After surrendering the loaner machine to Kaiser a week ago Wednesday, I wondered how long it would be before I got my own machine. Would I be one of the lucky ones that the RTs at Kaiser said got a spanking new machine 'drop shipped' to their home "in 2-5 days"?
Nope. 2-5 days came and went, along with an extra day - Labor Day. I resigned myself to being tired and draggy once again.
To my credit, I didn't call and bug Kaiser, although I wanted to!
Then, as I was rushing around on Wednesday from courtroom to courtroom, I received a call on my cell. It was Apria telling me to come in and get my machine and mask. Yay! They had called my house and my husband gave them my work and cell #s.
I made an appointment for the very next afternoon at 2. The office was in Rancho Cucamonga where I live, which was nice; closer than driving to the sleep center in Fontana. When I arrived there were two ladies in the waiting room. The three of us were ushered to a large room where shiny new CPAP machines were set out. They were the same machines that we were loaned, with one major exception: these were CPAP, or fixed pressure, rather than APAP, or automatic adjustable pressure. The machine is a Philips-Respironics "System One" REMstar Plus with C-flex with heated humidifier.
It turned out only one of the ladies was a patient; the other was her mom who had been using CPAP for years. Later a gentleman joined us. He had just missed the exciting informational video that told us the same stuff about sleep apnea we already knew, and included lots of plugs for Apria and how wonderful they were. (Apparently necessary, since the Internet is rife with complaints about how terrible and incompetent they are - Google 'Apria problems' and you'll see.)
After the video our assigned RT (respiratory therapist) Tanya began her spiel. Her name tag said she was the senior RT. I annoyed her a bit by jumping ahead with my questions; all that reading I've done on the Internet! She did a good job of showing us how to use the machines and clean them, going into a lot more detail than we got at Kaiser (of course, we took 1 1/2 hours at Apria to go over what we spent about 10 minutes doing at Kaiser).
I was surprised to see a small box containing a nasal mask sitting in front of my machine. I told Tanya I thought I was going to get to try on and choose my mask. No, she said; your doctor ordered this nasal mask for you. "See?" she said, pointing to my paperwork that said 'nasal mask'. The other lady had a full-face mask sitting in front of her.
We were told that Apria allowed "one mask exchange within 30 days" if you didn't like your assigned one, but it had to be the same type; i.e. another nasal mask for me. If I wanted nasal pillows (which sit in your nostrils with nothing over your nose), "you need to get a different prescription". Hmmm.
We were also told that no way would anyone be allowed to try on different masks; once a mask was opened it couldn't be used again for anyone else. That took "trying on" completely out of the equation. I can kind of understand that; who would want a mask someone else wore? On the other hand, couldn't they have samples? They had *one*, anyway -- Tanya used baby wipes to clean off a mask to loan the gentleman in our group, since apparently his mask had been sent to his home.
My assigned mask was a Fisher & Paykel "Flexifit 405" nasal mask. It looks very much like the one I test-drove from the sleep clinic. It might be the same one, although Tanya told me to use the 'small' mask size in the box. Since I've had a mark on the bridge of my nose all day long from sleeping with it last night, tonight I may try the 'large' included in the box. There is no medium size, oddly.
The hose in our kits is a lot nicer than the ones Kaiser gave us, as the Kaiser RTs had promised. Mine is nice and pliable, while the Kaiser ones were hard and stiff.
After training ended we packed up our kits and went home. I was eager to sleep with my brand new CPAP. I made a run to CVS to get a couple bottles of distilled water for the humidifier and set up the machine on my nightstand, filling the humidifier carefully below the fill line.
Then I put on the new mask, turned on the unit, pulled twice on the mask to seat it as we'd been taught, and lay down in bed. The clock read midnight.
I pushed the 'ramp' unit which cut my assigned pressure 9 in half, to 4.5. That pressure feels a lot better than the full 9. It's supposed to let you ease into sleep with a slow increase in pressure over 15 minutes. Alas, sleep did not come quickly; I kept getting bombarded with the 9 pressure when 15 minutes passed. All in all I lay there an hour, pushing the ramp again and again. It took an Ativan to get to sleep (maybe - the Ativan bottle said expired in 2007!)
I awoke at 7 a.m. having gotten 6 hours sleep. Today I do not feel great. Better than usual yes, but great, no. Not at all the wonderful chirpy happy self I was during the week with the Kaiser loaner APAP. I wonder if it's APAP vs CPAP? Or that I had issues getting comfy with the too-small mask last night?
I called Kaiser today to talk to Kim, the RT, about the mask thing. She was very surprised to hear that I was told "the Doctor ordered a nasal mask". My paperwork was supposed to say "any mask comfortable" and "patient to be fit for mask by Apria". I guess to Apria, that meant "we have lots of those Flexfit 405s stacked in the warehouse; give her one of those". (I saw on the Internet there's a new version of that mask...the 407...hmmm!)
Kim got ahold of Julia, the Apria liaison for Kaiser Fontana, and told her about my problem. Supposedly Julia has arranged that I can go back to Apria and choose a mask - ANY mask - nasal pillows included.
Kim said I should talk to Julia first. Welllll, guess what. I got her message machine. Since it's 4:15 on a Friday afternoon, I sincerely doubt I'll hear back from her and I certainly won't be able to get to Apria before they close today. And if I just show up at Apria? They'll tell me they can't give me the pillow things without a prescription. Catch 22.
I guess I'll start calling Julia on the hour beginning Monday until I get her -- and get her to call RC Apria to tell them to give me the pillows. Or maybe I'll ask Kim to fax the prescription to me. In the meantime, hopefully I can make the Flexifit work....
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