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Question - does the VA have un iform standards at clinics

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I have run into this new issue and feel that my VA system in Alabama is using a different set of procedures compared to others.

I am 70% rated,on oxygen and CPAP so all medical is covered.   After 3 months of struggle I finally got a CPAP machine from the VA - but it was a struggle.

We lost power here after some severe storms and it was off for 2.5 days (2 nights).  I ran out of oxygen battery from my portable in 7 hours but OK.  However, I could not use the CPAP and I had a really rough 2 nights.  My friend is in NY and on CPAP as well.  He asked about camping and his VA sent him a battery unit for his Philips Dream Station like mine and a 12 car adapter  ... very nice stuff.  He is rated 10% but not for sleep apnea so I's not sure how all that works.

I asked my sleep clinic in Montgomery if the had the battery unit OR (important OR) a 12v car adapter and I could make my own OR if they had a bad power unit so I could just get the plug on the end and make my own.

I got what I thought was a pretty arrogant reply - "The VA does no supply any battery backup for CPAP but you can purchase your own on the Internet" - well no shit!  I thought that was a horribly attitude and no mention or the OR possibilities.

So my question is if the VA has uniform policy or did my friend just get very lucky?  It seems that all of the VA clinics should offer the same supplies uniformly.

Does anyone have experience with this?  Thanks very much for the input.

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There is absolutely no uniformity or standards at VA or the VAMC. I would say that your friend got very lucky. What one veteran get granted or approved for at one VA or VAMC may not at another.  I was informed with the same answer when lightning fried my Cpap machine and it quit working all together.  I was given a new Cpap machine and was informed to buy a power surge plug.

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Rexlan There are somethings that are consistent and then there are some that , well, not so much. This is what I would do: I would send a secure message to your primary doc. Tell him pretty much what happened. Ask him if he could intervene. And, here's the kicker, tell him because of those couple days without a working CPAP, tell him you aren't feeling well and request ANOTHER sleep study! The VA doesn't like spending $ on medical procedures especially if they are earlier than they should be scheduled. I don't know if you have any MH disabilities, like depression or anxiety, but tell him you are Really nervous about the situation happening again. My guess is you will get some action.

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As usual great information and replies -- thanks very much!!

My stuff is Viet Nam PTSD (1965)  .. I let it go close to 50 years and only applied last August.  Funny thing is I didn't want the $$ just the health care we were promised back in the day -- totally rethinking that now. 

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Rexlan If you are a Vietnam veteran and kinda new to this, take a look at the listing of presumptive diseases for AO here  https://www.publichealth.va.gov/exposures/agentorange/conditions/index.asp  Hopefully you are healthy and none of this applies to you. but this listing has expanded quite a bit over the last 10 years or so. Don't forget that if you have any of these conditions, they often result in SECONDARY conditions that can also be disabilities. For example, type II diabetes often leads to hbp and eye problems tthat on the surface most people wouldn't connect. Keep on reading and learning on Hadit and ask questions when you need to.

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SSA and VA disability compensations were set up to help individuals that would become disabled or to assist them later on in life to maintain an average or standard of living.  When I was in the military like most to all, I was not thinking about disability or have to quit work at a younger age. My plan was to retire. When I got hurt I continued on but when I got sick and couldn't recover, my first thoughts were, what the heck are you going to do now. Even when I was discharged, I was not thinking or knowing anything about disability. It wasn't until one of my VA doctor's telling me that I had to quit work just to have a more better life due to chronic pain that could only be treated but never be cured.  I went to school thinking I could beat this thing but my condition(s) only got worst to the point where I had to realized that I couldn't  ever go back to work. I had to realized that these programs were set up for individuals like me. After helping a friend get granted 100% TDIU, I encouraged him to file for SSDI but he refused and decided to wait for his retirement age of 65. Yes, my friend was not even 50 years old.  Yes, I knew that there was no guarantee that he would be granted SSDI but it was most likely would get it.   My thoughts were, since he was  already awarded 100% TDIU and it was not likely that he would ever go back to work and would never accrue any more work credits then why not get his SS benefits compared to waiting for them. He still refused to file a claim but that was/is on him.  We never know what will happen and in this day in age where people are losing their jobs and running out of basic supplies. If you qualify for benefits, apply now and let these benefits help you and your family. These benefits are earned through our sacrifice and our commitment to our country and are in no way the same as welfare. Some veterans feel that SSA and VA are welfare and they of course are not.


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VA has exactly the same policy at each VA: 


Its called "willy nilly" where one person says one thing, someone else will tell you the exact opposite.  You can count on that being fully implemented at each VAMC except in cases where the VA "has no idea" what they are doing.  (Which is 90 percent of the time).  

Case in point.  My VA not only sent me a CPAP battery backup, they sent me 2 of them, yet they told you VA doesnt supply them.  My advice is to talk to someone else, they surely will have a different opinion on it, unless they have no idea what they are doing.  

Edited by broncovet
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I had some problems with my VA iSSUED C-PAP  And went to the VA Sleep Clinic to let them know , I am not sure what it was  but I kept waking up during the night  and from what me and my spouse could tell the c=pap was not putting out enough pressure.

   so we tried to turn it up  but nothing helped we clean it good and replace all filters and I was still having breathing problems   so I took it in to the VA Sleep Clinic let them know what all we did to it to try and get it to do what it is supposed to do  so I can get some much needed sleep safely,

   and they were very rude and said you need to leave the damn thing alone  do not make any adjustments  to this machine,  it was adjusted to your sleep apneas  to a certain setting 'pressure, now you messing with the adjustment you got it all out of adjustment, I ask if they can readjust it  and they said I will need another sleep study  and it looks like that is about 6 months out...grrrrr

I was pissed off by this time and went straight to my hospital director  he is the boss over all the Dr's and employees there  and he called the sleep clinic and had them to issue me a new c-pap machine and use the settings from my last sleep study..they got me a new C-pap  and Its working good now...some times we just need to get in touch with the right person  in my case it was the Hospital Director  he helps all us Veterans...and he does not like the clinic clerks to talk down to any veteran...he says we are the reason they all have jobs  including himself.

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22 hours ago, broncovet said:

VA has exactly the same policy at each VA: 

Case in point.  My VA not only sent me a CPAP battery backup, they sent me 2 of them, yet they told you VA doesn't supply them.  My advice is to talk to someone else, they surely will have a different opinion on it, unless they have no idea what they are doing.  

Thanks for this reply.  I know the advocate I've dealt with has not been helpful and my primary Dr. is worthless and I have consequently pissed her off probably.  The CPAP clinic has been terrible.

But I will reach out to the advocate again on this issue and see/report what happens.



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It sounds like your sleep clinic is as bad as mine.  There is NO POSSIBLE WAY for you to screw up the machine.  Change settings = yes, but easy to adjust.  As I said in my other thread, 99% of the titration sleep studies are WRONG.  Strange bed, environment and you will never have a normal sleep.  It is quite marginal with an at home study too.  Almost always the machine pressures are set too high and this causes mask leaks and awakenings.

They set mine at 5 to 15 and I could not sleep at all.  Started tweaking it and found my sweet spot to be 5 to 7.5.  My AHI now averages about 1.8 and has been great for almost a year.

Unless you have a really severe blockage more pressure is not necessarily the answer.  You can tweak it and only change it 1 Cm at a time, test 2 nights, until you find what works for you on pressures.  The flex setting that reduces pressure during exhale is also important and mine is set a 2. (1-3 is available)

Also you need to look at the Sleepyhead software and download your sim card.  Then you can see EXACTLY what is going on, when you have an apnea and if it is a central, obstructive or hypopnea.  You will also be able to see the machine automatic pressure adjustments while you sleep, arousal when you wake up, etc.

Fort me, the arousal right before I wake is associated with a high pressure then a mask leak as a result ... lower pressure for me get back a shallow and calm breathing pattern and I sleep great.

Edited by rexlan
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