Do you use the services of a DME or go it alone with internet supplies and advice .

chumley, I currently use a DME (Lifeplus) for all my supplies, but I rely solely on my pulmonary specialist for advice.  At present, there is an open question regarding annual maintenance which Lifeplus says is unnecessary, but the specialist disagrees, and is looking into it further.

Since finding this forum and all its links to CPAP suppliers, I'm going to be paying closer attention to my out-of-pocket expenses.  If BC/BS payments leave my out-of-pocket expenses higher than buying directly from a supplier then it's a no-brainer what I will do.

I get my replacement filters, nasal pillows, etc. from internet sites.  My DME charged my $1250 for my CPAP (my insurance does not cover any durable medical equipment).  When it comes time to replace my CPAP, I will definitely use an internet site.

I will never buy a CPAP online and here is why;

1.  The respiratory tech. from my DME supplier can come to my house if I need her to, but she is close and I usuall
     go to her.
2.  I can communicate with her in person any time I need to.
3.  She checks my CPAP pressure for accuracy with her manometer both before and after she adjusts it.  The great
     value of this was brought home to me last week when her manometer showed the digital reading on my CPAP is low.
4.  She makes sure I'm aware of all of the features of my CPAP by actually showing me them.
5.  She is a physical therapist and has had a lot of experience with patients and different issues.
6.  My DME supplier will order any equipment I want in a timely manner.
7.  I know my CPAP is in good working order and hasn't be knocked around during shipping.

The DME suppliers I choose work with me in the manner I expect (#1-7) or I find another DME supplier.  I've been treated for OSA for 6 years and misdiagnosed many years prior.  I am a scientist, but I'm not an expert in this field, nor do I have manometers sitting around.  I can't afford to take any chances with my health and will never do anything that may compromise my health.

An interface might be a different matter.  If I knew what worked for me and I kept abreast of the latest innovations, I might chose to buy a mask online if I wasn't fortunate to have insurance that covered it.

Vicki

Vicki wrote:

I will never buy a CPAP online and here is why;

1.  The respiratory tech. from my DME supplier can come to my house if I need her to, but she is close and I usuall
     go to her.
2.  I can communicate with her in person any time I need to.
3.  She checks my CPAP pressure for accuracy with her manometer both before and after she adjusts it.  The great
     value of this was brought home to me last week when her manometer showed the digital reading on my CPAP is low.
4.  She makes sure I'm aware of all of the features of my CPAP by actually showing me them.
5.  She is a physical therapist and has had a lot of experience with patients and different issues.
6.  My DME supplier will order any equipment I want in a timely manner.
7.  I know my CPAP is in good working order and hasn't be knocked around during shipping.

The DME suppliers I choose work with me in the manner I expect (#1-7) or I find another DME supplier.  I've been treated for OSA for 6 years and misdiagnosed many years prior.  I am a scientist, but I'm not an expert in this field, nor do I have manometers sitting around.  I can't afford to take any chances with my health and will never do anything that may compromise my health.

An interface might be a different matter.  If I knew what worked for me and I kept abreast of the latest innovations, I might chose to buy a mask online if I wasn't fortunate to have insurance that covered it.Vicki

Thanks, Vicki, these are all excellent points, and I agree that buying a CPAP machine online could be very risky, and a chance that I will never take.  From a supplies standpoint, however, I think the Internet can be a viable option for those whose insurance does not cover durable medical supplies, or those who do have insurance, but the co-pay or deductible make the Internet a more cost-saving option..

Having said that, however, I agree that everyone using a CPAP needs an informed source, preferably a respiratory technician, to assist with maintenance, instructions, and any issues that arise.  Although my pulmonary specialist is very hands-on, he cannot possible deal with the day-to-day issues that arise.  That is where a good technician is invaluable.

I would also like to thank you for the information on the manometer.  I wasn't sure what type of device is used to check CPAP pressure for accuracy.

Another reason to use a DME is extra parts support.  Sometimes, if you lose a tiny, but essential piece of your mask (I thought it wouldn't be possible until a piece of my mask went down the drain with the soapy water), your DME may have extra parts available, that same day, as part of their service.  In contrast, online suppliers provide "no-frills" service, so you have to pay for the missing part, pay for shipping, then wait until the package arrives.  Using an online service, with the possible exception of re-purchasing a mask, seems penny-wise and pound-foolish to me.

I disagree with the internet supplier bashers. I have bought many items from internet suppliers and have never had a problem . How do you think the cpap gets to the DME ? Does it just appear there ? No, it gets there by UPS or FedEx just like the internet suppliers send it to me.

A manometer. I use an auto, why do I need this ancient piece of equipment.   Join the Modern time and try an auto unit.

If you like to pay $ 2000  for a $299 cpap go to your DME . If you want a modern auto unit for about $600 go online !

Chumley

I buy all my cpap supplies, including machine and masks, online.  I've never bought anything from a local DME.   Some, like Vicki, are lucky to have found a knowledgable RT and a DME that bends over backwards to be helpful.  Many aren't so lucky.  Even changing to a different DME isn't always better.  In smaller cities or rural areas, the DMEs to choose from can be even more limited.  That's not to say that the one and only small DME in a boondocks area might not provide far better service than a huge chain store in a big city.

I've not had any problem at all buying my masks and machine online.  There are online stores with better phone support than some people have found with the "extra service" of some less-than-helpful local DMEs.  Hands-on support, or phone support - either one is only as good as the person helping you.  

Certainly if a person has good insurance and finds a jewel of a DME/RT, there can be advantages -- getting to try out masks at home and exchange for a different mask -- or even getting the personal service that Vicki enjoys from her really good RT.

However, the uninsured and those who cannot find a "good" DME within a decent driving distance can buy excellent equipment online and receive excellent treatment.  Sometimes better in every respect, support as well as price,  than what many people on the message boards have reported getting from some local DMEs.  Online shopping for my equipment has been a positive experience for me.

Chumley,

A manometer is an instrument which measures the pressure a device is actually putting out.  You cannot know the air pressure a device is actually putting out without a manometer.  The digital display on a device may not be the actual pressure a device is actually putting out, in fact, in my case, with my new device, the digital display was LOW.  Of course, DMEs get their equipment via UPS, etc.  My point was that they check the pressure a device is actually putting out AFTER they receive them.

Your response makes me very curious as to why you posted your question to begin with since you obviously do not want to hear any negative reasons to purchasing equipment online.  Your response to my post also makes it very clear that you already had the answer to your question before you posted it.

Nevertheless, thank you for providing me the opportunity to reiterate my responses.

Vicki



Last edited by Vicki on Thu Sep 22, 2005 12:08 am; edited 3 times in total
_________________
That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

You can get a decent manometer online too. From $40 and up. Then you can check you pressure regularly to make sure your xpap is up to snuff.

-BP

Fact is some folks feel comfortable going out on their own and buying online.  Some don't.  What is better for me, might not be better for you.  If you have to ask which is better, more than likely you are uncomfortable with it.  If that is the case, go with what you are comfortable with.

Vicki, I built my own manometer , I know what it is and what it is used for .  That said, My auto pressure as measured by my manometer is exactly as displayed by my 420E.  Now I must ask you this. How do you know that your manometer is calibrated correctly ? Mine uses water and a few cm of tubing. It measures directly not by conversion.  Your measurement is only as good as the measure.

I'm not a scientist but my uncle was .  His name is Isaac Newton. Perhaps you have heard of him. He was also an a** at times. His withholding the prize for the invention of the clock to Harrison comes to mind . You see Harrison wasn't a man of science .  He was a carpenter and Newton despised him for that reason . Harrison finally won his prize and modern navigation was born .  

Sorry folks,  didn't mean to distract anyone.  

Some just take themselves way to seriously .  

Thanks to all that replied.  

Chumley

Chumley, You must be VERY old!  Sir Isaac died in 1727.  I think we all need to stand before our elder here!

I've heard several people who had gotten their machine and masks from local DMEs and seemed to prefer it.  
I think those were people getting their equipment for the first time.  They liked having the equipment explained, the chance to try different masks and to ask questions.  And they liked having a place near by to call or visit with questions or concerns they might have.  

My guess is that online providers might be more attractive to people who are purchasing their second or so machines and masks, for they've already had a chance to see what works and what doesn't.  

The key is options.  The consumer has options.  And online vs local store is a choice in our marketplace for so many things.  Some people prefer to go into a store and buy their CDs, others like to order them online.  Why does there have to be one choice?