Just like Harley Clifford, Nick Davies has what looks to be a good future. The kind of future that could change everything and the way people look at the cable aspect of wakeboarding. And make people respect it more than ever before. It’s ridiculous at how much natural talent he has on top of a wakeboard. And while Harley Clifford is the first person to win the pro tour their rookie year since Parks Bonifay, I have heard multiple of the biggest names in wakeboarding say that Nick Davies has the highest amount of natural talent they have ever seen. And if you watch him it’s the truth. And while I am not the biggest fan of all the jumping around going on it’s still impressive. And his amount of handle control is even more impressive to me. He knows wherever he is at every moment and exactly where the rope is. And he is one of the coolest new kids in the industry. Probably because it looks like he’s having more fun than anybody. I don’t know who made this video but thanks if you did. I’ll take it down if you want.

It hasn’t been easy, but I have made it to week three. I have learned a lot about sleep apnea and have been thru a lot of experiences that I still cannot explain. I am sleeping thru the night and my seven day average for hours of sleep is now up to an exact nine hours and my thirty day average is at an exact eight hours. Only three weeks ago I was only sleeping four to six hours; what a change! My energy is up, my mood is up, I shoveled snow for only the second time since I started CPAP and only the second time in three years. My life is being restored in the night! I have become sleep addicted, spending most of my day thinking about sleeping. I get into bed as quickly as possible and stay sleeping as long as I can.

I have had some noteworthy mask difficulties. I have had to really clamp it down the past few nights and so tight it has left marks on my face for a few hours in the morning. My mask was leaking in the same place every night and blowing air right into my eye. I believe it to be a seal failure because there is a slight deformity in the seal when I examined it. Almost like it melted, stretched and then cooled. I might have used water that was to hot when I washed it, but it was below the temp I thought it would melt at.

My DME supplier said that “You need to expect leaks to happen, just go back to sleep,” “No, I expect this to be 100%.” This is medical equipment and being the cost is so high I don’t think it is beyond asking for superior results. What if I paid my bill to them in the same manner, you know, deduct 25% for leaks in my wallet. When they called about the balance I could just say, “You need to expect that sometimes people won’t pay their bills, just go back to your paperwork.” This is the same rep that gave my wife an auto-PAP for a titration study and didn’t bracket the pressure settings around her current prescription.

I want to try the Respironics Comfort Gel Full-Face Mask, but I confess it might end up as a Christmas gift because of tight finances. At over $150 even from discount internet suppliers these masks are a little too costly for just trying on a whim. I have heard great things about the Gel Masks fit and I am now desperate to try one. At my sleep study she had me try on a few, but they made my face feel like it was as long as a horse. Given the tradeoff between feeling big and not leaking, leaving unsightly lines or pressure sores on your face, I’d take the horse mask if it is comfortable.

I called the sleep lab to see about setting up a mask fit appointment, but was told the person who normally does the appointments left and has no expected return date. It sounds like they were fired, furloughed, or had a health or family issue. The person I spoke with said they would speak with their boss to see if someone was available to do an appointment and then return my call. That was several days ago and I have not heard a response. I hope this does not signal the end of their mask fit program, as it is a valuable service. At the end of the appointment they basically give you a loner mask to try out of their inventory. At a cost of several hundred dollars apiece, it is a rather expensive chore to test masks. Being that you cannot sell discarded masks on the used market, there is no way to recover the cost of a bad choice. Even using your insurance that only covers masks every six months or once per year, means you will be stuck with your failures for the same amount of time.

Personal Changes

I need a life! For the past three years all of my activities have been sedentary, to protect and save my body for the future, but now I have all this energy and limited places to spend it. I can put the effort into the house and as it is winter it is a good place to start, but by no means is it the end. I need more. Things have been changing: as I have gotten stronger I have begun to reclaim the household chores I once pushed over onto our teen age son Tyler; snow shoveling, grass cutting, grocery carrying and such a like. I haven’t been reading as much as I had been, haven’t been blogging or writing in my Personal Log as much as I had been. This has all been a great blessing and is not being met with complaint by me, but only observation.

I have had one major setback in one of my areas of personal change; I have relapsed to using tobacco. I have had precious few breaks from this habit since age thirteen, but I am gaining ground. I have been taking Zyban and I have made two attempts to quit in the past few weeks. The most successful was 5 days, but a life and death issue within my extended family threw me off the wagon and out of personal balance. I will make a fresh effort this weekend.
I have been checking by blood pressure and sugar very regularly and have watched it rise and fall with my tobacco use. I believe that I was trying to stimulate my metabolism with nicotine and coffee so fight the effects of sleep apnea. My hope is that because I am getting proper rest I can now back away from the stimulants. I have begun to cut my normal morning coffee with decaf. Starting first with a ratio of five to one and progressing to a full fifty-fifty. I don’t know how far I will progress, as I have noticed my consumption reach new heights in an effort to boost my caffeine intake. I think I will hold here until I see my volume decrease.

Improving Health?

I think I might be looking at my insulin resistance going away! Yesterday I was craving sugar bad, all day! After I had eaten a full dinner, two PayDay bars and thirty whoppers (the small malted milk balls not Burger King) I was still hunting for more sweets. I was a little apprehensive to check my blood sugar before bed, as it should have been thru the roof. Less than two hours after a full meal and with all that quick sugar, I thought it would be an out of sight reading, but it was only 106. I was not expecting it to be below 200, but what is this? No wonder I was craving sugar, I wonder how low it was before I consumed all that stuff? How accurate is this type of observation, as it is not a very scientific in method. Watching changes in me has become another sedentary hobby I will have to break. I think the observation is valid, but the conclusions in questionable. Yet, if I keep it general by saying my sugar was lower than I expected, the observation can remain valid.

As my RA symptoms have been resolving I have noticed that not all of my pain is gone. The ugly truth is that I still have the pain from damage done by the RA: I still have shoulder trouble from blowing out my shoulders lifting weights, still have a trigger finger and still have some nerve pain in my feet; it would be disingenuous of me to say otherwise. Yet, the inflammation and swelling is gone from it familiar places, the fatigue is nonexistent and there is zero morning stiffness. That is at least progress especially when accounting that I have not taken a Humira injection in 3 weeks.

I now face the challenge of explaining all of this to my Physicians in a way that is coherent and factual. I actually want to scream “God showed me how to get better!” but I haven’t even posted that on this Blog yet. Maybe that is my next step, to tell the whole story and what a story it is too! The story that stretches from my writing of “The Longest Day” until today, but I feel it is missing a dramatic climax. Telling the tale of “The Third Day” could be the ending I am looking for, but I don’t feel I can exclude the recovery process though it stretches before still. I might have to leave that out of the story, as those pages are not written in the days of the book of my life yet and I need not consider them as they will arrive in due time and Lord willing be less dramatic.

ManLoosed@Home

New posts everyday will be below.

It’s here. The first ever CWB “Boots For You” giveaway. We are going to be giving a pair of CWB Hinge Tech boots of your choice away every other month for the next long time. All you have to do is follow the rules and they could be yours. Trust me. And if you don’t win this first month remember that there is alway the next one. This isn’t just a one time thing. Everyone loves free stuff. There is really not any rules though. They are more so guidelines. And it’s really simple. You don’t have to ponder any ridiculously hard questions. It’s just a guess. So good luck everyone. And if it doesn’t work out for you this time don’t forget about the next times.

• First of all I am going to guess a number between 1 and 100. Then you must guess a number between 1 and 100 and email that number to DerekGrasmanBlog@gmail.com. With your name and address. And that’s it. The closest number wins.That’s all you have to do to win these amazing Hinge Tech boots of your choice. Any pair you want.
• If more than one person guesses the number correctly we will then go into another round where I will pick another number and those people must guess again until we narrow it down to one person. And maybe a smaller parting gift for second place. Who knows.
• I will then have  a video blog announcing the winner and showing the number I picked.

THE DEADLINE FOR ENTRIES IS DECEMBER 15TH SO MAKE SURE YOU DON’T MISS IT!!!!!!!!!                                                                                  This post will most likely constantly be on top till the 15th but all the new posts everyday will be underneath.

Solemn occasion turned into a party.Is this how we respects to the departed?
http://www.cracked.com/video_18114_weirdest-wake-ever.html occasion turned into a party.Is this how we respects to the departed?

New post’s everyday will be below.

It’s here. The first ever CWB “Boots For You” giveaway. We are going to be giving a pair of CWB Hinge Tech boots of your choice away every other month for the next long time. All you have to do is follow the rules and they could be yours. Trust me. And if you don’t win this first month remember that there is alway the next one. This isn’t just a one time thing. Everyone loves free stuff. There is really not any rules though. They are more so guidelines. And it’s really simple. You don’t have to ponder any ridiculously hard questions. It’s just a guess. So good luck everyone. And if it doesn’t work out for you this time don’t forget about the next times.

• First of all I am going to guess a number between 1 and 100. Then you must guess a number between 1 and 100 and email that number to DerekGrasmanBlog@gmail.com. With your name and address. And that’s it. The closest number wins.That’s all you have to do to win these amazing Hinge Tech boots of your choice. Any pair you want.
• If more than one person guesses the number correctly we will then go into another round where I will pick another number and those people must guess again until we narrow it down to one person. And maybe a smaller parting gift for second place. Who knows.
• I will then have  a video blog announcing the winner and showing the number I picked.

THE DEADLINE FOR ENTRIES IS DECEMBER 15TH SO MAKE SURE YOU DON’T MISS IT!!!!!!!!!                                                                                  This post will most likely constantly be on top till the 15th but all the new posts everyday will be underneath.

The piano rock band OneRepublic’s second album is titled, “Waking Up.”  This is a good album, but I don’t think that there will be a mega hit like “Apologize” on this one.  It is a well written and composed album.  I like how they take the songs “Waking Up” and “Lullaby” and add extended orchestra instrumentals to them.  Those songs would work well in a fill with more somber themes.

For most people I would suggest, “All the Right Moves,” “Secrets,” “Good Life,” and “Marching On.”

New post’s everyday will be below.

It’s here. The first ever CWB “Boots For You” giveaway. We are going to be giving a pair of CWB Hinge Tech boots of your choice away every other month for the next long time. All you have to do is follow the rules and they could be yours. Trust me. And if you don’t win this first month remember that there is alway the next one. This isn’t just a one time thing. Everyone loves free stuff. There is really not any rules though. They are more so guidelines. And it’s really simple. You don’t have to ponder any ridiculously hard questions. It’s just a guess. So good luck everyone. And if it doesn’t work out for you this time don’t forget about the next times.

• First of all I am going to guess a number between 1 and 100. Then you must guess a number between 1 and 100 and email that number to DerekGrasmanBlog@gmail.com. With your name and address. And that’s it. The closest number wins.That’s all you have to do to win these amazing Hinge Tech boots of your choice. Any pair you want.
• If more than one person guesses the number correctly we will then go into another round where I will pick another number and those people must guess again until we narrow it down to one person. And maybe a smaller parting gift for second place. Who knows.
• I will then have  a video blog announcing the winner and showing the number I picked.

THE DEADLINE FOR ENTRIES IS DECEMBER 15TH SO MAKE SURE YOU DON’T MISS IT!!!!!!!!!                                                                                  This post will most likely constantly be on top till the 15th but all the new posts everyday will be underneath.

New post’s everyday will be below.

It’s here. The first ever CWB “Boots For You” giveaway. We are going to be giving a pair of CWB Hinge Tech boots of your choice away every other month for the next long time. All you have to do is follow the rules and they could be yours. Trust me. And if you don’t win this first month remember that there is alway the next one. This isn’t just a one time thing. Everyone loves free stuff. There is really not any rules though. They are more so guidelines. And it’s really simple. You don’t have to ponder any ridiculously hard questions. It’s just a guess. So good luck everyone. And if it doesn’t work out for you this time don’t forget about the next times.

• First of all I am going to guess a number between 1 and 100. Then you must guess a number between 1 and 100 and email that number to DerekGrasmanBlog@gmail.com. With your name and address. And that’s it. The closest number wins.That’s all you have to do to win these amazing Hinge Tech boots of your choice. Any pair you want.
• If more than one person guesses the number correctly we will then go into another round where I will pick another number and those people must guess again until we narrow it down to one person. And maybe a smaller parting gift for second place. Who knows.
• I will then have  a video blog announcing the winner and showing the number I picked.

THE DEADLINE FOR ENTRIES IS DECEMBER 15TH SO MAKE SURE YOU DON’T MISS IT!!!!!!!!!                                                                                  This post will most likely constantly be on top till the 15th but all the new posts everyday will be underneath.

It has finally arrived. Every year I get excited to see what my sponsors new website will look like. We do all the bio stuff then we don’t see it for awhile. I have always liked the CWB sites. They are not super technical but that also means they aren’t confusing. Nothing worse than a confusing site. And simple is better in most cases. Check it out by clicking the picture!

New post’s everyday will be below.

It’s here. The first ever CWB “Boots For You” giveaway. We are going to be giving a pair of CWB Hinge Tech boots of your choice away every other month for the next long time. All you have to do is follow the rules and they could be yours. Trust me. And if you don’t win this first month remember that there is alway the next one. This isn’t just a one time thing. Everyone loves free stuff. There is really not any rules though. They are more so guidelines. And it’s really simple. You don’t have to ponder any ridiculously hard questions. It’s just a guess. So good luck everyone. And if it doesn’t work out for you this time don’t forget about the next times.

• First of all I am going to guess a number between 1 and 100. Then you must guess a number between 1 and 100 and email that number to DerekGrasmanBlog@gmail.com. With your name and address. And that’s it. The closest number wins.That’s all you have to do to win these amazing Hinge Tech boots of your choice. Any pair you want.
• If more than one person guesses the number correctly we will then go into another round where I will pick another number and those people must guess again until we narrow it down to one person. And maybe a smaller parting gift for second place. Who knows.
• I will then have  a video blog announcing the winner and showing the number I picked.

THE DEADLINE FOR ENTRIES IS DECEMBER 15TH SO MAKE SURE YOU DON’T MISS IT!!!!!!!!!                                                                                  This post will most likely constantly be on top till the 15th but all the new posts everyday will be underneath.

I think I’ve got it all down; I hope. It seems that learning to sleep with a mask on is easy when compared to the things the body needs to relearn. After having been sleep deprived and oxygen starved for years, there might have to be some retraining. I started sleeping thru the night for the most part, but there was still one thing waking me up; the need to “GO”. Yes I said, “GO.” When I first started to learn about the symptoms of sleep apnea the one that seemed like it had an obvious reason was “GO-ing several time during the night.”

I figured it was because I was wakening so many times during the night that the “super-hold-it” response during sleep was not being activated. I never thought I had hurt my body this badly by not getting my sleep apnea treated. Here is what the American Sleep Apnea Association says about “GO”-ing:

Nocturia, or nocturnal urination, is sometimes a symptom of sleep apnea. In fact, nocturia among younger individuals–who are less likely to have other medical causes of nocturia–is a strong indicator of sleep apnea. While the precise relationship has not been thoroughly studied, it appears that the most likely reason patients with untreated sleep apnea have more frequent urination at night is related to the increased pressure in the right side of the heart. This increased pressure is usually the result of low oxygen levels in the bloodstream caused by the apnea events: when oxygen levels fall, the heart works harder to get oxygen to the brain.

An increased pressure in the heart is a sign that there is too much liquid in the body: when the heart receives the stimulus of the increased pressure, higher levels of a hormone called atrial natriuretic peptide (ANP) are secreted. ANP is a diuretic that is associated with the increased need to urinate.

When sleep apnea is effectively treated, nighttime urination is also reduced. Studies have shown that ANP levels in patients with untreated sleep apnea are increased and levels reduced in patients using CPAP effectively. Remember, not all causes of frequent urination are related to untreated sleep apnea; prostrate problems, for example, may cause increased need for urination. Discuss any concerns you may have with your doctor.

To much pressure on the right side of my heart?! Good grief, that’s a little more serious than just not sleeping well! That blows my idea of just being “to awake to hold it” right out the window! I wonder if this also wasn’t the reason for my excessive sweating. How badly could this have screwed up my body?

It has taken me a full 2 weeks on CPAP for this to go away! After the first 7 days my body learned I wasn’t going to die in the night, but it took another 7 days for my heart to learn I wasn’t drowning and I could stop trying to “GO” my way to better sleep.

I have been sleeping thru the night! No waking up to GO! Just sleep from 10:30PM-5:45AM, yahoo.

More so than anyone I have ever met I am positive Harley Clifford is the future of wakeboarding. He can do everything and none of it looks bad. And I bet you eventually he will have one of the best styles in wakeboarding. Kind of like  Danny Harf. It’s ridiculous how good the kid actually is. And he can still be classified as a kid. He can kill contests as well as freeriding. Backside 720’s are hard enough. I personally have never seen someone do one regular then immediately do one switch. Like in this Alliancewake.com video. Click the pictures.

Vandall and the West Side Riders are at it once again… this time they hit Pyramid Lake for a killer day of riding.  Check out AllainceWake.com for more.  Photos by Nick Meistrell.

When I woke up, I had this song stuck in my head, actually, one line in repetition when I woke up.  Methinks this is because I was listening to it in my dream :

A night where beautiful life is real
The mathematic to acting still
The unfamiliar the warm embrace
The family ties and the stranger’s face
The lighting thunder the power steed
The what it is and the what is believed
The strong connections desire to need
The waking now or the moment to dream
The laugh the murmur the moan and the scream
The voice of reason somewhere in between
The one and all the me and the we
The I and I the thou and the thee
A man a design a child of the streets
The daily chore the impossible feat
The drum the chorus phenomenal beat
Easy to touch and the harder to reach
The sweetest fruit in the top of the tree
The sun the moon the stars and the bree-eze

I’m coming to it, and it’s coming to me
I’m getting ready

**

It took me a good 20 minutes of laying in bed, trying to figure out what song it was.  I had “the waking now or the moment to dream” repeating in my head when I woke up.  I wrote it down right away because if it wasn’t a written song already, it was going to be mine (although it is a very broad statement anyways).  I realized that its Mos Def.  How could I forget that distinct voice?  I looked up the one line and “Sun, Moon, Stars” came up.  BAM!  So, here’s the video.  Good morning to you all, and I hope you hear this song in your dreams or at wake up mode.  It’s a good one, and definitely woke me up to another beautiful day.

Mos Def – Sun Moon Stars (video via youtube)

Traveling with CAPA

There is a lot of things that go into making our CPAP function. We might have mastered this art at home, but on the road can be a little more difficult. As I said in the second installment of CPAP tips; one of the things you need to obtain is a letter from your prescribing physician stated that this is necessary medical equipment. This becomes important when traveling especially internationally and passing thru customs. For me, I would will be packing your CPAP in checked baggage, but for those who desire to “breeze” thru the airport without stopping at the luggage carousel, there is a steep learning curve! Below is a basic checklist for whatever you carry choice might be.

CPAP Travel Checklist:

 
-Travel letter from you prescribing Dr. certifying your need for CPAP treatment.

-A plastic bag large enough to fit your CPAP in. (See TSA link below)

-Make sure you have the right power adapter for your destination, especially internationally.

- Bring an extension cord, just in case an outlet is not close enough to your bed.(Very hard if you’re traveling internationally, to get the right one!)

-Check to make sure that all your CPAP equipment and accessories are packed.

-Make arrangements to get distilled water at your destination. (More on this below.)

Hotels and CPAP:

I have heard of cases in which the lamps and alarm clocks in hotel rooms are hard wired to the wall and there was no outlet by the bed. Outlets were supplied for laptops and cell phone chargers, but these are sometimes a great distance away, be prepared with an extension cord or be prepared to ask for one at the front desk.

Do hotels have distilled water available? I wanted to give you a good report that hotels are so concerned their service and our comfort that they would, but alas, service truly is dead. After calling a few hotels today to see if they had distilled water for their guests, EVERY phone call was negative. One lady seemed not to know what distilled water was, asking me, “Are you sure you don’t mean bottled water?” What a disappointment this is! I am not a business traveler, so I have never need to iron clothing while in a hotel; on vacation I don’t care if my shorts have a few creases in them. I understand no supplying waster for a CPAP, but so many people need a clothes iron I was sure they would have it! To be fair these were average hotels, not 5 start locations, which I suspect might go to the store for you if you needed distilled water.

In the TSA’s Own Words:

TSA’s Page on CPAP

TSA on Medical Liquids (Our Distilled Water)

It might be worth is to print this page, so you can give it to them in the event you carry on your CAPA. If the people at the security screening even know what a CPAP is I will be surprised, let alone to know THEIR OWN handling procedures. Do I expect this of them? Frankly yes, not only do I have OSA, but I am also on immune-suppressive therapy for RA; this makes me vulnerable to germs! With how many people pass thru security checkpoints in a day, I might as well attach the CPAP to the hose and drag the whole assembly thru the restroom floor!

CPAP and the Airlines:

Because a CPAP is considered necessary medical equipment, it supersedes any airline directive to allow only one carry on. Unless I am starved for space in my checked baggage I won’t be carrying my CPAP on the plane with me, as I said before. If it was an international flight lasting for >8 hours, I would consider carrying it on, but not wearing it. I would rather snore at everyone on the plane! Just looking at the amount of regulation and hoops for O2 is enough to make me buggy! Looking at the list of approved oxygen concentrators, it seems as if the flight attendants might not allow you to use it anyway. Here is what one airline has about “Medical Equipment” and specifically O2 concentrators.

United: Worst Explination! No Specific CPAP Statement.
Southwest One CPAP: SW On CPAP
Continental: On CPAP and Vents
Delta: Look under “Assisted Devices”
JetBlue: Best Policy So Far!

It seems that I must notify the airline two days in advance if I want to use it, not if I just carry it on. There is a loop hole there, but the thought of getting to the plane door only to be told I MUST check my CPAP in that flimsy bag, is horrifying! Print these policies out, so you have a chance to fight back if they try to break or ignore their own rules.

Summary:

I would check it. When I travel it usually isn’t just for an overnight, but an extended stay on a vacation. Normally I am traveling with my family and we have a ton of luggage anyway, so a little extra for my CPAP is worth it. If you still want to take your CPAP as a carry-on you are entitled to! Just make sure you are prepared. Even if it was OK on your flight to your destination, it doesn’t mean it will be just as OK going the other way! Prepare to be challenged, be ready to give an answer and hopefully you won’t have to teach the TSA and the Airlines about their own policies. Have a nice trip and sleep well on it!

We are trying to finish filming for an online video for Alliancewake.com that has literally taken far to long to finish filming. We keep getting sidetracked or set back by weather or other projects. We did get some done today so that’s good. Here’s a couple pictures of what we did.

Jeff House is the latest interviewee on Trevor Hansens the Powwow. Jeff is a man of few words. And with this interview you can really see what he’s about haha. He’s my roommate and domestic partner now for five years. And he rips the world. Click the picture for the full interview. His answers were not near as descriptive as mine. He just doesn’t have his online writing flow I guess. I can just flow with it for days. Maybe I should have given shorter answers.

CPAP Tips #2: The Best Advice I Got!

The Best Advice- Starting off Right

The best advice I have ever gotten is to get a copy of your “Sleep Test” results AND a copy of your prescription for yourself and if you are a traveler a letter stating that this is  a prescription and medically necessary device. The test results from ANY medical test are your property! They are your results and your prescription and you by law have access to your medical records! You most likely will not understand all of the results, especially the raw data, but I will point you in the right direction for some help with this in a minute.

Results: Can Tell You More

A copy of your test results can tell you a lot more than just pass or fail! (Going into my sleep study it was my sincere hope to failed with grace!) This can tell you the average number of events you had every hour, the length and types of events, your lowest O2 readings during the night and what type of sleep they observed you to have. There are two parts of the sleep study you might need; the first is a summery page, written by the sleep Physician and the second is a graph of the whole sleep study and titration (if you had a split study.)

Useful information is not always communicated by your physician, but still can be very important. On my sleep study summery page there was a note, which my physicians never discussed with me: “No supine (on back) or REM sleep was observed during the test or titration. Titration pressure might not be adequate.” An important detail, as the most sever events occur on your back in REM sleep, don’t you think! That led me to request a data capable machine from the DME supplier so I could monitor if my AHI number increased to a place that I might need re-titrated. I can also use this one piece of information to convince my insurance company to pay for a titration study or home titration study sooner than they want to. I’ll just show them that note!

For help understanding this information I recommend seeking help from the American Sleep Apnea Association on their FORUM page. There is a section specifically for understanding your sleep study. Reading thru the information on others studies can help you understand yours. Feel free to ask any questions that remain, as their moderators are very knowable and ready to help you. These are great people who I can brag on enough for their role in educating me. (You can also find me there from time to time, but under a different name.)

Here is a link: ASAA FORUM

 Rx’s: Suppliers Need Them!

 A copy of your prescription is also vital! While your “sleep specialist” or GP might send your Rx to DME supplier of your or their choice; you can use this piece of paper (Rx) to SAVE MONEY! I have found that you local home medical companies cannot beat the prices that you can find from reputable suppliers on the internet. So if you are paying for this equipment out of pocket, this is a way to save major cash! Even on the internet a xPAP machine is still a prescription item, so you need your script! Some internet suppliers don’t require “proof” of a script for a mask, but some do.

This in a time saving piece of paper, as the other way for a supplier to obtain your Rx is to call the Physician’s Office and asks them to send them a copy of it. This can take a great deal of time, depending on how organized you Dr. Office is or is not. By having the script in hand, you can simply email them a photocopy. Most will keep your script on file and you will not need to send them a copy every time you place an order.

If your Doctor is to specific or not specific enough on the Rx, both could lead to later problems. The Sleep Lab I went to made a recommendation to the Dr. based on what mask I chose for the titration portion of the sleep study; if specified a specific mask. If your Dr. puts the specific mask on your prescription, all the suppliers must supply you with  that exact mask and can’t not change it; which can be good or bad. If a week after you start using this mask at home and begin to have difficulties, you need to get the physician to write a new script for the next exact mask you want to try. All this can be avoided if you ask the prescriber to write “a mask of their choice” when writing the Rx. There might be times that a DME supplied refused to give you a specific mask you request. Don’t be fooled they can order anything they want from any company, but at times just don’t want to. As with fixed $$ for machines, some don’t want to carry the more expensive masks because it cuts into their money. In this case get your prescriber to be specific and force their hand. The “interface” or mask is the most important thing that is “of your choosing”, so get it done right and don’t stop until you are satisfied! Most internet suppliers will also bill your insurance if they are not excluded, so don’t be afraid to go off and try new mask types. Just know your insurance might not cover another mask for 6-12 months.

My DME supplier has a  mask return program. If I am not satisfied with the mask in the first 30 days I can return it and choose another. This is excellent as masks are normally $150 and up. Some internet suppliers have similar programs that go out to 90 days, but usually you sign up and pay for this service. You must ask your DME supplier if they have a program such as this, they might not tell you up front and it is a pity to find out after that time has expired!

It is also important to know your titrated pressure as you might need this from time to time. Being admitted to a hospital on an emergency basis is one such time that is critical to know this information. Being that you have been admitted for something serious, you could make your situation worse by having apneas events while trying to recover. They can find this information, but usually it will be kept at you GP’s Office which isn’t open 24hrs a day.

( A note about outpatient surgeries: There are special procedures that need to be followed for outpatient surgery if you suffer from sleep apnea. The anesthesia used in “outpatient surgeries” can cause sleep apnea to become life threateningly. Even for a day surgery this might win you a tube down the throat or even an extra night in the hospital to monitor your breathing.)

Links to a Internet CPAP Suppliers:

CPAP Supply USA
CPAP Wholesale
CPAP Plus/Direct
(*These are only examples, I do not endorse one over the other, or guarantee your satisfaction with any of them.)

Dr. Letter: Medically Rx’d and Necessary Device

I will cover this later in the travel section, but this is an invaluable letter to have if you are business or international traveler. To get off to a great start, get a letter on the Dr. stationary and make plenty of copies. This letter is also useful to give to your electric company. Why your electric company? I’m glad you asked!

In the event that you have your electricity disconnected for non-payment or an outage occurs in your area, because you have “Durable Medical Equipment” as a medical necessity, your electric can not be turned off and must be at the top of the list to be restored in the event of a power failure. Before you need it, communicate with your electric company and give them the letter from your Dr. In the event that they lose your payment or there is a natural disaster, your lights will be first back on!

ManLoosed@Home

Arnette’s own, Randall “Vandall” Harris, and the West Side Riders recently took a trip to Lake Nacimiento for two days of insane riding.  Get the full story in Vandall’s own words at alliancewake.com.  Photos by S. Smith.

Not all CPAP machines are created equal! BUT Medicare and most insurance companies only have one billing code for them and pay a fixed amount to the equipment supplier for that code, not the specific machine. This means that DME (durable medical equipment) supplier can make more money by giving you the cheapest machine they can find and collecting the standard reimbursement from your insurance company. It is up to you to find what is the best machine for the money that you insurance will pay out! Some machines can be very expensive , but it might be worth a little out of pocket expense for the right equipment for you.

Some insurance companies, sleep labs or your sleep doctor sometimes contract and set the brands and quality levels of machines that the DME will supply to their patients. My insurance company, for instance, has specified the brand of machine they are to deliver, but not the exact model. My wife and I, who got our CPAPs only 30 days apart and with the same insurance, recieved 2 different machines. I negotiated with the DME supplier for a data capable machine because I am a technical guy and am interested in a machine that was able to measure my nightly AHI (Apnea Hypopnea Index).

My insurance company bought the humidifier, but, by contract, leases the CPAP from the DME. If I ever change insurance companies I can keep the humidifier but must return the CPAP unit. Some other insurance carries do a lease to purchase arrangement; this begins as a lease, but after they verify you have been using the machine (called a compliance check) they will purchase it for you.

Compliance checks are done via a smart card that slips into your CPAP, some transmit data over the internet or via a modem. On some CPAP machines only the hours of usage and number of sessions (CPAP use >4hrs) are recorded. On fully data capable machines enough information is recorded that your DME supplier, Sleep Doctor or even yourself can monitor your treatment by examining the data recorded on the card. For about $200 you can purchase the software and card reader to do this, but only if you have gotten the right machine.

If you are doing this all out of pocket and not insurance is involved, you can save a great deal of money by dealing with reputable dealers on the internet. These are dealers that offer warranties, have a return policy (especially on masks) and have great customer service. Because these are prescription items, especially CPAP machines, most will call you prescribing Physician and request a copy of your Rx. The best way streamline this I will talk about next time!

Our friends at Alliance Wake are running weekly photo battles on their site.  Hit up alliancewake.com to vote on this week’s photos, and find out how you can enter your own photo for a chance to win a sick Arnette prize pack featuring the Agent and other goodies.

Today’s suggestion is probably one that most people wouldn’t think a great deal about these days. In the Western World, the issue of AIDS is probably somewhat on the backburner so to speak, though that would depend on the community you live within or deal with on a daily basis.

Though AIDS remains a major health threat in Western countries, the real frontline is in the Third World, where entire countries are under serious threat from AIDS/HIV and/or the consequences of the disease on the economy, the community, the family, etc.

So helping to prevent AIDS and to assist in the provision of treatment for AIDS/HIV, as well as caring for those left in it’s wake are all very important.

Some web sites with valuable information:

www.unaids.org

www.aids.net.au

www.afao.org.au

A response to reading ‘365 Ways to Change the World,’ by Michael Norton

It’s 1:18 Tuesday morning. I’m laying on my bed staring at my laptop screen. I refuse to sleep, and my body appears to agree. The only music I’m listening to is the sound of the laptop fan and the clicking of my keyboard as it frantically scatters words onto the screen. Thoughts blur around my mind as I figure out what exactly should I type next. This is the norm when I started doing the journaling thing. I spend a few minutes/hours in the wee hours in the morning writing down anything that comes to mind or whatever interested/bothered me that previous day. I used to hate being up late and waking up later than 9 AM the next morning. But now I love it.

I get a chance to speak to “you”, my faceless audience. But in reality, I get to talk with myself.

I get to see who I really am. Not the person I present myself to the general public during the day or while I’m “awake”, but my true self while I “sleep”. No boundaries, no limitations. I get to see all my flaws and my strengthens and understand them, while I share with “you” my dreams and wants. I don’t feel selfish or obsessive here. I can’t lose anything, so I never worry about hoarding from “you”. “You’re” my equal.

When I sleep, I begin to see things differently. Things go my way. Events are constructed by me. Consqeuences are in my everyone’s favor. I’m strong and able-minded. I’m the person I dream about to be. I see myself knowing and able to do all things, being in places I never been before, expressing myself in ways I’ve never thought imaginable. I also see myself being wanted. Being loved…

When I sleep, I’m not the same when I’m awake. I’m not conformed to my own social conventions where it’s unwise to always talk to a “stranger” randomly, or attempt to flirt with a female only to hesitate being shot down or looked at like I’m crazy or something of the sort. I have no need to think about what I have to do with my life in order to fill into society’s shoes of success or masculinity. I don’t obsessively think about how much I have to do on a given day, how I look, or how I can improve myself. I never worry about if I say the wrong thing or if what I said comforts someone. When I sleep, I’m already improved. I’m already successful. I’m perfect.

When I sleep, I never have to end my stories about how I feel about the world I live in while I’m awake. I feel like I rule this world and everything revolves around me. I dictate the stories that occur in everyday life. The natural order of things are determined by my mind-state. Am I God? No. I don’t require to be worshipped or have my existance be discussed over silly debates due to belief conflicts. I could care less…

But can I sleep while I’m awake? Can I drift along this world and live the way I live in my dreams. I want to walk along the beach with someone special during a summer evening and talk about the things we love onto the wee hours of the morning. I want to live comfortably without having to go through tests and trials of memorization ability only to find out you never needed to. I want to become a wanted part within people’s lives, so if I so happen to die, my friends would have volumes of stories to tell about our relationships. Can I do that….?

Can I sleep knowing when I wake up I’ll still be sleeping?

I guess I don’t want to sleep because I know when I wake up, my dream would be nothing but a memory. A memory snatched away by amensia.

Every professional or semi professional rider has that trick. A go to trick that he does nearly every time they shoot. And without this trick their career wouldn’t be nearly as publicized. Like the achilles heel if this trick was damaged or removed they may never be the same. Andrew Adkison has the nose grab backroll, Chris O’shea the tail grab backroll to blind, Kevin Henshaw the switch melon 180 wing, Chad Sharpe the indy glide, JD Webb the batwing, Jeff Mckee the toeside indy poke, Nick Jones the heelside melon off axis 360, Danny Harf the toeside backside japan off axis 360 (and any other trick he does), and I have the stalefish back roll (sometimes to blind). While these are not the only tricks we do they are by far our most successful as of recently. This is not a bad quality at all. In fact it is a good quality. Being able to capture what works for you is a sign of knowing your own riding. And while these may be our tricks now they often don’t last more than two years before the rider finds a new trick. The fact being that getting good photos is hard. And unlike shooting video where a new trick is completely documented a photo is a split second of that trick. When it comes down to it though the real talent is in the hands of the photographer. And in the talent of the magazine editors to pick the right photos for our viewing pleasure. Here is a chronological order over the past few years of my achilles heel.

photo: meddock

photo: smith

photo: gustafson

photo: gustafson

photo: cortese