors, although now this problem is seeping over to a lot of other specialties as well. I have no issue with it at my oncologist' because I know they work closely together and I have confidence with their arrangement. I don't have the same level of confidence with the sleep doctor's office especially since they don't ever seem to follow through on the 'research' issues we've brought up.

and to answer your specific questions: No, yes, No.

Much I know about my specific sleep issues I had to figure out myself or with help from the board. At least I don't get hassled from the sleep doc office for doing my own thing.

[Guest]

What I want to know is, after referral from your primary care dr. or employer was your first encounter with a doctor specializing in sleep or a tech to fit you with the sleep study gear?
Did you see a doctor right after the study or just go straight to getting the CPAP from a tech?
Anybody out there go through this process with Kaiser?

I never got a chance to review in detail my results either with a doctor or a tech. That seems weird, is that normal?
1. I got mine through the VA. My first step was to attend a class with 8 other veterans. A nice man and long time CPAP user explained how to hook up our sleep study gear and what to expect.
2. I returned the gear and was told I need a CPAP.
3. I attended another group class lead by two very experienced Respiratory Techs (one of which is a CPAP user) on how to use my cool, new CPAP. On the desk was a summary of my results. The techs gave a brief overview of what the terms (AHI, O2 desat, etc.) meant. Then they taught us to use the CPAP.

All I want is one session with an MD that goes into more detail of my sleep study. At the VA , that's not a part of the typical process. I haven't requested a doctor appointment as I have another sleep study coming up at Kaiser. I'm hoping to get a bit more detail and a meeting with a doctor.

For the record the VA La Jolla sleep department is a large department, is quite responsive and does an excellent job. Your experience at a different VA may be dramatically different. La Jolla VA is a gem among VA hospitals

I never got a chance to review in detail my results either with a doctor or a tech. That seems weird, is that normal?

This prob happens more often than not. The docs are supposed to review the study results and sign off but in many cases that is also left to a nurse or sleep tech.

Your experience at a different VA may be dramatically different.

That is true in most things in life, esp Health Care ~~ Esp. even more in Sleep Medicine.

La Jolla VA is a gem among VA hospitals.

Yet you are not happy with the treatment?
So to be fair you need to find someone else here who was treated at the La Jolla VA.

IME - VA hospitals are/were short of experienced sleep doctors. Your gem may not have enuff certified sleep doctors. Even seeing one may not be a good thing. Get your equipment there then learn how to manage and understand things here, on this forum.

On the positive side the VA is excellent at providing top of the line equipment and access to your medical records (sleep study). Request copies of every visit - sometimes they write in things that never happened. The VA has a very limited choice of masks. If you get one that works for you -- you are lucky.

None of your questions were answered because I have not been treated at the La Jolla VA and can only relate my real life experiences.

[SoCal Guy]

But, what does it matter except to a curious mind?

You again, aaagh,
let's leave each other alone, not good chemistry. Plenty of other's I'm sure that will appreciate you kind of comments

[BlackSpinner]

Yes I saw a sleep doctor (totally different system in Quebec) once when he wrote the prescription and once after the titration. When I told him I could deal with the adjustment myself he said "great, come back if you can't handle something. Bon chance" and how great the internet was.

[SoCal Guy]

Yet you are not happy with the treatment?

Huh?, Not at all, in fact I went out of my way to complement them. So that didn't work out to well

Simply found it strange I never saw a Doc or PA, just techs with a 2 year degree. Wanted to see if that was normal.
I'm always so grateful for that VA benefit, it's come in handy all my post military life. If occasionally there are some slight deficiencies
compared to regular HMO/PPO care, well I let that go.

I simply wanted to know what the norm was. As mentioned I have an upcoming sleep study with Kaiser, so we'll see if I end up talkin to a doc there.

Thanx to everyone for the great info and advice. Now I know

[dorilu]

In my case, I was required to meet with my sleep doctor, (a pulmonologist who specializes in sleep disorders) following my titration study, before he would prescribe cpap therapy.
He only briefly went over my results and told me he would call in a prescription for a cpap machine to a local DME in my area.
I have seen him twice more in the 3 month period I have been using cpap, due to the fact that my AHI remains high, even higher than what was documented at my sleep and titration studies.
He doesn't seem to know why this is the case and at my last appt. last week, he just said we would keep the pressures at 5-15 and to continue using it and he would see me in 6 months and evaluate.

My numbers have gotten somewhat better since I got help here on the forum from some great people who advised I change my min. pressures up to 12, and have given me good advice regarding mouth breathing, humidity and more.

IMO, you can get much more help from the members here who are way more knowledgeable about Cpap therapy than doctors appear to be. I agree with Julie that they may know about the science of apnea but not so much about how to go forward with it to achieve the desired results. Of course, I'm speaking from my experience with my Doctor, who leaves me feeling like he just doesn't have many answers when it comes to fine tuning therapy to get results.

[Wulfman...]

I've received 3 replies so far all contain good info, so thanks.

But....not one answers my question

- Did any of you meet with a Doctor specializing in sleep after initially being diagnosed?
- Is it normal to be well into CPAP therapy and never meet with a MD specializing in sleep?
- Did anyone go over your detailed, full sleep study with you or just give you a summary?

Sorry, I'm cranky from lack of sleep, really

Just keep in mind that my sleep study, diagnosis and beginning therapy was nearly 12 years ago.

- Yes.....Before and after. (basically wasted time)
- Yes.....From what I've read on the forum.
- No......Essentially a summary (verbally). About a year and a half later I requested the written summary.

But, my sleep doctor was an idiot and it was not a pleasant experience.
The pressure he prescribed was wrong.......along with some of his other perceptions regarding my diagnosis.
I found this forum weeks before my sleep study and learned more here and by reading about Sleep Apnea.


Den

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