View Full Version : Need advice re: getting started with CPAP
I have sleep apnea and the last time I tried a CPAP machine I was not able to tolerate the darned thing.
Again my doctor (new due to my relocation) wants me to have another sleep study (at the sleep center this time rather than just at home like I did 3 years ago).
The last time I figured I could save money on the machine by just buying one online.
Questions:
Am I kidding myself about cost savings?
Where do I look for a trustworthy seller?
How do I determine what I want/need?
Thanks in advance for your input!
PS. I figure I may be able to purchase a machine instead of paying for the sleep study. Might be a wash financially.
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Don't buy a CPAP online. They need to be programmed for specific settings based on your needs, which a sleep study and review from your Doctor will determine.
I understand wanting to save money, but this is definitely best left to a Physician.
I have an RPSGT credential, i.e. the guy who performs the sleep studies and interprets them (not in my current job but several years ago, credential is still active). CPAP is tolerated, depending on whose stats you believe, by 50-70% of those it is prescribed for. Thank God I don't have sleep apnea 'cause I'd be one of those who couldn't do it......at least I don't think I could. Sleep apnea is a BIG threat to your health and longevity so if you have it then it would behoove you to find a way to tolerate it. Of course there are other alternatives out there, such as oral devices (don't think I'd like something in my mouth all night) and some new thing where they implant a device that keeps your internal musculature from getting too relaxed and causing obstructions; don't know a lot about that one.
A CPAP is a medical device so quite likely a doc's script is necessary to purchase one legitimately. Of course on Craig's List you can find Aunt Bessie selling Uncle Wilbur's machine since he's deceased, but that is kind of :blink: . Newer machines have a variable setting where the device senses what level of pressure you need throughout the night. Generally speaking the deeper the sleep, the higher the pressure required. It's called Auto-Titrating. If you're a mouth-breather you would most likely need a "full-face" mask, which covers both the nose and mouth. If you can effectively breathe through your nose all night then a nasal device might work.
Machines are not that expensive but you do need a prescription for them usually. If you have a sleep study already you can usually get your GP to write you one. My sleep study is from 2004 and my DR still writes me one when I need it. It used to be you needed a prescription for the masks too, but they seem to have changed that.
I buy my machines and equipment from either http://www.cpap-supply.com/ or Amazon. Amazon is best for Masks, etc while Cpap-supply is better for machines because they will set it up for you.
Now. It took me a while to get settled with mine. I couldn't sleep with one at all and would take it off without knowing it during the night. I had to play around with different types of masks and straps but eventually settled on what worked for me. Now I can't sleep without the damn thing. But it took me a few months to really settle in to it.
This is the system I use now. It also has a bipap mode which some people really prefer, although I keep it turned off. BiPap means it won't keep pressure on while you are breathing out. So it makes it easier for some people to breath when using it.
https://www.cpap-supply.com/ProductDetails.asp?ProductCode=DS220HS
And I paid 360 plus shipping for it.
And this is the mask.
https://www.amazon.com/dp/B075SVRCPV/ref=sr_1_9?ie=UTF8&qid=1506038005&sr=8-9&keywords=resmed+quattro
Masks should be replaced every 3 to 4 months although you can extend how long they last by keeping them clean. Especially the strap. Those need to be cleaned and they will stretch out. The good news though is that you can replace just the strap. In fact all the parts on the mask can be replaced. So depending on your situation you can replace parts instead of the whole thing if you need too. Unless it gets stepped on though the only parts that would need replacing are thee cushion and the strap.
Once you get a machine use some google fu and find out how to enter the admin menu. This will allow you to change pressure and other settings that normally are set when you buy it. I have found this especially useful when I have a cold or something. I can adjust the pressure and it helps.
Hope this helps a little bit.
Don't buy a CPAP online. They need to be programmed for specific settings based on your needs, which a sleep study and review from your Doctor will determine.
I understand wanting to save money, but this is definitely best left to a Physician.
He has a study already. When he sends in his order a reputable company will request that and set it to the Drs specs from the Study.
Bipap has an inspiratory pressure as well as an expiratory pressure. It is usually only needed in severe cases. That it drops pressure as you exhale is device-specific and not all Bipaps do that.
CPAP = Continuous Positive Airway Pressure
Bipap= Bilevel [ie. breathing in and out] Positive Airway Pressure
Bipap has an inspiratory pressure as well as an expiratory pressure. It is usually only needed in severe cases. That it drops pressure as you exhale is device-specific and not all Bipaps do that.
Good to know. All the ones I looked at did that so I assumed all of them did. Thanks for the info.
Good to know. All the ones I looked at did that so I assumed all of them did. Thanks for the info.
Nowadays (2017) most probably do. I got out of "sleep" in 2011 but have kept my credential active, but being in Respiratory Therapy (my other credential) I still see it to some degree. Back in 2011 auto-titrating wasn't exactly new per se, but it was the wave of the future and apparently this has panned out. Most of the CPAPs we set for folks we set a pressure range, like 4-20cmH2O as opposed to a specific pressure like "back in the day". The drop of pressure on exhalation to make it easier is one of those "newer" niceties. Software is constantly evolving so that is no surprise.
just a scout
09-21-17, 19:51
Keeping it clean helps a lot. Wash the hose, mask and resivior once a week. A So-Clean is one of the best investments I've made.
Get a study done. Insurance should cover it and the machine. Do not buy a used one. Who knows what's growing in it.
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FlyingHunter
09-21-17, 20:16
Not trying to take this a different direction, however, have you, in partnership with your physician, looked at solutions to the underlying cause of sleep apnea before treating it with CPAP? Specifically, a programmed approach to diet and exercise to address the underlying pathology. In addition, certain medications, alcohol, smoking, chronic nasal congestion, co morbidities such as diabetes, liver disease and HBP as well as certain cardiomyopathies can have positive correlation to sleep apnea.
He has a study already. When he sends in his order a reputable company will request that and set it to the Drs specs from the Study.
I'm tracking that.
I'll rephrase:
Ask your Doctor if your previous study is sufficient and ask for his opinion.
I had a CPAP machine for awhile after some surgery four years ago. I didn't get a sleep study...I just wrote my own prescription and specified some basic settings which they programmed into the machine before sending it to me. I got the thing from CPAP.com. Cost about $1000...insurance would have covered it if I'd been able to submit a sleep study. CPAP.com is a very reputable place, good prices, good equipment. Mine was an auto-adjust ResMed with heated inline tubing for moisture. I had zero difficulty adjusting to sleeping with it and slept well. I definitely preferred the nasal pillow mask.
When in use, the machine downloads your sleep data to an SD card. I have some shareware software I downloaded from somewhere that plots that data for me and calculates an A-H index as often as I ask it. I stopped using the CPAP machine when my A-H index fell to about 6.
I agree about the automated hose cleaners. They work great. I just disinfected mine in the shower every couple of days.
Eurodriver
09-21-17, 20:36
.I just wrote my own prescription
Can you do that? I ask not in an accusatory manner; I genuinely had no idea.
I mean, I guess I file my own taxes...
Can you do that? I ask not in an accusatory manner; I genuinely had no idea.
I mean, I guess I file my own taxes...
Sure. Self-prescribing is legal, although very few (if any) pharmacists would fill a prescription for any Schedule II drugs (opiates) that I wrote for myself. I'd never try anyway. And there are a few states that have laws against self-prescribing narcotics.
I didn't need a sleep study...I had the most sensitive sleep apnea indicator known to man...my wife. I decided to get the CPAP machine after I woke up one night to this soft white glow next to my face. I was my wife holding her iPhone. I was like... "WTF are you doing (dearest beloved wife) ?" She said "I'm recording your sleeping to prove to you that you stop breathing repeatedly during the night". I succumbed and ordered it the next day. It was a worthwhile investment. Clearly the path of least resistance.
It took me a little bit to get used to the machine but I love it now. Seriously changed my life.
Mr. Goodtimes
09-21-17, 21:44
Sure. Self-prescribing is legal, although very few (if any) pharmacists would fill a prescription for any Schedule II drugs (opiates) that I wrote for myself. I'd never try anyway. And there are a few states that have laws against self-prescribing narcotics.
What about the sauce? Can you self prescribe Testosterone?
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Mr. Goodtimes
09-21-17, 21:47
Also, I've never had sleep apnea but I used to snore really bad. When I cleaned up my diet and eliminated potential allergens, my snoring went away. For me it's gluten and dairy. I pretty much eat a caveman diet except for some cheat meals on occasion.
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What about the sauce? Can you self prescribe Testosterone?
I can legally prescribe anything for myself, even narcotics. The question is whether or not the pharmacist will fill it. He/she is not obligated to do so. Testosterone preparations are a Schedule III controlled substance but most pharmacists don't worry about self-prescribing anything unless the potential for addiction or misuse is high, or if they don't know the doctor. In the midst of this current opioid hysteria, it would also be extremely unusual that any pharmacist would fill a self-prescription for any opiate or other such narcotic substance.
Mr. Goodtimes
09-22-17, 05:29
I can legally prescribe anything for myself, even narcotics. The question is whether or not the pharmacist will fill it. He/she is not obligated to do so. Testosterone preparations are a Schedule III controlled substance but most pharmacists don't worry about self-prescribing anything unless the potential for addiction or misuse is high, or if they don't know the doctor. In the midst of this current opioid hysteria, it would also be extremely unusual that any pharmacist would fill a self-prescription for any opiate or other such narcotic substance.
I see. That makes sense.
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Eurodriver
09-22-17, 05:59
What about the sauce? Can you self prescribe Testosterone?
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In case you all missed it, Mr GT is now considering Med school :) :)
Thanks for all the information and advice.
I definitely have sleep apnea and have taken steps to mitigate/manage my symptoms.
Losing weight, stopped alcoholic beverages, restarted an exercise program (stopped due to multiple surgeries over the last few years). I can no longer sleep on my back but now sleep in my recliner. (Makes travel much less inviting)
Due to the fact that both of my parents died from strokes I feel like I have no choice but to see if I can find a way to address the problem. I'm just not sure if paying for another sleep study is money well spent.
Eta: I had nasal surgery and afterwards my doctor told me that I was not a candidate for throat surgery (to alleviate some of the apnea) because my throat collapses both front to back and side to side. Good thing I spent the cash on the nasal surgery that doesn't seem to have made much of a difference...
In case you all missed it, Mr GT is now considering Med school :) :)
I can save him some time and money. The problem generally isn't lack of testosterone, it is what you do with the testosterone you have.
Essentially testosterone can be used for three things - building muscle so you can look at yourself in a mirror; growing hair; procreating.
My solutions -
1. Stand with your arms crossed. Put your fists under your biceps with your knuckles placed between the humerus and the biceps. Instant guns.
2. Great clips. #1 blade guard, all over.
3. Saved all that testosterone for what is really important - sex.
He can thank me later.
Thanks for all the information and advice.
I definitely have sleep apnea and have taken steps to mitigate/manage my symptoms.
Losing weight, stopped alcoholic beverages, restarted an exercise program (stopped due to multiple surgeries over the last few years). I can no longer sleep on my back but now sleep in my recliner. (Makes travel much less inviting)
Due to the fact that both of my parents died from strokes I feel like I have no choice but to see if I can find a way to address the problem. I'm just not sure if paying for another sleep study is money well spent.
Eta: I had nasal surgery and afterwards my doctor told me that I was not a candidate for throat surgery (to alleviate some of the apnea) because my throat collapses both front to back and side to side. Good thing I spent the cash on the nasal surgery that doesn't seem to have made much of a difference...
You won’t know what kind of sleep apnea you have, therefore no way to know how best to treat it, without a sleep study. Sleep apnea is no joke. It kills people.
You won’t know what kind of sleep apnea you have, therefore no way to know how best to treat it, without a sleep study. Sleep apnea is no joke. It kills people.So, if I get the results from my first overnight (home) study to my Dr is that good enough or should I spring for the sleep center study that they are trying to get pre-authorized?
Last time my insurance wouldn't pay for the sleep center study... I have my doubts about how much good information the home study can provide.
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I think you need a formal sleep study.
I think you need a formal sleep study.
Yeah, good idea. Although it is a minority of cases, you could have central sleep apnea which is treated differently than obstructive apneas. Did you wear a belt around your waist or chest area with the home sleep study? If not they have no way to differentiate between central and obstructive apnea. Both will cease airflow and cause oxygen levels to drop but the belt tells if there was effort being made to breathe (the difference between the two).
Yeah, good idea. Although it is a minority of cases, you could have central sleep apnea which is treated differently than obstructive apneas. Did you wear a belt around your waist or chest area with the home sleep study? If not they have no way to differentiate between central and obstructive apnea. Both will cease airflow and cause oxygen levels to drop but the belt tells if there was effort being made to breathe (the difference between the two).Belt around my chest. Lots of stopping breathing. Moderate to severe iirc.
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I have a love-hate relationship with my CPAP's. I can not sleep without it. I have two, one for camping and one for home. The camping unit goes camping with me and to the girlfriends when I stay there. I recently lowered my pressure from 14 to 10 when I lost 70 pounds! I was having trouble sleeping when I had a lightbulb moment and realized the CPAP did not need to work as hard anymore. You can google/youtube the directions for your machince. I use a full face mask. I tried the nasal pillows, and they did not work for me. I have a deviated septum too.
Belt around my chest. Lots of stopping breathing. Moderate to severe iirc.
If the belt showed you were making the effort to breathe but couldn't then it is obstructive apnea, i.e. the belt was moving (you were trying to breathe) but no air went in. It is usually a cumulative effort that gets harder and harder until you finally "snore" or gasp to get the breath in. That of course wakes you up over and over again all night long and why sleep apnea is so detrimental to your health----you never get a good night's sleep. Bad juju.
If the belt showed no effort to breathe then it is central apnea. Sometimes it is a mix of the two. Obstructive is more common but central is indicative of neurological involvement where your brain isn't sending the signal to breathe like it should (sometimes it is related to congestive heart failure too).
Keeping it clean helps a lot. Wash the hose, mask and resivior once a week. A So-Clean is one of the best investments I've made.
Get a study done. Insurance should cover it and the machine. Do not buy a used one. Who knows what's growing in it.
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Keep your stuff clean. It will get you really suck if you don't.
I didn't need a sleep study...I had the most sensitive sleep apnea indicator known to man...my wife. I decided to get the CPAP machine after I woke up one night to this soft white glow next to my face. I was my wife holding her iPhone. I was like... "WTF are you doing (dearest beloved wife) ?" She said "I'm recording your sleeping to prove to you that you stop breathing repeatedly during the night". I succumbed and ordered it the next day. It was a worthwhile investment. Clearly the path of least resistance.
Ask what it will cost! I wanted a new machine and had to have a sleep study. It was over five thousand dollars! I had it done at a clinic the first two times. This time was at the local hospital. Ask about costs! The majority was the Doc and his analysis of the study. I was told the doctor watches the whole video. I call BS on that one. The 10% copay hurt!
Well, since I finally found a physician who was able to get my insurance company to agree to an in-lab sleep study I thought I would update this thread.
Results are as follows:
Severe sleep apnea, sever oxygen desaturation with a low saturation of 75%.
Apnea hypotony index of 45 events an hour and the respiratory effort-related arousal index of 19/hour for a total respiratory disturbance index of 64/hour.
The study was split so that 1/2 the way through the night they woke me up and initiated CPAP therapy. I then recorded 2.4 events per hour. Pretty impressive imo.
Now I have an order for a CPAP machine set at 8cm H2O.
Looks like I have only one local medical supplier who takes my insurance. Q, how important is it to use a local shop?
Thanks for all the replies and information from my original post!
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Well, since I finally found a physician who was able to get my insurance company to agree to an in-lab sleep study I thought I would update this thread.
Results are as follows:
Severe sleep apnea, sever oxygen desaturation with a low saturation of 75%.
Apnea hypotony index of 45 events an hour and the respiratory effort-related arousal index of 19/hour for a total respiratory disturbance index of 64/hour.
The study was split so that 1/2 the way through the night they woke me up and initiated CPAP therapy. I then recorded 2.4 events per hour. Pretty impressive imo.
Now I have an order for a CPAP machine set at 8cm H2O.
Looks like I have only one local medical supplier who takes my insurance. Q, how important is it to use a local shop?
Thanks for all the replies and information from my original post!
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CPAP.com (http://cpap.com) No question.
I would recommend ResMed. Whatever you get, I'd recommend heated humidification, extra tubing set, and I'd recommend a hose washer of some kind. Most of them have the ability to store data on an SD card. Usually the software to use the card is only available to doctors, but there are some open source programs out there that will let you reviews the data that the CPAP machine accumulates on your sleep apnea. It's one reason to buy the machine that the sleep doctor sells, so that he can monitor you periodically, but I prescribed my own CPAP machine so I kind of run my own show there. I don't recommend that to everyone. I just barely know what I'm doing but the data is kind of interesting.
What I did learn from the data is that my sleep apnea was pretty much just obstructive. At that time in my life I wasn't that far out from head/neck surgery. As that resolved, I noted from the data that my need for CPAP was decreasing and now I no longer use it.
Thanks Hmac! Mine is obstructive it appears but I did have a few PVC episodes. My Dr asked me what it feels like when my heart goes out of rhythm. I don't ever remember an incidence when I thought it was out of rhythm... However, I do have a brother who has dealt with arrhythmia for many years.
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Looks like I have only one local medical supplier who takes my insurance. Q, how important is it to use a local shop?
Thanks for all the replies and information from my original post!
I have had BC/BS and TriCare for insurance. I have to get a prescription renewal each year to get supplies and service on the machine. Last year, when I was TriCare only, I had to bring my S-card in to get the supplies, in addition to the Rx. Do not know what that is all about.
I feel bad every time I get supplies, they really break it off in the insurance company's ass AFAIC, but my copays are low enough that I kind of swallow my revulsion and go with the flow.
My wife on the other hand, doesn't get her prescriptions renewed each year. It was hard enough to get her to a sleep study that I don't nag her too much, I just buy her filters, etc. online.
I also use CPAP.com for her stuff. I'd use your local shop to get the machine, and then decide whether it is worth while to go with them for supplies based on your copay.
I was gonna suggest you look into a MAD (High initial cost, but no recurring cost, no insurance monitoring for compliance, and easier to deal with). Given your sleep study results, it most likely isn't an appropriate treatment anyway.
The MAD makes a huge difference in my sleep quality, but I was only mild to moderate on an at-home study.
just a scout
11-29-18, 20:11
Get the machine from your doc. I got mine from the VA. Get supplies as you can and need. I get most from the VA, but look at CPAP.com and Amazon has surprisingly good deals too.
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just a scout
11-29-18, 20:11
I was gonna suggest you look into a MAD (High initial cost, but no recurring cost, no insurance monitoring for compliance, and easier to deal with). Given your sleep study results, it most likely isn't an appropriate treatment anyway.
The MAD makes a huge difference in my sleep quality, but I was only mild to moderate on an at-home study.
What does MAD stand for?
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What does MAD stand for?
Sorry...I have a bad TLA habit from work. :-)
MAD = Mandibular Advancement Device. It's basically a fancy mouth guard that snaps over your teeth and holds you lower jaw forward while you sleep to help prevent your airway from collapsing. My pulmonologist recommended that over a CPAP because I didn't have severe apnea and he sees a lot of compliance issues with CPAP, which then causes insurance problems. If you don't use the device enough, they will stop paying for the supplies...
Generally, it's best to have these things made and fine-tuned by a dentist that specializes in them. It's about $4k all up, but after that there are no recurring costs. It's also pretty easy to live with because it's just in your mouth while you sleep. Don't have masks and hoses and noisy machines. Def good if you travel a lot or do a lot of sleeping outdoors.
For me, it's been really effective. I don't think it's appropriate for severe apnea, though. Also, some insurances won't pay for MADs. (mine paid for about half)
Do the sleep study. I've done several in clinic and one at home. At home was waaaaaaay better! I have a BiPap now. Used my old CPAP last week because I left my BiPap cord at my ladies house! It sucked. Talk to your doctor. The BiPap works great for me.
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So the sleep study. I've done several in clinic and one at home. At home was waaaaaaay better! I have a BiPap now. Used my old CPAP last week because I left my BiPap cord at my ladies house! It sucked. Talk to your doctor. The BiPap works great for me.
A BIPAP is only going to be needed for severe obstructive sleep apnea or apnea with an element of neurological involvement. CPAP is more than adequate for the vast majority of sleep apnea cases.
All you guys who are vets should be using the VA for re-supply. You can get new stuff every 6 months (not a new machine of course, but mask/tubing/filters). If you're service-connected high enough it won't cost you anything.
A BIPAP is only going to be needed for severe obstructive sleep apnea or apnea with an element of neurological involvement. CPAP is more than adequate for the vast majority of sleep apnea cases.
All you guys who are vets should be using the VA for re-supply. You can get new stuff every 6 months (not a new machine of course, but mask/tubing/filters). If you're service-connected high enough it won't cost you anything.
I wish I'd started doing that years ago. Just started last year. I did the at home sleep study for the VA. I was shocked and pissed at the cost of my previous sleep study cost. I asked for a break down of the cost. It was over $5,250. I had to pay 10%. I was pissed.
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I wish I'd started doing that years ago. Just started last year. I did the at home sleep study for the VA. I was shocked and pissed at the cost of my previous sleep study cost. I asked for a break down of the cost. It was over $5,250. I had to pay 10%. I was pissed.
Not to sidetrack the thread, but while the VA does catch flak for shit (much of it well-deserved) they DO have some positives.
Not to sidetrack the thread, but while the VA does catch flak for shit (much of it well-deserved) they DO have some positives.
Free medical care always has some positives. The key question is whether or not they outweigh the negatives.
Free medical care always has some positives. The key question is whether or not they outweigh the negatives.
The biggest positives come on the hardware/goods side of the house, i.e. "stuff", as well as allowing fee-basing ("Veteran's Choice" program) for non-VA care when time or geographical limits are reached.
Negatives are backlogs (which aren't as bad as they used to be) for out-patient care and resident-based care as an in-patient. Yes, there are attendings, but from my experience residents have too much un-monitored decision making.
I know you were a resident at one time Hmac but certainly you can see the risks associated with a resident-based in-patient care program. Of course that's why it's "free" healthcare; they learn by doing in return for a much-reduced cost than a civilian hospital would incur.
The biggest positives come on the hardware/goods side of the house, i.e. "stuff", as well as allowing fee-basing ("Veteran's Choice" program) for non-VA care when time or geographical limits are reached.
Negatives are backlogs (which aren't as bad as they used to be) for out-patient care and resident-based care as an in-patient. Yes, there are attendings, but from my experience residents have too much un-monitored decision making.
I know you were a resident at one time Hmac but certainly you can see the risks associated with a resident-based in-patient care program. Of course that's why it's "free" healthcare; they learn by doing in return for a much-reduced cost than a civilian hospital would incur.
It's not generally the quality of the medical care, it's the administration, infrastructure/resource management, and employee staff attitudes that has established the unfortunate reputation of the VAH system over the last 60 years. Not every VA hospital is afflicted with defects in those components, but the nature of the VAH culture fosters them and it occurs broadly enough to set the tone and repeatedly reinforce the stereotype of the system. As a medical student and resident, I did rotations at the Omaha VA, the university medical center, and private hospitals. All had similar components of resident participation in patient care delivery. The difference in efficiency and attitude was vast and still today does tend to set the VAH apart.
It's not generally the quality of the medical care, it's the administration, infrastructure/resource management, and employee staff attitudes that has established the unfortunate reputation of the VAH system over the last 60 years. Not every VA hospital is afflicted with defects in those components, but the nature of the VAH culture fosters them and it occurs broadly enough to set the tone and repeatedly reinforce the stereotype of the system. As a medical student and resident, I did rotations at the Omaha VA, the university medical center, and private hospitals. All had similar components of resident participation in patient care delivery. The difference in efficiency and attitude was vast and still today does tend to set the VAH apart.
I can assure you that in the last several years (even a little before Trump) there has been a sea-change in what is tolerated. There is a massive undertaking to change the perception. I can't answer for administration, but down at the frontline level, "in the trenches" so to speak, things aren't quite the same as they were 5 or 6 years ago. And yes, you are correct that not all facilities are afflicted with the same level of "bad" as others.
Having been in healthcare for almost 29 years, I have worked in the private sector for the majority and you would be remiss to think that many private facilities aren't f****d up too (not that you are asserting that). The VA, being a Federally-funded, high-profile institution is of course in the spotlight on a national basis and therefore in the crosshairs far more than private hospitals. But I have worked at and known of many non-VA hospitals that have or had a bad rep. It just doesn't reach the national spotlight that the VA does, being the single largest healthcare organization in the U.S. There no doubt should be close scrutiny of a taxpayer-funded, veteran-oriented organization. To be sure, the VA exists for a specific purpose but their issues are certainly not unheard of in many private institutions either.
Example: a year or two ago there was a cellphone video taken at a VA emergency room waiting area in (I believe, might be wrong on that) North Carolina somewhere. The patient laid on the floor because he wasn't being seen in a timely fashion or was in too much pain, perhaps both. Someone else filmed it on their cellphone. What was seen was a snippet of the incident. I don't work there, so can't vouch for what actually happened. However, when it hit the news, both my wife (an RN of 25+ years) and myself looked at each other and shook our heads. Hmac, you've been in healthcare since the 70's so you know where I'm going with this.....people have no idea what kind of things transpire in healthcare or what kind of people you deal with at times. Drama llamas, drug seekers, just general dickheads. Sure, they comprise the vast minority of patients without a doubt but they're certainly out there.
The VA exists to serve veterans, but one must keep in mind that the military draws from all walks of life and therefore is a cross-section of society and all that entails: fine upstanding individuals, so-so folks, and assholes. I spent 4 years in the Army so I can personally vouch for that! The reason they have access to the VA and why it exists is because they've served, but they're still human.
Back to the CPAP issue, one organizational weakness I see at a local VA facility is that the CPAP clinic is based at a VA hospital that does half the work, and has roughly half the patients, of their bigger sister VA facility about 40 minutes up the road (depending on traffic of course). There are thousands of sleep apnea vets and a significant majority seek their care at the larger, more busy facility, yet the CPAP hub is 40 minutes away. Much bitching ensues understandably. Sure, it has to be one place or the other but perhaps a satellite CPAP clinic would be in order?
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