Guest guest Posted February 25, 2006 Report Share Posted February 25, 2006 Randy, that was a great orientation to sleep apnea and CPAPs! There are only a few things I want to add: If anyone on this list is diagnosed with sleep apnea and doesn't have DME coverage (durable medical equipment) under Kaiser - or if you know someone in that situation - Apria may NOT be the best place to go. They're very knowledgeable, but for folks with limited resources they can be very expensive also. Kaiser basically " rents " the machines from Apria as part of the respiratory therapy services. Since I'd had my machine for over five years, when we lost our DME coverage recently due to my husband's layoff they considered that my machine was essentially paid off and so they didn't charge me. My husband, however, had gotten a new CPAP a year or so ago to replace one with problems - and since he'd had it less than 15 months when we lost DME coverage, we still hadn't " paid it off " and had to either return the CPAP or pay them for services until it was paid off. The monthly charge was $65! Fortunately, we only had to pay for two months to basically pay off the CPAP. Apria also told us that the $65/month was a discounted rate for Kaiser patients; their normal monthly charge for " outside " patients is $170 or so per month. By comparison, if you get a prescription for a CPAP from Kaiser, and take it to a supplier such as the CPAP Company (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus (the same model my husband has) is approximately $500. Yes, you'll pay for supplies when you need to replace a hose or mask, but it's a LOT cheaper than paying $170 a month - or even the " discounted " rate of $65 a month, which adds up to over $900 by the time you pay off the CPAP! And if even $500 is out of reach for someone, then the American Lung Association accepts donations of CPAPs from people who no longer need them and reconditions them for folks who need the machines but can't afford them. . . so if any post-ops on the list find they no longer need their CPAPs, there's a place to donate them to help save lives! (and you can get a tax deduction, too!) Cathy C. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2006 Report Share Posted February 25, 2006 Randy, that was a great orientation to sleep apnea and CPAPs! There are only a few things I want to add: If anyone on this list is diagnosed with sleep apnea and doesn't have DME coverage (durable medical equipment) under Kaiser - or if you know someone in that situation - Apria may NOT be the best place to go. They're very knowledgeable, but for folks with limited resources they can be very expensive also. Kaiser basically " rents " the machines from Apria as part of the respiratory therapy services. Since I'd had my machine for over five years, when we lost our DME coverage recently due to my husband's layoff they considered that my machine was essentially paid off and so they didn't charge me. My husband, however, had gotten a new CPAP a year or so ago to replace one with problems - and since he'd had it less than 15 months when we lost DME coverage, we still hadn't " paid it off " and had to either return the CPAP or pay them for services until it was paid off. The monthly charge was $65! Fortunately, we only had to pay for two months to basically pay off the CPAP. Apria also told us that the $65/month was a discounted rate for Kaiser patients; their normal monthly charge for " outside " patients is $170 or so per month. By comparison, if you get a prescription for a CPAP from Kaiser, and take it to a supplier such as the CPAP Company (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus (the same model my husband has) is approximately $500. Yes, you'll pay for supplies when you need to replace a hose or mask, but it's a LOT cheaper than paying $170 a month - or even the " discounted " rate of $65 a month, which adds up to over $900 by the time you pay off the CPAP! And if even $500 is out of reach for someone, then the American Lung Association accepts donations of CPAPs from people who no longer need them and reconditions them for folks who need the machines but can't afford them. . . so if any post-ops on the list find they no longer need their CPAPs, there's a place to donate them to help save lives! (and you can get a tax deduction, too!) Cathy C. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2006 Report Share Posted February 25, 2006 Very good point, Cathy. There are a number of good CPAP's available in the $250 - $350 range - and when you consider that I bought my first one almost twelve years ago for $1100, the prices have gone way down and the quality way up. No question that buying is MUCH better than renting. You can also get reconditioned machines all over the place. Older models may be a bit noisier, but even my original CPAP was quieter than the average room humidifier or space heater - and earplugs are REALLY cheap. You should also remember that some 80%-plus of people with sleep apnea are cured after bariatric surgery. I have long been advised not to expect to be one of them. Sleep apnea is partly a mechanical problem - part of the reason you stop breathing is the sheer weight of tissues weighing on your trachea, especially when you are relaxed in sleep. Part of the reason is physiognomy - how you are structured. People with short necks are more prone to sleep apnea, as are people with flatter palates, larger uvulae, and other boring details. And part of the reason has to do with your autonomic nervous system. A minority of sleep apneacs have the condition because they actually are falling asleep SO deeply that their autonomic nervous system, which is supposed to sustain involuntary functions, kind of falls asleep at the switch, too, and doesn't keep up your breathing properly. For most people with apnea, that takes the form of breathing more shallowly - which we do when we sleep anyway - and the rest of the factors add up to apnea. Of course, the irony is that when you stop breathing, partly because your autonomic nervous system couldn't do the job, the ANS kicks right back in to wake you up because it figures out that you've stopped breathing. Gee, thanks. Sleep apnea is not a disease, it's a disorder. Generally, they class you as having sleep apnea if you experience over 200 apnea episodes - stoppages of breathing - during a " standard " eight-hour sleep period. The pressure they prescribe for your CPAP depends partly on how often you stop breathing, how much you weigh, your other physical characteristics, and an objective measurement of how well you are kept breathing and oxygenated by a particular pressure level. Now, using a CPAP " trains " you over time; you may find that if you doze off on the couch after a couple of years on CPAP that you don't snore anymore. If you use an ADAM circuit with nose pillows, your CPAP works better if you sleep with your mouth closed; over time, you " learn " to do this as well. So it isn't surprising that when the biggest factors - the weight of your tissues on your windpipe and your overall weight - change drastically, most people are cured, or close enough not to matter. My apnea " rate " is over 1,000 apneas in an eight-hour period - without a CPAP, I don't go more than about forty seconds without a breathing stoppage. If I'm lucky, as I lose weight, that will decline to maybe half that rate - but still solidly in the sleep apnea range. But most of you should ask your PCP or your bariatric consult about a sleep study about one year post-surgery. But if you have no coverage, it's still better to buy your CPAP rather than rent it, even if it's only going to be for a year - and you'll have a machine you can donate when you're done. Randy Randy > > Randy, that was a great orientation to sleep apnea and CPAPs! There > are only a few things I want to add: > > If anyone on this list is diagnosed with sleep apnea and doesn't have > DME coverage (durable medical equipment) under Kaiser - or if you > know someone in that situation - Apria may NOT be the best place to > go. They're very knowledgeable, but for folks with limited resources > they can be very expensive also. > > Kaiser basically " rents " the machines from Apria as part of the > respiratory therapy services. Since I'd had my machine for over five > years, when we lost our DME coverage recently due to my husband's > layoff they considered that my machine was essentially paid off and > so they didn't charge me. My husband, however, had gotten a new CPAP > a year or so ago to replace one with problems - and since he'd had it > less than 15 months when we lost DME coverage, we still hadn't " paid > it off " and had to either return the CPAP or pay them for services > until it was paid off. The monthly charge was $65! Fortunately, we > only had to pay for two months to basically pay off the CPAP. > > Apria also told us that the $65/month was a discounted rate for > Kaiser patients; their normal monthly charge for " outside " patients > is $170 or so per month. > > By comparison, if you get a prescription for a CPAP from Kaiser, and > take it to a supplier such as the CPAP Company > (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus > (the same model my husband has) is approximately $500. Yes, you'll > pay for supplies when you need to replace a hose or mask, but it's a > LOT cheaper than paying $170 a month - or even the " discounted " rate > of $65 a month, which adds up to over $900 by the time you pay off > the CPAP! > > And if even $500 is out of reach for someone, then the American Lung > Association accepts donations of CPAPs from people who no longer need > them and reconditions them for folks who need the machines but can't > afford them. . . so if any post-ops on the list find they no longer > need their CPAPs, there's a place to donate them to help save lives! > (and you can get a tax deduction, too!) > > Cathy C. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2006 Report Share Posted February 25, 2006 Very good point, Cathy. There are a number of good CPAP's available in the $250 - $350 range - and when you consider that I bought my first one almost twelve years ago for $1100, the prices have gone way down and the quality way up. No question that buying is MUCH better than renting. You can also get reconditioned machines all over the place. Older models may be a bit noisier, but even my original CPAP was quieter than the average room humidifier or space heater - and earplugs are REALLY cheap. You should also remember that some 80%-plus of people with sleep apnea are cured after bariatric surgery. I have long been advised not to expect to be one of them. Sleep apnea is partly a mechanical problem - part of the reason you stop breathing is the sheer weight of tissues weighing on your trachea, especially when you are relaxed in sleep. Part of the reason is physiognomy - how you are structured. People with short necks are more prone to sleep apnea, as are people with flatter palates, larger uvulae, and other boring details. And part of the reason has to do with your autonomic nervous system. A minority of sleep apneacs have the condition because they actually are falling asleep SO deeply that their autonomic nervous system, which is supposed to sustain involuntary functions, kind of falls asleep at the switch, too, and doesn't keep up your breathing properly. For most people with apnea, that takes the form of breathing more shallowly - which we do when we sleep anyway - and the rest of the factors add up to apnea. Of course, the irony is that when you stop breathing, partly because your autonomic nervous system couldn't do the job, the ANS kicks right back in to wake you up because it figures out that you've stopped breathing. Gee, thanks. Sleep apnea is not a disease, it's a disorder. Generally, they class you as having sleep apnea if you experience over 200 apnea episodes - stoppages of breathing - during a " standard " eight-hour sleep period. The pressure they prescribe for your CPAP depends partly on how often you stop breathing, how much you weigh, your other physical characteristics, and an objective measurement of how well you are kept breathing and oxygenated by a particular pressure level. Now, using a CPAP " trains " you over time; you may find that if you doze off on the couch after a couple of years on CPAP that you don't snore anymore. If you use an ADAM circuit with nose pillows, your CPAP works better if you sleep with your mouth closed; over time, you " learn " to do this as well. So it isn't surprising that when the biggest factors - the weight of your tissues on your windpipe and your overall weight - change drastically, most people are cured, or close enough not to matter. My apnea " rate " is over 1,000 apneas in an eight-hour period - without a CPAP, I don't go more than about forty seconds without a breathing stoppage. If I'm lucky, as I lose weight, that will decline to maybe half that rate - but still solidly in the sleep apnea range. But most of you should ask your PCP or your bariatric consult about a sleep study about one year post-surgery. But if you have no coverage, it's still better to buy your CPAP rather than rent it, even if it's only going to be for a year - and you'll have a machine you can donate when you're done. Randy Randy > > Randy, that was a great orientation to sleep apnea and CPAPs! There > are only a few things I want to add: > > If anyone on this list is diagnosed with sleep apnea and doesn't have > DME coverage (durable medical equipment) under Kaiser - or if you > know someone in that situation - Apria may NOT be the best place to > go. They're very knowledgeable, but for folks with limited resources > they can be very expensive also. > > Kaiser basically " rents " the machines from Apria as part of the > respiratory therapy services. Since I'd had my machine for over five > years, when we lost our DME coverage recently due to my husband's > layoff they considered that my machine was essentially paid off and > so they didn't charge me. My husband, however, had gotten a new CPAP > a year or so ago to replace one with problems - and since he'd had it > less than 15 months when we lost DME coverage, we still hadn't " paid > it off " and had to either return the CPAP or pay them for services > until it was paid off. The monthly charge was $65! Fortunately, we > only had to pay for two months to basically pay off the CPAP. > > Apria also told us that the $65/month was a discounted rate for > Kaiser patients; their normal monthly charge for " outside " patients > is $170 or so per month. > > By comparison, if you get a prescription for a CPAP from Kaiser, and > take it to a supplier such as the CPAP Company > (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus > (the same model my husband has) is approximately $500. Yes, you'll > pay for supplies when you need to replace a hose or mask, but it's a > LOT cheaper than paying $170 a month - or even the " discounted " rate > of $65 a month, which adds up to over $900 by the time you pay off > the CPAP! > > And if even $500 is out of reach for someone, then the American Lung > Association accepts donations of CPAPs from people who no longer need > them and reconditions them for folks who need the machines but can't > afford them. . . so if any post-ops on the list find they no longer > need their CPAPs, there's a place to donate them to help save lives! > (and you can get a tax deduction, too!) > > Cathy C. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2006 Report Share Posted February 26, 2006 Thanks so much for the great info, guys! I'll have to wait and see what Kaiser tells me about my coverage. I'm not sure if the equipment is covered or not. I might just call my Benefits department and ask them next week, instead of keeping myself in suspense. :-) I'll also share all the info with my dh. It will be his turn next! > > > > Randy, that was a great orientation to sleep apnea and CPAPs! > There > > are only a few things I want to add: > > > > If anyone on this list is diagnosed with sleep apnea and doesn't > have > > DME coverage (durable medical equipment) under Kaiser - or if you > > know someone in that situation - Apria may NOT be the best place > to > > go. They're very knowledgeable, but for folks with limited > resources > > they can be very expensive also. > > > > Kaiser basically " rents " the machines from Apria as part of the > > respiratory therapy services. Since I'd had my machine for over > five > > years, when we lost our DME coverage recently due to my husband's > > layoff they considered that my machine was essentially paid off > and > > so they didn't charge me. My husband, however, had gotten a new > CPAP > > a year or so ago to replace one with problems - and since he'd had > it > > less than 15 months when we lost DME coverage, we still > hadn't " paid > > it off " and had to either return the CPAP or pay them for services > > until it was paid off. The monthly charge was $65! Fortunately, we > > only had to pay for two months to basically pay off the CPAP. > > > > Apria also told us that the $65/month was a discounted rate for > > Kaiser patients; their normal monthly charge for " outside " > patients > > is $170 or so per month. > > > > By comparison, if you get a prescription for a CPAP from Kaiser, > and > > take it to a supplier such as the CPAP Company > > (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus > > (the same model my husband has) is approximately $500. Yes, you'll > > pay for supplies when you need to replace a hose or mask, but it's > a > > LOT cheaper than paying $170 a month - or even the " discounted " > rate > > of $65 a month, which adds up to over $900 by the time you pay off > > the CPAP! > > > > And if even $500 is out of reach for someone, then the American > Lung > > Association accepts donations of CPAPs from people who no longer > need > > them and reconditions them for folks who need the machines but > can't > > afford them. . . so if any post-ops on the list find they no > longer > > need their CPAPs, there's a place to donate them to help save > lives! > > (and you can get a tax deduction, too!) > > > > Cathy C. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2006 Report Share Posted February 26, 2006 Thanks so much for the great info, guys! I'll have to wait and see what Kaiser tells me about my coverage. I'm not sure if the equipment is covered or not. I might just call my Benefits department and ask them next week, instead of keeping myself in suspense. :-) I'll also share all the info with my dh. It will be his turn next! > > > > Randy, that was a great orientation to sleep apnea and CPAPs! > There > > are only a few things I want to add: > > > > If anyone on this list is diagnosed with sleep apnea and doesn't > have > > DME coverage (durable medical equipment) under Kaiser - or if you > > know someone in that situation - Apria may NOT be the best place > to > > go. They're very knowledgeable, but for folks with limited > resources > > they can be very expensive also. > > > > Kaiser basically " rents " the machines from Apria as part of the > > respiratory therapy services. Since I'd had my machine for over > five > > years, when we lost our DME coverage recently due to my husband's > > layoff they considered that my machine was essentially paid off > and > > so they didn't charge me. My husband, however, had gotten a new > CPAP > > a year or so ago to replace one with problems - and since he'd had > it > > less than 15 months when we lost DME coverage, we still > hadn't " paid > > it off " and had to either return the CPAP or pay them for services > > until it was paid off. The monthly charge was $65! Fortunately, we > > only had to pay for two months to basically pay off the CPAP. > > > > Apria also told us that the $65/month was a discounted rate for > > Kaiser patients; their normal monthly charge for " outside " > patients > > is $170 or so per month. > > > > By comparison, if you get a prescription for a CPAP from Kaiser, > and > > take it to a supplier such as the CPAP Company > > (http://cpapcompany.com) in Sunnyvale, a Respironics Remstar Plus > > (the same model my husband has) is approximately $500. Yes, you'll > > pay for supplies when you need to replace a hose or mask, but it's > a > > LOT cheaper than paying $170 a month - or even the " discounted " > rate > > of $65 a month, which adds up to over $900 by the time you pay off > > the CPAP! > > > > And if even $500 is out of reach for someone, then the American > Lung > > Association accepts donations of CPAPs from people who no longer > need > > them and reconditions them for folks who need the machines but > can't > > afford them. . . so if any post-ops on the list find they no > longer > > need their CPAPs, there's a place to donate them to help save > lives! > > (and you can get a tax deduction, too!) > > > > Cathy C. > > > Quote Link to comment Share on other sites More sharing options...
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