Question - does the VA have un iform standards at clinics

[broncovet]

VA has exactly the same policy at each VA: 

Quote

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 April 26, 2020 by broncovet

[Buck52]

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.

[rexlan]

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.

 

 

[Buck52]

I FIND THE VA ADVOCATES ARE WORTHLESS  TO GET ANYTHING GOING WITH THE VA SYSTEM   Hospital Director is your best bet.

BUT YOU DO WHAT YOU THINK IS BEST.

[rexlan]

Buck52

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 April 27, 2020 by rexlan