Hacking the Fisher & Paykel Sleepstyle 200–HC234 to be exact. Recently I’ve learned how to reset the compliance data on this now antiquated machine. I don’t recall how long I’ve had the unit, but it’s at least been 10 years. The machine was used briefly for about 200 hours before I gave up on the thing. That my face is covered with a beard, and that the beard isn’t going any where is one of the reasons for my struggle. Yes, the familiar mantra, rings true. There is myriad face masks and you need to try several in order to find one that is comfortable, one that you can wear. One that you will wear for many hours a night, and one that you will wear out so to speak. Together with the DME (Durable Medical Equipment) technician we chose a nasal mask i.e., on that only covers my nose.
Well after 40 plus years of not having something on my face while sleeping, I struggled with the mask, and abandoned the fight. Now ten years later and several pounds heavier, coupled with the same obstructive sleep apnea, I have renewed the fight. It’s clear that something needed to be done as my energy levels have and do taper off as the day wears on. Realizing that OSA is the likely culprit I turned once again to the CPAP machine.
Digging it out of the closet where it was lovingly stored months earlier only to discover that the headset, specifically the head gear had deteriorated to the point of complete uselessness. In fact, the elastic was turning to dust, it was stretched beyond any functionality. I was greeted with a puff of black powdery dust when I picked it up. Strangely I was not deterred by this enormous setback, having always believed that the headgear was the problem with the mask. And not that the mask itself was ill fitting. With a cord and a couple of adjustable stays, I fashioned a new headgear from the remnants of the old, the Phoenix, that mythical headgear had arisen again. With a little extra modification and some additional padding, it worked. Though meant only to be temporary it served to make me reengage with the CPAP. I also ordered a new headgear which cost US$31.0 which added to my incentive to develop the habit of using the CPAP.
Since my renewed interested in the machine I also wanted to restart, or rather reset the compliance hours to reflect the renewal. The machine itself is in mint condition. Used less than 250 hours before it took its place in the closet. My average nightly use amounted to 1.8 hours or less, I don’t recall the actual number. This vintage machine lacks features incorporated into the modern CPAP and sorted derivations. No auto adjustments, it won’t compensate for a leaking mask. It can be adjusted for altitude, but that task is preformed manually, so on and so forth. It is somewhat telling that there is software under the hood, and that there is compliance data that cannot be accessed by the patient but only by the DME, and probably the prescribing doctor. The need interface hardware is no longer available so even if I had the required software, accessing that data is a nonstarter. Nevertheless, I managed to find, thanks to google and the person that uploaded it, the clinic tech’s manual wherein was contained the instructions to reset the machine.
As I suspected it was a simple matter of holding down the right buttons for the required length of time to access the program. In this case it was the RAMP button and the UP held together in unison for at least 3 seconds. Once I performed this task, I only needed to press the UP and the DOWN buttons in unison to clear the memory. Huzzah. A fresh a start as I can hope for. Coupled with my new mask headgear I am set.
My new found will power had enabled me to wear the mask all night. A habit I developed over the course of 5 days. I have yet to sleep through the night with the mask on. I wake up and lay awake for several minutes but manage to fall back asleep, and right now that’s all I can ask for. My jury-rigged headgear seems to work better than the new, but since I spent the money, I will continue to use the new headgear. As mentioned before there is no shortage of headgear, mask combinations. I am surprised that a prescription is required to purchase a mask and requisite headgear together. However, if you by them separately there exists no need for a script. During my last visit to the “Free Clinic”, the doctor inquired about my using the CPAP, I gave him the standard answer—I cannot get used to using it, blah, blah, blah. He seems willing to write the necessary script for me should I require one to update or upgrade the numerous perishables that are requirements for keeping the machine in top working condition i.e., headgear etc. Although many necessary items can be purchased without a script.
So, over the course of the next few weeks I will acquire more filters, extra water reservoirs (I have a few on hand) and the 6-foot hose that delivers the pressure to my windpipe. Depending on my financing, perhaps even the decadence of having a spare mask on hand in case.
What surprises me most is the number of people that use a CPAP. Three out of the nine people in my office (including me) use one. Also surprising are the complaints directed at the insurance companies and their policies regarding this apparatus. The recent article published on line by ProPublica was a bit of an eyeopener. What was alarming was the blatantly stupid policy employed by some insurers to use a single source—approved DME provider—which ramps up cost of providing the CPAP into the stratus sphere, all with the full knowledge of the insurer. Why? The insurance companies, and the bean counters that run them might be greedy, but they are not stupid. How, and why do they stick with a policy that sees the cost of a machine go for perhaps 3x’ what an individual could purchase it for on line? I suppose it has to do with co-pay, and coinsurance, a kind of damned if you do policy. Worse yet, from the standpoint of the consumer, the insured, is the compliance aspect related to the payment or reimbursement of the claim. In order to have the company pay out on the prescribed equipment, the patient needs to use the device 4-6 hours a night. The new CPAP machines have modems built in them that automatically, without the users’ knowledge, send the meta data to the DME, your physician, and the insurance company. If you fall short of the expected demands, they, the company will not pay for the treatment. This too then is, I suppose, why the insurers use expensive DME’s. A sort of gun to the head of the hapless patient.
Those like me that do not have insurance, though I did when I first got my rental machine which I now own, don’t have to worry about compliance when it comes to the insurance provider. Compliance may come into play on the physician’s end as some might not continue to see the patient if they are not in compliance. It’s likely, and I am guessing here, that by the time an insured individual makes the required co-pays, coinsurance, office visit co-pay, and deductible’s that such an individual could just about purchase a decent, modern machine outright, with all the accruements as well. Provided that they use the right DME, and I suggest going on line to find one.
From anecdotal evidence, there appears to be a fair number of people that once they get used to the machine and all the facets, realize a great benefit. Stories bound concerning the benefits from use. Including much greater energy, increased productivity, decreased sleepiness during the day, as well as some not mentioned. Too, there are many stories of people that fail to realize any benefit or continue to struggle with chronic issues which led the proscribed treatment and use of a CPAP. I’ve read stories and complaints from individuals that believed that life as they have come to know it will end. Not seeing the benefit of the ending of raspatory end of the business but that they will be and are crippled since they require a machine and a mask—Darth Vader’s name is often attached to this emotion. Like most treatments, there is some adjustments to be made but with the help of a good doctor, using a CPAP isn’t and shouldn’t be the end of the world. Having said that, I have not seen the life changing benefits of using the machine. I believe there is a benefit, and will keep using mine, but so far it’s been a mild, slight up tick in my energy level of the kind that I don’t get from drinking a cup of coffee.