CPAP


Just keep it clean please....

Golden Jubilee
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Post Sat Dec 03, 2016 8:49 am

Re: CPAP

Down in the US now, the med file for DOT is 6 pages long, and all has to be faxed to the DOT within 24 hrs. All questions must have an answer and all stuff between the doc and driver is sent. I don't know how we got to this point, but it really sucks. On top that, it is counter-productive saftey wise. Who is going to bring up concerns, when they know "big brother" will be looking at it? With digitized medical records, they can cross-check to see if you lied on the 6 page answers. Better to not say anything.
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Golden Jubilee
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Post Sat Dec 03, 2016 9:47 am

Re: CPAP

I just notice an article in the newspaper this morning about a requirement for railroad engineers to be tested for sleep apnia. Seems too many train drivers are falling asleep at the controls. Peoples lives are at stake, not just livelihoods.
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Golden Jubilee
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Post Sat Dec 03, 2016 10:25 am

Re: CPAP

Than should all drivers be tested? It is a real condition, and should be treated, BUT and it is a big BUT, one should be able to explore it with ones own doctor without gov interference. The problem has come up because in their "wisdom" the gov has decided that MD's aren't good enough to do a med cert. they have to be people who have gone thru a DOT school and test. What this means in practice, is an MD doesn't have the time or interest in going to a DOT school and so send DA or NP's to get the cert, nothing wrong there. but there are many that make it their sole business, and run sleep labs and sell the cure.
What has happened in practice is becomes very risky to explore a problem that may or may not exist. Add to that, the only "cure" the DOT will accept is the CPAP, even though it is only recommended medically for severe cases, mild to moderate, cases can be treated with other means.
A similar example is once, 12 years ago, when I went for a physical, I had mildly high blood pressure, I have been required to get a physical ever year since, although for 12 years I have never showed high blood pressure. (normal interval is 2 years) Once you show a sleep apnea possibility, you have to be tested every year, and have a recording machine showing you are using it. This is neither cheap nor none invasive. Furthermore, it has been found that who does the testing results in very different diagnosis for the same patient. People who have been found to have it by one, have been cleared by another. Not uncommon for any medical problem diagnosed by symptoms alone.
The long and short is: falling asleep at the wheel is deadly, regardless of the vehicle or reason. Apnea is a reason but so is over work, sickness and other things that can't be tested for, So an operator who is aware of their health, and stop driving when they are tired is required, this is not something that you can test or legislate, it is called RESPONCIBLILITY, and the lack of it is why we have so many drunk-driving incidents even tho it is against the law.
everybody is in favor of rules and laws that may be unfair, if they don't apply to them, If the general public had to get a physical every year to keep their driver lic the outcry would be incredible. That fact of John Q driving home from his overtime shift, has put in more waking hr working the commercial drivers can, should raise concerns about him falling asleep and hitting school children, but doesn't.
Long and short is, to operate on public roads, you need to be a responsible operator, regardless of the size machine you are using.
I believe the "requirement" to be tested you are referring to, is the same for all transportation workers, That is: a RECOMANDATION that IF the medical professional giving the physical SUSPECTS a breathing problem, that the patient be referred for a sleep test. How this is interpreted varies widely.

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Post Sat Dec 03, 2016 12:32 pm

Re: CPAP

AMEN CB, AMEN! I got a three month extension on my Physical so the sleep study could be done. I go to see the Doctor in 10 days, Everything else was a rush to get done but two weeks to get a followup appointment and not even with the "sleep" doctor I saw first. All the info will be sent to the PA that recommended me, who I have only seen once. My regular Dr. will not do the DOT Physical, because as you say, he is not interested in taking the additional time, especially for a low return on time invested. I go to a Primary Health Quick care place for my DOT Physical, and generally there is a new person there every year. (I have been put on blood pressure medicine, but my pressures have been in the same range for all of my life.) This latest PA said I had a BMI higher than allowed and that was why I was sent for a sleep study. Still have no problem sleeping. still wake up alert. Still am aware of most of what goes on around me when I am asleep. 20 years in the military ingrains that. Lots of things are wrong with regulations on CDL drivers that were implemented by people who have never driven a big rig in their life. Educated Idiots, I call them. Again, I will say, that if you need a CPAP and it helps you and improves your life and health, good! I am with CB on this, shouldn't all drivers be required to be checked?

Golden Jubilee
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Post Sat Dec 03, 2016 1:01 pm

Re: CPAP

Nikki, glad you are doing great!
Lloyd, I TOO was very unimpressed by the sleep study! It was BRUTAL in my opinion. But it got the answers...I have sleep apnea BAD.
My wife the RN would disagree of course with any backtalk about DOT concerns. Your life is at stake!
Not doing a little more paperwork is worth your life?
No, I've never driven truck, I have no idea...
I HAVE worked lots of graveyard shifts and NOT taken care of myself...
I guess NOT taking care of yourself is the basic question? How can you justify THAT?

Golden Jubilee
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Post Sat Dec 03, 2016 1:02 pm

Re: CPAP

lbesq wrote: This latest PA said I had a BMI higher than allowed and that was why I was sent for a sleep study. ?

I'm sorry to hear this. This is what I'm getting at, there ARE NO RULES on what BMI are ALLOWED, Congress made a law, that the DOT MUST go thru a rule making procedure showing cause and benefit (in otherwords, back their recommendations with scientific proof of the validity of the indicators), Rather than do that, they (the FMCSA) made RECOMENDATIONS, unfortunately, some medical professionals are not willing to question or use their own judgement when it comes to what the feds put out. There are no laws or rules that say over this you must be tested, only that IF they suspect breathing problems it is RECOMENDED that they test.
They want to issue a directive, but can not without following the procedure congress mandated, which for some reason (could it be that it will not pass muster?) they are unwilling to do so.
By requiring forms be submitted withing 24 hr of a physical, they in effect, prohibit you from getting a 2nd opinion. Even if your current medical has not expired, you are restricted, at least in your case they gave you a 3 months cert.
I talked about my fear of this with my MD, and she recommended a physicians assistant who was DOT certified to give the exam. She (my MD) knows my history, and believes there is no reason to suspect breathing problems, although am a little heavy and am over 50 years old.
In short, you must do as much research on who is going to do the physical as the person giving it does on you, or more.
For my last physical, my usual practioner was on maternity leave, and I was handed off to another, which was scary.
Last edited by cornbinder89 on Sat Dec 03, 2016 1:49 pm, edited 1 time in total.

Golden Jubilee
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Post Sat Dec 03, 2016 1:17 pm

Re: CPAP

Monsonmotors wrote:Nikki, glad you are doing great!
Lloyd, I TOO was very unimpressed by the sleep study! It was BRUTAL in my opinion. But it got the answers...I have sleep apnea BAD.
My wife the RN would disagree of course with any backtalk about DOT concerns. Your life is at stake!
Not doing a little more paperwork is worth your life?
No, I've never driven truck, I have no idea...
I HAVE worked lots of graveyard shifts and NOT taken care of myself...
I guess NOT taking care of yourself is the basic question? How can you justify THAT?

MM, what you are missing in all this, is you had plain symptoms (low energy, trouble breathing) that you should, and did get checked out. You had a good reason to get tested, that is not at issue here. What is, are those who don't suffer with those symptoms, have their life and liveyhood put in jeopardy by anyone who is not their medical doctor is making RECOMENDATIONS at the federal level who has never seen the person in question.
I am NOT saying don't seek answers or help if you suspect something or feel off. I AM saying that with a CDL you must be very careful.
Lloyds experience is very common, in DOT physicals' he has no symptoms or reason to suspect breathing problems.
By all mean life or livelyhood, life take precedent, if you suspect a problem get it checked out.... just not with who is giveing you a DOT Physical. Talk to your physician and explain you concern about it effecting your situation and get an assessment on if your doctor thinks it is needed or not, outside the DOT framework.
Hopefully you have a good relationship with your doctor and can address you concerns "off the record" before going "on record". CDL holder have an added concern, that is all I'm saying.

Golden Jubilee
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Post Sat Dec 03, 2016 3:18 pm

Re: CPAP

CB, I had no idea how dire DOT regulations were, I apologize.
In the hospital setting nurses contantly see examples of people who have ignored symptoms and put their medical checks off. The results are not good.
Chances ARE with a bad BMI you are more likely to have sleep apnea. Yes...
Last edited by Monsonmotors on Sat Dec 03, 2016 3:50 pm, edited 1 time in total.

Golden Jubilee
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Post Sat Dec 03, 2016 3:45 pm

Re: CPAP

Unfortuneately, they have made it so. A positive apnea test can be almost as bad for your job as a + drug test. The main difference is if you have apnea and can get help for it, it has benefits outside your job, but a false or inaccurate test and have as bad an effect as a + drug test.
I have learned I have to be as careful in protecting my CDL as I do my health.

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Post Sat Dec 03, 2016 5:44 pm

Re: CPAP

This is a good discussion, and perhaps brings light to issues some have not considered. I have stated, I have always snored(snoring is indicator to the PA) My BMI has went up, because I am not active and I sit for almost 7 hrs before load/unload of vehicles. Also we leave at different times of the day, depending on when we get the call for transport. Not consistent eating times, Plus eating either fast food or Gas station truck stop food on the road and at odd times. I am also 64 years young, have always been "over weight" according to every government/insurance standards. Can lower my heart rate by breathing shallow(which I have always done all my life) So yes, I probably have some of the symptoms of sleep apnea, my guess is on the low end. Can and Have put in 24-72 hr stretches when necessary with minimal nap or sleep. Do not have to do that so much any more. I always rest when I get tired when on the road.
As CB will tell you, the rules state that you have have a 14 hour work "day" and a mandatory 1/2 hour(off duty break) before or at 8hrs. In that time, you have 11 hrs of drive time and three hrs of load-unload/fuel/food/misc. for a total of 14 hours and a mandatory 10hrs off. If you are on the road and you have put in 7 hrs of driving then load/fuel/eat(1hr), and are tired, and you decide to take a nap, and you log off you CAN NOT go back to duty for 10 hours, even though you still had 6 hours in your "work" day. You are essentially forced to drive for those 11 hrs without being able to take a couple hr nap. I am glad that I am essentially retired and just help my son out, and do some Private hauling as an individual for friends. For those who make a living at this, a CPAP that is not needed can kill their job. Look forward to seeing if the "new" Airing Revolutionary Micro-CPAP Airing actually comes about, it looks very promising and even I would use something like this.
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