Top Topics
I think that it is. I tend to come down on the side of autonomy and don't enjoy the idea of a "nanny state"
While I do think that some of the advisers are not as cognizant of the risks as they might be, I have not found the medical community to be any better, and it is the rare professional who is actually well versed enough or has the time to go beyond the standard protocols and tailor a treatment plan for an individual. Ultimately it is up to the individual to choose what advice to select, and as long as a lay adviser is not taking money for it (and therefore has nothing to "sell") I have no issue with ordinary self educated folk advising others. I do support rx for the equipment for 2 main reasons. 1) I think health insurance should cover the cost and 2) I think the quality of the products needs to be regulated.
Don't misunderstand my stance... If I were to have an educated disagreement with my medical practitioner, I most certainly would want to have the capability to take it into my own hands (and I do have that). I think it is important to understand that we are all individuals and the best therapy will be a tailored therapy - not too much and not too little. An educated patient, or a really attentive practitioner (who has that!) is the only way to achieve this.
It is best for a good, interested medical professional to collaborate with an engaged educated patient. Second best is for the patient to be engaged and educated on her own and self manage. Second best may be best in the case of lack of good doctors whether the reason for the lack is location or money. Medical practitioners are there in this case to educate the patient - but I see very little of this.
I would not hesitate to adjust my own settings. I am a person who educates myself, and it is useful and valuable to me to be able to do so. I am also fortunate in that my Dr is one of few (according to anecdotal evidence) who actually pays attention to the data on my SD Card (although he does not use the handy online information that my DME has, but I can't see - he requires me to bring the card in) In the case of an engaged Doctor and an engaged patient, you have the best possible scenario. From watching friends and relatives and participating in forums, too often neither Dr or patient is engaged, and treatment suffers. Worst tho, is the patient who wants to engage but has a Dr or DME that fights them.
IMO in a perfect world, all information is available to any involved in treatment who want it - Dr, Patient, DME. Changes are agreed upon by Dr and Patient and recorded by DME. When Doctors refuse to educate themselves, the patient can and should pick up the slack (and find a new dr)
I am not one of those who believes CPAP is riskless. I think that the lower pressure you can be successfully treated on, the better off you are; to do this well you need full participation of all parties, and sharing of data.
+1 for apneaboard.com -- and it is also moderated, but by board owner and other volunteers. It is nice that members can post immediately. Innocent until proven guilty of trolling. I appreciate the "borderline medicine" as well :D I am a big girl and can decide for myself what advice to swallow.
btw 20 is a "moderate" case of apnea and certainly warrants treatment to keep you from experiencing the ill effects of hypoxia and poor sleep.
Sure. Anything that obstructs your airway can contribute. Stuffiness, any swelling in throat or nose can constrict and contribute to obstruction causing an increase in apnea.
awesome didgeridoo duet https://www.youtube.com/watch?v=oXBGZoBYaLY
an AHI of 7 is a gray area, and depending on other factors in the sleep study, such as high concentration of events during REM, or sub-apneac results (RERA) also depending on other factors such as heart arrhythmia or high BP can be considered clinically significant or not.
A night in which you slept well is weirdly a better indicator of whether or not your problems are apnea related --- if you had slept poorly, your sleep may not have gotten deep enough to see whther apnea is present during deep sleep or not.
I started on PAP last November, and am coming up on the 3 month get supplies mark. One thing I have noted about my Insurance (Cigna) is that their coverage information either on the website nor the handbook I got from my company contains any information at all about what is covered. I am really fortunate in that my plan covers 100% in network, but getting information about what is in-network is like pulling hens teeth, and its worse to find what is covered.
The DME is no better. They require a phone call (for which you must annoyingly sit on hold for a while) and then the person doesn't have information about you specifically, they just know what can usually be done. All very frustrating in this day and age of information always at the ready.
Really, at least the supply part of this process should be a refill process with your supplies listed and when they can be filled next, and a shopping cart. Why aren't they more on the ball? Well, I think that is because the insurance companies have reduced competition by selecting limited players.... It's hard to believe that with the markup on these things that there isn't a more consumer friendly process!
heated hose helps reduce "rainout". Hose cover combined with the uphill trick may work.
