Hello,

On Saturday night, I had my second sleep study. After doing a lot of research and from the help of these forums, I called my doctor and requested that she write the prescription for the following:

1. Mask to be patient's choice
2. Fully-Data Capable Machine
3. Built-in humidifier
4. C-Flex

She said she would write my prescription for anything I wanted. She also said it will take a few weeks in order for her (my PCP) to get the results. Is there anything I am missing on the prescription? Thank you in advance for your help.

~Sara~

sounds good to me but if your insurance co is paying they may have a cost limit
if you travel a lot,a  rugged smaller CPAP that also accepts 12 volts DC can be an advantage


_________________
respironics comfort gell mask,resmed S6 lightweight CPAP, pressure 10 no humidifier
NO DOCTOR EVER ASKED ME IF I SNORED

Sara...great job!  
How about not saying C-FLEX because that is the terminology for a Resperonics.  To widen your choice...maybe it could say just "Exhalation Relief".  I believe Resmed terms theirs as EPR.

Also not built in Humidifier...just humidifier.  The humidifier on most is seperate and it intergrates with the machine.  

Most insurance companies in the  US cover the xPAP according to Medicare guidelines.  The DME will always try to stick you with the model that will give them the most profit...the insurance codes are all the same no matter how expensive the CPAP is,  therefore the DME gets paid the same per their contract with your insurance...you will have to advocate for the better equipment...you may be met with resistance from the DME....the DME will give you several different reasons...such as: your insurance will not cover that or...your Dr did not script for that or...we do not carry that (they can order it)  Before you bleive and accept what they are telling you...check out their reason with the source they are telling you that is saying NO.

If you can...get an APAP...it can be set in straight CPAP mode but you will have it in case you need to see if your pressure needs to be retitrated...My Dr does not like them...for several reasons...but I think his main one is that he owns the sleep lab and wants me to come in and spend a few thousand every year...

An APAP is much more expensive and you may need the Dr to specifically write is out on the script.  So id willing, have her make the script out for an APAP

#1 APAP
#2 Fully data capable
#3 Humidifier
#4 Exhalation Relief
#5 Mask Patient's Choice

Good luck!

sara55 wrote:

Hello,

On Saturday night, I had my second sleep study. After doing a lot of research and from the help of these forums, I called my doctor and requested that she write the prescription for the following:

1. Mask to be patient's choice
2. Fully-Data Capable Machine
3. Built-in humidifier
4. C-Flex

She said she would write my prescription for anything I wanted. She also said it will take a few weeks in order for her (my PCP) to get the results. Is there anything I am missing on the prescription? Thank you in advance for your help.

~Sara~

Nicely done!  Sounds like you have a great doctor.

Just "humidifier" could get you "just" a passover humidifier. You would want it to say "heated humidifier" to get an integrated humidifier.

The DME "could" coast by w/not giving an auto even if your script says APAP or autoPAP if the script gives just one pressure. AutoPAPs are set to a pressure range. A good idea is a low end pressure 1-2 cms below your titrated pressure and a high end pressure 2-3 cms above your titrated pressure.

The DME can also try to coast by not providing a full face mask when and if the patient opts to try one w/o the order mentioning all mask styles (full face, nasal cushion or nasal pillows mask of patient's choice).

Good idea to list Ramp Off or pressure setting and time length (i.e. Ramp 5 cms, 30 minutes) if you want it On.

Expiration relief should also have a setting (1, 2 or 3)

Advanced patient data access On

Whilst you need to be prepared for a DME supplier trying to get by on the cheap, there are a lot of good ones out there too so don't go in expecting the worst, just be prepared for it, be diplomatic but be firm on what you want and will settle for.

I've gotten past "autoPAP fever" but if my family doctor, who is not well-versed in sleep medicine, is the one who is going to be writing my equipment order rather than a sleep specialist I would definitely try for an autoPAP. Otherwise I would be (and was) perfectly happy w/my fully data capable straight CPAP. I did self-purchase an autoPAP due to "auto fever" but found I used my CPAP at home and my autoPAP only for travel.

Most of us ended up seeking out these apnea forums due to problems w/our local DME suppliers NOT providing the education and support we needed when first starting out, and/or providing us w/bare-bones equipment that contributed to our problems and/or gave us a hassle on every little thing we asked for or needed. But we are NOT the majority of CPAP users. (Tho patients would be better off if we were!!!). The majority of CPAP users are receving adequate to good service, sometimes even outstanding service, from their local DME suppliers. We tend to forget that sometimes in these forums.


_________________
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.

Crohnie is right...I am one who often forgets due to my bad experiences.  Plus the only others I know who use CPAP are on this forum...and when good happens it is nature to not mention it..when bads happens it is all we talk about!

Thank you all for your wonderful and detailed responses. I will let my PCP know exactly what I want the prescription to say. She is wonderful because she actually listens to what is wrong. Granted she didn't test me for sleep apnea until about a year after I was complaining of the symptoms, but I forgive her because she is just a general PCP and not a sleep doctor. This forum is wonderful and I really appreciate everyone's time and information. Take care.

Eh, what the hay. Here's some specific script suggestions (not that I am recommending one machine over the other, just to give you and your doctor an idea).

1] Resmed S8 Elite w/EPR (w/integrated humidifier if you prefer)
2] Pressure ---- cms (whatever your pressure is)
3] EPR setting 3 (or whatever your doctor suggests)
4] Ramp off (unless you prefer it 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] Nasal mask, Full Face 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 3 (or whatever your doctor suggests)
4] Ramp off (unless you prefer it 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] Nasal mask, Full Face mask, or Nasal Pillows mask of patient's choice.

or for an autoPAP:

1] ResMed S8 AutoSet Vantage (w/integrated humidifier if you prefer)
2a] Minimum (EPAP) pressure (whatever your doctor has determined)
2b] Maximum (IPAP) pressure (whatever your doctor has determined)
3] EPR setting 3 (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 (unless you prefer it 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] Nasal mask, Full Face 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 (EPAP) pressure (whatever your doctor has determined)
2b] Maximum (IPAP) pressure (whatever your doctor has determined)
3] A-Flex setting 3 (or whatever your doctor suggests)
4] Ramp off (unless you prefer it 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] Nasal mask, Full Face 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 pressure (the autoPAPs have a pressure range (IPAP and EPAP) rather than a set pressure)
3] Scripted 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. (And certianly more convenient when traveling, especially by air).
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).


_________________
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.