I have a fear that my CPAP machine will die one day while I'm away from home, such as vacation overseas or during a business trip. I literally no longer can sleep without it, I have anatomical sleep apnea (perfectly fit), but it's quite severe (79 AHI).

I once forgot it on a trip to a different state, and tried to sleep in the hotel but basically just had insomnia, as I could no longer pass out when I woke up from the apneas. Terrifying to think I did so earlier in my life.

Anyways, I lucked out as I went to craigslist and found one during that trip the next day.

But even if I was home, I'm no longer eligible for a CPAP since my last sleep study was roughly 13 years ago. Apparently they think my anatomy is magically improved since then, aka the US medical system wants their cut of my time / money to keep living.

So even my recent new purchases are from folks on craigslist.

It's wild they would rather me go through another sleep study when during my initial one they cut it short because I had such severe apnea (of the sort where I could have a heart attack without it). They hooked me up to a machine within around an hr or so. Now that I'm older, the risk is even worse.

If you haven't already, you should try making an appointment with a sleep doctor. Mine was able to write me a new prescription without a new sleep study, just a regular office visit. Make those insurance companies pay for what you are entitled to!

Happened to me once. Water chamber broke in checked luggage. I slept poorly for a few days far from home.

Thinking back later:

- I wonder if I could have sealed the area where the water chamber goes and done it water-free?

- I should have taken 1x extra parts for everything

- I have a complete second setup, maybe I should have taken that?

thing is, the 100's of times I didn't need to "overthink" things set my "over" and "appropriate" thinking levels and I thought i was ok.

as to the sleep study - it is LOTS less invasive nowadays. You probably take a device home with you, strap it to your body while you sleep and return it the next day. None of this "sleep in hospital setting" nonsense.

You’re correct! My mother had just such a study a few years ago and it was utterly convenient.

I found it weird to realise CPAP machines requires prescriptions some places. In the UK you can just order one next delivery from Amazon.

The US (as well as other countries) has weird hangups because there's not a lot of granularity in prescription rules and insurance won't cover things unless they require a prescription.

So patients and doctors fight to have things continue to be restricted so that their workplace insurance will pay for it.

CPAP machines require a prescription in the UK.

https://www.hope2sleep.co.uk/cpap-machines-sleep-apnoea.html

Amazon is breaking the law by shipping one to you. I suspect there is very little enforcement of this law, which is why Amazon is unknowingly breaking it.

I can't find anything to support the claim that they require a prescription from any authoritative source. The page you reference cites guidelines from an association that has no legal power. The relevant Act seems to only define a prescription regime for medication, and to only specify category classifications for medical devices for the purpose of certification, not restrictions on purchase. But I'm not a lawyer.

Which law is it you think Amazon would be breaking?

EDIT: In fact the page you linked itself points out that the "prescription" they are talking about is in fact not a prescription. "When the word 'prescription' is used for the purchase or rental of a CPAP machine, this is not like a standard prescription which GP's provide for medication."

There are a number of places you can get an online prescription for a CPAP/APAP, and they're not that expensive to buy outright.

I was able to get a new prescription for < $100, and bought a new APAP for about $600, no new sleep study required.

If it's that crucial, then you need redundancy. A backup travel CPAP might be worth investing in.

... much like we have the sketchy telehealth services out there, some online CPAP shops will have 'prescription renewal' services available for like $50-100.

If you already have an OSA diagnosis you don't need a new sleep study for a new script provided the doctor is just willing to sign off a new prescription for supplies.

I've had a CPAP part failure when I traveled - I used a Dreamstation Go with its special 12mm tubing. The tubing split and I had a hell of a time finding replacement 15mm tubing in the city I was in. I stopped into a random durable medical equipment supplier and went "heyyyyy can I buy a hose I'm really screwed right now!" and they just slipped me a new hose out the back door and shook my hand. Then I had to have a friend 3D-print me a hose adapter... field-expedient medicine is fun.

My current travel setup is now designed to accept as many standard parts as I can ('standard' 15mm tubing available at Walmart/Walgreens/CVS, a 'standard' CPAP mask, and the machine is adapted to use USB-C Power Delivery so I just need a 100W PD source or better to run everything (even battery).

I would disagree that it's a sweet spot for execs.

Essentially no one should be working 60 hours a week, the human mind needs breaks to unconsciously work on problems.

I would posit unless someone is doing pure labor, anything involving creativity / problem solving actually has worse returns past 30 hrs a week of intense work.

Anyone in exec positions claiming otherwise likely would hesitate to let someone actually see what they do all day / week. No doubt they "work" all day in some cases, but that day is filled with lots of non work / downtime.

your mind maybe shrugs

your "work" maybe shrugs

I don't think it's meant to browbeat you, that feels a rather uncharitable read of what is essentially just the author saying connect with the people in your life because they'd love to hear from you and likely need someone to talk to as well.

Yeah, IBM is nothing like Google, it's a weird comparison.

Not really, in my experience you still have to be good at solving problems to use it effectively. Claude (and other AI) can help folks find a "fix", but a lot of times it's a band-aid if the user doesn't understand how to debug / solve things themselves.

So the type of programmers you're talking about, who could solve complex problems, are actually just enhanced by it.

Yes, exactly. I have exercised daily (either weight training or cardio) for nearly 20 years. I've also had anxiety and depression for that entire stretch of time.

Exercise was how I stayed mildly sane for a good majority of those years, but when I started taking medication it was like the entire world changed. I wish I had started earlier in life. It helped me to become a lot more introspective as well, being able to better examine why I was feeling the way I did.

There are some things that no amount of exercise or "healthy living" can fix, that's unfortunately just the human condition. It's nothing to be ashamed of.

Exactly this. I don't do it much in the USA to be honest, but when traveling.

Yeah, they acquired the company I worked at and left us alone for a year or two. Each year would get worse though, and each year we swapped nearly all bureaucratic things around. Always a different way to do performance reviews goals, etc.

A lot of the successful projects at the original company are now dead.

It's also weird being in IBM, because if your "contract" ends they put you on the bench. Then you basically have to job hunt within IBM, and if you can't find anything within a month or so you are out. It's super weird.

"It's also weird being in IBM, because if your "contract" ends they put you on the bench. Then you basically have to job hunt within IBM, and if you can't find anything within a month or so you are out. It's super weird."

This is standard operating procedure at most consulting/professional services firms.

Yes, the bench sounds great but it is incredibly nerve-wracking and I never liked that aspect of consulting at all. Better to just go to zero pay and be a free agent and if the company finds you another gig, great, but no promises either way.

I retired a couple of years ago at 54 and now spend my days feeding horses, mucking stalls and spreading the resulting manure (a task consulting prepared me for), but for about 24 of my 30 year career prior to retiring I worked for consulting companies and was lucky enough to never sit on the bench.

Also the CIA

Sounds similar to university applied research arms too.

GTRI locally hires a lot of non-students to work in its various labs. Its labs then pitch ideas to private companies and the DoD. Sometimes they're solicited directly if the lab is well-known and has a track record of delivering good research-oriented results. They research and build prototypes around various capabilities: robotics, avionics, even classified stuff.

They're always pitching, because contracts end or fall through, and that's the source of everyone's payroll. The labs can even be competitive with one another, and the individual researchers might spend time split between labs.

Academics as a service.

Can you elaborate? That sounds interesting

John Kiriakou Described the process in a podcast, maybe the JRE.

I don’t know how many contracts IBM deals with, but the concept of a bench is very common in government contracting. It helps retain talent in an environment that’s more volatile than a typical office. Good for the company to avoid brain drain and hiring overhead, good for the employee because it’s a built-in safety net. Much better than your contract ending and immediately being out of a job, especially in today’s market

Those are the positives. The downside is that the sales team presents you with really lousy contract opportunities and you are pressured to accept one knowing it is a crap assignment that isn't helping your career growth. And you can be stuck on one of those for years!

I don't think they're objecting to the idea of a bench as an ultimate fallback; I think they're objecting to the idea that there isn't, during such "internal layoffs", a default automatic reassignment of all headcount to other teams. In such cases, you would only land on the bench if you refuse the automatic reassignment.

Longer Bench allowed only for consultant with security clearance as those are such a hard thing to come by. General govt work, they just let you go like in commercial sector.

The thing is, the people on those "algorithm-free" forums still get manipulated by the algorithm in the rest of their life. So it seeps into everything.