Re: Case H3.98

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Posted by Stuart Holtby on March 07, 1998 at 10:47:54:

In Reply to: Re: Case H3.98 posted by Dr. Wexler on March 05, 1998 at 19:20:08:

Good answer Dr. Wexler!
I would emphasize dental orthotics well ahead of supplemental O2 as an alternative to a patient that doesn't tolerate CPAP or PAP therapies. Although the success rate is only around 60 -70% it is effective in many people.
You might also mention:
-support groups to help people whose problem adapting to PAP is more psychological than otherwise.
-close office followup once you establish therapy of any kind
In this man's case we had the luxury (hey, it's Canada) of bringing him back to the lab for another go. He did extremely well with CPAP at 13 cm using nasal pillows, and is doing well at a phone followup today.
Stuart Holtby MD
PS to any and all you guys reading this case - if you don't have a study buddy, get with the program and start submitting cases here!!! Practice formulating answers is CRUCIAL to passing that exam!!! There should be a FLOOD of cases on this forum. No one who fails will be permitted to whine at the SSM staff if they haven't submitted (and answered) at least one case!

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