Good luck, Matt!!! Keep us posted.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

Thanks ChronieToo.  Found one of your posts on a specific CPAP machine (S8Elite?) and it is pretty enlightening too.  Have a question though... It appears that I'm going to have a titration without seeing the Dr. first, which is fine with me.  I am curious though about what will happen next.  

Will I get a prescription for the CPAP machine and get one from a DME without first getting a chance to talk with the Dr?  Has that happened to people before?  I'd like to have the option of at least having input on what I end up with.  Based on what I'm seeing from other posts the S8 Elite sounds fine.  I think I need one with a humidifier at least.


--Matt

Practices vary from sleep lab to sleep lab. I made it a point to both tell my sleep tech AND write right on the paperwork we have to do the night of the titration that would NOT accept ANY CPAP equipment until I had a chance to discuss it w/the sleep doctor and WE MUTUALLY AGREED on what equipment would be ordered for me. When the sleep lab called me later that day to ask which DME supplier I wanted to use I reminded them and made it clear I wasn't accepting ANYTING until the doctor and I had the opportunity to discuss any proposed equipment and WE came to a MUTUAL AGREEMENT on what equipment I would get. I would suggest you do the same.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

ChronieToo,

I made a call to a local DME that works often with that sleep doctor.  They told me the doctor often doesn't prescribe specific machines but all 3 CPAPs they carry have humidifiers and data capability.  One was the S8 I had researched.    They have a local store, I think I'll go by and talk to someone there in person and maybe see the equipment and masks.

--Matt

Just be aware that the Resmed S8 Compact and the Resmed S8 Escape are NOT fully data capable. I think it is the Resmed S8 Escape that does have a "smart card" but the only data it collects and reports is compliance data and compliance data has absolutely no value to the patient or the doctor - only to the DME supplier to get reimbursement and continued reimbursement for the CPAP. It is the ELITE that you want to remember when considering a Resmed S8.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

So what's the difference between data capable and "fully" data capable?

Fully data capable gives you the Efficacy and Usage Data. 95th Percentile Pressure, 95th Percentile Leak rate, AHI, AI and HI for the night, week, month, 6 months and year, hours used that night, total hours on the device, hours used and number of nights used more than 4 hours plus number of nights since you first used the device.

Complicance data is only the number of nights used more than 4 hours and the total number of hours used.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

Matt.
I had to add my two cents.  Don't assume that your DME even knows that you can access that efficacy data on the Elite.  Mine did NOT. Neither did the respiratory therapist (who answers to the DME in my situation).  It was Crohnie Too who educated me on that and a nurse at the ResMed company that confirmed it.  So if anybody tries to tell you that the Escape is just as good as the Elite, do not believe them.  
 
I got my Escape at least a week before meeting with the doctor. In fact, they wanted to train me and send it home with me when I woke up after the sleep study. I had a split study so was titrated that same night.  I had another commitment that morning so I said I couldn't do it then. I went back at a later date to get the machine and mask and learn how to use them. That was better for me because I wasn't so overwhelmed then.  
 
You are wise to do this research before you get the machine.  I knew nothing, didn't find this forum until after I got on CPAP.  I wish I had known. before my insurance company paid for the Escape, that I could have asked for the Elite.  The Escape works fine, as far as I know (I still have some problems with tiredness) but, Crohnie Too is right, the only data you can get from it is compliance. Ask your doctor to prescribe the Elite. Even if he doesn't want you to use the EPR feature, it's still a better deal than the Escape.
Grandma


_________________
ResMed Quattro Full Face Mask
ResMed S8 Escape with heated humidifier
Pressure set at 10

Same with me.  When I asked for a data capable machine the RT at my first DME looked at me like a deer in headlights.  She also argued with me that I was asking for Bi-pap when I said I wanted  EPR/C-Flex.  

Many of the respiratory therapists get their certification and never do a single bit of further research into the new hardware.  Hopefully you will find a good one.

If I were you I would let everyone know that you want the prescription given to YOU, and then YOU will contact a DME...not them.  That way you are in control and not having a bare-bones machine being shoved down your throat...so to speak.  

So when you say you asked for X machine, who did you ask?  the DME or the Dr?  I've not even met the doctor.  I sat down last night and wrote a letter that I intend to give to the Sleep Tech (for the Sleep Doctor) with my "demands" :). It's just a really bizarre procedure...

--Matt

I have said it before-isn't it amazing that people who are clinically sleep deprived have to deal with this medical maze? Half the time we don't know what we are doing anyway because of fog brain and then they have us jumping through hoops all over the place...with professionals who know less than we do. It's scary.
Matt, I think if I were you, I would call the dr. that you are going to see to give them a heads up about what you are thinking. Presumably, he or she will read your sleep study data and write up the report and prescriptions.  Tell them that you want the prescription to state that you want a data capable xPAP with humidifier.  When you get your machine, if insurance is paying, they probably will rent it for a period of time to be sure it works for you and that you are compliant with treatment.  What you want to do, if you somehow don't get what you asked for, is return it for a trade up before your time limit runs out.  Just make sure you have a copy of your study and the prescription in hand.  Visiting the DME is a great idea.  If they are offering the Elite as a choice, you should be fine.  They may be more willing to give it to you because you've done your homework.  But people at my insurance company have told me that DMEs are notorious for making promises and then changing their minds.  I hate to be so suspicious but that's been my experience.  If you are paying out of pocket, get a written price agreement, do not go by a verbal agreement.  You can get much better prices on line anyway, if you have to pay for it yourself.
Grandma


_________________
ResMed Quattro Full Face Mask
ResMed S8 Escape with heated humidifier
Pressure set at 10

These are more detailed scripts than most doctors write but they will get you what you want how you want it, choose one:

1] Resmed S8 Elite w/EPR (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] EPR setting --- (whatever your doctor suggests)
4] Ramp off (or on)
5] Efficacy & Usage Data access
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the Resmed S8 Elite)
7] Full Face mask, Nasal Cushion mask, or Nasal Pillows mask of patient's choice.

1] Respironics REMstar M Series Pro w/C-Flex (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] C-flex setting --- ( whatever your doctor suggests)
4] Ramp off (or on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the REMstar Pro)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

1] ResMed S8 AutoSet Vantage (w/integrated humidifier if you prefer)
2a] Minimum pressure --- (whatever your doctor has determined
2b] Maximum pressure --- (whatever your doctor has determined
3] EPR setting --- (EPR does NOT work in auto mode, but if and when you opt to use the Vantage in straight CPAP mode you might want to use the EPR function)
4] Ramp off (or on)
5] Efficacy & Usage Data access
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifer. If so just add "w/integrated humidifier" to the Resmed S8 AutoSet Vantage)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

1] Respironics REMstar M Series Auto w/A-Flex (w/integrated humidifier if you prefer)
2a] Minimum pressure --- (whatever your doctor has determined)
2b] Maximum pressure --- (whatever your doctor has determined)
3] A-Flex setting --- (whatever your doctor suggests)
4] Ramp off (or on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the REMstar Auto w/A-Flex)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

You will notice the similarities to each suggestion.

1] Exact brand and model of machine
2] Scripted inhalation pressure (the autoPAPs have a pressure range rather than a set pressure)
3] Scripted exhalation pressure amount for lower pressure at exhalation
4] Starts w/4 cms of pressure and ramps up to your set pressure after you get to sleep
5] Allows you to access your nightly data via the LCD screen
6] While the integrated humidifiers are most convenient for travel and take up less space on your nightstand, in really dry situations sometimes they can't provide as much humidity as you might need or want. For many the integrated humidifiers are more than satisfactory - also the M Series integrated humidifier is notorious for its poor design).
7] This ensures that you can try several masks, including a Full Face mask (sometimes they insist on a script specifying full face if the script just says mask, or will only provide the exact mask mentioned in the equipment order).

In addition: if Ramp is used the starting pressure can be set at various pressures, not just 4 cms, and the length of Ramp time can be adjusted to fit the usual length of time it takes you to get to sleep up to a 45 minute maximum. Your doctor may have recommendations for that.

Also, I'm not sure about the Respironics but the Resmeds allow for a set straight CPAP pressure as well and it might be wise that your script include that set pressure too just in case the DME gives any argument about supplying an autoPAP which they most likely will.  The first two fully data capable CPAPs will do you just fine!! Its just that the autoPAPs sort of give you two xPAPs in one. MOST people use end up using their autoPAPs in straight CPAP mode except when their pressure might need some "tweaking" and the data from the auto capability help to avoid another titration study. An autoPAP isn't really all that much of an advantage but ... its up to you how hard you want to fight for one because it most likely will be a battle to get one from a local DME supplier.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

These are more detailed scripts than most doctors write but they will get you what you want how you want it, choose one:

1] Resmed S8 Elite w/EPR (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] EPR setting --- (whatever your doctor suggests)
4] Ramp off (or on)
5] Efficacy & Usage Data access
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the Resmed S8 Elite)
7] Full Face mask, Nasal Cushion mask, or Nasal Pillows mask of patient's choice.

1] Respironics REMstar M Series Pro w/C-Flex (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] C-flex setting --- ( whatever your doctor suggests)
4] Ramp off (or on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the REMstar Pro)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

1] ResMed S8 AutoSet Vantage (w/integrated humidifier if you prefer)
2a] Minimum pressure --- (whatever your doctor has determined
2b] Maximum pressure --- (whatever your doctor has determined
3] EPR setting --- (EPR does NOT work in auto mode, but if and when you opt to use the Vantage in straight CPAP mode you might want to use the EPR function)
4] Ramp off (or on)
5] Efficacy & Usage Data access
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifer. If so just add "w/integrated humidifier" to the Resmed S8 AutoSet Vantage)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

1] Respironics REMstar M Series Auto w/A-Flex (w/integrated humidifier if you prefer)
2a] Minimum pressure --- (whatever your doctor has determined)
2b] Maximum pressure --- (whatever your doctor has determined)
3] A-Flex setting --- (whatever your doctor suggests)
4] Ramp off (or on)
5] Show AHI/Leak feature On
6] Fisher & Paykel HC 150 heated humidifier (unless you prefer the integrated heated humidifier. If so just add "w/integrated humidifier" to the REMstar Auto w/A-Flex)
7] Full Face mask, Nasal Cushion mask or Nasal Pillows mask of patient's choice.

You will notice the similarities to each suggestion.

1] Exact brand and model of machine
2] Scripted inhalation pressure (the autoPAPs have a pressure range rather than a set pressure)
3] Scripted exhalation pressure amount for lower pressure at exhalation
4] Starts w/4 cms of pressure and ramps up to your set pressure after you get to sleep
5] Allows you to access your nightly data via the LCD screen
6] While the integrated humidifiers are most convenient for travel and take up less space on your nightstand, in really dry situations sometimes they can't provide as much humidity as you might need or want. For many the integrated humidifiers are more than satisfactory - also the M Series integrated humidifier is notorious for its poor design).
7] This ensures that you can try several masks, including a Full Face mask (sometimes they insist on a script specifying full face if the script just says mask, or will only provide the exact mask mentioned in the equipment order).

In addition: if Ramp is used the starting pressure can be set at various pressures, not just 4 cms, and the length of Ramp time can be adjusted to fit the usual length of time it takes you to get to sleep up to a 45 minute maximum. Your doctor may have recommendations for that.

Also, I'm not sure about the Respironics but the Resmeds allow for a set straight CPAP pressure as well and it might be wise that your script include that set pressure too just in case the DME gives any argument about supplying an autoPAP which they most likely will.  The first two fully data capable CPAPs will do you just fine!! Its just that the autoPAPs sort of give you two xPAPs in one. MOST people use end up using their autoPAPs in straight CPAP mode except when their pressure might need some "tweaking" and the data from the auto capability helps to avoid another titration study. An autoPAP isn't really all that much of an advantage but ... its up to you how hard you want to fight for one because it most likely will be a battle to get one from a local DME supplier.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

Wow!  Thanks so much for that info CrohnieToo...  I've written a letter to leave with the sleep tech (for the Dr.).   I spoke with someone today at the lab and they said that'd be fine, that the Dr. would get it.  The sleep lab also said that she (the Dr.) is really good and always orders CPAPs that are fully data capable.  

So on to the titration on Monday I guess...

--Matt

That's sounding promising then, Matt! Good luck. Be sure to let us know how you make it thru the night and how your experience at this sleep lab was.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.