Doctors want to know

[AfibApnea]

The Philips Respironics recall is, presumably, the exception and not the rule. However, it is being treated, by institutions like Apria, as just another, normal-course-of--business, event.

I use a BiPAP ASV machine because I have BOTH Obstructive and Central sleep apnea—in other words—I have Complex Sleep Apnea Syndrome. In order to gain the benefit I need to gain from my BiPAP ASV machine I need to be able to use it with the humidifier.

My doctors, including my cardiologist, want me to be able to continue using my BiPAP ASV machine in the way it was designed to be used (i.e., with its humidifier, if necessary). They realize it is integral to my health and that not being able to use it may be seriously detrimental to my health.

They are saying to me: “…I’m not sure how can I help. I am sorry, this clearly is important.” And “Often the issue is worsening (heart) symptoms when you are not using BiPAP…We should see how we are can get this replaced ASAP.”

What kind of leverage do doctors have when it comes to the current Philips Respironics recall? To whom can they express their concerns and what, if anything, can they say (to the hospital, to Apria) that can cause their patients to be granted a fully functioning machine.

p.s. I am writing this as a person experiencing Complex Sleep Apnea. This is because other information I’ve read on this forum seems to indicate that different rules may apply to people using BiPAP and BiPAP ASV machines than those who use CPAP machines. By limiting my questions to those using the more complicated machines I do not mean to rule out the needs of those having to use CPAP units, whom I'm sure just as much need properly functioning units.

[greatunclebill]

any good board certified pulmonologist/sleep specialist should know how to correctly craft a justification for a new machine. if your doctor don't know how to do that, you need to find one that can. if the patient has to tell the doctor what to write the doctor is in the wrong field.

the doctor has to convince the insurance company, not the dme. it goes thru the dme, but they have nothing to do with approval.

[ChicagoGranny]

I use a BiPAP ASV machine because I have BOTH Obstructive and Central sleep apnea—in other words—I have Complex Sleep Apnea Syndrome. In order to gain the benefit I need to gain from my BiPAP ASV machine I need to be able to use it with the humidifier.

Just keep using the machine and the humidifier until a new machine is available. The risk from the foam is extremely overstated. In your case, the dangers of sleeping without CPAP are high.

Release of volatile organic compounds (VOC) including Dimethyl diazene and Phenol. Evidence suggests these gases dissipate after 24 hours from first ‘out of box’ use. There is a risk of short-term effects such as: headache/dizziness; irritation of the eyes, nose, respiratory tract and skin; hypersensitivity; nausea and vomiting. There have not been any reports of this to date.

Full alert: https://www.gov.uk/drug-device-alerts/n ... slash-mhra

[chunkyfrog]

What she said.
Just lie safely in your bed, and get the best you can get--NOW.

[ChicagoGranny]

I’ve read on this forum seems to indicate that different rules may apply to people using BiPAP and BiPAP ASV machines than those who use CPAP machines.

BTW, have you registered your machine on the Philips recall site? https://www.cpaptalk.com/viewtopic/t182 ... ation.html

[AfibApnea]

Yes I registered the unit. Thank you for asking.

[ChicagoGranny]

Yes I registered the unit. Thank you for asking.

You will get a replacement similar to the machine you have been using. No one knows how long this will take.

[SleepGeek]

the doctor has to convince the insurance company, not the dme. it goes thru the dme, but they have nothing to do with approval.

As mentioned contact your insurance.
Also have your doc write another equipment order for a specific make & model re$med noting do not subsititute. But as mentioned if you have to tell you doc what and how to do it you will be better off with another doc.

Hopefully, you already have a copy of your sleep study with all the details.

[AfibApnea]

Thanks.

Obviously, neither the primary physician nor the cardiologist know exactly what the machine should be. And truth be told, neither do I. What I do know is that it must be a reSmed (cute!) since that is the machine Apria is currently dealing for Kaiser.

Oh, and I think, rereading what you've written ("write another equipment order"), that you assume "my doc" is associated with the sleep clinic, and would therefore obviously know what the proper substitute machine would be. No, the sleep clinic seems to be 'in bed' (couldn't resist) with Apria on this recall response.

1) What is the proper ResBed substitute machine? and 2) What might Apria suggest should be the proper ResMed substitute unit? (By the way, can the insurance company, if push came to shove, merely pull an old machine (e.g., circa 6+ years ago) out of the archives as a substitute?

And, yes, I assume Kaiser still has records of my, now ancient, sleep studies...

[Pugsy]

https://www.resmed.com/en-us/healthcare ... ve-10-asv/

ResMed AirCurve 10 ASV is the latest ResMed model that is essentially the equivalent to your Respironics machine.

[palerider]

https://www.resmed.com/en-us/healthcare ... ve-10-asv/

ResMed AirCurve 10 ASV is the latest ResMed model that is essentially the equivalent to your Respironics machine.

pfft, the AC10 ASV is *superior* in pretty much every way, saying they're equivalent is a slap in Resmed's face

But yes, it is the appropriate replacement machine from Resmed.

[Pugsy]

https://www.resmed.com/en-us/healthcare ... ve-10-asv/

ResMed AirCurve 10 ASV is the latest ResMed model that is essentially the equivalent to your Respironics machine.

pfft, the AC10 ASV is *superior* in pretty much every way, saying they're equivalent is a slap in Resmed's face

But yes, it is the appropriate replacement machine from Resmed.

I hear you and agree with you.
Since the discussion was more about replacing functionality rather than superiority, I opted to not bring that up.
What I find totally alarming is the DME or doctors couldn't seem to figure all this out. If they are that inept I would trust them to tell me the time of day. Pretty sad IMHO.

[Janknitz]

The sleep lab department at Kaiser are the experts in writing the prescription the way it needs to be written. From what I've observed, they pretty much run the show and the sleep lab pulmonologist merely signs off on on everything--cheaper that way--and at least at my local Kaiser the techs really know their stuff. As I said in your other thread, the sleep lab techs usually call the shots and know the ins and outs of getting the right equipment--within the Kaiser formulary. They can't help if it's not on the formulary, though. Your cardiologist can talk doctor to doctor to the sleep lab doc about his/her concerns that you have the right treatment without interruption. Sometimes that has some sway.

You can try taking the sleep lab techs something nice (cake, brownies, candy) and tell them how great they are, and mention that you need help with this issue. THEY are the ones that know how to tweak the system. If they feel kindly toward you they may go to bat for you.

The other option is to look for a machine on your own. They come up on Craigslist and E-bay.

[beautifuldreamer]

I used to have Kaiser and pretty much they were able to get me a new device though Apria by writing a prescription in the way it would be covered through my Kaiser coverage.

After 8 months of using the auto cpap I was prepared to pay out of pocket for a bipap but the Kaiser sleep medicine doctor from Kaiser Martinez said that they would write a prescription to get me one that was covered by my plan.

A few years later because I was continuing to have trouble with daytime sleepiness they scheduled me for sleep study and I was told I had mixed sleep apnea that required the ASV. I was initially given a System one bipap auto ASV. After 3 years of using it my humidifier was acting up and I was told they would replace my device since they could no longer get the humidifier for my system one.

I was having trouble with sleeping with the system one ASV and I inquired if I could get the ResMed AIrCurve 10 ASV instead of Philps Respironics. They said they could but first scheduled me for another overnight sleep study to compare sleeping with Philips Respironics ASValgorithm as compared to the Resmed Aircurve algorithm. The study showed that I clearly did better with the resmed.

So Kaiser San Jose Sleep Medicine Doctor wrote a prescription for the ResMed AirCurve 10 ASV for me.

All that to say is. The Kaiser Sleep Medicine doctors bit in Martinez and also San Jose know exactly how to write a prescription to get you what you require from Apria.

Hope that helps.

[AfibApnea]

How much does the ResMed AC10 ASV (BiPAP ASV unit) cost?

How is it *superior* in pretty much every way to the P Respironics System 1 BiPAP ASV? (is there an online comparison?)
Are the algorithms different as was alluded to in a previous post?

Seems that I'm being forced to go cold turkey on any request through the sleep clinic.
I need to use the humidifier and they're saying just use a nasal spray...