I called Apria on Monday morning and explained to the woman who answered about the mask issue. She was (amazingly) nice about it. She was from their national call center in Phoenix; even if you call the number for the local Apria office, you get the national center. She said she would call Rancho and tell them I was coming, and that I should go between 2-5 p.m.
I marched in around 3 p.m. The girl up front asked why I was there and I told her the national center should have called. I signed in.
I saw Tanya, my bossy R.T. from the other day, sitting at a computer. She gave me a strange 'why are you here' look. I smiled and used the restroom next to her station.
To their credit, I didn't have to wait at all. After exiting the restroom, I was called in right away by the male R.T. I think his name is Dale. He told me he doesn't use CPAP, but his wife does. I told him about the Kaiser/Apria mixup and he said the paperwork was ambiguous. It is as written - 'or best fit' (which I found out later weren't my orders at all...more on that in a bit).
I told him I wanted to try a nasal pillow mask since my Flexifit was so uncomfortable. He showed me the two models they had, Swift FX and LT. He said 'most ladies' prefer the FX because it has the softest headgear. I looked the two over and said I'd try the FX. He fetched me a set and we set up my CPAP machine which I'd been told to bring. The mask came with medium pillows which he said were probably the right size. He showed me how to adjust it. I put it on and we connected it to my machine. The sensation was strange, but I felt I understood how to wear it.
That was that - I signed a paper and was on my way.
Monday night I put the pillows on and had a devil of a time falling asleep. The pillows also rubbed my nose raw. Tuesday I went to Target and bought Ayr gel lotion for my nose (I saw a recommendation for it on the Internet). Tuesday night I had another battle with the pillows and ended up taking the whole thing off in the middle of the night and sleeping without CPAP. Needless to say, I felt crummy yesterday. Last night, I couldn't get the pillows to work at ALL. After a fruitless struggle I gave up and put on my Flexifit 405. Oddly enough, it felt strangely comforting to have the old mask on, and I fell asleep readily and stayed asleep until the alarm/husband nudging me awoke me. I didn't wake up once during the night. I feel pretty good today, although I only got 5-6 hours sleep which is not nearly enough.
Lucy, the case manager from Kaiser's sleep center, called today. I told her the saga of Apria and she said they have a LOT of problems with them. She read my orders direct from my chart: "Patient to be fitted for a mask by Apria". Nothing about only a nasal mask, or specifically the Flexifit 405. I promised to send her a photocopy of my order. She told me they shouldn't have pushed the Flexifit 405 on me in the first place; it's for broad noses (nicknamed the 'turtle'), and the 407 is the newer/better model. (The 405 is cheaper -- and I'm sure they have a warehouse full of those buggers!) It turns out the 407 is what Kaiser gave us for the titration study. I slept fine with the 407 during the study, although it is cumbersome on the face. Lucy loves the Swift LT. She spent some time explaining to me how my FX is supposed to be worn. But I'm not sold on nasal pillows. At least so far, it hurts my nose and doesn't stay on well. I'm going to give my FX another college try tonight. I may well return to Apria and ask for another exchange....not sure if I'll ask for the 407 or for the LT.
She said they would fax our prescription to a supplier if asked, if we wanted to buy a mask on our own. She cautioned me that no masks are comfortable.....I guess it's the lesser of evils...
She went over my medical chart with me. My sleep study revealed that I woke up 12.4x an hour. Between 6-15 is considered 'mild' sleep apnea. I woke up 13.3 times an hour while sleeping on my back and 9.9 times an hour on my side. (Impressive that they knew when I was on my back or my side!) More worrisome, she said, was my oxygen level. Anything below 90% oxygen is unacceptable. My oxygen went down 21.7% so it was around 80 %. It's bad to have one's oxygen lowered because we need oxygen for heart, brain, lungs, nails, etc. The good news with the titration study was CPAP completely eliminated my apnea. That's why I felt so good the week I had the Kaiser unit.
I told her that I felt better on the Kaiser APAP than I do my CPAP (although the mask struggles might account for some of my non-success). But of course, APAP is more expensive than CPAP so the Kaiser bean counters don't want to pay $100 per patient more for APAP.
The way they figured my CPAP pressure was to take an average of pressures that the APAP reported I needed. I ranged from 4-10, so they put mine at 9.
Kaiser will only cough up the APAP for really high pressures, she said, so I guess that counts me out.
.JPG)
Ollie gives me kisses while I wear the Swift FX after bringing it home on Monday.
No comments:
Post a Comment