Initial Cpap follow up appointment

[1454th Solider]

I was just diagnosed for sleep apnea OBSA by the VA and I have a follow up appointment I guess to get my CPAP machine. Does anyone have any insight on what to expect from this initial appointment?

[brokensoldier244th]

They will discuss your results, be open to questions, and show you the basics of the machine (or they should). They will probably send you to Respiratory to get the machine. SOMEONE should explain how to use it to you. I got mine almost 10 yrs ago, so mine is not internet capable, etc. Yours might be, meaning they should be able to pull records off of it occasionally to show compliance and to make adjustments if needed. Mine is an auto pap so I just set the humdity level and I can set certain other functions based on how my body reacts to pressure settings. Over time you'll learn what you can tolerate. 

 

MASKS- very important- have them show you full face, nasal only, and/or mouth and nose (but usually smaller than a full face). VA issues me full face but they also have 'masks' that just sit under your nose. If you are PTSD/Claustrophobic, etc, this might be a better option for you. If you are a mouth breather, though, not so much, because sleeping with an open mouth throws off the whole pressure dynamic that the machine is trying to create. Helpful hint- most any mask will attach to the tubing, so look on Amazon- there are other companies that make masks and headgear for Cpaps that are more comfortable/less bulky than just Resmed (or whomever your machine is made by- mine is Resmed). You aren't stuck using just Resmed masks, however, VA won't pay for your experimenting. If you want free masks, you'll have to go with whatever they are using now.

 

Do not crunch the mask down on your face/nose. You aren't cinching up a load. You don't want to compress the silicone too much or you'll get irritation marks and some pain around your mouth, nose, or minor headaches in the back of your head from the straps. You want it just tight enough to not leak when you are laying down. You'll probably have minor headaches for a few weeks after you first get it since you are forcing air (negative pressure) through your sinuses- your body will adjust, or talk to your Resp therapist RE: settings. You might be set too high or something, and a lower setting might alleviate the headaches but still be within the range for effective treatment. 

This machine is your new friend, it will go everywhere with you if you travel. Its also 'checkable' as a medical device for carry on so you don't get fee'd extra for it if you fly somewhere. 

 

DO NOT GO to a durable medical store to buy masks to experiment with. Many of them are really anal retentive about selling OSA stuff because of how they bill insurance. You can't just walk into most of them and pay cash (I was in an Indie film and wanted to buy a mask as a prop- they wouldn't sell it to me)- many of the physical stores I have tried won't even sell me OSA stuff for cash on the barrel- I have to either have insurance or a prescription from a doctor- and a VA prescription won't always count to them. It was really frustrating- but their prices are a lot higher than what you will find on Amazon, anyway. 

 

Good luck. Ive been using a CPAP for about 10 yrs, so if you have any other questions/concerns, feel free to PM me anytime, even after you get the machine, or if you have questions about different masks or headgear, etc.

*I am not a doctor, nothing I say is medically binding, just informational, at your own risk, etc etc....*

Edited January 26, 2021 by brokensoldier244th

[GBArmy]

1454thSoldier Should be straight forward. You had your initial sleep study and it showed you have at least mild or moderate OSA. You see the tech/medical person and they will discuss how to operate the machine (pretty basic stuff), help you select the correct mask type to wear, basic cleaning requirements, and then a next appointment to see how it's going. Their tech is now set up that the data is sent to them daily, so they can see your actuals, how much you are improved, etc. Used to be you had to periodically bring it in and they would read it off of the machine. It is sometimes difficult for the patient to get comfortable with wearing it, so it does take some trial and error. I know guys who got it and wore it for an hour or two, then put it away and never tried it again. It's up to you; your choice. If you have a family, maybe they want you around for a bit longer. Maybe not. But if you understand what OSA is, you understand some discomfort is usually a lot better than having a stroke or heart attack because you stopped breathing. I'm being blunt because some people just quit instead of trying to work thru it. Up to you 1454th; wish you well.

[brokensoldier244th]

Yeah, I predate the new, cool machines. I used to be a programmer so I figured out a way to pull the data off my machine and read it. Over time ive gotten pretty good at interpreting what the machine is doing, and eventually I would just secure message findings to respiratory and they showed/told me how to make adjustments to it on my own. 

 

OSA is no joke. It can kill you- either through a car accident due to falling asleep at the wheel, or in your sleep because your 02 sat drops to a point where you drift off to the Rainbow Bridge. I had it for years before I was diagnosed and I knew I had 'a problem' with sleepiness and exhaustion, I just never knew what it was. Once I started drifting off in the middle of conversations, while driving, or at work, it was time.

I had an older co-worker whose husband has OSA and she noticed some of the signs. Based on her small talk questions every now and then she finally started REALLY prodding me to get it looked at , and explained how dangerous it was and that it could kill me. Thats what did it for me- I was in my mid 30s, and I have 4 kids and a wife. Im already overweight quite a bit due to hypothyroid/medication/chronic pain issues, so my risk factors were high. Im still all three of the previous but at least I can have restful sleep which allows me some extra energy through the day to exercise a little and actually take part in 'life' rather than collapsing into bed for 14 hours every day like I was before. 

 

 

[broncovet]

The doc and VA will make choices for you as far as the machine, its settings (7lbs, 5, etc), but you choose the most comfortable mask.  

Its critical you are comfortable with the mask.  The machine does no good if you dont use it.  

I like the nasal pillows or "dream ware" masks.  I really dont like my face "covered up".  

However, when I have a plugged up nose, the nasal masks dont work.  So I have a spare "face mask".  

You need to keep the machine and hoses and mask clean.  (At least once a week).  I wash mine with soap and water, especialliy inside the hose and mask.  

They have machines that do the use ozone or other disenfectants to clean the mask for you, but, even with them, you need to wash it with soap and water occassionally.  

You have to remember to order new mask, hose, and filters about once every six months as the masks and hoses dont last forever.  

Mine has 2 sets of filters...one larger filter that can (and should) be washed.  The other is some sort of epa hepa filter (paper), that needs to be replaced every 3 months or so.  

You wont get a good result with your cpap if you dont clean it and service the filters regurarly.  

[brokensoldier244th]

My respiratory at the clinic here puts me in for 2 re-orders a year automatically. Other ROs may vary, though. 

[GBArmy]

I have to put in my reorders. I use a full face mask, and for a while a year or two back, the mask would fail anytime after 30-40 days. They were giving me  a hard time about replacements. Others must have complain though because the quality has improved to maybe every 4 months on needing to replace and they don't give a hassle anymore on it when I reorder. But though it helps, I still have a time falling asleep during the day if i'm just relaxing like TV or reading. What a pain.