A Bit of Hope 🤞

I mentioned the results of my sleep study in Friday’s post. Sleep specialists use the apnea-hypopnea index (AHI), a scale that tells whether you have sleep apnea and how serious it is. When I was given the results by the doctor who read the sleep study, she gave me the score based on the criteria set by the American Academy of Sleep Medicine (AASM).

Late Friday afternoon, my sleep medicine provider called me to discuss my results. She explained to me that there are actually two scales used. The one the doctor had sent me a message about was the one determined by the AASM, which is accepted by most insurance companies, and according to that scale, I am above the limit for the Inspire therapy implant. However, there is a second scale used by the U.S. Centers for Medicare & Medicaid Services (CMS). This is the scale used by Medicare and Medicaid to determine AHI.

I know all of this may sound technical, God knows it does for me. But the important thing my sleep medicine provider told me was that according to the AHI scale used by CMS, I qualify for the Inspire therapy implant. In other words, if I had Medicare or Medicaid, I’d qualify, but most other insurances don’t recognize the CMS AHI as a valid criteria.

Now, just because my insurance Cigna doesn’t normally recognize the CMS AHI score doesn’t mean they can’t be convinced otherwise. So, because I meet all of the other criteria, especially intolerance for the CPAP, she is referring me to the ENT specialist that does consultations for the Inspire therapy at Dartmouth-Hitchcock Hospital. She believes there may still be some hope.

The ENT would still have to do an endoscopy to see if my throat is round enough to meet the last criteria. I will have to consult with the ENT though before she will agree to go forward with qualifications for the procedure and getting it approved by Cigna. I suspect, I will not be able to see the ENT until the new year, but I’m hoping to hear from her office at some point this week.

Fingers crossed!

Quick Update: The ENT doctor’s office called and I have a consultation on Jan. 10.

About Joe

I began my life in the South and for five years lived as a closeted teacher, but am now making a new life for myself as an oral historian in New England. I think my life will work out the way it was always meant to be. That doesn't mean there won't be ups and downs; that's all part of life. It means I just have to be patient. I feel like October 7, 2015 is my new birthday. It's a beginning filled with great hope. It's a second chance to live my life…not anyone else's. My profile picture is "David and Me," 2001 painting by artist Steve Walker. It happens to be one of my favorite modern gay art pieces. View all posts by Joe

2 responses to “A Bit of Hope 🤞

  • Steve

    Great news! Possibilities remain and my fingers are crossed and hopeful for you!

    On another note, now that I’ve relocated for my new job in Pennsylvania, I’d love to plan a trip to Vermont in the spring or summer and hopefully get to meet you at some point. I’ve shared your posts many times with my husband. If you’re open to meeting your followers, I’d love to visit in person when that’s possible.

    Your friend,

    Steve Davis

    • Joe

      Absolutely, Steve. I’d love to meet a follower. I’ve met several in the past before and it’s always been a great experience. Let me know when you’re up this way and we can set something up.

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