New looking for information

[Badnvsleep]

First, I have been reading the post here for the last 2 weeks and want to thank everyone here for all the information that has been provided, I feel I have learned a ton from everyone already. I feel I have a ton more to learn as well.

My story, I just finished my split study and my Dr has written my script for a CPAP machine, sent it to a local DME and I have been waiting for them to call. I have called them a total of 3 times checking on the status of my order, holidays got in the way. Anyways, they finally called me back and now want to provide my machine, as they said a "basic" machine. I tried to discus my options with her but it seems that we are not on the same page for a machine. My script calls for a "CPAP machine set at 9 ( I don't know the units used with this sorry), humidifier and my choice of mask. After reading a lot of treads and post asking about machines, I was looking at the PR System One REMStar Auto CPAP machine, I like the idea of maybe being able to adjust the pressures automatically once I get the hang of wearing the mask and using the machine. My DME told me I would need to get a new script that said auto and then included the pressure ranges. This is where our conversation went south... I said that I thought this machine could also run in regular CPAP mode at the one pressure! I was told no that it had to be a range... This continued for a few minutes until, due to my lack of sleep, I thought I was going to either tell the DME that was find just give me a darn machine so maybe I could get a good night sleep or tell her to go take a long walk of the edge of the Grand Canyon... So I just told herI would call my Dr office back and talk to them.

Now my problem, I have not met with my Dr since the study was done, my follow up appointment is another week and half away, so I don't have a copy of sleep study results yet and don't know what they say. I think the plan was for me to have the machine and start using it before I see him again...

Now the questions.... am missing something about the Auto machines, can't they be set to run in CPAP mode at one pressure? Do I really need the range of pressures, even though my script calls for 9cm H2O (I think that's it)? I already changed the DME plan when I told her I wanted a machine that would record all the data, not just time used which is what she first wanted to give me. Last, does anyone here know of a decent, if that is even possible, DME in the Las Vegas, Nevada area, I think I want to go to someone else that I feel isn't trying to screw me over and someone that is willing to listen to my questions and provide the "educated or informed" answers I am looking for and need. Since this is all new to me I don't feel like I should know more then the DME, that's their darn job not mine......

I am really lucky with the insurance coverage, so that shouldn't be an issue. I just want to make sure I don't get a "brick" like I have read about.

Anyways, sorry for such a long first post and the ongoing rant, I really didn't know where else to turn to find out answers.

Again thank you for input or any information you can provide.....

[Janknitz]

Yes, of course an apap can be set at a fixed cpap pressure, but the dme does not want to provide you with an apap because they lose profit margin--cpap's, especially bricks, are cheaper than apap's, and since the DME makes the same amount whether they provide you with a brick or an APAP of course they want to give you a brick.


Read my blogpost "What you need to know before you meet your DME" and don't be afraid to call around to other DME's to see if anyone will provide what you want.

You can call the doctor's office and ask him to order an APAP. Tell them you are willing to use CPAP if you have some input into what machine you get. You don't really need a specific order for an APAP, but it does make it easier to deal with the DME> DON'T let the DME convince you that your insurer won't pay for an APAP unless you need a range of pressures. That's NOT true--the insurer doesn't care since it's the same billing code.

[kwikwater]

You're on the right track imho. I'd say you have made yourself way more aware than most newbies!! Yes, you might know more than the DME you've tried to do business with. It's not uncommon that the Doc has a favorite DME. You're not tied to that guy. Make a few phone calls. Hopefully you'll get some good input on DME's in Vegas. It's good to shoot for a APAP, but if it doesn't happen, it's not that hard to titrate yourself if need be. There's lots of help here with that.

I'd ask your doc for a hard copy script and go shopping for a DME that wants to help you, not them, passing out a brick and running away.

Good Luck

[robysue]

Two pieces of advice:

First read JanKnitz's excellent WHAT YOU NEED TO KNOW BEFORE YOU MEET YOUR DME.

Then read my Advice for those newly diagnosed with OSA

Since the DME is determined to sell you a brick, it's time to refuse delivery on the brick and start shopping around for other DMEs. Do NOT sign any paper saying you refuse treatment. You're not refusing treatment; you are simply choosing to take your business to a different DME. So tell the DME that you have decided to take your business elsewhere because they will not provide you with the machine you want to purchase and inform the prescribing doctor of the same thing. Call your insurance company and tell them what's going on as well and ask for a list of "in network DMEs."

And then start making phone calls to the DMEs and start asking questions. Make the DMEs earn your business. If you are persistent, you should find a cooperative DME before too long.

Good luck

[kaiasgram]

Hi and welcome David -- lol, three people posted while I was writing mine, so I'm editing out all the now-redundant stuff!

For the flexibility in pressure settings that it offers I think an Auto machine is the best choice especially when just starting therapy -- your first prescription is usually based on one night of sleep in the lab, and it often proves to be the case that fine tuning of pressure settings is needed in the first few months of therapy. You might indeed find that you do best with a single fixed pressure, but it's nice to have the option of a range of pressure in the event that works best for you.

[Badnvsleep]

Wow, thanks for all the quick responses....

Jan I found your link and read it on Jan 1, 2014 ( DavidB), that's what made me just end with the DME today and try to start fresh tomorrow...

Robysue- thanks for your link I read through it and will re-read it tomorrow after a little sleep tonight, I hope.

I have been trying to read all the information on here for newbies, I make enough mistakes as it is I would rather learn from someone else than go through so of the lesson already learned by other, I don't have a need to experience everything myself....

Thanks again everyone.......

[Sheriff Buford]

Bad: I would call the receptionist/nurse at the sleep doctor's office and ask (er...tell) them to write a script that specifically indicates the autopap machine you want. If they ask why, then tell them you think the "straight cpap" pressure will keep you awake all night... and you want the "adjusting" pressure(s) for comfort...that'll "shut them up". Tell the receptionist you'll come by the office and pick up the new prescription. Make a copy for yourself. Tell the DME they are on their "last chance" with you and if they mess with you anymore, you'll go somewhere else.

Some folks end up using straight cpap mode and some get comfortable to the autopap mode. I always encourage folks to see in what mode they feel better. I always use the straight cpap mode, but once or twice a year, I use the autopap mode to see if I feel better. As we get older, our body and circumstances change and we may adjust better to the alternate therapy, but we don't know that until we try. I'll go a week or two in the autopap mode before going back to the cpap mode because I feel I always feel better using the cpap mode. If you don't try the alternate mode on occasion, you may be missing out on feeling better during the day instead of sticking to one mode of treatment... in a stubborn way...

Sheriff

[bavinck]

I specified in writing several times that I wanted an auto, but my DME still tried to sell me on the non-auto when I went to purchase. I identified the type of machine he was giving me, told him politely that I wanted the auto, and he said OK but he would need to identify patient requested apap. My insurance doesn't care, yours might. Like everyone here is saying, educate yourself and most dmes seem to cave when they realize you know what is going on.

[chunkyfrog]

Another reason to get an auto is because pressure needs tend to change with weight loss. (or gain)
Also, there is NO auto machine that cannot be run on cpap mode--if that works for you.
Just don't get a "brick" Avoid machine names containing the words "Escape" or "Plus".