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Second opinion

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timetoplay +0 points · over 3 years ago Original Poster

Hello need some advice about getting a second opinion first I want to start off with a little background on what is going on.

I’m a truck driver been driving truck for 11 years I am also 6’1” 252.6 pounds with a 17” neck which that lead me to having to have a sleep study no big deal I thought I have never had a problem sleeping in my life my wife of 12 years has never complained of me snoring or has ever even noticed in that time an I Havnt experienced any of the other symptoms of sleep apnea that I have researched I’m usually very high energy an never had a problem staying awake at work so figured no big deal will do the sleep study that they ordered to keep my license.

At the moment in time I finished my study an how gotten the results an have gone back to the doctor they said I have an AHI of 5.5 which from what I have read 4-5 is considered normal the thing that is bothering me is that the doctor openly admitted to me that he made it a 5.5 so insurance would cover my machine and any other expenses so now I have a CPAP machine an have been using it with no problems for the last 30 days an have gotten my new medical card for work no problem.

I am here just wondering if I should waste my money to get a second opinion cause of what the doctor admitted to me about my AHI I feel kinda robbed but he never said what he raised the AHI from I will also say that I feel no different from when I started using the machine to now.

I should of also stated that I am 33 years old an I really have no problem using the machine if I truly need it an for all I know the doctor raised it from a 5 to a 5.5 AHI

Thank you for any opinions that may come to the topic have a nice day

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

Hi timetoplay,

I'm not sure about a second opinion regarding the numbers because they are so low and I wonder about the relevance or need but that is a discussion others will take up happily.

I am chained to a CPAP machine that causes endless concern and anger and I would STRONGLY advise anybody who can to avoid them and if they have issues that are serious enough to cause long term consequences pursue every other option available before considering a machine.

There have been a number of references in this forum to questionable practices within the CPAP industry I think this is a fairly clear example of that.

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

Sorry I didn't read your post properly and missed the license connection. Do they really threaten your license at 5.5? :O

Yes in your position I would request a re-run through a different location/clinic and make sure you get a copy of the results. I would also take antihistamines and dose myself with nasal sprays before I went in.

Figures can be fudged both ways. :)

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

One last dubious observation. I get the impression that a sleep study is just a jumble of numbers and the 'results' are an analysis of a chosen section of those numbers.

In other words the results of that first study are subject to interpretation.

If that is the case you may be able to request a copy of that data if you don't already have one and get a second opinion without even having to do another sleep study.

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timetoplay +0 points · over 3 years ago Original Poster

Yes they will take my medical card if I did not comply with the sleep study and now since I’ve been diagnosed I have to use the machine at least 70% of the time to stay in compliance just like for insurance.

I also should of mentioned the sleep study was an at home sleep study due to insurance wouldn’t approve a in lab sleep study I was told it was because of my age an I wasn’t experiencing any of the other symptoms

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

I don't really understand the systems over there but to me it seems like a form of entrapment.

Do you have a copy of the study data or could you request a copy?

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

If you were in Australia I would suggest that you hire another sleep study machine from your local pharmacist (less than $100 here including report) and do the study again, taking every precaution to enhance the results, then make sure your report were being processed by a different 'expert' than the last one.

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

When I say precautions I mean only a light meal, no alcohol, take an antihistamine, use a nasal spray, really clear your throat and sinuses and ask your wife to stay awake and make sure you don't roll onto your back.

I don't know if those precautions would work for everybody but they would give me the best possible results.

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Bigmike52 +0 points · over 3 years ago

If you are in the US, request a copy of your sleep study and prescription. This is your HIPPA right in this country. I would hope they wouldn't alter your sleep study as that is wrong. He certainly wasn't doing you any favors to increase your numbers as I would think an insurance company denying a machine would be proof enough for the DOT that you do not have sleep apnea. If you are under 5 cmH2o, a little weight loss could also get you compliant. Just my opinion.

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timetoplay +0 points · over 3 years ago Original Poster

I’m sure I can get a copy of the original report no problem an it does feel like entrapment due to the fact they will take my medical making me unable to work I’m looking into going to a different sleep center an not telling them I’m a truck driver to see if the results will change an possibly pay out of pocket for an in lab study an I will take the precautions you are talking about in mind thank you for the advice

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timetoplay +0 points · over 3 years ago Original Poster

I don’t think I would be questioning the results if the doctor didn’t openly admit to me he fudged my AHI so insurance would cover I don’t know if he did that to make money or honestly thought he was helping me

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timetoplay +0 points · over 3 years ago Original Poster

Thank you bigmike52 my wife has me on a strict diet I want to lose about 30 pounds before going in for another study

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

It's hard to define motive because it's likely that doctors see most apnea patients when they have ignored the problem for a long time and want/need to be taken seriously in which case the doctor would be simply doing what they believe the patient wanted.

I am sure there are other issues with medical practice and insurance and government regulations and research and statistics that can and do have an impact even if we ignore the potential for financial benefits and kickbacks and vested interests of various kinds.

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Bigmike52 +0 points · over 3 years ago

I wish MY wife would have me on a strict diet. I could use losing 30 lbs. Problem is I LOVE FOOD. If you don't have sleep apnea, you don't need a sleep doctor. Enough said?? I would be interested to know what your number was. My nephew is a senior DOT inspector in Washington DC. and assigns agents to investigate trucking issues. I am tempted to ask him what he thinks on this.

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timetoplay +0 points · over 3 years ago Original Poster

@Bigmike52 I would also be interested in what he would have to say I think I’m in the long run just going to have to keep using the CPAP to stay compliant until I lose the weight an can afford to pay for the new sleep study and also in the meantime get the original copy of the test since I never did receive one

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timetoplay +0 points · over 3 years ago Original Poster

Another thing to add I just went in with my machine so they can check I’m in compliance to get my medical an to also make sure it’s working properly.

The doctor ordered my CPAP machine be set at 8-16 in pressure it’s an automatic machine that will adjust it self while having Apneas I guess when I went in the machine averaged 9 for pressure and it kept my Apneas at 0.6 so not sure really all that means but maybe that will help you guys out in determining if I need a second opinion

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Sierra +0 points · over 3 years ago Sleep Patron

Yes, that is important information. As I read through the posts, that was the question I was going to ask. What is your treated AHI, and you have answered that with the 0.6 which is very good. My only concern is that I think your pressure range may be a bit high. Generally the lower the pressure the more comfortable the machine is to use. On your next visit I would ask about decreasing the minimum pressure a bit to 6 or 7 cm. The machine averaging at 9 cm does indicate it is sensing apnea events and is responding. That is a confirmation that you do suffer from apnea to some degree.

My thoughts considering that you already have the machine, you are OK with using it, and it is paid for, would be to continue using it as you are getting some benefit. An AHI of 1 is certainly much better than an AHI of 5. That is the number of apnea events per hour that you are having. Much better to disturbed once an hour, and only be short of oxygen once an hour rather than 5.

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Bigmike52 +0 points · over 3 years ago

Sierra is correct in saying your pressure at 8 minimum is seems a little high. I was diagnosed at an AHI of 29.4 and my minimum pressure was 7. As Sierra suggested ask your doctor if he can lower it as it would be more comfortable. What machine did you get? If you got a Resmed Airsense 10 or the Dreamstation both come with setting for pressure relief (On Resmed it's called EPR and on Dreamstation it's called FLEX) Look on the patients settings and you can experiment with the settings. By adjusting the number you will also lower the pressure of 8. See if that's more comfortable. Also you have a ramp adjustment that starts the pressure and slowing ramps up to your minimum of 8. You may already know this but if not then you learned something today. So much to learn, but that is what this forum does best. We need you as a truck driver as there are not nearly enough drivers to get the freight from one place to another. You are young and have many years to go.

Mike

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

For me the issue isn't if the machine helps or if it was free but if you want to be subject to the machine forever and if you want to be perpetually controlled by authorities with the power to destroy your life if you fail to meet their compliance.

In your shoes I would move heaven and earth to overturn the original report and reclaim my life THEN I would decide what to do about health and sleep.

Bigmike52 seems to think you have a right to relevant info but I suspect that may only be the report and not the study data. But you will need all the ammunition you can get so I suggest that you contact whoever processed the original data and try to get a copy and if that fails contact your doctor or even your insurance or traffic authority.

Whether that succeeds or not you will probably have to do another sleep study and take that back to your doctor and insist that he undo whatever processes have been initiated by the previous report.

There is a sleeptek here who could give you a less biased explanation of how the report is generated but I think there is some scope for interpretation and there must also be some provision for modification based on more than one study because even a simple cold could totally skew the results of a single study.

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Bigmike52 +1 point · over 3 years ago

biguglygremlin, It truly doesn't matter what "bigmike52" thinks. The important thing is what our laws say. The HIPAA laws in the USA were written to give us control of our medical privacy in this country. Since a prescription is about "me", I have the right to have a copy of that prescription as well as share it with anyone I choose. Any sleep report and study data IS the prescription. If they deny giving it to me they are in violation of the law. END OF STORY!! For those that don't understand what HIPAA is I posted a link:

                                          https://www.medicinenet.com/script/main/art.asp?articlekey=31785

I am an old man. I ignored sleep apnea as long as there has been a treatment. My wife has been telling me for 30 years I stopped breathing and snored terribly throughout the night.. Maybe if I listened, I wouldn't have developed high blood pressure, a heart attack, open heart surgery & diabetes. I started almost 2 years ago and keep my numbers <2.00. If one thing I say can help a newbie stay the course, I want to help just as many others choose to do on the forum. NOBODY wants CPAP, just as no one wants chemotherapy or kidney dialysis, or sawing every bone in your chest to replace clogged arteries. What we DO want is the opportunity to live and in my case spend the holidays with my children, grandchildren & great-grandchildren.

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

:)

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

Sorry. I tried to resist but it was just too hard.

It's a powerful story Bigmike52 and I'm sure your input is both helpful and appreciated.

Yes I am a loose cannon but I make no apologies.
I haven't involved myself to any degree in forums since the bad old days of download hubs, barefoot in the snow, so why now?

This forum is good at providing technical support for CPAP machines so what role could I play?

Apart from enjoying writing and the subtle interaction of hidden challenges I have an aptitude for the abstract and I enjoy twisted and obtuse reasoning so I tend to question pre-existing concepts and introduce new angles and aspects to a discussion.

I know that this is not always appreciated but in some cases it is essential.

This particular thread is a classic example.

Do you truly believe that a man in his prime with relatively normal readings, needs to be chained to a life support system for the rest of his life. Wouldn't it be better if he was able to go holidaying and camping and crash on his mate's couch or play with his wife on an impulse in the middle of the night without the added deterrent of a CPAP machine?

As you so rightly described there are other issues for you and I and anybody with severe apnea and it would be smart for EVERYBODY to do all they can BEFORE it got that bad but even then apnea is only part of a much bigger picture.

Yes you play a vital role Bigmike52 and it is necessary but it doesn't hurt to have other perspectives even if they are annoying. :P

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Bigmike52 +0 points · over 3 years ago

You have as much right to share your opinion as I mine. However I do take exception to your quote:

"Do you truly believe that a man in his prime with relatively normal readings, needs to be chained to a life support system for the rest of his life."

I don't believe anyone is chained to a life support system, as a CPAP is not a life support. It won't make you die if unplugged. Untreated OSA does have its consequences as I stated in an earlier post.

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Biguglygremlin +0 points · over 3 years ago Sleep Enthusiast

Oh come on now! I should be allowed some measure of poetic license, a little exaggeration and melodrama just for fun! :)

In this case the chain is compliance and you are right about the life support statement although some sufferers might feel otherwise and the authorities over here do consider it to be life support.

http://www.concessions.tas.gov.au/concessions/electricity_and_heating/life_support_machine_rebate

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